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Zip Code <br />Telephone <br />Inspection Type\ k>QF\ Ip / S <br />Yes No 'Re-Inspection on or After <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />Of to <br />T <br />7T <br />pay <br />y-< <br />-t 77 <br />J1 <br />CrAA <br />■+Item / Location TemperatureTei <br />Food Safety Certification <br />hlorine:Name:°Fppm <br />Other:luat. Amm.:'arewashing Sink:Exp. Date:°F°F ppm <br />Phone: <br />EHD 16-24 (2nd pg) 4/3/13 <br />Received By / Title: <br />EH Speciali^^^^^^ <br />Time in: — <br />V>oV- <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.orq/ehd <br />Warewashing <br />Heat: <br />Name of Facility: <br />Address: gQ SO A <br />Owner/Operator: <br />Facility Hot Water Temperature <br />Hand Sink: °p <br />Food Program Official Inspection Report_____ <br />LFXA _______Date: <o- M ~ ^3 <br />dHriRflg-' <br />-------- > <br />__^2-0^- (olb^3>Q)2^S__________ <br />Time Out: PageNet <br />FOOD PROGRAM 0IR CONTINUATION <br />Program Element:, . q / i , program Record: <br />SB180 Posted Yes No Permit Posted <br />(jT)S^K^,KAr42. Cry<^<^ <br />J’Cx' c .V^y\c-Q^2 <br />>p