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4 <br />o, <br />Telephone <br />Insi <br />Re-Inspection on or AfterYesNoSB180 Posted <br />\/ <br />£ <br />a <br />o -ic <br />> <br />b; V-U ■t / <br />j___1 <br />s& <br />(€> <br />TemperatureItem / LocationItem/Location <br />Food Safety Certification <br />:hlorine:Name:°Fppm <br />ither:luat. Amm.:arewashing Sink:Exp. Date:°F“F ppm <br />Received By/Title: <br />Phone:EH Specialist <br />Time in: <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.org/ehcl <br />"s-W <br />Warewashing <br />lHeat: <br />Food Program Official Inspection Report <br />City: <br />"KJl-1 <br />EHD 16-24 (2"a pg) 4/3/13 <br />^2 <br />Facility Hot Water Temperature <br />Hand Sink: op <br />Zipcode <br />b v^/ <br />< I x f Va x <br />C rA| <br />y > <br />) <br />^7 <br />r< <br />( ) Ce—l \\ o^r^-\52. <br />/V/xr <br />Name of Facility: \ \ <br />Address: <br />Owner/Operator: <br />Program Element:^ -> y | iQc(>^ram Recorcl: <br />Yes No Permit Posted <br />=7 <br />J <br />2_Q>q- <o l b- 302^ <br />Time Out: Page | of <br />FOOD PROGRAM 0IR CONTINUATION <br />OBSERVATIONS AND CORRECTIVE ACTIONS