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J <br />Zip Code: <br />/ ~r <br />Re-Inspection on or After:SB180 Posted <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />A c <br />oQ <br />V i <br />i <br />V>7 <br />TemperatureItem / Location <br />•5 G\ <br />Food Safety Certification <br />:hlorine:°FName: <br />°F'arewashing Sink:ppmExp. Date: <br />Ct Phone: <br />Time in: <br />EHD 16-24 (2nd pg) 4/3/13 <br />Item/Location Temperature <br />'ey- <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/ehd <br />Name of Facility: <br />Address: 1 <br />Warewashing <br />Iheat: <br />ReceiveclJ^Tjtle:, <br />EH Specialist:^__i < V> <br />C- / < i Q ' Q, L. <.v- ! <br />sA?r<x.^ <br />c fM <br />J rrKXrxVpxKxj t U-tsJlp <br />.__“Sq \Jg^<2-4<x----------------------------- <br />inspection Type: <br />\ 4? c <br />• S<AVO~/7 <br />Yes No <br />w: EVniiii <br />— aw vver <br />\ 4 O \ (XX vy€z\ Jus <br />Owner/Operator: \| <br />Program Element- q - / | kFiS ^ro9rarn Rec°rd: <br />Yes No Permit Posted <br />Food Program Official Inspection Report______ <br />Pzay aAVt^ FAssoc » Pate‘~ ‘ ~ )>ity: zipCode: °l S3B C7 <br />y J Telephone: <br />Facility Hot Water Temperature <br />[Hand Sink: °f <br />Tjr||Quat. Amm.: <br />ZOCV iQl V>- ?>O2S <br />TimeOut: Page, of ’O <br />FOOD PROGRAM 0IR CONTINUATION <br />ppm <br />Other: