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Zip Code: <br />Telephone: <br />Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />7W <br />o <br />TemperatureItem / Location <br />- CC <br />Food Safety Certification <br />hlorine:°FPPmName: <br />ither:luat. Amm.:°FPPm°FExp. Date: <br />Phone:EH Specialist: <br />Time Out:Time in: <br />Co <br />Warewashing <br />[Heat: <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 />__ _ Item/Location <br />CScXSXyC) \\\t- <br />v up O <br />( .. t eV z LLC_______ <br />Food Program Official Inspection Report <br />Da,e: u <br />Program Element: OjT / | ^—Program Reconjt | y <br />SB180 Posted I Yes Nb Permit Posted Yes No <br />Page<pf <br />FOOD PROGRAM 0IR CONTINUATION <br />Received By / Title^^^ <br />\CC CP I < I G _____V-x --------------------------------------------------------------------------------------------------------- <br />bCxCcAyz.----------------------------------------------- -------------------------- --------------- <br />VW sbdczvuY-x O/ VK)pCW^__W^v\ry> <br />\ A -Ax \ S * <br />EHD 16-24 (2nd pg) 4/3/13 <br />T==d^=—=^=1:^=^^=^— <br />[F Facility Hot Water Temperature <br />iHand Sink: <br />jWarewashing Sink: <br />lnsp.o1lonT,pe: ^<v/T