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Zip Code:City: <br />/ 54\O~7Z^ <br />Yes No <br />(I <br />/ \ A <br />C3> <br />1= <br />X21 <br /><2, <br />SZ at^AaXx ,■ <br /> <br /> <br />\\ <br />hlorine:°FName: <br />mat. Amm.:°FWarewashing Sink:ppmExp. Date: <br />Received By /:le:Z Phone: <br />.of <br />Time in: <br />FOOD PROGRAM OIR CONTINUATION <br />CJZ QvZ <br />Item/Location <br />Uvu \ <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 />Facility Hot Water Temperature <br />Hand Sink: <br />\ <£> <br />vAAs /a <br />Temperature <br />vc^\r <br />ru-i<d <br />Temperature <br />niF- <br />,__________ _________V k?"] F7 <br />ckxck-x I <br />Warewashing <br />lHeat: <br />ioSACaAl <br />e- rrvz^'x1' ^4 <br />OoOCa <br />AA, <br />(Tv <br />_______— <br />Food Safety Certification__________ <br />Program Element; , \ Program Record: <br />SB180 Posted Yes Ro Permit Posted <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />ZZ ______ <br /> vfXkcV'-A p^z\~A <br /> ___________ <br />yers <br />EH Specialist;—V^V' V. <br />EHD 16-24 (2nd pg) 4/3/13 <br />i~z~c <br />______________ClrxvA//' £*> <br />_ pkYAA~<K3Cv<A ___ <br />V o <br />____________Food Program Official Inspection Report <br />Name of Faculty: psr^yy.^ Y-OK/C<XP/<. AAV^ HSSCV- mTTT <br />Addre..: ( ^ ( 'V..k\ s V ? LV -J AK, <,,2 <br />Owner/Operator: \ Telephone: <br />Inspection Typetg^^g / -p^ <br />Re-Inspection on or After: ' <br />Time Out: i (—x Pagc <br />PPm <br />Other: