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Zip Code:Oz <br />Telephone: <br />Inspection Type:Program Element:c <br />SB180 Posted <br />-- <br />-? pSC.c-7 <br />i <br />-A <br />Temperature!TemperatureItem / LocationItem/Location <br />Food Safety Certification <br />:hlorine:Name:°F <br />tther:Exp. Date:°Fppm <br />-UXOReceived By / Title:J <br />Phone: <br />Time Out:2^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/ehd <br />Name of Facility: <br />Address: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br />Program Record: <br />ci A_________ <br />Permit Posted <br />Eu <br />WAS <br />Owner/Operator: <br />EH Specialist: <br />EHD 16-24 (2^ pg) 4/3/13 <br />{Mfr <br />Food Program Official Inspection Report_____ <br />____________Pate: (q- l~l - 'Z, <br />City: <br />cVx <br />^7 <br />Warewashing <br />ppm |Heat:-— <br />Yes No <br />Facility Hot Water Temperature <br />[Hand Sink: <br />[Warewashing Sink: Quat. Amm.: <br />-5 S inspection . ype: / I <br />Re-Inspection on or After: <br />\\oSd 2. / I <br />Yes No <br />2-0 6~ b I b-3 Qg-S <br />cy - S2 Pag vf <br />FOOD PROGRAM OIR CONTINUATION