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Telephone: <br />/ lnspectionType:p<XA^v^ /TE <br />7 Re-Inspection on or After:No <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />7 £ <br />1 <br />v to- <oeF <br />TemperatureItem/Location Item 1 Location <br />*5 <br />t <O <br />Name:Chlorine:°FPPm <br />Exp. Date:Warewashing Sink:luat. Amm.:Other:°F °FPPm <br />MlReceived By / Title: <br />EH Specialist: <br />Time in:Time Out: <br />EHD 16-24 (2nd pg) 4/3/13 <br />3 <br />(Apo - <a£) F- - kj-JcA-n-zy-x <br />1 TO • IQ8P <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 />Warewashing <br />Heat: <br />Date: <br />Zip Code: <br />-X-c Q <br />\ TO - l Ot> F <br />jiX- ('Cs, v <br />Food Safety Certification <br />\TO- to2) r <br />Temperature <br />12U F <br />Page ^f <br />FOOD PROGRAM 0IR CONTINUATION <br />____________ <br />Facility Hot Water Temperature <br />Hand Sink: oF <br />phonV <br />^Program Record: <br />Permit Posted Yes <br />______ Food Program Official Inspection Report______ <br />Name of Facility: CA. Icj^~ Date: <br />Address: (Q \ V V vOm City: p/. <br />Owner/Operator: <br />Program Element:.. / <br />SB180 Posted Yes Nd