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s <br />City= Lodt <br />//e <br />V'-yvAX <br />TemperatureItem / LocationItem/Location <br />Food Safety Certification <br />Name: <br />Quat. Amm.:Exp. Date: <br />Phone: <br />Page | of f <br />FOOD PROGRAM OIR CONTINUATION <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 />Received By / Title: <br />EH Specialist: <br />Time in: <br />Date: <br />Zip Code: <br />Telephone: <br />Inspection Type: <br />Re-Inspection on or After: <br />I___ <br />Chlorine: <br />7-^ <br />EHD 16-24 (Z—pg) 4/3/13 <br />°F °F <br />Z7 /i.Qv' <br />°F <br />Ml, ~ <br />Time Out:Hu ,'z <br />ppm <br />Facility Hot Water Temperature <br />[Hand Sink: op <br />Warewashing Sink: <br />Program Record: <br />Permit Posted Yes <br />Warewashing <br />ppm |HM1: <br />______Food Program Official Inspection Report_______ <br />0/ /'t/i+s' Date: /Z/y/zr^ <br />City: Lodi z|Pc°de: fe/g <br />Name of Facility: <br />Address: <br />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes No <br />______________ <br />^4 - ^7'______ <br />57^^- T^T' <br />y / ~ Q • <br />_______Pr, I*- ~~ <br />Z-. <br />7/ <br />t ^7 / <br />5 c 7^-^____ <br />- // o_________ <br />____L 7-^- 7 / <br />r^cci^ .'s ^7' <br />7'>r7<.y7< 77^ <br />____ <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br /><r. uu <br />L^,/. <br />s7 _ _ /_ . 'S f( Z <br />Tri. Jr ■ t / <br />zry.,. -(^___ <br />VxtJ 4m ^7 <br />In - 1ZZZ -7. m <br />/tis /'L* A > <br />________A /<#i - 9/ <br />_______)z-i' <br />ty'itif II- <br />Z7c'^ '_____ <br />Temperature