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o <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />7 <br />7 <br />) <br />v-< <br />10 <br />Item / LocationItem/Locatlon <br />Food Safety Certification <br />Chlorine:°FName:ppm <br />Other:Quat. Amm.:°FExp. Date:F ppm <br />Phone: <br />a. <br />Warewashing <br />■■■■Heat: <br />Received By / Title: <br />EH Specialist^ <br />time in: <br />^7 <br />Facility Hot Water Temperature <br />Hand Sink: »f <br />s \ <br />Owner/Operator: <2 <br />Program Elemer^^ <br />SB180 Posted Yes No <br />Page of <br />FOOD PROGRAM OIR CONTINUATION <br />?O o____- <br />*3 k 2_c«r\ <br />EHD 16-24 (2"" pg) 4/3/13 <br />_____2-fi^ -bib- 5O3^~ <br />Time Out: Pa3e| °f <br />CrM_______ <br /><SrV<3V^ AA t g r <br />(J\( ____________________________________ <br />Program Record:^ <br />Permit Posted Yes No <br />Warewashing Sink: <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 /> vw> <br />Food Program Official Inspection Report <br />Name of Facility: CLyf\A 4 T <£■.________________________________Date: ~l 'Z^Q- Zb <br />[Address: q - , SA iNVAyy ZiP I <br />• x i \ \ Telephone:> \ \ \ tAcyt I ~ <br />/ I S- <br />'Fl Mn <br />inspection Type: 2^^^, -j-g <br />Re-Inspection on or After: