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a SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 EAST MAIN STREET, STOCKTON, CA 95202-3029 <br /> TELEPHONE:(209)468-3420 FAX: W <br /> (209)464-0138 WEB:WW.SJGOV.ORGIEHD <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: fi5 &n Date: 4 ZOO <br /> Address: SSS City: Zip Code: <br /> Owner/Operak r: Telephone: <br /> Program Element: � PrograrA Record: Lv 062q '7- J Inspection Type: S� <br /> SB180 Posted 0 Yes ❑ No Permit Posted U Yes F No 4 n Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> f.�►r15L' 'fin s ~rrn Com. Gi- C <br /> e- �ro lU ev`i Sll'In� S <br /> 6 b Serves. �S ; <br /> " r <br /> a s a+rz ama 4":d- Val '5W4 S'"I--P, bb <br /> xA& - an 5 0-1- Cdr bbsW94. <br /> N a S rvw - v O� a bse-vve_j i Y� - "-V. - 4k-•4 <br /> U e4--"(rte 6 e r-e-4S 5 � 110 () <br /> 5!4 K6 c,-F rV%.o fie. - w�-b I� sem. a oj-z)rs � <br /> hb a.(`£ a YW �Yuc er 6;(06.f.� fA <br /> fb-Ger` <br /> 60 a " <br /> d1 ' brAA&rj h 4Av►-6 a <br /> Sq oa I` � Gc.C4i-n-i �� <br /> Item 1 Location Temperature Item!Location Temperature Item!Location Temperature ' <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: 'F Chiorine: ppm] <br /> pm Heat: 'F <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: aF <br /> Received By!Title: Ivk_� <br /> EH Specialist: + —I'w�, Phone: 12 <br /> Time in: V' Time Out: Page of <br /> EHD 16-23 (211 pg) 8114108 FOOD 01 CONTINUATION <br /> 08114108 <br />