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�¢xlk SAN JOAQUIN COUNTY <br /> W. X <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Y. 6O0 East Main Street, Stockton, CA 95202-3029 <br /> ;iFaiei►;a Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.s'gov.orglehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Q _ Date: 0 - Z - 09 <br /> ddress: L466_6 City: W Zip Code: g a a <br /> Owner/Operator: PJ� u 1-nTelephone: q a g _ ol) <br /> Program Element: ,6', o U <br /> Program Record: g� Inspection Type: oto <br /> 3t 9 17 <br /> l) <br /> Posted Yes ❑ No V Permit Posted )Wes ii No Re-Inspection on or After: <br /> (?BSERUATONS'A1�1DCARRECT1VEFACTI0N6 <br /> �a iiC4a,W tkaj c ✓v uex <br /> lea, davtd2 ��e � u Uc-e o F �1a�er For <br /> 4a !.e avt <br /> avi is 66CL'4-r_� 4'k- a- <br /> CIv `44`2-e u)�j <br /> roM woo c Tie <br /> 4 `n lanEn ael vie,ll- <br /> . j644,c <br /> ItemlC.ocafionTemperature "<. Itetrr/;1»ocatfon Teri witi" Jteni.I Location Tarnpbrature <br /> Warewashin <br /> FoodSaetyCert�f:ciaK $Fgcil f#ot`Naber;Tem nature 9.='F <br /> y PeName: Hand Sink: °F hlorine: ppm Heat:Exp.Date: 6 a y !�� are mg Sink: /�Q °F uat.Amm.: ppm Other <br /> Received By 1 Title: <br /> EH Specialist: Phone: <br /> Time in:# i DO 601y) Time Out: , �s- Page of/ <br /> EHD 16-23(2ntl pg) 11/06/08 FOOD 01R CONTINUATVON <br />