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SAN JOAQUIN COUNTY <br /> 'ate°.c°c <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sioov.orolehd <br /> 4�FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ch'r ck�n Date: <br /> ddress: City: Zip Code: <br /> wnerlOperator: C Kj��qLh'� OIA- Telephone: <br /> Program Element: /,o t Program Record: inspection Typt <br /> B180 Posted I! V✓O Yes F1 Permit Posted l�❑!/Yes ❑I O` Re-Inspection on or After:NOWN <br /> !AAM <br /> .:- y. . .; <br /> ECTIVE <br /> Oki P /93 /'20 /c Le o <br /> Chu ckoi o/ <br /> / P e <br /> a ✓iov, 0 <br /> ayem 0(?pf rno L <br /> S d M&4 W WM <br /> 3 A a as <br /> t/ MATAOjej <br /> Ovid <br /> W mas'ta w ' wao <br /> uue f <br /> alt c mea a d tK <br /> W F , <br /> d vtK W dNt <br /> W,n e ,, ,, /_'' <br /> jaf <br /> 1n wp( at&w GUSa ojoxAxvI.Wd <br /> vi a \w ari <br /> `re <br /> 1 k GI ZYI <br /> NW <br /> Name: and Sink: h of hlorine: PPM eat: ,F <br /> Exp.Date: rVarewashing Sink: V ,P uat Amm.:�(aV PPM er: ,F <br /> Received By I Title: t O <br /> EH Specialist: Phone: <br /> ime in: I - Time Out:7W'3 a Page of <br /> EHD 1624(Td pg) 0113 FOOD PROGRAM OR CONTINUATION <br />