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.CSG SAN JOAQUIN COUP ' <br /> Q` ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.si4ov.orq/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: C, Sfiu n�- Date: S , 4 <br /> Address: 1,fJ1, �bdlqg � City: C_j Q <br /> Zip Code: F32-(j <br /> Owner/Operator: 1 'i Telephone: I � <br /> �- <br /> Program Element: i 2� Program Record: TF C7U,L.3b Inspection Type: �ou-hrL J <br /> . <br /> SS180 Posted es 11No Permit Posted es _ No Re-Inspection on or After: n <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> i yr Y- at Cl ILT- J1 HeCA cr-a6 MPS+ i S at 11101- - #-Oi S to ro <br /> NU t7OL a es 1PC,Ia Mer s t2oo K . OV(6tV tZZa <br /> �t N0 SGtnifi nside sUnl cep- , -Oq' suni-n CA 4- <br /> 100c,blo2jn e +Ada <br /> z NU �' 011\ vii in (-loS w S S' SGn+�i <br /> 13 0bseAsh Embni- ch,v i S alzwnd soda 1'n 6 ick 1 <br /> � � wai-1�eS5 �u-hc� C.aRc�n -Iyyr-1���r <br /> i�r sCA MQGhrl too v &Umg buy d ( 10-cin <br /> t W ws, �n u"or not gNc,0 cx6LC Mui nitmn a cqcx� <br /> am -Y\MG& <br /> flandlezt caras <br /> Item/Location r Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: _ of Chlorine: ppm Heat: of <br /> Exp.Date: ` Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title <br /> EH Specialist: Phone: _ fO <br /> Time in: j Time Out: Page3f,-_:� <br /> E H D 16-24 (2n1 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />