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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �;.. �;P• Telephone: (209)468-3420 Fax: (209) 464-0138 Web:www.sj og v.org/ehd <br /> �lFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: __ e n O Date: <br /> Address: o �1L1eeK City: / _f� / Zip Code: 952—L� <br /> Owner/Operator: _1/7 1r0 C � �— Q Telephone: <br /> Program Element: '62 1 Program_Reecord: Ul I Z Inspection Type: Po L'+('� <br /> SB1BO Posted 4Yes ❑ No Permit Posted A..Yes ❑ No Re-Inspection on or After: <br /> IWE <br /> OBSERVATIONS ANC CORRECTIVE AC ITIONS <br /> I - - <br /> Sr�me_ <br /> - v— t'P\ �1.� r2c(r- <br /> urG r-Q V� rests �'i�ir L Qq•\ JC-, <br /> 3 T_ .1 ' f- 'K4cz ck W% `'F f b cfeu e %Z11- s ra v\c3 er t C, <br /> �ncrecvz s r�H •t'd t�� pP� c(.t(or-��, <br /> 54,..,, + A — DC7 6�w, C <br /> u t� o c <br /> I <br /> "Te 2- Door .Di l4Se -FrM2 'L go o r or i Vv TINT <br /> 1 s �r v 'F <br /> � 1. <br /> -e_F p�ic,v2rs Z' <br /> F®od Safety Ce'. <br /> Name: ! Ona Hand Sink: of Florine: SQ ppm Heat: of <br /> C7 s _ <br /> Exp. Date: _/4_/ lo <br /> arewashing Sin : �� of Quat.Amm.: ppm Other: aF <br /> Received B <br /> EH Specialis : Phone: 1.1 <br /> Time in: Time Out: Z; Y� Page-of <br /> EHD 16-24(2"d pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />