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SAN JOAQUIN COU Y <br /> :{ <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> to: <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ,.�;�P Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.si oq vorglehd <br /> . <br /> tf�pA <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: of r wo.0 d S 61a S off. Fc-)o d Date: 2 -3-15 <br /> Address: <br /> 3- <br /> Address: I o I .S W Hri dYl r,,4 r Ln City: Zip Code: <br /> Owner/Operator. T� Y E;v-f_ Y"2 r) 0j I <^ _ r Telephone: $ _ `s <br /> Program Element: T p) Program ecord: 9-C) I (0 '12-4 LJ$ Inspection Type: � <br /> SB180 Posted X-Yes No Permit Poste Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTION'S' <br /> - — --------- - ._... ........................_.-- <br /> �L rhe loon ►,-ins -- C 50ja , C�ofce'e_ , 3-e_oj p) y' .'e. <br /> L)_n—s-s 2._t N-'T�l rh C°-��Gyt n .. �t h - of d- �1a�'t d_._._ _ � /�P-C J-,e J <br /> -u�c, rvo ± -JaCt�ss'i_h�-� 1 -e �a _ ..... <br /> � rn�� -fir(3b rrlek�c,( <br /> t -e-k t►-� - n UL r _ tee � _.-. no n.x_ <br /> un Lao C LAB,n b <br /> ItemlLocation Temperature Item/Location I Temperature <br /> _...:..-..--- .. ........ _ ....._:--— <br /> �R�r <br /> Io <br /> Food Safety Certification Facility Hot Water Temperature I Warewashing <br /> Name: Hand Sink: 'F Ch1 ine: -/ h Ppm Heat: F <br /> Exp.Date: arewashing.S' �a© o f Ou .Amm,t,R��4 ppm Other. o f <br /> Received By/Title: UUJJ <br /> EH Specialist: - � L / / Phone: '953—7(3 �7 - <br /> Time in: / v Time-(Out: 0 Page of <br /> EHD 16-24 (2n°pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />