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0 SAN JOAQUIN COUNO <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> coq.., `.�;;a• Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sipov.orglehd <br /> +oda <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 5 n se J L� Date: IA—kc-1 <br /> Address: 1210 S1�1 � City: fz\ Zip Code: 9 5 <br /> Owner/Operator: f�Q h '�-GG Telephone: S99 - \Aq <br /> Program Element: \VOt b Program Record: SC)2-ZO, I Inspection Type: 'M <br /> 1 ��Q <br /> IS 8180 Posted Yes D Rermit Posted Yes ❑1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> ~'1--o- S i e e 1 1 <br /> C". .-e- C In <br /> B i G AAi b 200 4212 o2 <br /> Item/Location Temperature Item!Location Temperature <br /> 302) <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: �� and Sink: `�� OF Ch : ,l ppm Heat: OF <br /> L A <br /> Exp.Date: _ZG_l arewashin Sink: 1 of uat Amm.: ppm ther: OF <br /> Received By 1 Title: &404Sp_ <br /> EH specialist: Phone: 14 <br /> Time in: `c^.SD Time Out: 1 1 V` ,r� Pag ofZ <br /> EHD 16-24 (2,dpg) 4013 �J FOOD PROGRAM OIR CONTINUATION <br />