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SAN JOAQUIN COUN1110' <br /> X ENVIRONMENTAL HEALTH DEPARTMENT <br /> a 600 East Main Street, Stockton, CA 95202-3029 <br /> ��ilxaa�':p Telephone.(209)468-3420 Fax:(209) 464-0138 Web:www.slgov.orp/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: <br /> S af i►l GL L Date: 7 _ d <br /> Address f/ I / rp City: Zip Code: <br /> Owner/Operator: W !fit Telephone: <br /> Program Element: Program Record: 570 / Inspection Type: <br /> ISBISOY�Posted 1 Yes C No Permit Posted Yes :1 No ! Re-Inspection on or After: <br /> OBSE"RVATIONS AND CORRECTIVE ACTIONS <br /> sin wa-Jer .. & y <br /> GL-r`/'i 7� tr0 � <S V•e �7 rf a� 1�1�ai'.1��77 .��x <br /> Of <br /> l d s. k <br /> �k r <br /> ttem/Loc:ation Temperature Item I Location Temperature Item I Location Temperature <br /> alt zzl- o- S <br /> �Y ✓ <br /> ood Safety Certification( / Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: 79p;,- <br /> 9f- -F Chlorine: ppm Heat: aF <br /> IV r <br /> Exp.Date: arewashing Sink: -F Quat.Amm.: ppm her: "F <br /> Received By!Title: <br /> EH Specialist: P ne: <br /> Time In: O; sg Time Out:����Gy� Page of <br /> EHD 16-24 (214 pg) 1/18/12 1 FOOD PROGRAM OIR CONTINUATION <br />