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I <br /> o °"'".•� i SAN JOAQUIN COUNTY <br /> Y,­W19G", .,dG <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ y 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �Q �P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> CIFOR 3 <br /> �I <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ZZa U�r Date: 15_aLl 7 <br /> Address: e city: + _��� Zip Code: a� <br /> Owner/Operator: O 1 27 2_0L �I,mow y a I T. Telephone: `b <br /> Program Element: Program Record: n.A 3 Inspection Type: <br /> 58180 Posted Yes I No Permit Posted Yes No Re-Inspection on or After: <br /> ::.. _ BRUTC31S A13 Gt3ttE� tifi AGTIQN r, x. <br /> -k� � -f C Yn P1a r w 11-� 4- ►'u <br /> -} 'i + -A r-e 4e r d a <br /> eo- Q r O L) I a m - 1 '1 rt o 1-+n a fv►i e^f t1e7+'l <br /> LA*'L knq V-C n D L&Li <br /> re '' hp r , Loss OF- ou.r_r <br /> j <br /> 47 Y.) 5 v--h 0)1 92 <br /> Q <br /> cy- 6-l+ is <br /> O oto wor F <br /> �o n c_os _nd Srel <br /> n <br /> .� ` 2,.+fZ CA tS--. 'L� <br /> r-e - o, rte_ r <br /> )a AAL <br /> vl W c. d o w S a l l Y_e t,12L C-L- <br /> :� _ ernperattr t i. " T ttor� 9 CiCrnrr TerEaperat�aFe s <br /> 11 <br /> it <br /> { <br /> I� <br /> Fdudr cf(eatfgn gym. Ere#dyi�t VfFater, 1s1C ure X. g #ftarelasfiltttg <br /> Name: Hand Sink: ,�r� aF Chlorine: ppm Heat: `F <br /> Exp.Date: I1 shing Sink: 'F Quat.Amm.: ppm Other: 'F <br /> 3 <br /> Received By IT itle <br /> EH Specialist: Phone: 4q63-72919 <br /> i <br /> Time in: Time Out: Page of <br /> 10= 60 I ► i <br /> EHD 1624 (2ne pg)413.13 FOOD PROGRAM OIR CONTINUATION <br /> I, <br /> 3 <br />