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qu try T <br /> SAN JOAQUIN COU;�i <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> = 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �q•.,, .�;�P Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.smgov.orq/ehd <br /> �I POR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: LOS A CG C-JWC-. 1- }V 0 Date: t/I <br /> Address: 2 CI LP y V V-i 1 1� City: -� �tZip Code: q <br /> Owner/Operator: "I v `.�(0 IV-() <br /> -O ,0 C o 2�U C-) Telephone:�rr]l <br /> Program Element: Program Record: Inspection Type: <br /> 1/ C>�A 1Ca iflfi <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Ccs+ IUiN' = TV-U Gic i S "lr i-1 cd GA I CC)o 0 Of <br /> g 01) Gn tai fia C b C G t--- <br /> v Cwt i(- r..e i + U (covin" car IiAa <br /> r O�- i-ocd tis 1)q ckun T1 <br /> -WO \ be VJGnf S r+- CAA-t,QCke <br /> O�- Tt"Le 1-0((; -PLUCA- firX CusAzmn-o� AD 5122 <br /> 'PJC) WO- wGkW,-V Un 114, TUCC) Ct Ct- `IN)CAW OOVVXd fi-0 2(J <br /> vfvR ,g"y- -S U - vrce L-}e cn S� <br /> e d F 1"he Us c e <br /> On L 4e <br /> -YhP,re -%S U m2 �+ � CJ1�tt�1c c Th-Q TZ�iCG '�'Qu% <br /> vcG}- St7XeS CvilclnrTt—S fyr CuS i nef(2 <br /> it hU C-k&tnnz'.(- pa-)4emAj fur r S. Curr e <br /> gT) s i irLe • "ee \7q L�c cm Ay\-e- <br /> Co& <br /> G M bk.e w a S , i ce ad U4g+ -T v <br /> Item/Location Temperature, ` ' ltem I Location ( Temperature <br /> Food SafetyCertification I! Facility Hot water -- --_ ----- <br /> y ,ErhpE.��a`ure � warewashing <br /> Name: Hand Sink: ri <br /> F <br /> (Chlone: Heat: <br /> —._ PPM �I --- -F <br /> E.P.Date: arewashing Sink: F !Quat.Amm.: ppm (Other: of <br /> Received By/Title: 'r <br /> VWPA <br /> EH Specialist: Phone: & -f,q rU_ <br /> Time in: `„:•-y,v Time Out: -y: 2-v Page of <br /> EHD 16-24 (2nd pg) 4/3/13 7 FOOD PROGRAM OIR CONTINUATION <br />