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SAN JOAQUIN COUN , <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazeiton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: pon,i , , ct\urro il no c ecj Liz- Date: R/ 2tyi c- <br />Address: Q)3- 0 14con s+ City: StaAci-Ein Zip Code: <br />Owner/Operator: guipa 1,--kG\ 1) e tq C .e 1,1 CI' <br />Telephone: 4701 <br />-- <br />2_ \ (4,14, <br />Program Element: (-1. Program Record: T> 'F. c \ I -,-5)4 •.5 Inspection Type: <br />SB180 Posted ,--/-es 0 Permit Posted r Yes 0 I Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />(9 -VCCd ik-0\VO k.P_Ar CSTI ckte .\''?,ovicie o .oc=c\v‘roil-Nck <br />cf2A- 16 --1 cz4e kn (oo do1/4\i, S • 7k2Wcite '.0001 \-01-x,1 ( -,2 r curOS <br />-Cur o\I f2A-nvIcAteec -In 3o dio-I S <br />@)- w i n R9 GI ()MC qr-t, St/4-al ur\ 11-‘g„ c/kAn-t- _ S-t-vce <br />Inc dg -1-1\a &On Hier P*Aof-e-t -te)cla\t, <br />4- a -tb ‘ cskte .4.oTA-1-1 -\-- -f---0- -ía <br />- c cin 1--h c 1-) 1 or 11\-e Icc <br />\I ftJ <br />'RJ2/k)02:1- <br /> 0-1 C ‘ <br />Item/Location Temperature Item I Location ' Temperature <br />Food Safety Certification Facility Hot Water Temperature <br />Hand Sink: <br />k 00 <br />.F <br />Warewashing <br />Heat: °F Name: Chlorine: ppm <br />Exp. Date: arewashing Sink: .F Quat. Amm.:. ppm Other: <br />Received By / Title: I <br />EH Specialist:#ciur Phone: <br />Time in: 1 0 ! gril Time Out: I 0 A.k.7 Page( or <br />EHD 16-24 (2^d pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION