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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.orgiehd <br /> <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT __- Name of Facility: Wo no, -1- e ( a - 1 r a c y Date: <br />2 2 Address: I 7 /7 S Union 5 4- <br />City: 5 4 e,...., <br />' / I <br />Zip Code: 9.5.2 0 c <br />Owner/Operator: 0 A V I I 4.- l; 5 0 ID (4 h C4 il Telephone: s 9 1 -i, 76 6 <br />Program Element: 3 Program Record: S 0 0612 1 .61 Inspection Type: Co ms_4.4 "a /. c,,, <br />SB180 Posted 0 Yes 0 Permit Posted IT Yes 0 1 Re-Inspection on or After: <br />OBSERVAT ONS AND CORRECTIVE ACTIONS <br />I <br />V i in 14 4171 <br />0 erov; cl c,)->i, .40)e, a n I 2",p c if Cor r 4 i 4 <br />IA) e el? C- nt) c.. 1 Co ; re .1_ (N P <br />0 GC} n(107 n a t ii 6 r J; i; I 4e ; 6 ,0 I s <br />et 11 33 11115 <br />G Y le pprnel, 1 1 2 o is 0 7\ ( : t AS )1 4 re beo rv i <br />Qa64e, 6 0 i (per 11.) /Id r <br />W In - '3 K v) (t.fppet <br />Temperature Item I Location Temperature <br />Food Safety Certification Facility Hot Water Temperature .._ <br />0F <br />Warewashing , <br />Heat: Name: Hand Sink: II 6 Chlorine: ppm °F <br />Exp. Date: Warewashing Sink: I 16 .F Quat. Amm.: ppm Other: °F <br />Received By / Title: )(., <br />r Otk)kkr•-1(4--' <br />EH Specialist: Phone: <br />I/ er ii.‘, <br />ime in: Gto f Time Out: T.. 37- Page of <br />/ f <br />FOOD PROGRAM OIR CONTINUATION END 16-24 (2^, pg) 4/3/13