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SAN JOAQUIN CO .TV <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjcpv.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: Date: set, v, 's 61AT - 0/ 7.y / .e 2 <br />City: Zip Code: Address: -3 s--s----6 N , ( colm tAlat9---; • 5 1---z,:k_.fivi 9 6 — 2_ Os— n <br />Owner/Operator: c.% vi,pAi,.,A___ Pi'vvt../.44.44 fiancor541-- i Telephony-I) 5 .,0 _ 2.1.01 <br />Program Element: /6 y3 Program Record: Inspection Type: /es oco c---7_ci <br />SB180 Posted Yes No Permit Posted Yes Re-Insp ection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />(Ai <br />cc , <br /> <br />ii<e-C af 1-4- 1 t. 1:0„, - p <br /> -r14.-Gr.amit c,, <br />\----/-Ao 01 v\a-- co.-vrA ,..i ?, d .0 ble t 2 Lilee kg , ,o.a._v , 0 <br />® ca ri-t- ke -LAI t--4 j„c 4, / , (,,, c p r.,..,I <br />s'il di) HIA40 Of - )\,xt1-€_ rdati, e;t6ofj ayt ctf <br />0 1(1 fo 0,0 1 Y 0 Ile e fee -I- aAfe SS tve /e4 <br />Item/Location Temperature Item / Location Temperature <br />C/InAA. Yfr",.S <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: <br />SI ) 1-1 6 <br />Hand Sink: i 3S °F Chlorine: ppm Heat: . <br />Exp. Date: <br /> <br />Warewashing Sink: .F Duet. Amm.: ppm Other: , <br />Received By! Title: <br />""11-A--- { <br />EH Specialist: Phone: 7 , • 0115- 3 )__6 _,• gy <br />Time in:Time Out: Page of <br />16P:1i r <br />EHD 16-24 (2nd pg) 4/3/13