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SAN JOAQUIN COUI I <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orcilehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: (5., 4 p {e SS 0 AA 4 Pt i- t 2) I I Date: 0 _ 1 y <br />Address: "366 0 N.1 <br />w <br />City: 6 to r) Zip Code: <br />Owner/Operator: —ronut cD <br />eNSCA-t a \ <br />Telephone:-.629-60 7 <br />Program Element: 6-33 -3 Program Record: c). R. 0 °Li 19 6 Inspection Type: 1-2.004i /Lk <br />SB180 Posted es No Permit Posted No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />F44e ri \AA _S <br />-cAU‘:3-t p <br />The r-e Ct- <br />ki-W -Fet r C.Lect /7 a friA . 2_,? 1 a ,t..„ <br />) 6a 147- T ).41-e, ci bet 6 o Sulae- ar) tri oor , <br />n-k n-i-s Ii e L J I ieek. 6-, a Le..4.1 - 0 erf -a--; <br />(54,,,e a u d c-ktekt.s b-f--F oround <br />abi <br />P /2-e <br /> <br />Ai We WI I VI &Cit €._ 1-) 14/40_,M <br /> <br />5 h h.i d col n --10e4 472 h n 6; <br />yes b Wot4{ r V.e4 \ 0..eAC S p Pr 0 U-1 AA_ 1-N KAAP-e-e <br />CA- C-Coc) p LL 01-F srnottx h401 Thu) <br />3 - 6-o p s) <br />Item/Location Temperature <br />(!t <br />Temperature <br />y dr <br />Item / Location <br />3i/v-er in) <br />eixor e-ebte 31°F <br />Warewashing Food Safety Certification <br />Name:1-00 L./ <br />Exp. Date: <br />Facility. Hot Water Temperature <br />t x() OF <br />1:2_cd °F Quat. Amm.: <br />Hand Sink: Chlorine: <br />Warewas g Sink: <br />PPm <br />PPm <br />Heat: <br />Other: <br />Received By / Titl <br />EH Specialist: Phone: <br />Time in: I <br />EHD 16-24 (2,4 pg) 4/3/13 <br />Time out: LA '0 0 <br />Page of <br />FOOD PROGRAM OIR CONTINUATION