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SAN JOAQUIN COUN'i <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjqov.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: G und r k--)( v‘-ecso At 'lilt 1.11 Date: w 13/) <br />Address: 1 SC) . 'w \pi ON City: C..totA,_.tutsi Zip Code: <br />Owner/Operator: Fckc ( l.t a ) Telephone: <br />7y <br />, 3) 3._ TaiN.4 <br />Program Element: A ti75,..fr, Program Record: ?IF.. 0 0 4\-c Inspection Type: y 0,,ctirte <br />SB180 Posted r Yes 0 Permit Posted fT Yes Dl Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />_ <br />CD -11-LeAre cAre, F- kr, )2-S Vn 1-tte 112-ck‘Le4 ‘-em--) k)asS lb "tt.1 VI krOCA4 C c_koy5ecil- <br />@)-- Ikke, 'vecyl-) wC,A4eX 1 n L2 -k- '-\ 1-n\sclnci 'N.. co li., \-,(7),/‘ cke <br />_ <br />31- CA- kb. ‘c,(- vit,•v2A-Till t --oC Gri- <br />ac--3-er -c-ee c c‘r e pn-ic.1 • <br />- y12-erv1oNA cezyuck- on <br />V000k Vivnoluu c.weAS Sike 071 <br />I A r ,ci I vex --inci <br />emperature <br />WOf- <br />Item / Location Temperature <br />1 -!\( (d)cor- <br />Food Safety Certification Facility ot Water <br />Hand Si,. <br />Temperature ., Warewashing <br />Chlorine "cki k ppm Heat: °F <br />r Name: ./-15-)-1 pCt kik-C't 1 k 00 oF <br />Exp. Date: <br />''-.3 / 4-/ ( Warew ing Sink: Pxo oF Quat Amm ppm Other: <br />Received By / Title: .--.--- Received <br />-.4.1 Iria. <br />— EH Specialist: Pt / <br />, <br />VIM Phone: <br />() en - 4-(02) - 4\4-6 <br />Time in: 1\ , ..0 1 Time Out: p. :IL?, Page /of ( <br />END 16-24 (2^, pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION