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Inspection Type: *-7124J-fht <br />Re-Inspection on or After: i t I <br />Program Element: (4, 3 5 Program Record: 0 b 7s,) <br />SB180 Posted Yes No Permit Posted Yes No <br />Name of Facility: <br /> <br />Address: <br />iv k)tLC <br />Owner/Operator: K. cc <br />fr' <br />I 01 Vw Cfrt vtt <br />‘ .,44 ,1,4A4-- ,t ,,ii-e,kiii."--1-e <br />fri-ov:f ICz 0_,Tri:I f,t, r.,,te 0 40.014 <br />C)19,tyvwt 1 ,e,04,1-v ,44:1412-e.er Afrtd ,s13 id a .ta i-i4)ir - aAreo-tA-4‘?e <br />y1vi ,i11.4.44 • <br />0 14-04-\0(44.-e4.64-1 ,1/44.- otfAe,d rwl-f ok,44 ( A 44 val free)W& ) <br />PARNA/ Ai- Ali" ot,tatvi4 <br />vr <br />ep 0. .044.A,06.1 !Ai AAA <br />bliktts(c/t Atiot-t (..e owl <br />rs., , 4 -IA A ^ a .,111-614-(4 JA-CA- i/J-t Al ,14 <br />ofrvv( AULC Jat-. <br />cl/t) iLil <br />Exp. Date: <br />Received By / Title: <br />EH Specialist: <br />Time in: 1; aro <br />EHD 16-24 (2,6 pg) 4/313 <br />Hand Sink: <br />Warewashing Sink: / <br />Heat: <br />Phone: f _fk 4:7417 <br />ep,f- Time Out: Page <br />FOOD PROGRAM OIR CONTINUATION <br />0 Quat. Amm.: Other: <br />0 Chlorine: <br />Date: /3//b <br />Zip Code: <br />Telephone: <br />City: <br />SAN JOAQUIN CO rv <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjcpv.orWehd <br /> <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT