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SAN JOAQUIN COUN1 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: rl c5c-ex pew' Ag_ Pe? Ottf:61- Date: //...,1 Zs, <br />ddress: ,25c:cv N% fitit' 1,04- 14/041 City: <br />57 fen'-- <br />Zip Code: <br />4 c240 '- <br />Owner/Opera or: Telephone: <br />Program Element: Program Record: <br />re <br />(7ç) <br /> 47- ,C if inspection Type: 1,674,4 /1_2____.. <br />SB180 Posted (Yes , No Permit Posted Yes No Re-Inspection on or After: <br />' OBSERVATIONS AND CORRECTIVE ACTIONS <br />cw-EeA k <br />.2 s 1 11 k /7 ( <br />1-i- I ) r3--, <br />3 '3.tu-AN, f ReLailt ( , ( ,!96-Pkt,y-) 3s • <br />cf c i A - 0 z \ r k -ei C Lovnow I cliy-ts 614--__eluz2zza44 <br />ivccd avk ttof 1-k-ts•e_._ I- e_.-„Ar. (:)1._ i 3 s'-t- cpc Gt-1-i)ck, <br />ta2vt,t_11 <br />69 i SC/4? '7 2 orc-z---,t 604f e ( <br />Item/Location Temperature Item / Location Temperature <br />F_c_(_)c jil Safe S2L2a Aitificsti ,t Facility Hot Water Temperature Warewashing <br />Name: L-7tS "/ _ Hand Sink: o F (1._ Z4,4,49.-4-4-e_ <br />Chlorine: ppm Heat: 0 <br />Exp. Date: ei / ,_2 c f .-zo '2_0 Warewashing Sink: .F Quat. Amm.: ppm Other: 0 <br />Received By / Title:g..7 . Cli Ci e ?_.13 Z.2/ -/? 33 <br />EH Specialist: f ' 4 2i) #q sc 3M9.1 <br />Time in: I <br />b <br />Time Out: Page of <br />ai 14 /S":"? <br />EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION