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O-K -h,) e...S ry-vj p o1/4.4: <br />I to Co 4Rir 05y- Trl <br />(?o5-k- ti? 0 ut..1 rt at pt..4 <br />C- (gi,L3o6 <br />Ui-r1 I Cnc, C2c1 z5 12- xYli Ho'l <br />10 o÷h 6 i v ct_ 0 (.43 r s <br />- 2-Ltbe.4,K_ <br />Hand Sink: <br />Exp. Date: Warewashing Sink: °F <br />Received By / Title: <br />EHD 16-24 (2,, pg) 4/3/13 <br />Heat: Chlorine: <br />VS11,l <br />EH Specialist: <br />Time in: <br />FOOD PROGRAM OIR CONTINUATION <br />Quat. Amm.: Other: <br />Phone: 615,5 _ n <br />Time Out: 0 5 k., <br />Paget of <br />SAN JOAQUIN COU <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siciov.orq/ehd <br /> <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: Se `re . L i-Do a-5 Date: 3_30 _16 <br />Address: 1 6 --os Re „et., ay__ City: 6+ocic_i_or.1 Zip Code: (:-.) 6 ...0,:;) <br />Owner/Operator: K 1 yyl 1 50 ry‘ ri` ++1 Telephone: <br />Program Element: 1 to 0.3 / 0 1Program Record: 6 Roo 9 1 .53 Li 3 Inspection Type: 0 73 14- C u 00--; <br />SB180 Posted 0 Yes 0 permit Posted E Yes 0 I Re-Inspection on or After: