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°""" SAN .JOAQUIN COUN1 <br /> '° 'c <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • 'oq��Fo-Ra;P Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: S L C Date: /_:Z _ /1 <br /> Address: o n City: Mu H 4-er4 Zip Code: <br /> Owner/Operator: // S L C Telephone: <br /> Program Element: Program Record: CAO <br /> 35--73 Inspection Type: <br /> SB180 Posted []Yes ❑ No Permit Posted E Yes Li No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> C1 ddce Oh s�fo ��► w /a o/ i <br /> ,4e_ .�� <br /> ZI:WS <br /> G D lc A)P-' <br /> • C2 �6 Psr <br /> (�2c,c cc, apo <br /> Item/Location I Temperature Item/Location Temperature Item I Location Temperature <br /> 3 54� l 7 r� <br /> food Safety Certification - Facility-Hot Water Temperature Warewashing <br /> Name: Off! MO �es Hand Sink: O of hl e e µ /0a ppm Heat: �F <br /> Exp.Da : arewashing Sink: OaF Quat.Amm.: ppm ther: 'F <br /> 14 <br /> Received By/Title- <br /> :t <br /> Specialist: Phone: <br /> Time in: Time Out: O.OS Page of <br /> EHD 16-24 (2°°pg) 4/9/12 FOOD PROGRAM OIR CONTINUATION <br />