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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> a4cl'aea�;6. Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.orglehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: re, It es Date: - _ U <br /> Address: 0 f, WCA icy I city: S 4 K h Zip Code: S G <br /> Owner/Operator: Telephone: Y 3 -103 <br /> I <br /> Program Element: Program Record: Inspection Type: `! OU Y•�n <br /> 6180 Posted O Yes 0 No .Permit Posted 0 Yes 0 No Re-Inspection on or After: <br /> ;OBSERVATIONS AND CORRECTIVE ACTIONS <br /> / 1, }awe lS <br /> IF G ! G M r e cl I /� !OK <br /> itemlLScation Temperature , r._ Item/Location ,Temperature Item/Location Temperatures <br /> . . , .,�.F3ci__. .,- . - . .r;w� - <br /> Food Safety Certification Facility Hot Water Temperature ' ' _ -Warewashirig • '� <br /> Name: and Sink: 'F hlorine: PPM eat: ^F <br /> Exp.Date: a ashing Sink: 'F Quat.Amm.: PPM ther: `F <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: 1:2: .7 Time Out: Page of <br /> EHD 16-24(2n°Pg) 1112109FOOD PROGRAM OIR CONTINUATION <br />