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on°"•" SAN JOAQUIN COUt" <br /> ENVIRONMENTAL HEALTH DErARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • isq.. l <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> ti c6'A`' <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT . <br /> Name of Facility: "(he vrestN b)( rens Date: (0/12 j3 <br /> Address: 504 N, WiI&M WCA city: S- (/r-iTin Zip Code: gaj705 <br /> Owner/Operator: D�Q J� ��QI„ �f,.) Telephone: �_6(g-06 <br /> Program Element: t 2Program Reeord: R 010 1 —t--A Ll Inspection Type: <br /> sted 0 Yes t fi t1,e, <br /> SB180 PoNo Permit Posted C' es 0 No Re-Inspection on or After: — <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 'Scap bis <br /> U r U +- dy�}S a�1QIYa wQSh S�znc�}ll . �l wi�l e. y . <br /> E29 Ka+ Oil food can firms are 14 be ed . Label tzcb( , <br /> v0 es no-i- &tzrred me rete sUniti u cxe+ . st71r� ins ¢. canit, <br /> h2jc"* a+ qtt - mes . tvda correcAed an s te. <br /> �oc�lcontrA-Inm bave j0 uild all f a cotclInors <br /> n . crrr>2O Gt <br /> t=>7o loan � Cprti f�ca-4e r.a+- avaita I¢. . Fa Co to ��-D <br /> trn 2)6 days FOX it 20q - 4b4 - 6I3a *Fitb gran_ r C. ti-K4 <br /> carne aro ad ness w i-, pr"-T) : LG n <br /> ro ?fe v ices N rr i nSpeCAhT re?Uri- .rte U '\1G t0- . g(A)n t-utn ins eWun <br /> 1 CIF-� &rte. <br /> 0h t-*V w111 close. <br /> Item/Location Temperature _ Item/Location Temperature <br /> 9-df- verest r Coa1Q,> 4I°r- 2dr Vin C06V.,r 33°r-- <br /> diad towiTt s 4 IT <br /> 3 d,rcoater I'F <br /> / <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: 100 vF hlorine: PPM Heat: of <br /> Exp.Date: arewashing Sink: I ZQ of Puat.Amm.: PPM ther: eF <br /> Received By/Title: <br /> EH Specialist: Phone: !1/1 _ 46 44 <br /> Time in: (.,00"-jIj Time Out: ( : 4`, Page2-0f-Z <br /> EHD 1rr24 (2n°pg) 4W3 FOOD PROGRAM OIR CONTINUATION <br />