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SAN JOAQUIN CO*Y <br />Z:' z ENVIRONMENTAL HEALTH DEPARTMENT <br />P: -1 <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siaov.org/ehd <br />9CIFOR� <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: y�� 5 I n `'` '•i.t S Date: <br />Address: 0.5't Yt'u + to h Zip Code: q <br />aO <br />Owner/Operator:V 'Tq r .� 5wN +i, Telephone: a <br />-7-742 <br />Program Element: ZL4 Program Record: P R a 5-A 01. 7 Inspection Type: —1ZOO- j r ut <br />SB180 Poste Yes ❑ No Permit PostediA Yes ❑ No Re -Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />I I h r14C r Yo Trw,e r- <br />Z <br />O LS n o a urx.>I to Le . O- e r o Lune rs <br />we -r -e- <br />,VV--e-V U u nedelva r <br />Wil 1 re cv- 4:651WC' ma <br />m <br />r <br />Y2 &s -bare_ wood ak7d.prr"rT Zrzea_ re <br />_ tg . <br />barle Woo u 1� <br />m, <br />t2ijJ <br />rvt 5 h r -e -f �`v <br />hd r' •kB <br />�` <br />LcJ_,ve.eC <br />LII F <br />Item/Location <br />Temperature <br />Item / Location -_ <br />Temperature <br />02. cru %r I rl-f <br />r r�ea-4 I- <br />32- <br />3er <br />rlZc4 LALlime, <br />ol¢ot- r , <br />q3f <br />XA 001 <br />37F <br />pqj(f r a r re, <br />y5 F <br />Go6Ce r <br />r On d4solav <br />J Food Safety Certification Facility Hot <br />Water Temperature <br />C (ovine: PPM Heat: <br />of <br />Name: 'T� �, C 1,J. Hand Sink: 130 of <br />T'`-• <br />Exp. Date: _ _ b [Ware,'V? k• �J�b =F <br />o <br />PPM ther: <br />of <br />Received By / Title: <br />EH Specialist: Phone: <br />line in: 1 oZ� Time Out: n: <br />Page.,pfZIL <br />EHD 1624 (2ntl Pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />