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"" •r,` SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �q'. �Q'• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> CIPO�� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: IE IDate: 611ZE22Z <br /> Address: a City: S C •ary Zip Code: -39 S <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: /2 Inspection Type: N <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS ANIFIENErFIERMIT <br /> I S &- y <br /> 'G it sYtO�S <br /> i7 A q A2s c bh_ <br /> 13 {� ha6kao S�h L ,>7 'A <br /> GY[f P BJ �Bdhl cnfl <br /> w¢J A6,57- <br /> A�� <br /> o Lr <br /> /'A :of S li/�✓� <br /> i 3 <br /> U D v1 � GA42 <br /> , <br /> � Nor /,r.✓ Gf: <br /> peratuie• <br /> WAIVIh Her _ C e� w^ 3 <br /> CLICEI D ae4 A2 <br /> ✓'J L r' u .—r J <br /> L r w i Ga e ✓ Uv�l `i F <br /> FegIIft.,Hot Water Temperat. Warewashing <br /> ame: er-N Hand Sink: I�il -F hlorine: ppm Heat: �F <br /> Exp.Date: rewashing Sink: llVuat.Amm.: im Other: -F?� Z f <br /> Received By/Title: TMW 1_ e� n <br /> EH Specialist: a Y'�J Q Y�/� Phonnee: — <br /> '^RO <br /> Time in: � M Time Out: , Z M Page of <br /> EHD 16-24 (21-pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />