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aoPn ..coa SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> •.cq.. ;P Telephone:(209) 468-3420 Fax.(209) 464-0138 Web:www.sigov.oro/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: S-r p G —r 'O Ij NI 00 1 t. A Date: O — 10 - 2 ,3 <br /> Address: 2?> U4 L h P,0 City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After:02 <br /> _ OBSERVATIONS AND CORRECTIVE ACTIONS <br /> VtL':.n-rl[7'N <br /> E NA r- 6 N Q <br /> TH-& tZ , rr-4DVPn IAVQNI>511, PS L W Gk n1eft5 <br /> „ • rOO.D '(1'I A K C f7 rq I N fAND <br /> fro I r� (-or Y -t v 209 — 3 oA cm q r2 � CjQV. ORG . <br /> ► r� [ Y <br /> uT qN CI�V� tfibiOUT c — <br /> so T-p -5ev�ye r&riaqG i G CGU W s t4fill <br /> 155y-r,y'7Q_ R 10 I <br /> C10 <br /> 7 1 a IC l 1p 16 't-WE-7 W,AL K-► <br /> COD GoV vi 014 U0. Lw L <br /> A '36 . i (919POCKNED k GYLI N rL -r4A wr WpLs Nov <br /> 515CA) KrVp 'tb p� Wf%L.L. s Co R6cc t0j2jq <br /> • 4. 0B5a&qeV L)t4<A i Pi C ON 3— <br /> T - S INK L ACE 517 W 1 S 10 <br /> F�_- <br /> SA N 1 t ►7-1 N O W N o c !tom t -r 100'P cz <br /> 02 '2_4C)0 — LAOO mula N ► tN s <br /> S Nov I-b l3£ PlA L v 15 Iia✓ [ -tE 0Wry it-4060 Gf�6. cot2t�C�T .1 74 <br /> Item/Location Te . -"...- ure: Item/Location 1 Temperature <br /> WALK r 0o1-62 C ei4c' o[ ►714� <br /> Com oP Co - 1- 3 C0I,N Ivo � HO-jr OL d 57 <br /> CoV N - - ► ' D r- <br /> couN -top - ► - DIZ 4OV <br /> .Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: 6.b Hand Sink: 1 QQ "FChlorine: Ppm Heat: 'F <br /> Exp. Date: arewashing Sink: 1 'LL7 'F oust.Amm.: PPM Other: of <br /> Received By I Title: <br /> EH Specialist: A U,�L 1 LM L)ff"lb Phone: 209-56 t — g 23 <br /> Time in: % 0 A 2 A M Time Out: ► ► i 1.O -A M L <br /> of3 <br /> • <br /> EHD 16-24 IV pg) 4/3H3 FOOD PROGRAM OIR CONTINUATION <br />