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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />4... ,...;s Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />�l POM1� <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: 10 «05 <br />Date: _ tc&-Z3 <br />Address:-LS-614 <br />2.Sbr-{ 4✓ L-14�Pro o l� � <br />City: Code: <br />i-a'N 45 2vS <br />Owner/Operator: <br />Telephone: <br />Program Element: 61 Program Record: OSl.b�if <br />Inspection Type: �of� <br />BI80 Posted ,eyes No Permit Posted ,,_Yes No <br />Reinspection on or After: <br />�W r- C f (l <br />AQTIONS. / , <br />u/q-A SJN� t(,n� (c)J4C(-- f'o <br />)`U <br />LouZ` r <br />px-�- workrf' broker. <br />l 1 Z CQ S <br />UU <br />0 (04 f5 nCw'P�e.�iv, 1Va- <br />GVin ttCover 0.(k K 4re� <br />'O& <br />ft5 Tti2 C -0 V(,04. kc -m '(00 <br />Inc -+ha. At (<r r ck <br />.fr- ckt!0001L <br />i� tS oo4f^ ctA.1 ec?haJ. <br />t C. ,/ tj V t -N_ 1,-jK-rC wcstirn <br />ro0A, rs e.ovnrn 1%3a9-, (2-1W la �z <br />`` <br />f, Ley <br />�0 C--(62 r. C,.,k Pro d[ ( <br />Lt -5c CL Cori *-0S�`C <br />(r -Lf- C o'6S (�%. 5 41cTrzR� <br />(dc) Rem Cki(c,"--a a r ZC-)tl /rte l cfi <br />Item/Location Mbmperature -- - �-Item /Location' <br />alL <br />�.��//� _ <br />eccf- �t (f7 T7 <br />r-; csz - 5 4L? I- Ge ( 6s <br />ood Safety, Carpfit Wty. Hot Water Temperature Warewashing <br />Name: SJ(p r -j 0 Pere?-, and Sink: t a� of Chlorine: (off ppm Heat: of <br />Exp. Date: .3 —2,6 1warewashing Sink: <br />2z) op Oust. Amm.: ppm Other: of <br />Received By / Title: <br />EH Specialist: <br />Phone: <br />Time in:t„Q .� <br />Time Out: ,L , o� Page of 2_ <br />EHD 1624 (2n0 pg) 4013 FOOD PROGRAM OIR CONTINUATION <br />