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o.�c <br /> P4"'" SAN JOAQUIN COUNTY <br /> y� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • •.. '_ ;P• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sogov.org/ehd <br /> G(• C �I� � F1 INSPECTION REPORT <br /> Name of Facility: 0 L13LS Date: / <br /> Address: 7 J City: T 6 Zip Code- <br /> Owner/Operator: I J it �1 itV) Telephone: <br /> Program Element: Program Record: ! (/ 4E 3 Gf Inspection Type: <br /> SB180 Posted Ye§ Permit Posted ("es) No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> F%1� L/ <br /> 4 on <br /> Item/Location Temperature Item/Location Temperature <br /> Food Safety Certificati n Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: F Chlorine: ppmHeat: F <br /> Exp.Date. a Warewashing Sink: of Quat.Amm.: Other: of ppm <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: Time Out: Page of <br /> EHD 16-24 (2ntl pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />