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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.orq/ehd <br /> <br />Mot <br />ftEfflitrPROGRAM OFFICIAL INSPECTION REPORT <br />of Facility: tt <br /> ddress: <br />/ 4 Date: -7/0.3kei <br />2til , City: Zip Code: <br />621'0 <br />I <br />Name <br />Owner/Operator: Telephone: <br />Program Element: Program Record: Inspection Type: 6 g1%.*„, , <br />-t” <br />Seztattihnted-7-Yes--t-No . • Perm-P —Re-Inspestion-en or After: it -4;ftfiett I -=ter e - No <br />kcet712 & OBSERVATIONS AND CORRECTIVE ACTIONS <br />wo — — 4,4 j L. A A: , / 03 ,i <br />`ie inA'e_4:tki Au,t44,1) <br />.4C-0,44t4,4_,, itit..u., (4-1..; c, k e 444,,Ac ..4_*,,x).77-di21 <br />till <br />k)a.AL. PL42 eewvilla 1-.A-el P4-E <br />4 itt42-&-ed - OL./12 ' <br />L I "A A. f b A.1 ,111 4 . 4 ' t 4/ 0 . _ , 4 .. 1 1 'H .1 <br />a/1116/ ' ' Teat / OW . <br />/Lei fitivit._ /31A,L1<a4 dai-AIA:44_e Adeil74re4 eme ./iz) <br />Po <br />, 1.21,4 to-e42 0 ditt-d4 a4/44.44, i CIA-V_ n1C.O.:ft., AIL' t_ <br />f 4___Th4A344' <br />it ,,A._"' -L ei' A i 4.ezt*l_pr___) <br />AA-44/‘44144:5 Itre,442.4-ged.. ‘fi 4A44, --4 1-(Ak-t., Se,tie _ <br />Item/Location Temperature Item / Location Temperature Item 1,Location Tempe <br />,i. % <br />. . Food Sat Certification _ Facility Hot . vl .,a,411‘.11. Warewashing <br />Name: Hand Sip c, A MT' * Chlorine: PPm Heat: °F — <br />p. Date: mg Sink: 0F Quat. ..Ott er: °F <br />Received By / Title: <br />EH Specialist: i -. <br />1.447"..._ <br />Phone 46 (967 ) ,,,g „.03:4 <br />Time in: Time Out: ' Pagefof 2, <br />END 16-23 (2^° pg) 11/06/08 FOOD OIR CONTINUATION