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Program Element: <br />SB180 Posted Yes No <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />A <br />g-s s;<3x1 <br />j TemperatureItem / LocationTemperatureItem/Location <br />Food Safety Certification <br />°FName:ppm <br />Other:Exp. Date:ppm <br />Received By / Title: <br />Phone: <br />Time Out:Time in: <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.org/ehd <br />Name of Facility: <br />Address: <br />Owner/Operator: <br />°F °F <br />Program Record: 7 <br />Permit Posted Yes No <br />A j1 <br />A V.S'H <br />1 <br />Facility Hot Water Temperature <br />land Sink: 2-5^> °F <br />/arewashing Sink: <br />Food Program Official Inspection Report_______ <br />j.v Cpd? Date: <br />EH Specialist: \ J c <br />EHD 16-24 (2napg) 4/3/13 <br />City:fA-V(\ yAov^ipCode:__________ <br />Telephone: <br />Inspection Type: <br />Re-Inspection on or After: <br />w: [XJipi <br />y- b-a>o^s' <br />lO\Mg>c\ Pa9el0' I <br />FOOD PROGRAM 0IR CONTINUATION <br />Warewashing <br />hlorine: ~ ( nr,™ HHeat: <br />_______________■ <br />luat. Amm.: