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\ f C\ c <br />Telephone:Owner/Operator: <br />SB180 Posted <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />i- <br />TemperatureItem / LocationItem/Locatlon <br />Food Safety Certification <br />Name:Fppm <br />Other:Quat. Amm.:Warewashing Sink:Exp. Date:°F°F PPm <br />Received By / Title: <br />EH Specialist: <br />Time Out:Time in: <br />FOOD PROGRAM OIR CONTINUATIONEHD 16-24 (2"° pg) 4/3/13 <br />Chlorine: <br />Warewashing <br />Heat: <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 />■P j Ax <> <br />% c AgQ^A C <br />Name of Facility: <br />Address: <br />Food Program Official Inspection Report_______ <br />A CrM____________________________Dale: <br />Zip Code: <br />Temperature <br />by C)cA, Y rA, C gv <br />cr-rx <br />UM F <br />Facility Hot Water Temperature <br />Hand Sink: °F <br />City: ~T?t< <br />zoq-ipA-Boas <br />-A page' °' <br />■SoSZ-fal/ S, 5 ONO 'nspecti°nType: X/ojA-/ T <br />Yes No Re-Inspection on or After: <br />Program Element: y ^^2^ ^^^<^rograrri Record: <br />Yes No Permit Posted