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7 2_____ <br />Zip Code:City: <br />Telephone:Owner/Operator: <br />Program Record:Program Element: <br />No Permit Posted YesSB180 Posted Yes <br />TemperatureItem / Location . <br />Food Safety Certification <br />Heat:Name: <br />Other:Warewashing Sink:Exp. Date:°Fppm <br />Received By/Title: <br />Phone:EH Specialist: <br />Time Out:Time in: <br />FOOD PROGRAM OIR CONTINUATIONEHD 16-24 (2nd pg) 4/3/13 <br />Item/Location <br />Warewashing <br />PPm <br />1 <br />’IChlorine: <br />_____ <br />°F <br />San Joaquin CounW <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 />Inspection Type: <br />Re-Inspection on or After: <br />Food Program Official Inspection Report <br />Date: <br />_______ <br />Page of <br />_________ <br />_________ <br />No <br />Temperature <br />Facility Hot Water Temperature <br />Hand Sink: <br />llQuat. Amm.: <br />_________ <br />Rr