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Owner/Operator: <br />e. <br />Re-Inspection on or After:Permit Posted <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />/ft <br />4 <br />Temperature TemperatureItem / LocationItem/Location <br />Food Safety Certification <br />:hlorine:Name:FPPm <br />Other:Warewashing Sink:uat. Amm.:Exp. Date:°F°F PPm <br />Phone: <br />Time Out:Time in:r- <br />EHD 16-24 (2nd pg) 4/3/13 f <br />San Joaquin Coun <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 />Received By / Title: <br />EH Specialist: <br />Warewashing <br />Heat: <br />Cily; <br />Facility Hot Water Temperature <br />Hand Sink: op <br />Kj C* <br />islo <br />■ <br />Yes No <br />w: EOiii |4Tw£»:< <br />Page of . <br />FOOD PROGRAM OIR COiITINuItiON <br />Food Program Official Inspection Report <br />Name of Facility: y Dale: -sr/zf/F <br />|AddrGSS: Cc^eS/y^' C]ly: Zip code: ? <br />_ ~ ^^■■&/2-2s39<o <br />Program Element: ip. Program Record! Inspection Type: <br />SB180 Posted Yes No