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OBSERVATIONS AND CORRECTIVE ACTIONS <br />@ cz?/)4 <br />7- <br />i <br />12 T g, <br />a <br />Time in:Page., of <br />FOOD PROGRAM OIR CONTINUATION <br />ISES <br />San Joaquin Count <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 />_______OK <br />9.53-7>?/7 <br />iO VO <br />■•AJi <br />Lctor-ie r <br />u/tr-k r <br />Name: <br />Exp. Date: <br />Phone: <br />Time Out: <br />Chlorine: <br />Quat. Amm.: <br />1X7^6 <br />Warewashing <br />Heat: <br />Other: <br />ppm <br />PPm <br />°F <br />°F <br />Temperature <br />4lr~~ <br />Received By / Title: / <br />EHSpecialistr77w? <br />f! oD <br />EHD 16-24 (2nd pg) 4/3/13 <br />/^6> -ios <br />/ <br />/V? 7-7 T. <br />jorii S__ <br />i-c/ip ol <br />(Qg \ j L<5 7- <br />Cot b (-C_■- <br />Lip <br />Item/Location <br />._____ ......... <br />Food Safety Certification <br />Food Program Official Inspection Report_______ <br />Date: <br />Zip Code: <br />Telephone <br />>y d "i- <br />' Fm <br />Item I Location <br />@ f/k) Qwsi <br />_____17) f■/ 7z>’ T <br />■ - * 7 I - ? f '? / / ; ■ . ■ <br />Facility Hot Water Temperature <br />Hand Sink: op <br />Warewashing Sink: op <br />-• /-jo'i n <J LU dy Q i <br />Q-f___jOO <br />-----------j <br />■pr-tgp_ <br />4?^ f <br />m^'i-h 2>t <br /><7 at <br />r S-jer-te d 7- 6 l Id. ikt <br />iku__h-as___) <br />Name of Facility: <br />Address: q y <br />Owner/Operator: JI- j <br />Program Element: y <br />SB180 Posted Yes No <br />ecu -S 4/-T.-C <br />. _ Or~ • z^zr 7r h b ki <br />ptt'pkY' • <br />r-4)t?r7 ' <br />-/-ood d>hei(A __ <br />LUdtrsr) <br />y du up <br />—~ 'id <br />___rUdidfY' -__7 <br />Q7~__________idt <br />uJas h no-j' <br />JU QOcQj'tPY' <br />/and__d'Jrn 7 <br />^rp IM cU- <br />tadT-b’r <br />w------------ <br />Temperature <br />____ <br />■ . <br />c'ty: ed tv cl< -hop <br />____________&r /yUi <br />Program Record: P p (J Inspection Type: <br />Permit Posted Yes No Re-Inspection on or After: