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OBSERVATIONS AND CORRECTIVE ACTIONS <br />( <br />Temperature TemperatureItem / Location <br />-^0 ^7 X Phone: <br />Time in:Time Out: <br />San Joaquin Couni . <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 />953 -7 2 H <br />/ ■■2 ‘-fD <br />H Cf /? <5 ■ <br />Z______o K___________ <br />cpV& s h <br />Name: <br />Exp. Date: <br />C^Cd - U <br />Po-t d^f f h /o <br />Chlorine: <br />Quat. Amm.: <br />Warewashing <br />Heat: <br />Other: <br />PPm <br />Ppm <br />°F <br />°F <br />(i^ bo uJ PPte. Pcin "rdm-. <br />rf /J -h • <br />Facility Hot Water Temperature <br />Hand Sink: op <br />Warewashing Sink: op <br />Z? J <br />Food Safety Certification <br />Received By / Title: , <br />EHSp,,'a"5tr7Tm/^( <br />//ZvJ <br />EHD 16-24 (2"dpg) 4/3/13 <br />Pl# <br />-dr <br />------------ <br />Food Program Official Inspection Report________ <br />Fun'K-fober- Date: ~ <br />AJ Sd-__________ZiPCode: <br />d. r~ or ____TelePh0,^^[>^^ <br />JO <15 PrOgram ReC°rd: P(\ 1)5 7 </__________________inspection Type:-^.^^ <br />No Permit Posted Yes No Re-Inspection on or After: <br /></■________________________________________ <br />d r or /VUrJie//^ <br />Pf\ D5^5Ji/ <br />No <br />7/^;7wr <br />K po-p^-da / !c <br />hr r7 - rv^ cdicij <br />oP ~TPc)jn s <br />______PPL_____________ <br />@ Cwt... <br />- Food Cxi vdcirrrters <br />/7/77Z? rd_> Por d 5 4T-d <br />CT) dbo bdc cd n s <br />__—UJcjPfy' -for__A <br />X 47 Op ‘5rhrt <br />- rrrop n^cdt r~ Ps. 1 r do <br />Name of Facility: <br />Address: <br />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes <br />JioP PoP / <br />iPAPP nr hig <br />Pag^of^ <br />FOOD PROGRAM OIR CONTINUATION <br />@ p d b e ‘ 5 A Fs <br />Item/Location <br />J door Tlidp____ <br />PF n 5)3 '