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OBSERVATIONS AND CORRECTIVE ACTIONS <br /><4 <br />I <br />1a <br />k. <br />a <br />(/xj4# <br />^3—{}■ <br />Certification <br />Name:Chlorine:ppm <br />Exp. Date:Warewashing Sink:Quat. Amm.:Other:°F °FPPm <br />Time in:Time Out: <br />EHD 16-24 (2nd pg) 4/3/13 <br />Food Warewashing <br />Heat: <br />Temperature <br />i ~ i C/b . <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/ehcl <br />Item I Location <br />G V ~ \ CTO <br />Ao \CCr IQSB-F <br />Ao G<yo^pfT-\ <br />Item-Location <br />■2^5 G-GjvcG-i?r\ ~~ Gt rC <br />V-- _____ <br />Facility Hot Water Temperature <br />Hand Sink: Tp <br />lift I aHS{gH*-'7 <br />Page , of <br />FOOD PROGRAM OIR CONTINUATION <br />3 <br />°F <br />2, 3 V M <br />Phone: <br />Ip-~'• P" ■ • Ae- A~7Frtas <br />____SjTGcu" <br />L?jTP Gk <br />A CXTcop , <br />\CQ- I OGG <br />G-GQ - 15 <br />q^ZMZ <br />__ ____________Telephone:5^^ <br />Inspection Type:—r-,.. c- <br />Re-lnspection on or After: <br />fV-p <br />Received By / Title: <br />EH Specialist:, -y-xj ? <br />G OrSLA U Q <br />AO kM<7~A'>v'V\ kMcr-bT—■ X-SJo^Gy <br />* L-OgLf G> 4 k Qaa xaG/rrSG <br />f WvG A-a-A A-a <br />Food Program Official Inspection Report <br />Name of Facility? C kJ A 5 ^esA\jo^________________________Date: <br />Address: City: Zip Code: <br />Owner/Operator: G <br />Program Element: 'S Program Record: <br />SB180 Posted Yes Rermit Posted Yes □! <br />lA\V* Ag F ' <br />C\ - 0 p (y> - c OS <br />G~m '^v2l V <br />VVAvJfgiAeA - 1 Q<o G <br />M-> U \ -o I lOcaGTGl <br />Temperature <br />iXSAAl\