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OBSERVATIONS AND CORRECTIVE ACTIONS <br />ijvP— <br />V>-*~uc--z.G <br />It~o <br />LVW.)a <br />\AXp- <br />o <br />Q^yxS"^*-IV <br />Name:CF PPm <br />Exp. Date:Other:FPPm <br />fA-rrmpps <br />Phone: <br />EHD 16-24 (2«pg) 4/3/13 <br />Sr n <br />JSv>V kQl£_ <br />_ k tr <br />Al v7 <br />°F <br />M V—> <br />Temperature <br />\ ? -LG <br />1 O-Q o—? <br />Received By / Title: <br />EH Specialist: . <br />Time in: ~ 3 <br />Warewashing <br />Heat: <br />" 0 o-<x r. e— <br />YXo-k yJixKe- <br />v— \ po-Q <br />No <br />Vo/' <br />___\_sLGy <br />\bSp <br />( V <br />Vz^ <br />I 50 (- <br />' 38 r <br />) __\ ~ \- <sV~l - <br />\-VoV V~ c\cl t <br />—Czk—4<c_0—p-----LXx^Ax\jrP----------------- <br />y \ > X < A cA <br />dd Safety Certification F <br />IlHand Sink: <br />'Warewashing Sink: <br />V- x p<y-\_______________skp City: G <br />i. \ Oj ,-^x <k-x <br />S2ft283______ <br />Yes No <br />San Joaquin Cou. { <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 />Food Program Official Inspection Report <br />________Date: - 3- l y, <br />Zip Code: gs^ <br />Telephone: <br />Inspection Type: <br />__________________ —i <br />Re-Inspection on or After: I <br />item / Location <br />\5^rx<- <br />. <br />-----: <br />^■OcloL <br />Pag®! of <br />FOOD PROGRAM 0IR CONTINUATION <br />Item/Location <br />( <br />v <br />i Temperature <br />l _b 2_ E; <br />f F I _____ <br />Facility Hot Water Temperature <br />[Chlorine: <br />p iQuat. Amm.: <br />Timeout: <br />\ oo c=> <br />n2) t- <br /><yv o—?q •Yx/v^- <br />oA f X/ eV <br />kTGG F_______ <br />^vo-zT \A5f <br />-Vf> USE <br />Xo,v F <br />V'-vtA (zA <br />V<X.r\^n„ WVzv <br />Name of Facility: Oy-^ <br />Address: —7 L-Z 1 -D • <br />\..., V\ \ \, -x \ <br />Owner/Operator: o - i I_____________F \ X- VAc-n A <br />Program Element:___________________Program Record: <br />SB180 Posted Yes No Permit Posted