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. Scoop SKp <br />- <br />cl <br />ouJ+e, I CJ2./£>2 <br />LD <br />( 2^. <br />Item I Location Temperature <br />Food Safety Certification <br />F <br />F <br />Page _2>f 2^ <br />FOOD PROGRAM OIR CONTINUATION <br />Name: <br />Exp. Date: <br />PPm <br />PPm <br />' / CO' <br />Grcyz^-e — <br /><A ___- S 6 G <br />San Joaquin County <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 />SB180 Posted Yes No <br />U -U. <br />Name of Facility: <br />Address: <br />Owner/Operator: <br />Program Element: <br />Warewashing <br />Heat: <br />Other: <br />Facility Hot Water Temperature <br />land Sink: op <br />l/arewashing Sink: op <br />|___. <br />Chlorine: <br />Quat. Amm.: <br />C* <br />Clty~ <br />OOr— p rcf'> V <br /><W<1 Gc ler- <br />Phone: IL -^cr/Q <br />Time Out: . / <br />f^yC<S 3 <br />I'd <br />CTVCj- 4^1 <br />W: FVnilll 1-JlWtt. x1 <br />Received By / Title^^y <br />EHW: <br />Time in: <br />EHD 16-24 (2™>pg) 4/3/13 <br />• 'T'kxz ’t^— <br />l^'W. <br />__________Q-Poor P l y <br />Item/Location Temperature 1 <br />Food Program Official Inspection Report <br /> <br />^25f £■_ _________City: z|Pc°de: <br />____________________________________________________Telephone^_________________________ <br />Program Record: ^qT _______________________________Inspection Type: | <br />Permit Posted Yes No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />Gr H-u•2'" (co.'/-o /j|oo <br />- (_OOpf>M. 2_________________________________________ <br />I / L_Ta^4ert\ ^-/ Treto/ <br />UxqE 4vr>t^ " I <br />fet/cx ~~