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OBSERVATIONS AND CORRECTIVE ACTIONS <br />c>ve.n <br />a<-e oy&tx <br />Temperature TemperatureItem / LocationItem/Location <br />Food Safety Certification <br />FOOD PROGRAM OIR CONTINUATION <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 />Name: <br />Exp. Date: <br />Chlorine: <br />Quat. Amm.: <br />PPm <br />ppm <br />°F <br />°F <br />Name of Facility: <br />Address: <br />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes I <br />Warewashing <br />Heat: <br />Other: <br />- PLCTS <br />Facility Hot Water Temperature i <br />Hand Sink: op <br />Warewashing Sink: op <br />Ph°ne: 3 0 <br />TimeOut: | 4^?Page] of <br />-fopy rthe i <br />Ugodioq rt£ ihg <br />Food Program Official Inspection Report_______ <br />' Date: ' <br />City: Zip Code: ~ <br />Telephone: <br />Inspection Type: H p, -f- <br />Re-lnspection on or After: <br />orrt wityjouS J r <br />OF <br />xl 6 q VdC\q <br />C - Tn cpg^t <br />IM <br />Program Record: <br /> Yes Rermit Posted <br />(P fegrcwc, <br />pPCViC^ C\ <br />- Tbg docKS <br />pfeAichz______ <br />-it£ -CCapfS 0^ <br />- oK <br />Received By / Title: p <br />EH Specialist: <br />Time in: q , pi-,) <br />EHD 16-24 (2'«pg) 4/3/13 <br />vw-Vec-Kon C FW^f cu^rtni^r ertc-~V <br />_____ CrtM€d jn wcM^r Sffic <br />wcH^r - <br />(3j 510 C gjt i n C '• <br />_____________Art Ph Q 4C <br />IkQ -fet t&dLxy . coTi'^crted or\Si~|€