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I <br />n. <br />fyx <br />, Temperature <br />Food Safety Certification <br />Heat:Chlorine:Name: <br />Other:Quat. Amm.:Warewashing Sink:Exp. Date:°F°F ppm <br />Phone: <br />EHD 16-24 (2nd pg) 4/3/13 <br />no? <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 />°F <br />(V) j'Xfi'V'X <br />Name of Facility: <br />Address: <br />Received By / Title: <br />EH Specialist: <br />Time in: <br />Warewashing <br />ppm <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />‘ U E:.(, FL/____________________________ <br />Facility Hot Water Temperature <br />Hand Sink: op <br />______ <br />Item / Location <br />f—tl <br />Time Out: ' Pa9^of ' <br />FOOD PROGRAM 0IR CONTINUATION <br />1 la y. <br />Owner/Operator: 1 <br />Program Element: <br />SB180 Posted <br />v</ /ItAi) - I F <br />L J X JI o TT <br />— ItMpfYW. <br />L I 1 <br />/( <br />O <br />Food Program Official Inspection Report <br />iTcS raephone: <br />Program Record: Inspection Type: <br />fl Yes Rerm it Posted Yes □! Re-Inspection on or After: <br />T TemperatureJ <br />/h-^p4' zw <br />QI <br /><C iZ\ J <br />! <br />XI I /z ■- I M ______________________________________ <br />CiHA Jc^yF Aa <br />(?) (OK rvt/vu c^r I ^fF <br />i aMAu - <br />...^4/7 3-yw t. ^c <br />ctv/- A/lu<,A <br />r <br />/^4-VV^|?c.x - ___ <br />~~ [us <br />* I Item/Location