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Owner/Operator: <br />Program Element: <br />SB180 Posted <br />'TemperatureItem l LocationItem/Location <br />Food Safety Certification <br />hlorine:Name:°FPPm <br />Other:Warewashing Sink:Exp. Date:°FPPm <br />EH Specialist: <br />Time in: <br />EHD 16-24 (2ndpg) 4/3/13 <br />Warewashing <br />[Heat: <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 of Facility: <br />Address: <br />Inspection Type: <2^€r) E <br />Re-Inspection on or After: <br />Page/4?f L <br />FOOD PROGRAM OIR CONTINUATION <br />NOCP fi <br />\^c\^ <br />phone^ <br />Time Out: <br />(ip c&Wm fry <br />- £tr0. <br />observations and corrective actions <br />Received By / Title: . T~ y- •_ <br />dzprx^feui n <br />g» f)~( rpur t <br />i nC3 <br />Program Record: <br /> Yes Rermit Posted Yes I <br />Facility Hot Water Temperature <br />Hand Sink: op <br />op liQuat. A mm.: <br />Food Program Official Inspection Report <br />Date:Vi5/TC" <br />Clty: Zip Code: <br />Telephone: