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J. <br />■Zip Code:City: <br />Telephone:Owner/Operator: <br />Inspection Type:Program Element:Program Record: <br /> Yes I Re-Inspection on or After:SB180 Posted <br />•Tu. <br />n <br />% <br />77^7 ■t' <br />TemperatureItem / Location <br />Z <br />Food Safety Certification <br />Name:°F <br />Quat. Amm.:Other:'arewashing Sink:Exp. Date:°F°F PPm <br />Received By / Title: <br />EH Specialist: <br />Time in: <br />F-~ <br />............ <br />Chlorine: <br />// <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.orq/ehd <br /><? <br />Zzi< <br />Name of Facility: <br />Address: <br />6 <br />3 <br />_______________ <br /> Yes Permit Posted <br />w <br />EHD 16-24 (2nd pg) 4/3/13 <br />OBSERVATIONS AND CORRECTIVE ACTIONS —z: <br />Facility Hot Water Temperature <br />IHand Sink: op <br />C'iU/iJL <br />? Temperature <br />-VTzL.'^ <br />Warewashing <br />ppm Heat. <br />fc>c> p <br />_ 7^ <br />Z Phone: zc-q> <?-0^34 <br />Time Out: <br />- - .c<^Cy <br />lQ(7Ux~ io^r- ioft’f____(2) dto- <br />X/no ' <br />'Iw <br />7 <br />•• <br />■3 <br />Page ; of J <br />FOOD PROGRAM 0IR CONTINUATION <br />Food Program Official Inspection Report . <br />z-v _ Date: ifhdih <br />tddJfA >^L / Z><9 A <br />Item/Location <br />/l id'} - . <br />^4-