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OBSERVATIONS AND CORRECTIVE ACTIONS <br />XCf’ <br />gFTkWW53T: <br />Us 0 ftd 'i'V 13£1 <br />Item / LocationItem/Location Temperature Ii <br />Food Safety Certification <br />EHD 16-24 (2nd pg) 4/3/13 <br />EH Specialist: <br />Time in: L f <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 />C. I <br />Name: <br />Exp. Date: <br />Chlorine: <br />Quat. Amm.: <br />Heat: <br />Other: <br />°F <br />°F <br />-------- /6, r <br />Owner/Operator: <br />Program Element: <br />SB180 Posted <br />Warewashing <br />PPm <br />ppm <br />_______________________ <br />Program Record: <br /> Yes Rermit Posted Yes I <br />OjA <br />yVO <br />Facility Hot Water Temperature <br />Hand Sink: op <br />Warewashing Sink: op <br />Temperature <br />--.J ■; M <br />! f <br />Received By / Title: <br />Eh: i <br />_____' • 10^ f________ <br />/pr~VU7Liii i <br />c( <br />S3 Ihh ' A iv4 <br />( ZL/xAzyA;__ <br />~ _____________ ________ <br />04 /13 ‘ f <br />- 3 Ph <br />.'XjU hfi,------------------------- <br />___________ <br />_____ <br />vvAAv/y^A <br />Czuzm__< <br />C-lALLU <br />- i (nA)i^ c j <br />" p Xa/Z-.W^F <br />OVjwr- hu.p t <br />HL "-Hs ‘ ___________—prone:1 <br />TimeOut: p; PageNet ^3 <br />FOOD PROGRAM 0IR CONTINUATION <br />_______ Food Program Official Inspection Report_____ <br />Name of Facility: 1 Date: V //< //^ <br />Address: 77L tZ O' / ' U City: Zip Code: ' ' <br />Telephone: <br />Inspection Type: <br />Re-Inspection on or After: <br />KJffce+i