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< <br />Zip Code:City: <br />Telephone:Owner/Operator: <br />Inspection Type:Program Record:Program Element: <br />Re-Inspection on or After:YesPermit PostedNoYesSB180 Posted <br />OBSERVATIONS AND CORRECTIVE ACTIONS fl <br />/ <br />v <br />_ <br />4-' <br />Item / LocationItem/Location Temperature <br />Food Safety Certification <br />Chlorine:ppmName: <br />Other:Quat. Amm.:°FWarewashing Sink:ppm°FExp. Date: <br />Received By / Title: <br />Phone:EH Specialist: <br />Page ofTime Out:Time in: <br />FOOD PROGRAM OIR CONTINUATION <br />EHD 16-24 (2"dpg) 4/3/13 <br />Warewashing <br />Heat: <br />No <br />Name of Facility: <br />Address: <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 />■ < : :'T <br />°F <br />Facility Hot Water Temperature <br />Hand Sink: °F <br />Food Program Official Inspection Report <br />Date: <br />Temperature <br />T-w-I'/k