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City: sStcCfcVoi1 <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />Temperatureftem/Location Item / LocationTemperature <br />Food Safety Certification <br />Name:PPm <br />Other:Warewashing Sink:Quat. Amm.:Exp. Date:°F °FPPm <br />bz Phone: <br />°F <br />Warewashing <br />li-leat: <br />—----- <br />Chlorine: <br />- MO <br />- 2 clr <br />■ ( c/Tr-^okjd, <br />' Facility Hot Water Temperature <br />Hand Sink: op <br />Page <br />FOOD PROGRAM OIR CONTINUATION <br />San Joaquin Col . y <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 />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes <br />Received By / Title: <br />EH Specialist: <br />Time in: Q <br />EHD 16-24 (2nd pg) 4/3/13 <br />- cvpcri gnr) gr^ <br />Xn 5v>c tens <br />XoCO UctS obF qbcurcl - J <br />AS i <br />(]) Cub ~ <br />' wd ■ fopolb AS cybW<^ -Wyrb \ns\clC Wfln <br />cub VoLJth vnO \?z \\x^(2c\ Ayto Ahl cc^u^ViaT <br />_________ <br />- Ttw .9- dr (ccte <br />‘‘ r ' a C ‘ * * * An I- Vy. ,.______ ___.__r <br />cwii^c. rc&cwM-i6(| <br />_____________Food Program Official Inspection Report_______ <br />Name of Facility: UQUS rVlOvd) ___________________________Date: T~ <br />Zkddress: £, St City: .Sf Zip Code: ^^20^ <br />. Unvb Church ri v Telephone: <br />Program Record: Inspection Type:-^^^ <br />No Permit Posted Yes No Re-Inspection on or After: <br />at <br />age ■ CA/b ttejif <br />r€>? v gyen qnr) "Vh^c^ ar^ nvm<24iMS> <br />vne tens av€ cacxcci <br />SfeHd ~ j i~ wd-S \ust y <br />'mtz> antftwr fem <br />aJd'^c A | F bjefScC \a, <br />cb