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No <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br /> <br /> <br />\06) - lOgjT- . <br /> <br />'-vA <br />Food Safety Certification <br />,<14’ <br />Chlorine: <br />iQuat. Amm.: <br />Temperature <br />If- <br /> <br />\4CT~. -to V^o^yeiF. <br />Name: <br />Exp. Date: <br />°F <br />°F <br />Ph°"e: AQt^- <br />Time Out: Q , Page] of^_ <br />-- FOOD PROGRAM OIR CONTINUATION <br />Received By / Title: <br />EH Specialist: <br />Time in: > < J <br />Facility Hot Water Temperature <br />Hand Sink: op <br />fwarewashing Sink: °p <br />San Joaquin Co. ty <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 />EHD 16-24 (2nd pg) 4/3/13 <br /> (f) <br />___-O-fc_______________ <br />\s AKr- M-mSV ia)-ic&F. ~ <br />■ cfricvw <br />- ■ <br />Temperature <br />^hrps Qli bgdfhS. cirg. <br />ofrTS Fa rw-F - <br />s I Item / Location <br />- ...If\ <br />Warewashing33^ <br />ppm 0,hcr: <br />-• fcltvw# <br />•---CTgdV- y< <br />> 6cVXclIiyHmt nafr cm <br />s UQn0 T W i<^- <br />\7 Item/Location ___ <br />a i cr^h/T <br />FdC & b'Sp._______ <br />Food Program Official Inspection Report_______ <br />-Annual , pate:14- ~ <br />SF ’ citT-^ <br />Telepheneq^_Z^3 <br />Program Record: p \ Inspection Type. p <br />Permit Posted Yes No Re-Inspection on or After: <br /> <br />vgT <br />-OF ~ <br />-VzAivAwaUV at <br />-OF- <br /> <br />(V &VD ar I W , <br />-01^-_______________ <br />I40F- <br />Name of Facility: <br />Address: ] yV <br />Owner/Operator: (T-j- <br />Program Element: <br />SB180 Posted Yes