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<- K-roAu/ <br />) <br />-fixAff <br />/Lo<■ i <br />Food Safety Certification ^_A_ <br />Phone: <br />jSS’W' <br />> L-'fj-___UAJ I <br />San Joaquin Coun’ <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 />Received By I Title: <br />EH Specialist: <br />Time in: <br />Chlorine: <br />Quat. Amm.: <br />Warewashing <br />Heat“ <br />Other: <br />ppm <br />PPm <br />PageJ of (_| <br />FOOD PROGRAM 0IR CONTINUATION <br />Facility Hot Water Temperature <br />tancj gjn^, <br />Warewashing Sink: op <br />pg D5OC <br /> Yes Cl <br />I6?6 Program Record: <br /> Yes Hermit Posted <br />^o/~ <br />Name: <br />Exp. Date: <br />___ <br />OF <br />°F <br />(cm rC)-e^^ <br />jg : a^i___________ <br />EHD 16-24 (2nd pg) 4/3/13 <br />\-o <br />f .'Z <br />7 <br />Name of Facility: Q i M c q, peMA^ ^AKaILY <br />a<1J,”s: T-Z' cevrFA, -yr <br />Owner/Operator: <br />Program Element: <br />SB180 Posted <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br /><PP^\ <br />oCi - \ <br />kujs I \ Xs -------- <br />-------4 <L 0^555*--------------ojl----CcJ <br /><Zj<________ <br />V----—\A\ ; <br />- . J- <br />Food Program Official Inspection Report_______ <br />F| OTA________________________ Date: Z-D^^ <br />City; . i^-^a / Z|pCode: 952. o z. <br />Telephone: <br />'n*P«l.« T,p.: eveTF <br />Re-Inspection on or After: <br />-^09 -^S 4 I - 3 9 Z <br />TimeOut: ID > <br />A'T.^ -% <br />y- ScnxCx <br />Itom/Locstion « Tomporstu <br />__________:_______ <br />C l-h A C-t- <br />(W yusQ—godV^ - <br />1 5 -j—~ CO j^vy >p Ct , <br />, t> w <br />V0__