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S A I D J O M Q V I N Environmental Health Department <br /> COU N7Y <br /> Mobile Food Facility Official Inspection Report <br /> Facility Name and Address: BLACKWATER ON WHEELS#4GA6786, 912 YOSEMITE AVE, STOCKTON 95204 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Craig Jackson Expiration Date:October 18,2022 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 110°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> right end--steam table-- 138.00°F center--steam table--169.00°F <br /> left end--steam table--140.00°F <br /> NOTES <br /> LIC 4GA6786 <br /> Ok to issue permit for 2019 <br /> The person in charge is responsible for ensuring that the above mentioned facility is in compliance with all applicable sections of the California Health and <br /> Safety Code.If a reinspection is required,fees will be assessed at the current hourly rate. <br /> VvV <br /> Received by: 6z Name and Title: Craig Jackson, employee <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209)953-7817 <br /> FA0015151 PR0522240 SCO01 05/02/2019 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Mobile Food Facility OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />