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Timelm 935 am <br /> rme Out: 9:50 am <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.sjgov.ora/ehd <br /> {c1 6H"l <br /> Mobile Food Facility Service Request Inspection Report <br /> Name of Facility: BLACKWATER ON WHEELS#4GA6786 Date: 10/12/2017 <br /> Address: 912 N YOSEMITE AVE, STOCKTON 95204 <br /> Requestor: PATRICK SALISBURY, BLACKWATER ON WHEELS 44GA6786 Telephone: (209)423-4148 <br /> Program Element: 1603 - FOOD VEHICLE INSPECTION Request#: SR0078249 <br /> Inspection Type: 061 -CONSULTATION <br /> VIOLATIONS AND CORRECTIVE ACTIONS <br /> Items listed on this report as violations do not meet the requirements set forth in the California Health and Safety Code commencing with section 7; <br /> 113700.All violations must be corrected within specified timeframe. Violations that are classified as"MAJOR"pose an immediate threat to public health <br /> and have the potential to cause foodborne illness.All major violations must be corrected immediately. Non-compliance may warfant immediate closure of <br /> the food facility. <br /> #64 Lack of Proper Owner Identification <br /> OBSERVATIONS: Provide the following signs on one side of the cart: <br /> Business name: 3" <br /> Owner's name: 1" <br /> City, state, and zipcode: 1" <br /> CALCODE DESCRIPTION: 1. The business name or the name of the operator, city state and ZIP code, and the name of the permittee if <br /> different from the business name is not clearly visible on the customer side of the mobile food facility.[§114299(a)] 2. Business or <br /> operator name is not at least 3 inches high and address is not one inch high.(§114299(b)) 3. Sign is not in contrasting color with the <br /> vehicle exterior.[§114299(b)] 4. For a motorized vehicle and a mobile support unit, the sign is not present on both sides of vehicle. <br /> (§114299(c)] <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: -F Water/Hot Water Ware Sink Temp: -F <br /> Quaternary Ammonia(CA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION --TEMP°F--COMMENTS <br /> Steam table-- 170.00°F 1 dr Koolatron--41.00°F <br /> NOTES <br /> This is a consultation to reactivate hot dog cart with the same owner. <br /> -License#4GA6786,VIN CA965261 <br /> -Owner states freshwater and wastewater tanks are about 4-5 gallons each <br /> -The commissary will be the owner's restaurant, Blackwater Deli on 912 N Yosemite <br /> -Owner wants to make soup and sandwiches at the restaurant and sell on from the cart. Maintain proper holding temps on the <br /> cart. Only the assembling of hot dogs is allowed on the cart. All other foods must be prepackaged. <br /> -Owner will not operate the cart during the same time as the restaurant. Owner can use the food manager's certificate from <br /> the restaurant for the cart <br /> Cannot issue permit for 2017 until the signs are completed <br /> FA0015151 SR0078249 SCO61 10/1212017 <br /> EH 16-23 Rev.06/30/15 Page 1 of 2 Mobile Food Facility Service Request Inspection Report <br />