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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... _ P Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> QLtkoR�'� <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: FAMILY MART, 5104 E WASHINGTON ST, STOCKTON 95205 <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 dr Cola sliding door cooler--41.00°F Walk in cooler--41.00°F <br /> 1 dr True--41.00°F <br /> NOTES <br /> Ok to issue permit after the fee of$215. PE: 1615 <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 /> Received by: Name and Title: zeeshan ohar, Owner <br /> Y 9 <br /> EH Specialist: LEYNA HUYNH Phone: (209)468-3446 <br /> FA0002798 SR0075424 SC061 09/07/2016 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program Service Request Inspection Report <br />