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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: SUPER FISH POKE AND TEA BAR, 5052 N WEST LN , STOCKTON <br /> Mop sink 115.00°F 2 dr Turbo Air prep cooler--41.00°F <br /> Mop sink 120.00°F 2 dr True--41.00°F <br /> NOTES <br /> This is a final inspection <br /> -Water heater: Rheem electric water heater, 50 gallons, serial M381704986, model XE50M06ST45U1 <br /> -Plumbing inspection by the city was done on 09/18/217 <br /> Ok to issue permit after the fee of$350 is paid. PE: 1624 <br /> Also pay$76 for an extra 30 min on the service request <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: David MA, Owner <br /> EH Specialist: LEYNA HUYNH Phone: (209)468-3446 <br /> SR0077504 SC523 11/01/2017 <br /> EHD 16-23 Rev.06/30/15 Page 3 of 3 Food Program Service Request Inspection Report <br />