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SAN J O A Y U I N Environmental Health Department <br /> i CiU '� <br /> Mobile Food Facility Official Inspection Report <br /> Facility Name and Address: LA POBLANA#68332U1,2440 S AIRPORT WAY, STOCKTON 95206 <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: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM—LOCATION--TEMP°F—COMMENTS <br /> Fried bean—Steam table—140.00°F 2 D cooler—43.00°F <br /> Steam table—144.00°F Chicken—Steam table--197.00°F <br /> NOTES <br /> La Poblana <br /> LI C#68332U1 <br /> VIN#.....4447 <br /> Chlorine test strips,fire extinguisher and 1st aid kit are available. <br /> Okay to issue the permit for 2020 once fee is paid. <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: Fatima Ramirez, Owner <br /> EH Specialist: GEHANE FAHMY Phone: (209)953-7698 <br /> FA0012589 PR0516382 SCO01 11/18/2019 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Mobile Food Facility OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />