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�� ) i N Environmental Health Department <br /> _ C_E�U N � `Y Time In: 9:10 am <br /> �+ Time Out: 9:35 am <br /> Gareotnes5 grows here. <br /> Food Program Service Request Inspection Report <br /> Name of Facility: KUNG FU TEA Date: 03/04/2020 <br /> Address: 4663 PACIFIC AVE, STOCKTON 95250 <br /> Requestor. TYSON TRAN, TVT CONSTRUCTION Telephone: <br /> Program Element: 1601 - FOOD PLAN CHECK Request#: SR0081249 <br /> Inspection Type: 523 - Plan Check/Report Reviewldh d (OGc7�utr aS3 31 2- <br /> VIOLATIONS <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 warrant immediate closure of <br /> the food facility. <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Tracy Yang Expiration Date: February 25,2025 <br /> Warewash Chlorine(CO: ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM --LOCATION --TEMP° F --COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> All conditions written 03/02/2020 <br /> Ok to issue permit once fee is paid. Return to office today. Program 1624 Fee $355 <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: Thuan Do, owner <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209) 953-7817 <br /> SR0081249 SC523 03/04/2020 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program Service Request Inspection Report <br />