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San Joaquin County <br />Environmental Health Department <br />1868 East HazeIton Avenue, Stockton, CA95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www sigov org/ehd <br />Food Program Official Inspection Report <br />Facility Name and Address: LA BOHEMIA #5H79999, 731 S SACRAMENTO ST, LODI 95240 <br />LIC 5H79999 VIN S3506555 <br />Sanitizer buicket 100 ppm chlorine. <br />Note: Jose stated ice in soda storage along with other food items (bags of vegetable, milk) only use for temperature purpose. <br />Do not serve the ice there as food. <br />OK to issue 2016 permit after fee is paid. PE 1635 <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: Jose Hernandez, owner <br />EH Specialist: JEFFREY WONG Phone: (209) 468-0335 <br />FA0016578 PR0519217 SC001 12/14/2015 <br />EHD 16-23 Rev. 06/30/15 Page 2 of 2 Food Program OIR