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San Joaquin County <br />Environmental Health Department <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.smov.orq/ehd <br /> <br />Mobile Food Facility Service Request Inspection Report <br />Facility Name and Address: YARIZ, 5316 MOONSTONE CT, SALIDA <br />OBSERVATIONS <br />Name on Food Safety Certificate: <br /> <br />Expiration Date: <br /> <br />Warewash Chlorine (Cl): ppm Heat: ° F Water/Hot Water Ware Sink Temp: 120 ° F <br />Quaternary Ammonia (QA): <br />PPm <br /> Hand Sink Temp: 108 ° F <br />FOOD ITEM — LOCATION --TEMP ° F — COMMENTS <br />Atosa prep table — 38.00° F <br />NOTES <br />New produce trailer. <br />License plate: 4RV6223; CA assigned ID #CA1178264; Control #1257264 <br />Owner will bring in copy of registration for the trailer when they return to the office. <br />Permit pending commissary letter approval. <br />Owner to complete PINK and GREEN forms when returning to pay for permit. <br />Owner paid for Food Plan Check; however, it is not required. The $456 will be used to pay for the New Vehicle consultation <br />and annual permit fee. <br />PE 1633 ($179) <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: Alfonso Ortiz, owner <br />EH Specialist: SCOTT SANGALANG Phone: (209) 468-3452 <br />5R0079555 SC061 11/05/2018 <br />Page 2 of 2 Mobile Food Facility Service Request Inspection Report EHD 16-23 Rev. 06/30/15