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T r. <br /> SA N,J OAQ U I N Environmental Health Department <br /> ----COUNTY---- <br /> ` G(evrr+ess grows here. <br /> Mobile Food Facility Service Request Inspection Report <br /> Facility Name and Address: TRI-TIPERY FOOD TRUCK, 11359 NEWPORT RD , BALLICO <br /> VIN 1 F65F5KY6J0A04305 <br /> PE 1635 <br /> OK to issue 2018 permit once the following is received. <br /> -Completed pink and green forms with (copies of tax ID and driver's license), and vehicle registration <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 /> 0 TIS`' <br /> Received by: Name and Title: Alfredo Nuno, Cook <br /> EH Specialist: STEPHANIE RAMIREZ Phone: (209) 468-9851 <br /> SR0079065 SC061 05/02/2018 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Mobile Food Facility Service Request Inspection Report <br />