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Time In: 8:48 am <br />Time Out: 858 am <br />aPAVl1r1• P San Joaquin County <br />a �a.00 <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax. (209) 464-0138 Web: www.sigov.org/ehd <br />'d�rASkN <br />Mobile Food Facility Official Inspection Report <br />Name of Facility: POPCORN ETC <br />Date: 12/23/2016 <br />Address: 100 S CHEROKEE LN, LODI 95240 <br />Owner/Operator: SEALEY, CORRINE & ROBBIN <br />Telephone: (209) 625-5088 <br />Program Element: 1633 - FOOD VEHICLE/CART (LTD FOOD PREP) <br />Inspection Type: ROUTINE INSPECTION - Operating Permit <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. Noncompliance may warrant immediate closum of <br />the food facility. <br />OVERALL INSPECTION NOTES AND COMMENTS <br />OBSERVATIONS <br />Name on Food Safety Certificate: <br />Warewash Chlorine (Cl): 100 ppm <br />Quaternary Ammonia (QA): ppm <br />FOOD ITEM -- LOCATION -- TEMP°F -- COMMENTS <br />No Temperature Data Collected <br />NOTES <br />LIC 4LS9245 <br />OK to issue permit. PE 1633 <br />Expiration Date: <br />Heat: ° F Water/Hot Water Ware Sink Temp: ° F <br />Hand Sink Temp: 124 ° F <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: corrin Sealy, owner <br />EH Specialist: JEFFREY WONG Phone: (209) 468-0335 <br />FA0006976 PRO536657 SC001 12/2312016 <br />EHD 16-23 Rev. 06/30/15 Page 1 of 1 Mobile Food Facility DIR <br />