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a Time Irt A30 am <br /> rime Out: 9:06 am <br /> ANtrf San Joaquin County <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 /> vdisa�' <br /> Mobile Food Facility Service Request Inspection Report <br /> Name of Facility: POBLANA#2 LIC#4RK5919 Date: 04/11/2019 <br /> Address: 1717 S UNION ST , STOCKTON 95206 <br /> Requestor: FATIMA RAMIREZ, POBLANA#2 LIC#4RK5919 Telephone: (209)954-6784 <br /> Program Element: 1603 - FOOD VEHICLE INSPECTION Request#: SR0080455 <br /> Inspection Type: 061 -CONSULTATION <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 /> #64 Lack of Proper Owner Identification <br /> OBSERVATIONS:Add the state on vehicle signage. Correct by 1 week. <br /> CALCODE DESCRIPTION: 1. The business name or the name of the operator, city state and ZIP code, and the name of the permittee if <br /> different from the business name is not clearly visible on the customer side of the mobile food facility.[§114299(a)] 2. Business or <br /> operator name is not at least 3 inches high and address is not one inch high.[§114299(b)] 3. Sign is not in contrasting color with the <br /> vehicle exterior.[§114299(b)] 4. For a motorized vehicle and a mobile support unit, the sign is not present on both sides of vehicle. <br /> [§114299(c)] <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Expiration Date: <br /> Warewash Chlorine IQ: ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 114°F <br /> FOOD ITEM --LOCATION --TEMP°F--COMMENTS <br /> Norcold tek II chest cooler--41.00°F hot hold cabinet— 141.00°F <br /> steam table hot water—147.00°F <br /> NOTES <br /> previously permitted in Santa Clara County <br /> License plate 4RK5919 <br /> VIN...CA1184093 <br /> Operator will sell: steamed hot dogs on cart, prepared and pre-packaged burritos from existing food truck(La Poblana 2440 <br /> Airport), and cut fruit (food prep must occur on truck or at commissary -not on cart) <br /> OK to permit as a 1633 once annual permit fee is paid. <br /> SR0080455 SC031 04/11/2019 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 Mobile Food Facility Service Request Inspection Report <br /> �49 '13S3 <br />