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rt Time In: g-so am <br /> Time Out: 1030 am <br /> aPallln,v San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> .. t Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sioov.ora/ehd <br /> * 1 15'Aa <br /> Mobile Food Facility Service Request Inspection Report <br /> Name of Facility: HAWAIIAN ICE FLAVOR#3/CALIFORNIA CHURROS#3 Date: 04/03/2019 <br /> Address: 145 S KILROY RD,TURLOCK 95380 <br /> Requestor: VIRGINIA BARRERA,HAWAIIAN ICE FLAVOR#3/CALIFORNIA CHURRO Telephone: (209)605-0840 <br /> Program Element: 1603-FOOD VEHICLE INSPECTION Request#: SR0080410 <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 Cade commenting with section 7; <br /> 113700.All violations must be corrected within specified timeframe. Violations that are classifiedas MAJOR"pose an Immediate threat to public health <br /> and have the potential to cause foodbome illness.All major violations must be corrected immediateN.Non-compliance may warrant immediate closure of <br /> the food facility. <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: NIA Expiration Date: <br /> Warewash Chlorine(G): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Ouatemary Ammonia(OA): ppm Hand Sink Temp: 101°F <br /> FOOD ITEM•-LOCATION—TEMP°F—COMMENTS <br /> Hand washing sink(shaved ice)—101.00°F Hand washing sink(chumos)—100.00°F <br /> NOTES <br /> New mobile food vehicle consultation. <br /> Food handler cards on site. <br /> California Churros#3 <br /> Observed no violations. <br /> OK to issue permit for 2019 once fees have been paid. <br /> Program element 1633. <br /> Hawaiian Ice Flavor#3 <br /> Observed no violations. <br /> OK to issue permit for 2019 once fees have been paid. <br /> Program element 1633. <br /> Official inspection report given to owner. <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 <br /> ..is required,fees will be assessed at the current hourly rate. <br /> ��I'Y <br /> 'V -t'Jn' <br /> Received by: Name and Title: virgina barrera,owner <br /> EH Specialist: VICTOR ACEVEDO Phone: (209)468-0337 <br /> SR0080410 SCO61 04032019 <br /> EHD 1623 Rev.06/30115 Page 1 of 1 Mobile Food Facility service Request Inspection Report <br />