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SAN =J OAQ U I N Environmental Health Department <br /> COUNTY- <br /> �c,F❑�t' Greotness grows hers. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: FIRE WINGS, 6625 Pacific AVE , STOCKTON 95207 <br /> the SJC Environmental Health Program for Hazardous Material Business Plan (HMBP)and will be required to report your <br /> hazardous materials in the California Environmental Reporting System (CERS). For more information or to comply with the <br /> reporting requirement in CERS, please go to: http://cers.calepa.ca.gov/ <br /> OK to issue permit once fee is paid <br /> Fill out form 5021 and return to inspector with proof of payment by 1 week <br /> Program 1625 Fee$376 <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: Christopher Sy, manager <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209)616-3051 <br /> FA0023834 SR0083533 SC523 04/12/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 3 of 3 Food Program Service Request Inspection Report <br />