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SIU I Environmental Health Department <br /> - i CUNTY I <br /> Greotne55 grows here Time In: 845 am <br /> Time Out: 9:05 am <br /> Mobile Food Facility Official Inspection Report <br /> Name of Facility: MOMOS FRIGID FROG#4ND2508 Date: 07/14/2021 <br /> Address: 154 W ST CHARLES PL, SAN ANDREAS 95249 <br /> Owner/Operator: MORALES,AARON Telephone: (209)570-0678 <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.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: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 123°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> Lic#4ND2508 <br /> No violations <br /> Ok to issue permit for 2021. <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: <br /> EH Specialist: VIDAL PEDRAZA Phone: <br /> FA0022412 PR0539119 SCO01 07/14/2021 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Mobile Food Facility OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />