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Mobile Food Facility Service Request Inspection Report <br />Facility Name and Address: IGNIS PROVISIONS, 1031 S HAM LN , LODI <br />Environmental Health Department <br />No Temperature Data Collected <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />Final <br />Lic # 4VD5058 <br />No registration, Provide the registration to obtain the permit. <br />Hashizaki cooler 33 <br />Hashizaki freezer 0 <br />hashizaki prep cooler 40 <br />Ok to issue permit. Obtain permit prior to operating the business. <br />Apply for the permit with commissary agreement, vehicle registration, id , ss# or tax id and masterfile record id forms. <br />PE 1635 <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:Phone:(209) 616-3020 <br />, <br />VIDAL PEDRAZA <br />Page 2 of 2EHD 16-23 Rev. 07/05/2022 Mobile Food Facility Service Request Inspection Report <br /> SR0085857 SC523 03/29/2023