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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: LA MICHOACANA PRIME STOCKTON, 2535 PACIFIC AVE , STOCKTON 95204 <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Rafael Heredia Expiration Date:April 03,2028 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 122°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 113°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Hand sink--Back kitchen--104.00°F Two door Kintera prep cooler--41.00°F <br /> Mop sink--122.00°F Two door Atosa display cooler--40.00°F <br /> Three door True prep cooler--39.00°F Omcan open display cooler--41.00°F <br /> Prep sink--120.00°F Hand sink--Restroom--102.00°F <br /> NOTES <br /> Consultation inspection for ownership change. No major violations.Time given for correction of minor violations. No <br /> re-inspection. <br /> Ok to issue permit once permit fee($350)is paid and updated 5021 is received. <br /> PE 1623 <br /> Emailed inspection report to operator. <br /> NOTE: Approval must be gained through California Department of Food and Agriculture Milk and Dairy Safety Branch for the <br /> use of a popsicle machine. You can contact them at: 2403 West Washington Street, Room 10, Stockton, CA 95203 (209) <br /> 466-7186. <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: LYDIA BAKER Phone: (209)616-3046 <br /> FA0007776 SR0087055 SC061 08/22/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 2 Food Program Service Request Inspection Report <br />