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r I Environmental Health Department <br /> SANJOAQU <br /> C UNT <br /> Greotrre55 grows here Time In: 11.48 am <br /> Time Out: 12:18 pm <br /> Mobile Food Facility Official Inspection Report <br /> Name of Facility: ISLAND SHAVED ICE#4LK1202 Date: 10/26/2023 <br /> Address: 730 S CALIFORNIA ST, STOCKTON 95203 <br /> Owner/Operator: PANYASEE, PETER Telephone: (209)981-0091 <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: Peter Panyasee Expiration Date:October 09,2025 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 121 °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> Routine inspection. No violations observed. No re-inspection. <br /> Okay to issue 2024 permit once permit fee is paid. <br /> Discussed inspection report with Stacy Panyasee(Operator). Official inspection report was emailed to operator. <br /> Maintain copy of inspection report on site. <br /> To minimize person-to-person contact,the signature of the person receiving the inspection report was not captured. <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 /> FA0022594 PR0539505 SCO01 10/26/2023 <br /> EHD 16-23 Rev.09/16/2020 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.sjgov.org/EHD <br />