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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... _ P Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> QLtkoR�'� <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: CHARLEYS WING CHUN, 2034 PACIFIC AVE , STOCKTON <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: 125°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> Information required on the cart: <br /> Name of the business in 3 inch letters <br /> Name of the owner in 1 inch letters <br /> City State and zip code in 1 inch letters <br /> Ok to issue permit. Obtain permit prior to operating the business. <br /> PE 1681 <br /> This permit will be for the commissary and the cart at this location only. <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: Charles Hart, owner <br /> EH Specialist: VIDAL PEDRAZA Phone: (209)468-0334 <br /> SR0078985 SC061 04/18/2018 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program Service Request Inspection Report <br />