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... . San Joaquin County <br /> )O. .QOG <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • cq.. �a• Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> �/PORN <br /> Food Program Official Inspection Report <br /> Facility Name and Address: CHURCHS CHICKEN#5773, 8023 WEST LN, STOCKTON 95210 <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: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> biscuit refrigerator--41.00°F Women's restroom--hand sink--76.00°F <br /> NOTES <br /> sanitizer in 3 comp 300ppm (quat) <br /> sanitizer bucket 300ppm (quat) <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: tina navarrettee, <br /> EH Specialist: STEPHANIE RAMIREZ Phone: (209)468-9851 <br /> FA0002725 PRO160792 SC333 07/24/2017 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program OIR <br />