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Pa�'y 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 /> ��/FORa <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: THREE PALMS GROCERY, 6732 E WATERLOO RD , STOCKTON 95215 <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 115°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 dr Hussmann--41.00°F Beer walk in cooler--41.00°F <br /> Mop sink--120.00°F <br /> NOTES <br /> This is a new ownership consultation. <br /> Ok to issue permit after the fee of$220 is paid. PEA 616 <br /> Report emailed to I.nunez99@yahoo.com <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 /> V ' <br /> Received by: Name and Title: luis Nunez, Owner <br /> EH Specialist: LEYNA HUYNH Phone: (209)468-3446 <br /> FA0004030 SR0076973 SC061 03/31/2017 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program Service Request Inspection Report <br />