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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �. Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sioov.org/ehd <br /> Mobile Food Facility Service Request Inspection Report <br /> Facility Name and Address: LA PALMITA#5X52753, 2440 S AIRPORT WAY, STOCKTON <br /> #64 Lack of Proper Owner Identification <br /> OBSERVATIONS:Previous owner information is still on vehicle. Remove from truck and provide current information before <br /> operating. <br /> CALCODE DESCRIPTION: 1. The business name or the name of the operator,city state and ZIP code, and the name of the permittee if <br /> different from the business name is not clearly visible on the customer side of the mobile food facility.[§114299(a)] 2. Business or <br /> operator name is not at least 3 inches high and address is not one inch high.[§114299(b)] 3. Sign is not in contrasting color with the <br /> vehicle exterior.[§114299(b)] 4. For a motorized vehicle and a mobile support unit, the sign is not present on both sides of vehicle. <br /> [§114299(c)] <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: needed Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 1181 F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 108°F <br /> FOOD ITEM—LOCATION--TEMP°F—COMMENTS <br /> cooler—40.00°F steam table—135.00°F <br /> hot case—165.00°F <br /> NOTES <br /> Change of ownership to food vehicle. New vehicle to San Joaquin County previously permitted in Los Angeles County and <br /> Santa Fe Springs. <br /> License: 5X52753; VIN: 1GBJP32R7W3315158 <br /> Bleach and test strips available. <br /> The Verification of Vehicle Commissary form has not been completed yet. Provide completed form with appropriate signature <br /> from commissary before permit is issued. <br /> Owner to complete PINK and GREEN forms. <br /> Ok to permit as 1635($237)once all fees have been paid and the above forms(commissary verification, pink, and green) <br /> completed. <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: Melissa Vences, operator <br /> EH Specialist: SCOTT SANGALANG Phone: (209)468-3452 <br /> SR0080420 SCO61 04/05/2019 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Mobile Food Facility Service Request Inspection Report <br />