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SAN JOAQUIN Environmental Health Department <br /> col.ir� 1 Y <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: BENS MARKET,845 S LINCOLN ST , STOCKTON 95206 <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp °F <br /> FOOD ITEM--LOCATION --TEMP°F --COMMENTS <br /> 6 door reach in-- retail--41.00°F walk in --back--38.000 F <br /> NOTES <br /> Ok to issue permit once fee is paid <br /> Return to office by 11/23/21 to pay fee and turn in paper work <br /> PE 1617 Fee $301 <br /> Current equipment: 3 comp sink &40 gallon/34,000 BTU Galaxie water heater. One rest room <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: Rashed Kassim, owner <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209) 616-3051 <br /> FA0002833 SR0084475 SC061 11/2212021 <br /> EHD 16-23 Rev.09/16/2020 Page 3 of 3 Food Program service Request Inspection Report <br />