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SAN =J OAQ U I N Environmental Health Department <br /> COUNTY- <br /> �c,F❑�t' Greotness grows hers. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: HEIRLOOM KITCHEN, 61 LINCOLN CENTER , STOCKTON 95207 <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Matthew Ortiz-Expired certificate Expiration Date:September 12,2021 <br /> Warewash Chlorine(Cl): 100 ppm Heat: °F Water/Hot Water Ware Sink Temp: 137°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 137°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 door true--outside area--41.00°F keg cooler--kitchen--44.00°F <br /> 2 door valporo outside area--40.00°F 2 door prep--kitchen--41.00°F <br /> 2 door kintera- outside area--41.00°F <br /> NOTES <br /> Ok to issue permit once fee is paid <br /> Program 1625 Fee$237 <br /> Return to office before opening to pay fee and fill out paper work <br /> Equipment AO Smith water heater 40,000 BTU, dishwasher, 3 comp, prep sink, hand sink, mop sink, 2 rest rooms(use a <br /> separate water heater-in attic) <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: Matthew and Torie Ortiz, owners <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209)616-3051 <br /> FA0002440 SR0084128 SC061 10/18/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 3 of 3 Food Program Service Request Inspection Report <br />