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SAN J 0 A Q U I Environmental Health Department <br /> Mobile Food Facility Official Inspection Report <br /> Facility Name and Address: LUPE'S ISLAND FLAVOR#3X28781, 1717 UNION ST, STOCKTON 95206 <br /> #44 Premises: Clean/Litter Free;Vermin-Proof <br /> OBSERVATIONS:2 of 8 ceiling vents screens are torn. Repair/replace screens in 1 week. <br /> CALCODE DESCRIPTION:The premises of each food facility shall be kept clean and free of litter and rubbish all clean and soiled linen <br /> shall be properly stored non-food items shall be stored and displayed separate from food and food-contact surfaces the facility shall be <br /> kept vermin proof. (114067 6), 114123, 114143(a)&(b), 114256, 114256.1, 114256.2, 114256.4, 114257, 114257.1, 114259, 114259.2, <br /> 114259.3, 114279, 114281, 114282) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Yesenia Castillo Expiration Date:October 28,2026 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 118°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 104°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 D cooler--40.00°F steam table--126.00°F <br /> NOTES <br /> Routine inspection. <br /> LUPE'S ISLAND FLAVOR <br /> #37572W2 <br /> VIN#1 GCHP32K1 K3318399 <br /> License plate had been changed. 5021 form to update. <br /> Bleach and chlorine test strips on site. <br /> Fire extinguisher and first aid kit on site. <br /> Okay to issue permit for 2022 once fee is paid. <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: <br /> EH Specialist: GEHANE FAHMY Phone: (209)616-3052 <br /> FA0026527 PR0546839 SCO01 11/10/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Mobile Food Facility OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />