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Environmental Health Department <br /> SAN-6-JOAQUIN <br /> .�M C0UT <br /> ik,�F05 `.r Greotness grows here. <br /> Mobile Food Facility Service Request Inspection Report <br /> Facility Name and Address: KONA- ICE, 3412 E MINER AVE , STOCKTON <br /> OKAY to issue permit once permit fee is paid. <br /> LIC Plate#: U689976 <br /> Program Element: 1633 <br /> Maintain a copy of the most current inspection report on-site. <br /> To minimize person-to-person contact,the signature of the person receiving the inspection report was not captured. <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: CLAUDIA MURO Phone: (209)561-8923 <br /> SR0085733 SC061 09/01/2022 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Mobile Food Facility Service Request Inspection Report <br />