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11�11h71 i ,e,d O A Q U I iI14,i1, Environmental Health Department <br /> — U `,JT",' <br /> Mobile Food Facility Official Inspection Report <br /> Facility Name and Address: KONA ICE OF NW STOCKTON#U689976, 1717 S UNION ST, STOCKTON 95206 <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: 102°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 102°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 6 door freezer---15.00°F <br /> NOTES <br /> License plate number has changed: now#08865M3(temporary plate#was U689976) <br /> VIN 1GD07RFP5N1142426(same)-matches HCD insignia (142426) <br /> OK to permit for 2023 once: a new commissary letter is provided,the corrected registration is provided and the annual permit <br /> fee is paid ($179/1633)-may pay after 11-1-2022 <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: discussed w/Patrick Tan, owner's bro <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0027349 PR0547970 SCO01 10/20/2022 <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 />