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Environmental Health Department <br /> SAN-6-JOAQUIN <br /> �M COUNTY <br /> r'�JFOSx'tYY r Greotness grows here. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: KUNG FU TEA, 1448 HULSEY WAY, MANTECA 95336 <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Needed Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Mop sink--120.00°F 3 comp sink--124.00°F <br /> Front hand sink--101.00°F Hand sink--Rest room--101.00°F <br /> Back hand sink--115.00°F <br /> NOTES <br /> Change of ownership. <br /> Type of business: Boba Tea <br /> Okay to operate. <br /> Obtain permit prior operating your business. <br /> PE 1624$355 to be3 paid for the new permit under the new ownership. <br /> 5021 form to be updated and sent to gfahmy@sjgov.org <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: Thuan, Owner <br /> EH Specialist: GEHANE FAHMY Phone: (209)953-7698 <br /> FA0019618 SR0082473 SC061 08/24/2020 <br /> EHD 16-23 Rev.8/18/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />