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i �� I I I AI Environmental Health Department <br /> YSA N U N <br /> f�■z�w� COUNTY <br /> Greorness grows here. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: CENTRAL GAS TRACY, 950 W ELEVENTH ST,TRACY 95376 <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: n/a Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 65°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> restroom hand sink--65.00°F 7 door walk-in cooler--47.00°F--no potentially hazardous food <br /> mop sink--65.00°F 3 door Pepsi True--41.00°F <br /> NOTES <br /> Change of ownership consultation inspection <br /> Pre-packaged food/no food prep <br /> Re-inspection required prior to issuance of permit <br /> Item#21 shall be in compliance prior to issuance of permit. <br /> Contact inspector for re-inspection (209)616-3025 <br /> No signature obtained/COVID-19 <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/Moe Msalam, cashier <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0006388 SR0082896 SC061 11/25/2020 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />