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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: LOVE NUTRITION, 2728 PAVILION PKWY ,TRACY <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: needed Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 door freezer--36.00°F mop sink--120.00°F <br /> 2 door True--37.00°F restroom hand sink--100.00°F <br /> hand sink--100.00°F 3-comp sink--120.00°F <br /> NOTES <br /> Food plan check final inspection <br /> OK to permit as a 1623 once the annual permit fee is paid <br /> The annual permit fee shall be paid prior to opening for business. <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/owner Tinika Bowers, <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> SR0080144 SC523 12/08/2020 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />