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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: LA MICHOCANA PLUS, 3081 N TRACY BLVD , 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: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 3 door True prep-right unit--24.00°F Ultra chest freezers x 2--30.00°F--Two Ultra chest freezers- <br /> both are 30F <br /> 3 door True prep-left unit--35.00°F 2 door Norlake freezers x 5--5.00°F--Five 2 door Norlake <br /> freezers temperatures range from 5F to-19F <br /> NOTES <br /> wiping cloth bucket 400 ppm Quat/quat test strips are available <br /> OK to permit as a 1623 once the annual permit fee is paid ($350) <br /> An additional charge of 36 minutes is due($91.20) <br /> Total due$441.20 <br /> No signature obtained/COVID-19 <br /> Report typed at the office 4:13-4:26p <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/Sam and Tito, <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> SR0083143 SC523 04/06/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />