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i �� I I I AI Environmental Health Department <br /> YSA N U N <br /> r�■z�w� COUNTY <br /> Greotr+ess 9row3 here. <br /> Mobile Food Facility Service Request Inspection Report <br /> Facility Name and Address: THE LEMON BOX,478 S PROVIDENCE ST, MOUNTAIN HOUSE <br /> NOTES <br /> New limited food prep trailer <br /> License plate#4RZ9085 <br /> VIN...J002468 <br /> State Insignia...J002468 <br /> 30 gallon fresh water/55 gallon waste water/6 gallon hot water heater/water for lemonade is separate <br /> Chlorine sanitizer and test strips are available <br /> OK to permit as a 1633 once the annual permit fee is paid ($179) <br /> Maintain service receipts from City of Tracy(commissary for waste water) <br /> No signature obtained/COVID-19 <br /> Report typed up at the office 2:49-3:03p <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/Nicole Moore-Raygoza <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> SR0083594 SC061 04/23/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Mobile Food Facility Service Request Inspection Report <br />