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SANOAQU I N Environmental Health Department <br /> COUNTY IY <br /> Grtol: SS grow$ here, <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: , 1355 W ATHERTON DR , MANTECA <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Required Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 115°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 110°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 sliding D cooler--Break room--41.00°F Hand sink Rest room 2/play room- 107.00°F <br /> Hand sink--Break room--101.00°F Hand sink Rest room 1 /play room- 103.00°F <br /> 2 CO2 tanks--40.00°L Mop sink--128.00°F <br /> NOTES <br /> Final inspection. <br /> Kitchen installed on site to serve soda, coffee and bake frozen cookies to be served to customers. <br /> Baked goods will be shelf stable, not requiring warmer or cooler to maintain the required temperature for potentially hazardous <br /> food. <br /> Flooring, base coving,walls and ceiling, in play room area rest rooms, back kitchen, customers rest rooms and employees rest <br /> rooms are complying with Cal Codes. <br /> Electric water heater installed of 12KW. <br /> Kitchen is 657 sq ft. <br /> Okay to operate. Obtain permit prior operating business. <br /> PE1613$350 to be paid for the new health permit. <br /> Pink and green forms need to be filled. <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: <br /> EH Specialist: GEHANE FAHMY Phone: (209)616-3052 <br /> SR0081557 SC523 05/27/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />