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SA :J O Q V I + �Ips' Environmental Health Department <br /> COUNT <br /> Food Program Official Inspection Report <br /> Facility Name and Address: LIVING SPACES FURNITURE, 1355 W ATHERTON DR, MANTECA 95337 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Required Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 104°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 93°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Hand sink--Women rest room--104.00°F 2 sliding D cooler--Break room--44.00°F <br /> Hand sink--Men rest room--100.00°F 2 CO2 tanks- 40.000 L <br /> Hand sink 1 --Play area--101.00°F Hand sink 2--Play area--102.00°F <br /> NOTES <br /> Facility didn't start yet serving coffee, soda and baked goods to customers due to 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: <br /> EH Specialist: GEHANE FAHMY Phone: (209)616-3052 <br /> FA0026609 PR0546965 SCO01 08/13/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Food Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />