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SAN JOAQUIN Environmental Health Department <br />_•sf.. COUNTY <br />t Grenrness grow,- here <br />Food Program Service Request Inspection Report <br />Facility Name and Address: CUPPAJO COFFEE, 2626 PACIFIC AVE, STOCKTON 95204 <br />Name on Food Safety Certificate: <br />Warewash Chlorine (CI): 100 ppm Heat: <br />Quaternary Ammonia (QA): ppm <br />FOOD ITEM -- LOCATION --TEMP ° F -- COMMENTS <br />admiral cooler -- sink area — 37.00° F <br />Expiration Date: <br />° F Water/Hot Water Ware Sink Temp 120 ° F <br />Hand Sink Temp 120 ° F <br />NOTES <br />Ok to issue permit once fee is paid. Return to office today. <br />Program 1681 Fee$237 <br />sanyo -- cart area -- 41.00° F <br />Equipment: 40 gallon Bradford White 40,000 BTU unit, mini 3 camp sink and hand sink at ware washing, hand sink at coffee <br />prep area (2 comp is for employee use) and 1 rest room <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: <br />Name and Title: Raziel Pelaez & Monica Oden, owne <br />EH Specialist: MARI BEL FLOHRSCHUTZ Phone: (209) 616-3051 <br />FA0026571 SR0084403 SCO61 11/09/2021 <br />EHD 16-23 Rev. 09/16/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />