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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: DUTCH BROS COFFEE-CA-0805, 15135 OLD HARLAN RD , LATHROP <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: needed Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 132°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 131 °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 door Bev Air reach-in--35.00°F mop sink--124.00°F <br /> 3 door walk-in cooler--40.00°F restroom hand sink--102.00°F <br /> BOH hand sink--131.00°F FOH hand sink--133.00°F <br /> 3 comp sink--132.00°F <br /> NOTES <br /> Food plan check final inspection conducted. <br /> Anticipated opening: early March 2022 <br /> OK to permit as a 1613 once the annual permit fee is paid ($350) <br /> No signature obtained <br /> Report typed up at the office 2:20pm-2:33pm <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/Justin Burchard, Miller P <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> SR0082081 SC523 02/17/2022 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />