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i �� I I I AI Environmental Health Department <br /> YSA N U N <br /> r�■z�w� COUNTY <br /> Greorness grows here. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: AFC SUSHI @ SAFEWAY#2600, 1801 W ELEVENTH ST ,TRACY 95376 <br /> OK to permit as a 1612 once the annual permit fee is paid ($350) <br /> No signature obtained <br /> Report typed up at the office 6-15-22 2:33p-2:44p <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/Biak Nung, Sr. Reg. Mg <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0017612 SR0085360 SC061 06/14/2022 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />