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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: STARBUCKS COFFEE, 19699 S MOUNTAIN HOUSE PKWY, MOUNTAIN HOUSE <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Front of house hand sink- 101.00°F mop sink--123.00°F <br /> Bradley sink--101.00°F 3 comp--120.00°F <br /> back of house hand sink 103.00°F 1 door Delfield back bar left--36.00°F <br /> drive thru hand sink--104.00°F 1 door Delfield back bar right--38.00°F <br /> 1 door Delfield left espresso--31.00°F 1 door True freezer--0.00°F <br /> mop sink--123.00°F <br /> NOTES <br /> OK to permit as a 1624 once the annual permit fee of$355 is received <br /> An additional charge of$109.20 for today's activity(18 minutes left on the pre-paid amount plus 42 minutes chargeable) <br /> No signature obtained <br /> Report typed up in the office 3:31-3:43pm <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/Eric&Paul,Wells <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> SR0084195 SC523 07/06/2022 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 2 Food Program Service Request Inspection Report <br />