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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: PHO TOWN, 1886 W ELEVENTH ST,TRACY 95376 <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: needed Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 121 IF <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 103°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 door Everest- 41.00°F back hand sink--107.00°F <br /> front hand sink- 103.00°F mop sink--120.00°F <br /> 2 door Economy freezer--21.00°F 2 door Traulsen prep--44.00°F--re-checked unit:46F <br /> 1 door Haier chest freezer--23.00°F restroom hand sink--100.00°F <br /> 1 door Turbo Air--43.00°F--re-checked unit:43F <br /> NOTES <br /> wiping cloth bucket 200 ppm Cl/Cl test strips are available <br /> OK to permit as a 1623 once the annual permit fee is paid ($350) <br /> No signature obtained <br /> Report typed up in the office 2:05p-2:17p <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/Tom Nguyen, employee <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0007169 SR0085576 SC061 07/29/2022 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 2 Food Program Service Request Inspection Report <br />