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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: MOUNTAIN MIKE'S PIZZA, 19677 S MOUNTAIN HOUSE PKWY, MOUNTAIN HOUSE <br /> A final inspection is scheduled fro Tuesday 11-8-22 @ 1 pm <br /> Items#6&7 shall be in compliance prior to issuance of a permit. <br /> Permit not issued this date. <br /> No signature obtained <br /> Report typed in the office 2:48p-3:05p <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/Victor&Dave Panaich, <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> SR0084212 SC523 11/03/2022 <br /> EHD 16-23 Rev.07/05/2022 Page 3 of 3 Food Program Service Request Inspection Report <br />