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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: DOGHOUSE BAKERY, 623 E OAK ST, LODI 95240 <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> air- blue air freezer 3 door--7.00°F air- blue air freezer 2 door--0.00°F <br /> air- true reachin cooler in front--40.00°F air- true freezer 3 door--0.00°F <br /> air- display cases--40.00°F air- blue air cooler 2 door glass--39.00°F <br /> air- true freezer 2 door--0.00°F <br /> NOTES <br /> Ok to issue permit. Obtain permit prior to operating the facility. <br /> PE 1612 <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: <br /> EH Specialist: VIDAL PEDRAZA Phone: (209)616-3020 <br /> FA0007153 SR0087199 SC061 09/21/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 2 Food Program Service Request Inspection Report <br />