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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: ROUND TABLE PIZZA, 2511 NAGLEE RD , TRACY 95304 <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: needed Expiration Date: <br /> Warewash Chlorine(Cl): 50 ppm Heat: °F Water/Hot Water Ware Sink Temp: 1551 F <br /> Quaternary Ammonia(QA): 400 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 4 drawer/1 door pizza prep--37.00°F 1 comp food prep sink--125.00°F <br /> walk-in cooler--37.00°F 1 door Arctic Air freezer--11.00°F <br /> 1 door Pepsi True(rear) -38.00°F 1 door Pepsi True(front)--35.00°F <br /> back of house hand sink 107.00°F restroom hand sinks--120.00°F <br /> 2 door True pizza prep--33.00°F front of house hand sink--100.00°F <br /> NOTES <br /> Change of ownership inspection conducted <br /> OK to permit as a 1625 once the annual permit fee is paid ($376) <br /> Effective 11-1-23 <br /> No signature obtained <br /> Report typed in the office 2:08p-2:20p <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/Paul & HB,owners <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0018457 SR0087320 SC061 10/24/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 2 Food Program Service Request Inspection Report <br />