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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: ACE SUSHI @ SAVE MART 781, 875 S TRACY BLVD ,TRACY <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: needed Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 122°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 4 door prep 41.00°F 3 comp--122.00°F <br /> hand sinks- 100.00°F walk-in cooler--41.00°F <br /> merchandiser--41.00°F 2 comp food prep sink--122.00°F <br /> NOTES <br /> Consultation to add a permit to the facility:ACE Sushi <br /> Designated areas will be provided in the walk-in cooler,the walk-in freezer,the merchandiser, and the 4 door reach-in. <br /> OK to issue a permit as a 1612 once the annual permit fee is paid ($350) <br /> No signature obtained <br /> Report typed in the office 1:58p-2:09p <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/Daniel Chang,ACE Reg <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> SR0087375 SC061 11/14/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 2 Food Program Service Request Inspection Report <br />