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Environmental Health Department <br /> SAN-6-JOAQUIN <br /> �M COUNTY <br /> r'�JFOSx'tYY r Greotness grows here. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: A TABLE, 293 W LOUSIE AVE , MANTECA 95336 <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Required 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: 118°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Prep sink 120.00°F Hand sink--Rest room--104.00°F <br /> Mop sink 120.00°F 2 D reach in cooler/under prep table--Back kitchen--36.00°F <br /> 2 D upright cooler--Back--41.00°F <br /> NOTES <br /> Consultation inspection. <br /> As per new operator, she will take over Jan 1 st and will start operation in March/April 2024 <br /> Okay to operate. <br /> Obtain permit prior operating your business. <br /> PE 1623$350 to be paid for the new permit. <br /> 5021 form to be updated. <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: GEHANE FAHMY Phone: (209)616-3052 <br /> FA0012190 SR0087509 SC061 12/18/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 3 of 3 Food Program Service Request Inspection Report <br />