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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... _ P Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> QLtkoR�'� <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: VITALITY BOWLS SUPERFOOD CAFE, 882 LIFESTYLE ST , MANTECA 95337 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Dolores Baluyut Expiration Date: May 17,2022 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 121 °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> FOH hand sink--100.00°F restroom hand sinks--110.00°F <br /> 1 door Avantco freezer--front counter--6.00°F 2 door True prep- large unit--35.00°F <br /> 1 door Avantco-tall unit -back--41.00°F 2 door True prep- small unit--36.00°F <br /> 2 door Avantco freezer--right unit--16.00°F 1 door Avantco-small unit--back--44.00°F--Recheck:41 F <br /> 2 door Avantco--front-espresso--38.00°F chest freezer--23.00°F <br /> 2 door Avantco freezer--left unit--14.00°F BOH hand sink--101.00°F <br /> 1 comp prep--128.00°F 1 door Avantco-tall unit--front--44.00°F--Recheck:39F <br /> NOTES <br /> Change of owner inspection. <br /> OK to permit as a 1624 once the annual permit fee is paid. <br /> Return to 1868 E Hazelton in Stockton to pay$318 annual permit fee prior to opening. <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 reinspectiioon-is required,fees will be assessed at the current hourly rate. <br /> � 1 <br /> Received by: Name and Title: Dolores Baluyut, owner <br /> EH Specialist: KADEANNE LINHARES Phone: (209)468-0330 <br /> FA0020766 SR0077627 SC061 06/19/2017 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program Service Request Inspection Report <br />