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�...Q .. C 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.s'gov.org/ehd <br /> 4�IFO'Rt� <br /> Food Program Official Inspection Report <br /> Facility Name and Address: SIMPLY DONUTS, 1365 E YOSEMITE AVE, MANTECA 95336 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Juan Hernandez Expiration Date:October 17,2018 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 121 °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 110°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 door True--40.00°F 2 door Ascend--40.00°F <br /> mop sink--120.00°F restrrom hand sink--120.00°F <br /> 1 comp prep sink--120.00°F <br /> NOTES <br /> chlorine available <br /> strips needed <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: �U— Name and Title: Juan Hernandez, owner <br /> EH Specialist: KADEANNE LINHARES Phone: (209)468-0330 <br /> FA0000899 PRO161026 SCO01 10/21/2016 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program OIR <br />