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SAN =J OAQ U I N Environmental Health Department <br /> COUNTY- <br /> �c,F❑�t' Greotness grows hers. <br /> Mobile Food Facility Service Request Inspection Report <br /> Facility Name and Address: BOSS MOM WIFE SNACKS, 1681 KLONDIKE WAY, MANTECA <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 101 IF <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 101 OF <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 door eline--18.00°F 1 door prep atosa--41.00°F <br /> 1 door Dukers--41.00°F <br /> NOTES <br /> LIC 4UA9793 <br /> VIN 1 R9BC1622MF600967 <br /> Insignia is located above entrance door(interior of trailer) <br /> Ok to issue permit for year 2021 once fee is paid <br /> Return to the office before sales start <br /> Program 1635 Fee$237 <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: Sara Rosas Garcia, owner <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209)616-3051 <br /> SR0083966 SC523 10/04/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Mobile Food Facility Service Request Inspection Report <br />