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SAN JOAQUIN Environmental Health Department <br />COUNITY <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: <br />Warewash Chlorine (CO: ppm Heat: ° F <br />Quaternary Ammonia (CA): ppm <br />FOOD ITEM -- LOCATION -- TEMP ° F -- COMMENTS <br />1 door eline -- 18.00° 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 />Expiration Date: <br />Water/Hot Water Ware Sink Temp 101 OF <br />Hand Sink Temp 101 OF <br />1 door prep atosa -- 41.00° F <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: <br />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 />