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i �� I I I AI Environmental Health Department <br /> YSA N U N <br /> f�■z�w� COUNTY <br /> Greotr+ess grows here. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: EPIC ACADEMY, 2760 PENROSE AVE , LATHROP <br /> #34 Warewashing Facilites Maintained <br /> OBSERVATIONS:Provide chlorine or quat sanitizer test strips prior to operation. <br /> CALCODE DESCRIPTION:Food facilities that prepare food shall be equipped with warewashing facilities. Testing equipment and <br /> materials shall be provided to measure the applicable sanitization method. (I14067(f,g), 114099, 114099.3, 114099.5, 114101(a), <br /> 114101.1, 114101.2, 114103, 114107, 114125) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: needed 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: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> walk-in freezer--13.00°F left steam table--156.00°F <br /> right steam table--173.00°F restroom hand sink--101.00°F <br /> NOTES <br /> Food plan check final inspection. <br /> OK to permit as a 1632. <br /> Please fill out and return to inspector the pink and green forms provided at the final inspection (Kadeanne Linhares <br /> klinhares@sjgov.org). <br /> No signature obtained <br /> Report typed 8-8-22 3:55p-4:05p <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: discussed w/Jamie Anderson, Dir. Fo <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> SR0085451 SC523 08/08/2022 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 2 Food Program Service Request Inspection Report <br />