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i �� I I I AI Environmental Health Department <br /> YSA N U N <br /> f�■z�w� COUNTY <br /> Greorness grows here. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: SPROUTS FARMERS MARKET, 16576 GOLDEN VALLEY PKWY, LATHROP <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: needed Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> restroom hand sinks(x6)--100.00°F Meat Dept hand sink--100.00°F <br /> NOTES <br /> OK to permit as a 1619 once the annual permit fee is paid ($500) <br /> An additional fee is due:48 minutes from 10-5-22 ($124.80)&48 minutes from today($124.80). <br /> Total due prior to permit being issued: $749.60 <br /> No signature obtained <br /> Report typed in the office 3:38p-3:50p <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/Mike Schultz, Super. <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> SR0084608 SC523 10/17/2022 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 2 Food Program Service Request Inspection Report <br />