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SA :J O Q V I + �Ips' Environmental Health Department <br /> COUNT <br /> Food Program Official Inspection Report <br /> Facility Name and Address: CVS Pharmacy#5403, 1175 W Lathrop Rd, MANTECA 95336 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: N/A Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 D display cooler/dairy--41.00°F Mop sink--117.00°F <br /> Hand sink--Employee rest room--101.00°F 3 D display cooler/dairy and snacks--41.00°F <br /> Hand sink--Customer rest room--100.00°F <br /> NOTES <br /> Prepackaged food only. <br /> All baby formulas have valid dates. <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: <br /> EH Specialist: GEHANE FAHMY Phone: (209)616-3052 <br /> FA0019897 PR0530691 SCO01 05/24/2023 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Food Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />