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Time In: 3-25 prn <br /> Time Out: 3:40 pm <br /> �...Q ...P San Joaquin County <br /> y� Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �..• �P Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> '9Gl P Oftt� <br /> Food Program Official Inspection Report <br /> Name of Facility: CONVENIENT STORE Date: 04/28/2016 <br /> Address: 225 S CHEROKEE LN, LODI 95240 <br /> Owner/Operator: ALRUOSAN,AHMAD Telephone: <br /> Program Element: 1616-RETAIL MARKET< 1000 SQ FT W/FOOD PREP <br /> Inspection Type: ROUTINE INSPECTION -Operating Permit <br /> VIOLATIONS AND CORRECTIVE ACTIONS <br /> Items listed on this report as violations do not meet the requirements set forth in the California Health and Safety Code commencing with section 7; <br /> 113700.All violations must be corrected within specified timeframe. Violations that are classified as"MAJOR"pose an immediate threat to public health <br /> and have the potential to cause foodborne illness.All major violations must be corrected immediately.Non-compliance may warrant immediate closure of <br /> the food facility. <br /> #34 Warewashing Facilites Maintained <br /> OBSERVATIONS:Test strips lacking. Provide in 3 days. <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: Expiration Date: <br /> Warewash Chlorine(Cl): 100 ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 120°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> RR--104.00°F mop sink--122.00°F <br /> CT-R Display--29.00°F 3-comp/handwash--120.00°F <br /> NOTES <br /> OIR emailed lany. <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: lany mulyana, clerk <br /> EH Specialist: JEFFREY WONG Phone: (209)468-0335 <br /> FA0000728 PRO161885 SCO01 04/28/2016 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program OIR <br />