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Time In: 2.00 prn <br /> Time Out: 3:00 pm <br /> �.... .. P San Joaquin County <br /> .X 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 /> '9C%FORM <br /> Food Program Service Request Inspection Report <br /> Name of Facility: Date: 04/06/2016 <br /> Address: 6707 SAMPSON RD , STOCKTON <br /> Requestor: KEN KAESTMAN,ARCHITECT Telephone: (209)450-0085 <br /> Program Element: 1601 -FOOD PLAN CHECK Request#: SR0072609 <br /> Inspection Type: 521 -Plan Check/Report Review <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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: 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 cooler--38.00°F Restroom--100.00°F <br /> NOTES <br /> Provide 6-inch splash guard between handwash sink and warewash sink per condition#5 on the approval letter dated 7/9/2015 <br /> from SJC EHD in 2 weeks or before operating. <br /> Notes: <br /> -Facility does not meet condition#1 for 3/8 inch coving at janitorial area and restroom per approval letter dated 7/9/2015 from <br /> SJC EHD. Agreed to allow permitting and operation of facility if there is no open food as owner stated (PE 1618). 3/8 inch <br /> coving requirement will be required if facility changes to include open food either under current or future owner(that is, new <br /> permit will not be issued until the requirement is met.) <br /> -Facility will sell only liquor and prepackaged food. No open food is allowed. <br /> -Water heater Rheem 20 gallons, 8000 watts (no BTU listed) <br /> -Waste liquid (i.e. condensation)must be drained to floor sink with minimum 1 inch air gap for future equipment(see <br /> Condition#3 per 7/9/15 letter) <br /> OK to issue permit after fee is paid: PE 1618 <br /> OIR will be emailed to Giljit. <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: ajmer gill, owner <br /> EH Specialist: JEFFREY WONG Phone: (209)468-0335 <br /> SR0072609 SC521 04/06/2016 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program Service Request Inspection Report <br />