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Time In: 1.15 pm <br /> Time Out: 2:05 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: 09/14/2016 <br /> Address: 4932 PACIFIC AVE , STOCKTON 95207 <br /> Requestor: ARTHUR OSTROWSKI, NORR Telephone: (312)873-1067 <br /> Program Element: 1601 -FOOD PLAN CHECK Request#: SR0074224 <br /> Inspection Type: 523-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 /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> Pre-final was requested.Work on the following for final: <br /> 1.Hot water shall be 120 F or higher for sinks in kitchen. <br /> 2.Warm water shall be between 100-108 F in rest rooms. <br /> 3.All refrigerators shall be 41 F or lower. <br /> 4.Install soap dispensers in rest rooms. <br /> 5.All gaps between water lines and ceiling or walls shall be sealed. <br /> 6.AI1 holes on walls shall be covered. <br /> 7.Waste line for soda machine shall be installed. <br /> 8.If possible have food manager certificate on site. <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 beassessedat the current hourly rate. <br /> Received by: Name and Title: Sam Turnage, Site super <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209)953-7817 <br /> SR0074224 SC523 09/14/2016 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program Service Request Inspection Report <br />