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: SA NUJ FAQ U I N Environmental Health Department <br /> ._ COUNTY <br /> Tl : 11 <br /> E"ram <br /> ^'•ti7F Opt�% Greotness grows here. <br /> Timee Out: 11::4545 am <br /> Food Program Official Inspection Report <br /> Name of Facility: MR SIBS Date: 11/08/2019 <br /> Address: 4950 PACIFIC AVE, STOCKTON 95207 <br /> Owner/Operator: PEEPLES, DEBBIE A Telephone: (209)474-6423 <br /> Program Element: 1612-FOOD EST<500 SQ FT W/O SEATING <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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Debbie Peeples Expiration Date:January 16,2020 <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 /> 1 door--front--41.00°F 1 door central--right--40.00°F <br /> 1 door central--left--34.00°F ice cream mix--35.00°F <br /> NOTES <br /> No Violations <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 reinspe <br /> ction <br /> iisrequired,fees will be assessed at the current hourly rate. <br /> Received by: Name and Title: Debbie Peeples, owner <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209)953-7817 <br /> FA0002698 PRO160873 SCO01 11/08/2019 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program OR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />