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Time In: 10A0 am <br /> Time Out: 11:00 am <br /> San Joaquin County <br /> y Environmental Health Department <br /> Y. 1868 East Hazelton Avenue Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> Food Program Service Request Inspection Report <br /> Name of Facility: HICKORY FARMS#13566 Date: 11/24/2015 <br /> Address: 3200 NAGLEE RD , TRACY 95376 <br /> Requestor: JENNY MORRISON, HICKORY FARMS#13566 Telephone. (209) 518-6822 <br /> Program Element: 1602 -FOOD CONSULTATION Request#: SR0073434 <br /> Inspection Type: 061 -CONSULTATION <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: 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: 100°F <br /> FOOD ITEM --LOCATION --TEMP°F--COMMENTS <br /> Display--40.00°F <br /> NOTES <br /> No violations <br /> *Facility has temporary hand sink and only uses single-use utensils for sampling. <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: Amanda, Store Manager <br /> EH Specialist: MELISSA NISSIM Phone: (209) 468-3168 <br /> FA0007423 SR0073434 SC061 11/24/2015 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program Service Request Inspection Report <br />