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Time In: 1-10pm <br /> Time Out: 2:101)m <br /> Pquin/ San Joaquin County <br /> a. Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • cq., ;a• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> �rFORN <br /> Food Program Official Inspection Report <br /> Name of Facility: COLLIERVILLE COUNTRY STORE Date: 05/26/2017 <br /> Address: 3706 E COLLIER RD,ACAMPO 95220 <br /> Owner/Operator: SINGH, HARI &PRAVINA DEVI Telephone: (916)682-4178 <br /> Program Element: 1617-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 /> #35 Equipment/Utensils Approved and in Good Repair <br /> OBSERVATIONS:2 nozzles at soda dispenser dirty. Clean and sanitize in 1 day. <br /> CALCODE DESCRIPTION:All utensils and equipment shall be fully operative and in good repair. (114175).All utensils and equipment <br /> shall be approved,installed properly,and meet applicable standards. (114130, 114130.1, 114130.2, 114130.3, 114130.4, 114130.5, <br /> 114132, 114133, 114137, 114139, 114153, 114155, 114163, 114165, 114167, 114169, 114172, 114177, 114180, 114182) <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: 122°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 108°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Pierre Hot n Ready--135.00°F 4D cooler(burritos)--41.00°F <br /> RR--117.00°F WI(dairy--45.00°F <br /> NOTES <br /> Note: <br /> Facility serves prepackage, coffee and icy treats, and open food in hot hold <br /> OIR emailed navynn8088@yahoo.com <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: nick singh, mgr <br /> EH Specialist: JEFFREY WONG Phone: (209)468-0335 <br /> FA0000238 PRO161892 SCO01 05/26/2017 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program OIR <br />