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Time In: 3.15 pm <br /> Time Out: 4:00 pm <br /> �..... .IV <br /> . P San Joaquin County <br /> Environmental Health Department <br /> W X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • cq., iP• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> �iFORN <br /> Food Program Complaint Inspection Report <br /> Name of Facility: COSTCO WHOLESALE#1091 Date: 06/28/2017 <br /> Address: 2681 REYNOLDS RANCH PKWY, LODI 95240 <br /> Owner/Operator: COSTCO WHOLESALE CORPORATION Telephone: (209)366-7300 <br /> Program Element: 1600-FOOD PROGRAM Complaint#: C00043711 <br /> DESCRIPTION OF COMPLAINT ALLEGATIONS <br /> The San Joaquin County Environmental Health Department received the following complaint: <br /> COMPLAINANT ALLEGES ON 6/24/2017 BOTH COMPLAINANT AND SPOUSE CONSUMED HAMBURGER AND <br /> BAGGED ASIAN SALAD PURCHASED FROM COSTCO. BOTH COMPLAINANT AND SPOUSE WOKE UP FEELING ILL <br /> WITH SYMPTOMS OF STOMACH PAIN,VOMITING AND DIARRHEA. <br /> IN a follow up email on 6/27/17, complainant stated'bur son got sick and did not eat the burger. But then tonight we <br /> realized he had eaten the asian salad." <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 /> #7 Hot and Cold Holding Temperatures <br /> OBSERVATIONS:Asian Cashew chopped salad 45 F. Provide 41 F and below for potentially hazardous food (PHF) <br /> CALCODE DESCRIPTION:Potentially hazardous foods shall be held at or below 41/45°F or at or above 135°F. (113996, 113998, <br /> 114037, 114343(a)) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> Interviewed management,who stated: <br /> -not aware of this complaint nor similar complaint <br /> -no employee called in sick nor report of family member being sick <br /> -Did not observe any sign of food contamination <br /> -Freezer Walk In for hamburger patties <br /> -Ground beef aisle 41 F <br /> -pasta salad aisle 40 F <br /> -Asian salad (kit)aisle 38 F to 40 F <br /> -Asian Cashew Chopped Salad (bagged)45 F at Produce Walk In <br /> -Sweet Kale salad (bagged)43 F <br /> -Produce Walk In air 43 F <br /> OIR emailed to w01091 mgr4@costco.com <br /> FA0020431 C00043711 SC333 06/28/2017 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 Food Program Complaint Inspection Report <br />