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SA NUJ OAHU I N Environmental Health Department <br /> L■ COUNTY <br /> ^ r1 `p' Greo[Dess grows here, Time In: 1.50 pm <br /> Time Out: 2:41 om <br /> Food Program Official Inspection Report <br /> Name of Facility: DOMINOS Date: 04/24/2019 <br /> Address: 107 W NORTH ST, MANTECA 95336 <br /> Owner/Operator: TEAM CENTRAL VALLEY INC Telephone: (209)633-0000 <br /> Program Element: 1624-RESTAURANT/BAR 21-50 SEATS <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: Katelyn Mitchell Expiration Date: May 28,2021 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 127°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> bacon--Randell--33.00°F walk in--35.00°F <br /> chicken nuggets--Randell--30.00°F Randell prep cooler--34.00°F <br /> sausage--Randell--26.00°F mozarella--Randell--26.00°F <br /> chicken breasts--Randell--35.00°F pepperoni--Randell--30.00°F <br /> ham--Randell--24.00°F mop sink--120.00°F <br /> hand sink--front--108.00°F 3 cheese Randell--26.00°F <br /> chicken wings--Randell--28.00°F hand sink--right rr--100.00°F <br /> NOTES <br /> Quat and test strips available. <br /> No violations observed at this time. <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: Katelyn Mitchell, General Manager <br /> EH Specialist: SCOTT SANGALANG Phone: (209)468-3452 <br /> FA0022562 PR0539463 SCO01 04/24/2019 <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 />