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SANOAQU I N Environmental Health Department <br /> COUNTY IY <br /> GrtoWSS grovr3 here, <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: POLARIS ICE CREAM ROLLS, 3200 N NAGLEE RD , TRACY 95304 <br /> #33 Nonfood Contact Surfaces Clean <br /> OBSERVATIONS:Clean and sanitize all nonfood contact surfaces prior to opening. <br /> CALCODE DESCRIPTION:All nonfood contact surfaces of utensils and equipment shall be clean. (114115(c)) <br /> #34 Warewashing Facilites Maintained <br /> OBSERVATIONS:Obtain chlorine sanitizer test strips by 1 week. <br /> CALCODE DESCRIPTION:Food facilities that prepare food shall be equipped with warewashing facilities. Testing equipment and <br /> materials shall be provided to measure the applicable sanitization method. (I14067(f,g), 114099, 114099.3, 114099.5, 114101(a), <br /> 114101.1, 114101.2, 114103, 114107, 114125) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: taken and passed 4-26-19 Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 121 °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 door V Star--43.00°F--`Recheck:46F front of house hand sink--100.00°F <br /> 2 door Norpole--37.00°F back of house hand sink--100.00°F <br /> mop sink--120.00°F <br /> NOTES <br /> walk-in cooler not in use <br /> Effective 5-1-19 <br /> OK to permit as a 1613 once annual permit fee is paid ($350) <br /> Return to 1868 E Hazelton Ave. in Stockton to pay annual permit fee prior to opening. <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: Ying Yin Liao, owner <br /> EH Specialist: KADEANNE LINHARES Phone: (209)468-0330 <br /> FA0024557 SR0080502 SC061 04/30/2019 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program Service Request Inspection Report <br />