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Time In: 920 am <br /> Time Out: 10:00 am <br /> o .. .. San Joaquin County <br /> .X Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... P Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> Food Program Service Request Inspection Report <br /> Name of Facility: DOMINOS PIZZA Date: 10/25/2016 <br /> Address: 2233 GRAND CANAL BLVD , STOCKTON 95207 <br /> Requestor: Telephone: <br /> Program Element: 1601 -FOOD PLAN CHECK Request#: SR0075290 <br /> Inspection Type: 523-Plan Check/Report Review <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: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 130°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 120°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> walk in--39.00°F 4 door prep--top--38.00°F <br /> 4 door prep--bottom--36.00°F <br /> NOTES <br /> Correct the following before opening: <br /> 1. Install self closing device for rest room doors. <br /> 2. Install ventilation fans in rest rooms. <br /> 3. Post hand wash signs in rest room and SB180 at a visible area to customers. <br /> 4. Install toilet paper, soap, an paper towel dispensers. <br /> Correct the following by 30/60 days: <br /> 5. Provide food handler and food manager certificates. <br /> ok to issue permit once fee is paid. Return to office. Program 1623. Fee$318 <br /> All produce shall come in pre-washed and ready to use. <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: michael mendoza, contractor <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209)953-7817 <br /> SR0075290 SC523 10/25/2016 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program Service Request Inspection Report <br />