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�...Q .. C San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �..• _ P• Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.s'gov.org/ehd <br /> 4�IFO'Rt� <br /> Food Program Official Inspection Report <br /> Facility Name and Address: CJS HERMITAGE, 1940 E FREMONT ST, STOCKTON 95205 <br /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:The drain pipes at the 3 comp sink floor sink does not have an air gap. Provide an air gap that is at least <br /> twice the diameter of the drain pipe. <br /> CALCODE DESCRIPTION:The potable water supply shall be protected with a backflow or back siphonage protection device,as required <br /> by applicable plumbing codes. (114192)All plumbing and plumbing fixtures shall be installed in compliance with local plumbing <br /> ordinances, shall be maintained so as to prevent any contamination,and shall be kept clean,fully operative,and in good repair. Any hose <br /> used for conveying potable water shall be of approved materials,labeled,properly stored,and used for no other purpose. (114171, <br /> 114189.1, 114190, 114193, 114193.1, 114199, 114201, 114269) <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: 109°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 3 dr cooler--41.00°F <br /> NOTES <br /> -Previous report and food handler cards on site <br /> Report emailed to gayleen56@gmail.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: <br /> EH Specialist: LEYNA HUYNH Phone: (209)468-3446 <br /> FA0001986 PRO167507 SCO01 04/20/2017 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program OIR <br />