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S A N _J OAQ I I I N Environmental Health Department <br /> COUNTY IV <br /> `��,F❑ Greotness grows here, <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: KING ISLAND CAFE, 11530 W EIGHT MILE RD , STOCKTON 95219 <br /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:Unable to determine whether there is grease trap or grease interceptor. Provide information that a <br /> grease trap has been installed. <br /> A prep sinks has been installed with a direct connection to the sewer line.An air gap of one inch minimum is required <br /> between the sink and the sewer line. <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: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> This department must see permits from other agencies prior to issuing a permit. <br /> Call me or email me the when the above are corrected. <br /> coldtech 1 d freezer <br /> verest 2d freezer <br /> everest 1 d cooler <br /> berverage air 2d prep cooler <br /> true 2d cooler <br /> true 2d prep cooler <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 /> &� <br /> Received by: Name and Title: Charles Speurlock, owner <br /> EH Specialist: VIDAL PEDRAZA Phone: (209)468-0334 <br /> FA0021010 SR0080666 SC061 05/28/2019 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program Service Request Inspection Report <br />