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Time In: 10.45 am <br /> Time Out: 11:00 am <br /> gPvItY San Joaquin County <br /> �Q.��•cGG <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.sigov.org/ehd <br /> �L�PORN; <br /> Food Program Complaint Inspection Report <br /> Name of Facility: COSTCO WHOLESALE#658 Date: 04/27/2016 <br /> Address: 3250 W GRANT LINE RD, TRACY 95377 <br /> Owner/Operator: COSTCO WHOLESALE CORPORATION Telephone: (209)830-5343 <br /> Program Element: 1600-FOOD PROGRAM Complaint#: C00041416 <br /> DESCRIPTION OF COMPLAINT ALLEGATIONS <br /> The San Joaquin County Environmental Health Department received the following complaint: <br /> COMPLAINANT CONSUMED A PEANUT BUTTER AND JELLY SANDWICH AT 8:00 PM ON 4/25/2016 AND FELT SICK <br /> AT MIDNIGHT. COMPLAINANT HAS BEEN THROWING UP ALL NIGHT AND WILL SEE A DOCTOR TODAY(4/26/2016). <br /> COMPLAINANT NOTICED THE BREAD THAT THEY HAD PURCHASED FROM COSTCO ON 4/24/2016 WAS SPOILED. <br /> FRANZ GLUTEN FREE BREAD HAS LITTLE GREEN MOLD SPOTS ON THE CRUST. EXPIRATION DATE ON THE <br /> BREAD IS 6/26/2016. <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 /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> Site visit-Facility was not aware of complaint. Only two loaves with the best buy date of 6-26-16 on shelves. Opened one loaf <br /> of bread and did not observe any mold. Facility has not received any other complaints. <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: 6d <br /> 41�� <br /> Name and Title: Carlos,Admin <br /> EH Specialist: MELISSA NISSIM Phone: (209)468-3168 <br /> FA0014131 C00041416 SCO04 04/27/2016 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program Complaint Inspection Report <br />