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Time In: 9,30 am <br /> Time Out: 10:56 am <br /> t utnd.� San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> l daYyt Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.siaov.org/ehd <br /> Food Program Complaint Inspection Report <br /> Name of Facility: Costco Wholesale#38 Date: 01/27/2016 <br /> Address: 1616 E HAMMER LN, STOCKTON 95210 <br /> Owner/Operator: COSTCO WHOLESALE CORPORATION Telephone (209)478-2040 <br /> Program Element: 1600- FOOD PROGRAM Complaint#: C00040974 <br /> DESCRIPTION OF COMPLAINT ALLEGATIONS <br /> The San Joaquin County Environmental Health Department received the following complaint: <br /> Complainant(c)consumed a polish hot dog with mustard and anions. Food was consumed on 1/24/2016 between 2:30- <br /> 2:45 pm. (c) began to have severe abdominal pain at about 3:30 pm. (c) began experiencing symptoms of diarrhea and <br /> vomiting at approximately 5:30 pm. On 1/25/2016(c)was ill and in bed all day. Spouse consumed a hot dog with ketchup <br /> and did not become ill. <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.Nan-compliance may warrant immediate closure of <br /> the food facility. <br /> #7 Hot and Cold Holding Temperatures Major <br /> OBSERVATIONS:Chicken 60 F, Bacon/Cheese 57.6 and 60 F, coleslaw 51 F, and Turkey Provolne 130 F. Provide 41 F <br /> or below or 135 F or above for all potentially hazardous food (PHF). Observed all food except Chicken Bake disposed <br /> voluntarily by Janice. <br /> CALCODE DESCRIPTION:Potentially hazardous foods shall be held at or below 4V 45°F or at or above 135F.(113996, 113998, <br /> 114037, 114343(a)) <br /> #27 Food Protected from Contamination <br /> OBSERVATIONS: No cover for cooked chicken and bacon/cheese. Provide. <br /> CALCODE DESCRIPTION:All food shall be separated and protected from contamination. (113984(a, b, c, d, f), 113986, 114060, <br /> 114067(a, d, e,A 114069(a, b), 114077, 114089.1 (c), 114143(c)) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: JaniceHedman Expiration Date:May 14,2020 <br /> Warewash Chlorine(CD: ppm Heal: °F Water/Hot Water Ware Sink Temp: 134°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 105°F <br /> FOOD ITEM --LOCATION --TEMP 0 F--COMMENTS <br /> FAD001705 C00040974 SC444 01/27/2016 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 Food Program Complaint Inspection Report <br />