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Time In: 2-25 pm
<br /> Time Out: 3:25 pm
<br /> �.... .. P 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 /> '9C%FORM
<br /> Food Program Service Request Inspection Report
<br /> Name of Facility: HOLLYWOOD VIDEO#005522 Date: 09/09/2016
<br /> Address: 265 W LOUISE AVE , MANTECA 95336
<br /> Requestor: FATIMA ARROYO, CHUBBYS DINER Telephone: (925)922-3420
<br /> Program Element: 1601 -FOOD PLAN CHECK Request#: SR0073887
<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 /> #7 Hot and Cold Holding Temperatures
<br /> OBSERVATIONS:The 1 door Bev Air salad prep unit is not plugged in this date. Ensure unit is capable of maintaining cold
<br /> food at 41 F or below prior to use.
<br /> CALCODE DESCRIPTION:Potentially hazardous foods shall be held at or below 41/45°F or at or above 135°F. (113996, 113998,
<br /> 114037, 114343(a))
<br /> #14 Food Contact Surfaces Sanitized or Warewashing Sanitization
<br /> OBSERVATIONS:Clean and sanitize all food contact surfaces prior to opening.
<br /> CALCODE DESCRIPTION:All food contact surfaces of utensils and equipment shall be clean and sanitized. (I 13984(e), 114097,
<br /> 114099.1, 114099.4, 114099.6, 114101 (b-d), 114105, 114109, 114111, 114113, 114115(a,b, d), 114117, 114125(b), 114135, 114141)
<br /> #33 Nonfood Contact Surfaces Clean
<br /> OBSERVATIONS:Clean all nonfood contact surfaces prior to opening.
<br /> CALCODE DESCRIPTION.All nonfood contact surfaces of utensils and equipment shall be clean. (114115(c))
<br /> #35 Equipment/Utensils Approved and in Good Repair
<br /> OBSERVATIONS:The bread/bun oven is not hooked up.Vent equipment per fire department's requirements prior to use.
<br /> CALCODE DESCRIPTION:All utensils and equipment shall be fully operative and in good repair. (114175).All utensils and equipment
<br /> shall be approved,installed properly,and meet applicable standards. (114130, 114130.1, 114130.2, 114130.3, 114130.4, 114130.5,
<br /> 114132, 114133, 114137, 114139, 114153, 114155, 114163, 114165, 114167, 114169, 114177, 114180, 114182)
<br /> #41 Plumbing Maintained;Approved Back Flow Device
<br /> OBSERVATIONS:The ice machine has not been hooked up yet. Ensure the ice machine drains to a floor sink with an
<br /> appropriate air gap.
<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 /> FA0012187 SR0073887 SC523 09/09/2016
<br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 Food Program Service Request Inspection Report
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