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SAN JOAQUIN Environmental Health Department IJ NIT Time In: 9.15 am ry Time Out: 10:30 am SclForit' Greotness grows here. Food Program Service Request Inspection Report Name of Facility: ARCO AM/PM 7049 Date: 11/22/2019 Address: 800 E KETTLEMAN LN , LODI 95240 Requestor: RICHARD DUGIE, DUGIE DESIGN GROUP LLC Telephone: (425)492-4159 Program Element: 1601 -FOOD PLAN CHECK Request#: SR0080097 Inspection Type: 523-Plan Check/Report Review VIOLATIONS AND CORRECTIVE ACTIONS 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; 113700.All violations must be corrected within specified timeframe. Violations that are classified as"MAJOR"pose an immediate threat to public health and have the potential to cause foodborne illness.All major violations must be corrected immediately.Non-compliance may warrant immediate closure of the food facility. #21 Hot and Cold Potable Water Not Available OBSERVATIONS:Non adjustable hand sink has temp at 119F. Provide 100F-108F today. Corrected on site. CALCODE DESCRIPTION:An adequate,protected,pressurized,potable supply of hot water and cold water shall be provided at all times. (113953(c), 114099.2(b) 114101(a), 114189, 114192, 114192.1, 114195) #36 Equipment/Utensils/Linens: Proper Storage/Use OBSERVATIONS:There are currently 199 LB of carbon dioxide(CO2)cylinders at the facility. Please be aware that CO2 is an asphyxiant and is therefore considered a hazardous material subject to regulation under Chapter 6.95, Health and Safety Code, Division 20, The reportable quantity for CO2 is 137 pounds or 1,200 cubic feet in San Joaquin County(SJC). You will be placed into the SJC Environmental Health Program for Hazardous Material Business Plan (HMBP)and will be required to report your hazardous materials in the California Environmental Reporting System (CERS). For more information or to comply with the reporting requirement in CERS, please go to: http://cers.calepa.ca.gov/ CALCODE DESCRIPTION:All clean and soiled linen shall be properly stored non-food items shall be stored and displayed separate from food and food-contact surfaces. (114185.3- 114185.4) Utensils and equipment shall be handled and stored so as to be protected from contamination. (114074-114075, 114081, 114119, 114121, 114161, 114178, 114179, 114083, 114185, 114185.2, 114185.5) #41 Plumbing Maintained;Approved Back Flow Device OBSERVATIONS:Pipe, draining the soda machine, is lacking air gap. Provide air gap today 1 inch minimum off the floor sink. Corrected on site. CALCODE DESCRIPTION:The potable water supply shall be protected with a backflow or back siphonage protection device,as required by applicable plumbing codes. (114192)All plumbing and plumbing fixtures shall be installed in compliance with local plumbing ordinances,shall be maintained so as to prevent any contamination,and shall be kept clean,fully operative,and in good repair. Any hose used for conveying potable water shall be of approved materials,labeled,properly stored,and used for no other purpose. (114171, 114189.1, 114190, 114193, 114193.1, 114199, 114201, 114269) OVERALL INSPECTION NOTES AND COMMENTS OBSERVATIONS Name on Food Safety Certificate: Expiration Date: Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 128°F Quaternary Ammonia(QA): ppm Hand Sink Temp: 112°F FA0000511 SR0080097 SC523 11/22/2019 EHD 16-23 Rev.06/30/15 Page 1 of 2 Food Program Service Request Inspection Report