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i �� I I I AI Environmental Health Department <br /> YSA N U N <br /> r �Z�wti COUNTY Time In: 12-11 pm <br /> Time Out: 12:25 pm <br /> c `�� Greotr+essrGws here. <br /> Food Program Service Request Inspection Report <br /> Name of Facility: CANTEEN @ COSTCO#658 TRACY BREAKROOM Date: 12/09/2019 <br /> Address: 3250 W GRANT LINE RD ,TRACY 95377 <br /> Requestor: CANTEEN @ COSTCO#658 TRACY BREAKROOM, COMPASS GROUP U Telephone: (704)328-5184 <br /> Program Element: 1602-FOOD CONSULTATION Request#: SR0081429 <br /> Inspection Type: 061 -CONSULTATION <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 /> OBSERVATIONS <br /> Name on Food Safety Certificate: n/a Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 door Nourish freezer -3.00°F 1 door Minus 40 Hydrate-left--40.00°F <br /> 1 door Minus 40 Hydrate-right--41.00°F 1 door Nourish--39.00°F <br /> NOTES <br /> Actual Inspection time 10:41-10:45am <br /> Ok to permit as a 1615 once annual permit fee is paid. <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: Name and Title: signature not obtained, report will be <br /> EH Specialist: KADEANNE LINHARES Phone: (209)468-0330 <br /> SR0081429 SC061 12/09/2019 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program Service Request Inspection Report <br />