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SANOAQU I N Environmental Health Department <br /> COUNT -( IY <br /> Crearrie3S grows here, Time In: 1022 am <br /> Time Out: 10:42 am <br /> Food Program Official Inspection Report <br /> Name of Facility: CANTEEN @ COSTCO#658 BREAKROOM Date: 01/17/2020 <br /> Address: 3250 W GRANT LINE RD, TRACY 95377 <br /> Owner/Operator: CANTEEN @ COSTCO#658 BREAKROOM Telephone: <br /> Program Element: 1615-RETAIL MKT 301-2000 SQ FT(PREPKGD/LTD PREP) <br /> Inspection Type: ROUTINE INSPECTION -Operating Permit <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: 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 MinusForty Nourish--37.00°F 1 door MinusForty Hydrate-left--41.00°F--no phf <br /> 1 door MinusForty Hydrate-right--38.00°F 1 door MinusForty Nourish freezer--15.00°F <br /> NOTES <br /> pre-packaged food/no food prep <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 /> 1��OwReceived by: Name and Title: Alexis Fong, owner <br /> EH Specialist: KADEANNE LINHARES Phone: (209)468-0330 <br /> FA0025653 PR0545095 SCO01 01/17/2020 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program OR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />