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SAN J O A Q U I N Environmental Health Department <br /> C_U�j N I Y <br /> •- Time In: 1:34 IZ <br /> GreaCrae�s grows firer <br /> Time Out: 2:00 pm <br /> Food Program Official Inspection Report <br /> Name of Facility: COUNTRY KITCHEN Date: 01/12/2018 <br /> Address: 1327 W LOCKEFORD ST, LODI 95240 <br /> Owner/Operator: XENOS, DENNIS T Telephone: (408)294-2262 <br /> Program Element: 1625-RESTAURANT/BAR 51-100 SEATS <br /> Inspection Type: INSPECTION/REINSPECTION 1 hr minimum <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 /> #33 Nonfood Contact Surfaces Clean <br /> OBSERVATIONS:Observed debris on hood filter. Clean. <br /> CALCODE DESCRIPTION:All nonfood contact surfaces of utensils and equipment shall be clean. (114115(c)) <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: 131 °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 door Bev air(new)--41.00°F mop sink--123.00°F <br /> NOTES <br /> sanitizer at(new dishwasher)-50ppm <br /> Observed valid food handler card. <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 reinspectionisrequired,fees will be assessed at the current hourly rate. <br /> Received by: Name and Title: brian, <br /> EH Specialist: STEPHANIE RAMIREZ Phone: (209)468-9851 <br /> FA0000424 PRO160094 SC333 01/12/2018 <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 />