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�...Q .. P San Joaquin County <br /> y� 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 /> '9Gl P Oftt� <br /> Food Program Official Inspection Report <br /> Facility Name and Address: COUNTRY KITCHEN, 1327 W LOCKEFORD ST, LODI 95240 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Denis T Xenos Expiration Date:January 12,2017 <br /> Warewash Chlorine(Cl): 50 ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 door Bev Air refrigerator--41.00°F 2 door refrigerator--under prep table--46.00°F <br /> reach-in--under prep--40.00°F hand sink--restroom--106.00°F <br /> hand isnk--100.00°F 2 door refigrator--storage room--39.00°F <br /> mop sink--120.00°F 2 door display refrigrator--39.00°F <br /> 2 door metal reefrigerator--next to office--52.00°F 2 comp--120.00°F <br /> NOTES <br /> No comment entered. <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 /> 0't <br /> Received by: Name and Title: denis xenos, <br /> EH Specialist: STEPHANIE RAMIREZ Phone: (209)468-9851 <br /> FA0000424 PRO160094 SCO01 10/13/2016 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program OIR <br />