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Time In: 11 05 am <br /> Time Out: 11:45 am <br /> Q�g�tN San Joaquin County <br /> Environmental Health Department <br /> _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> ��1FOlR� <br /> Food Program Official Inspection Report <br /> Name of Facility: MR SIBS Date: 11/19/2015 <br /> Address: 4950 PACIFIC AVE,STOCKTON 95207 <br /> Owner/Operator: PEEPLES, DEBBIE A Telephone: (209)474-6423 <br /> Program Element: 1612 - FOOD EST<500 SQ FT W/O SEATING <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 foodbome 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: Debbie Peeples Expiration Date: January 16,2020 <br /> Warewash Chlorine(Cl): 200 ppm Heat: °F Water/Hot Water Ware Sink Temp: 130°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 124°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 door central—right/back--37.00°F 1 door true--front--38.00°F <br /> 1 door central--left/back--37.00°F chili—147.00°F <br /> soft serve--38.00°F cheese sauce--140.00°F <br /> NOTES <br /> No Violations <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 /> (17 <br /> Received by: I Name and Title: debbie peeples, owner <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209) 953-7817 <br /> FA0002698 PRO160873 SCO01 11/19/2015 <br /> EHD 15-23 Rev.06/30/15 Page 1 of 1 Food Program OIR <br />