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SA NUJ OAHU I N Environmental Health Department <br /> ■ COUNT Y-- <br /> c/ `p' Greorne5S grows hey,. Time In: 1000 am <br /> Time Out: 11:30 am <br /> Food Program Official Inspection Report <br /> Name of Facility: COSTCO WHOLESALE#1091 Date: 05/14/2020 <br /> Address: 2680 REYNOLDS RANCH PKWY, LODI 95240 <br /> Owner/Operator: COSTCO WHOLESALE CORPORATION Telephone: (425)313-8100 <br /> Program Element: 1619-RETAIL MKT>1000 SQ FT(=/>2 DEPTS) <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 /> #33 Nonfood Contact Surfaces Clean <br /> OBSERVATIONS:Debris and spillage were observed at display cases at D-19. Clean these debris and spillage today. <br /> CALCODE DESCRIPTION:All nonfood contact surfaces of utensils and equipment shall be clean. (114115(c)) <br /> #43 Toilet Facilites Clean/Supplied/Maintained <br /> OBSERVATIONS:Self-closing door is not provided for the restroom at receiving dock. Provide self-closing doors within two <br /> weeks. <br /> CALCODE DESCRIPTION:Toilet facilities shall be maintained clean, sanitary and in good repair. Toilet rooms shall be separated by a <br /> well-fitting self-closing door. Toilet tissue shall be provided in a permanently installed dispenser at each toilet. The number of toilet <br /> facilities shall be in accordance with local building and plumbing ordinances. Toilet facilities shall be provided for patrons:in <br /> establishments with more than 20,000 sq ft. establishments offering on-site liquor consumption. (114250, 114250.1, 114276) <br /> #44 Premises: Clean/Litter Free;Vermin-Proof <br /> OBSERVATIONS:Spillage and debris observed on floor inside Dairy Walk-In Cooler, clean these areas today and maintain <br /> facility clean and free of litter and rubbish. <br /> CALCODE DESCRIPTION:The premises of each food facility shall be kept clean and free of litter and rubbish all clean and soiled linen <br /> shall be properly stored non-food items shall be stored and displayed separate from food and food-contact surfaces the facility shall be <br /> kept vermin proof. (114067 6), 114123, 114143(a)&(b), 114256, 114256.1, 114256.2, 114256.4, 114257, 114257.1, 114259, 114259.2, <br /> 114259.3, 114279, 114281, 114282) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Andrew Ximenez Expiration Date:October 14,2023 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> FA0020431 PR0536360 SCO01 05/14/2020 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 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 />