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SAN JOAQUIN Environmental Health Department <br /> IJ NIT Y_ Time In: 820 am <br /> ry Time Out: 9:00 am <br /> Greotness grows here. <br /> Food Program Service Request Inspection Report <br /> Name of Facility: DUTCH BROS COFFEE Date: 07/24/2020 <br /> Address: 530 S CHEROKEE LN , LODI 95240 <br /> Requestor: TODD CLARK, IT ARCHITECTURE INC Telephone: (559)442-4642 <br /> Program Element: 1601 -FOOD PLAN CHECK Request#: SR0081804 <br /> Inspection Type: 523-Plan Check/Report Review <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 /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> Re-inspection conducted this date, the followings were noted: <br /> The floor in the public restroom is in compliance. <br /> Inspection report was discussed with Kip Curtiss, Project Manager. <br /> Owner/operator must obtain a food safety certificate within 60 days from the date the permit is issued and provide a copy of <br /> the certificate to this office.All other employees must obtain food handler cards within 30 day of the employment and maintain <br /> records at the facility. <br /> Post the provided sign advising patrons that a copy of the most recent inspection report is available for review. <br /> Okay to issue permit for program element 1613 once the following conditions are satisfied: <br /> • Owner should return to this office, 1868 E. Hazelton Ave, Stockton,to complete the provided facility information (Pink and <br /> Green). <br /> • Pay the permit of$350. <br /> • Provide the copy of owner's driver license and tax ID or Social Security Number. <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 /> Z;�� <br /> Received by: Name and Title: Kip Curtiss, Project Manager <br /> EH Specialist: STEVEN SHIH Phone: (209)616-3152 <br /> SR0081804 SC523 07/24/2020 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program Service Request Inspection Report <br />