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° ur I Environmental Health Department <br /> SAN-6-JOAQU <br /> Greotness grows here. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: ROUND TABLE PIZZA, 253 SPRECKELS AVE , MANTECA 95336 <br /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:Back non adjustable hand sink, across the walk in cooler, has a loose faucet and 3 comp sink has a <br /> loose faucet that is leaking from its neck. Repair in 2 weeks. <br /> CALCODE DESCRIPTION:The potable water supply shall be protected with a backflow or back siphonage protection device,as required <br /> by applicable plumbing codes. (114192)All plumbing and plumbing fixtures shall be installed in compliance with local plumbing <br /> ordinances,shall be maintained so as to prevent any contamination,and shall be kept clean,fully operative,and in good repair. Any hose <br /> used for conveying potable water shall be of approved materials,labeled,properly stored,and used for no other purpose. (114171, <br /> 114189.1, 114190, 114193, 114193.1, 114199, 114201, 114269) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Required Expiration Date: <br /> Warewash Chlorine(Cl): 100 ppm Heat: °F Water/Hot Water Ware Sink Temp: 103°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 CO2 tank--137.000 L 1 D mini warmer--187.00°F <br /> 1 CO2 tank--50.000 L Rt 1 D Arctic Air reach in cooler/under prep table--Pizza prep <br /> line--39.00°F <br /> Walk in cooler--40.00°F 1 D Pepsi cooler--41.00°F <br /> Front non adjustable hand sink--94.00°F Back non adjustable hand sink--by washing area--88.00°F <br /> Lt 1 D Arctic Air reach in cooler/under prep table--Pizza prep line Back non adjustable hand sink--across walk in cooler--89.00°F <br /> --41.00°F <br /> Prep sink--104.00°F Middle 1 D Arctic Air reach in cooler/under prep table--Pizza <br /> prep line--41.00°F <br /> NOTES <br /> Change of ownership. <br /> All cold food items on the cold hold are at 41 F or below. <br /> I observe big CO2 tank more than 137LBS and 1 CO2 of 50lbs on site.As per new owner, he will replace it with 2 CO2 tanks <br /> 50lbs each and one <br /> CO2 tank 20lbs total of 120lbs. <br /> Okay to operate. Obtain permit prior operating your business. <br /> PE 1626$425 to be paid for the new Health Permit under the new ownership. <br /> 5021 form provided to be updated. <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 /> Received by: Name and Title: <br /> EH Specialist: GEHANE FAHMY Phone: (209)616-3052 <br /> FA0018244 SR0082952 SC061 12/04/2020 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />