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®rk--Cwl <br /> SANAPIQUIN Environmental Health Department <br /> COUNTY— Time tri: p=Time Out: 12 8qm Greotness grows hero. <br /> Food Program Service Request Inspection Report <br /> Name of Facility: CANTEEN @ COSTCO#1091 LODI BREAKROOM Date: 02/07/2020 <br /> Address: 2680 REYNOLDS RANCH PKWY, LODI 95240 <br /> Requester: CANTEEN @ COSTCO#1091 LODI BREAKROOM,COMPASS GROUP US Telephone: (704)328-5184 <br /> Program Element: 1602-FOOD CONSULTATION Request#: SR0081434 <br /> Inspection Type: 061 -CONSULTATION <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 Cade commencing vAth section 7; <br /> 113700.All violations must be corrected Within specified timeframe. Violations that am classified es"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 wanant immediate closure of <br /> the food facility. <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: N/A Expiration Date: <br /> Warew sh Chlorine(Cl): ppm Heat: °F Water/Hot Water Were Sink Temp: °F <br /> Quaternary Ammonia(OA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM—LOCATION—TEMP°F—COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> Consultation inspection. <br /> Micro market installed in the employee lounge. <br /> Consist of one cooler,one freezer and shelfing for prepackaged goods. <br /> Program element: 1615 <br /> Ok to issue permit once fees have been paid. <br /> Official inspection report emailed.t Dr Imberu cooler-38F <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 vrill be assessed at the current hourly rate. <br /> V <br /> Received by: Name and Title: Gabriel Godinez,Assistant GM <br /> EH Specialist: VICTOR ACEVEDO Phone: (209)468-0337 <br /> SR0081434 SCO61 02/072020 <br /> EHD 16-23 Rev.06MIS Page 1 of 1 Food Program Sery ce Request InspeCbn ReWn <br />