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S A N-J O A Q U I N Environmental Health Department <br /> C Q U N T Y Time In: 2-30 pm <br /> Time Out: 2:49 om <br /> e�c,aos�t` Greotness grows here. <br /> Food Program Service Request Inspection Report <br /> Name of Facility: DOUBLE DIP GALLERY Date: 12/21/2020 <br /> Address: 222 W PINE ST, LODI 95240 <br /> Requestor: NATALIE SAUERLAND, DOUBLE DIP GALLERY Telephone: (209)327-9849 <br /> Program Element: 1602-FOOD CONSULTATION Request#: SR0083012 <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 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 /> OBSERVATIONS <br /> Name on Food Safety Certificate: Anthony Segale Expiration Date: December 10,2024 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 113°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 3 comp(hot water)--120.00°F 2 door reach-in--under milk shake machine--41.00°F <br /> hand sink(warm water)--restroom--102.00°F hand sink--near 3 comp--113.00°F <br /> mop sink(hot water)--120.00°F <br /> NOTES <br /> PE 1617 <br /> Ok to issue permit once fee is paid <br /> Note: Front reach-in freezer is not pugged in at this time. <br /> Provide food items in this unit in the frozen state or at 41 F or lower,when in use. <br /> All existing equipment. <br /> Same menu as previous operator. <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: Natalie Sauerland, owner, sig not cap <br /> EH Specialist: STEPHANIE RAMIREZ Phone: <br /> FA0022105 SR0083012 SC061 12/21/2020 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program Service Request Inspection Report <br />