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SAN =J OAQ U I N Environmental Health Department <br /> COUNTY- <br /> �c,F❑�t' Greotness grows hers. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: NEW YORK DONUTS, 1864 COUNTRY CLUB BLVD , STOCKTON 95204 <br /> #48 Compliance with Plan Review Requirements <br /> OBSERVATIONS:A remodel might take place in a few months.Any major remodel requires that plans shall be submitted to <br /> this dept before work starts. <br /> CALCODE DESCRIPTION:A person proposing to build or remodel a food facility shall submit plans for approval before starting any new <br /> construction or remodeling of any facility for use as a retail food facility. (114380) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Lee Hem Expiration Date:June 12,2022 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 130°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 130°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 door blue air--customer--49.00°F roper--back room--37.00°F <br /> frigidare--donut prep--41.00°F 1 door habco--customer--41.00°F <br /> NOTES <br /> Ok to issue permit once fee is paid <br /> Return to office by 10/27/21 to fill out paper work and pay fee <br /> Program 1623 Fee$350 <br /> Equipment: 2 comp sink, 3 comp sink, mop sink, hand sink, rest room,40 gallon,40,000 BTU Hydrojet water heater <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: Taing Ney Kea, owner <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209)616-3051 <br /> FA0001918 SR0084376 SC061 10/26/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />