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SIU I Environmental Health Department <br /> - i CUNTY I <br /> Greotrress grows here, Time In: 12-15 p <br /> Time Out: 12:40 pm <br /> Food Program Official Inspection Report <br /> Name of Facility: A GREEN ZONE C Date: 07/12/2021 <br /> Address: 2356 BEARDSLEY AVE, MANTECA 95337 <br /> Owner/Operator: HOLLOWAY-DYER, CARROL Telephone: <br /> Program Element: 1609-CLASS B COTTAGE FOOD-INDIRECT SALES <br /> Inspection Type: ROUTINE INSPECTION -Operating Permit <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: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> Class B CFO application. <br /> Dry food only will be packaged in home kitchen. <br /> Bleach and chlorine test strips are available. <br /> All dry food are stored in plastic containers with tight lid and labels and 6 inches off the floor. <br /> Soap and paper towels are provided to the hand wash station. <br /> Health permit provided to 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: <br /> EH Specialist: GEHANE FAHMY Phone: (209)616-3052 <br /> FA0026080 PR0546114 SCO01 07/12/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 1 Food Program OR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />