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SAN J O A Q U I N Environmental Health Department <br />----COUNTY- <br />Greatness groY/i h¢rx. <br />Food Program Service Request Inspection Report <br />Facility Name and Address: MILK & DREAM, 4950 PACIFIC AVE, STOCKTON 95207 <br />#47 Signs Posted; Last Inspection Report Available <br />OBSERVATIONS: Post SB180 were it is visible to customers. <br />CALCODE DESCRIPTION: Handwashing signs shall be posted in each toilet room, directing attention to the need to thoroughly wash <br />hands after using the restroom (1 1395a5) (b) No smoking signs shall be posted in food preparation, food storage, warewashing, and <br />utensil storage areas (113978). (c) Consumers shall be notified that clean tableware is to be used when they return to self-service areas <br />such as salad bars and buffets. (d) Any food facility constructed before January 1, 2004, without public toilet facilities, shall prominently <br />post a sign within the food facility in a public area stating that toilet facilities are not provided (113725.1, 114381(a)). Proper posting of <br />nutritional information at facilities with 20 or more chains in Califomia (114094). <br />OVERALL INSPECTION NOTES AND COMMENTS <br />OBSERVATIONS <br />Name on Food Safety Certificate: <br />Warewash Chlorine (Cl): ppm Heat. <br />Quatemary Ammonia (QA): ppm <br />FOOD ITEM -- LOCATION -- TEMP ° F -- COMMENTS <br />Sm 1 door true — 40.00° F <br />Freezer -- 15.00° F <br />NOTES <br />Ok to issue permit once fee is paid <br />Program 1612 Fee $350 <br />Return to office by 2 days <br />Expiration Date: <br />Water/Hot Water <br />Lg 1 door true -- 40.00° F <br />Equipment: 3 comp sink, hand sink, commercial coolers and freezer <br />Ware Sink Temp 115 ° F <br />Hand Sink Temp 15 ° F <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: Dawson Phan, owner <br />EH Specialist: MARIBEL FLOHRSCHIJTZ <br />Phone: (209) 616-3051 <br />FA0025509 SR0084020 SCO61 08/10/2021 <br />EHD 16-23 Rev. 09/16/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />