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P"o <br /> SANaJOAQUIN Environmental Health Department <br /> COUNTY— Timeln: to0pm <br /> rime Out: 2:00 om <br /> Greatness grows here. <br /> Food Program Service Request Inspection Report <br /> Name of Facility: DOMINO'S PIZZA Date: 07/08/2021 <br /> Address: 2605 PACIFIC AVE, STOCKTON 95204 <br /> Requestor: HEIDI MILLER, ACUTE CONSULTING, INC. Telephone: (925) 818-4132 <br /> Program Element: 1601 - FOOD PLAN CHECK Request#: SR0083179 <br /> Inspection Type: 523 - Plan Check/Report Review <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 foodbome illness.All major violations must be corrected immediately. Non-compliance may warrant immediate closure of <br /> the food facility. <br /> #1 Demonstration of Knowledge <br /> OBSERVATIONS: By 60 days from opening at least one employee shall have the food safety certificate. <br /> All other employees shall have the food handler cards. <br /> CALCODE DESCRIPTION:All food employees shall have adequate knowledge of and be trained in food safety as it relates to their <br /> assigned duties. (113947)Food facilities that prepare, handle or serve non-prepackaged potentially hazardous food, shall have an <br /> employee who has passed an approved food safety certification examination. (113947-113947.1)Any food handler hired after June 1, <br /> 2011 shall obtain a Food Handler Card within 30 days(113948). <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: 120°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 120°F <br /> FOODITEM--LOCATION --TEMP°F--COMMENTS <br /> right 2 door prep--41.00°F left 2 door prep--41.00°F <br /> 1 door sm coca cola--41.00°F 1 door galaxy—38.00°F <br /> walk in—38.00°F 1 door coca cola cooler--48.00°F <br /> NOTES <br /> Ok to issue permit once fee is paid <br /> Return to office to pay permit fee $376 <br /> Program 1614 <br /> Correct the following before opening: <br /> 1. Install wall bracket for mops, ect at mop basin <br /> 2. Silicone behind all sinks <br /> 3. Post hand wash signs in rest rooms <br /> 4. Paint bare wood strip at window sill <br /> 5. Install soap/paper towel dispensers for all hand sinks <br /> Equipment: 2 Navien Tankless water heaters, 4 hand sinks, prep sink, 3 comp sink, mop basin, 2 rest rooms, clothes washer <br /> SR0083179 SC523 07/082021 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 2 Food Program Service Request Inspection Report <br />