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i �� I I I AI Environmental Health Department <br /> YSA N U N <br /> f �z wti COUNTY Time In: 928 am <br /> Time Out: 10:00 am <br /> c `�� Greotr+essrGws here. <br /> Food Program Service Request Inspection Report <br /> Name of Facility: CANTEEN @ COSTCO#658 MARKET#2 Date: 10/23/2020 <br /> Address: 25862 S SCHULTE CT, TRACY 95377 <br /> Requestor: Telephone: <br /> Program Element: 1602-FOOD CONSULTATION Request#: SR0082658 <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: n/a 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 /> 1 door Minus Forty freezer--17.00°F 2 door Imbera Hydrate--40.00°F <br /> 1 door Minus Forty--40.00°F <br /> NOTES <br /> Additional market added to Building"A"at Costco#179-middle of building on west side (office is in the middle of building on <br /> the east side). <br /> Existing Market is in SW corner of Building"A" <br /> All pre-packaged food/no food prep <br /> OK to operate market(will be added to existing permit) <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: Discussed w/Mark Mason, Facilities <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> SR0082658 SC061 10/23/2020 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 1 Food Program Service Request Inspection Report <br />