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Environmental Health Department <br />Facility Name and Address: COLLIERVILLE COUNTRY STORE, 3706 E COLLIER RD, ACAMPO 95220 <br />Food Program Official Inspection Report <br /> #35 Equipment/Utensils Approved and in Good Repair <br />OBSERVATIONS: Observed debris on metal drink shelf in rear walk-in. Clean today and maintain clean. <br />The outside of the soda fountain hoses had dust/debris buildup. Clean today. <br />CALCODE DESCRIPTION: All utensils and equipment shall be fully operative and in good repair. (114175). All utensils and equipment <br />shall be approved, installed properly, and meet applicable standards. (114130, 114130.1, 114130.2, 114130.3, 114130.4, 114130.5, <br />114132, 114133, 114137, 114139, 114153, 114155, 114163, 114165, 114167, 114169, 114172, 114177, 114180, 114182) <br /> #45 Floors, Walls, Ceilings; Clean and Maintained <br />OBSERVATIONS: Observed debris on rear walk-in floor. Clean today and maintain clean. <br />CALCODE DESCRIPTION: The walls / ceilings shall have durable, smooth, nonabsorbent, light-colored, and washable surfaces. All floor <br />surfaces, other than the customer service areas, shall be approved, smooth, durable and made of nonabsorbent material that is easily <br />cleanable. Approved base coving shall be provided in all areas, except customer service areas and where food is stored in original <br />unopened containers. Food facilities shall be fully enclosed. All food facilities shall be kept clean and in good repair. (114143 (d), <br />114266, 114268, 114268.1, 114271, 114272) <br />Chlorine (Cl): <br />Name on Food Safety Certificate:Expiration Date: <br />ppmQuaternary Ammonia (QA): <br />Heat:ppm º FWarewash Water/Hot Water Ware Sink Temp:º F <br />Hand Sink Temp:º F <br />OBSERVATIONS <br /> 120 <br /> 100 <br />needed <br />OVERALL INSPECTION NOTES AND COMMENTS <br />rear walk-in -- 41.00º F chicken nuggets -- under heat lamps -- 127.00º F <br />hand sink -- employee restroom -- 100.00º F 3 comp sink -- back room -- 120.00º F <br />5 dr display cooler -- market -- 41.00º F <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />Routine inspection. <br />Chlorine test strips available. <br />Discussed report with Hari Singh. <br />No signature captured. <br />Maintain a copy of this report on site. <br />Report will be mailed to the facility. <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:Phone:(209) 616-3035 <br />, <br />DARIA AFONSKAIA <br />Page 2 of 2EHD 16-23 Rev. 09/16/2020 Food Program OIR <br />FA0000238 PR0161892 SC001 11/04/2021 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD