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SAN J 0 A Q U I N Environmental Health Department <br /> CC)U NTY <br /> Food Program Official Inspection Report <br /> Facility Name and Address: COUNTRY CLUB MOBIL CIRCLE K, 2575 COUNTRY CLUB BLVD, STOCKTON 95204 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Needed 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 /> First re-inspection. No major violations identified. Time was given for correction of minor violations. Re-inspection in <br /> two weeks. Only one violation was corrected. <br /> Discussed report with Nete Rillamas(Clerk). Official inspection report was emailed to the operator. <br /> To minimize person-to-person contact,the signature of the person receiving the inspection report was not captured. <br /> RE-INSPECTION IN TWO WEEKS. <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: LYDIA BAKER Phone: (209)616-3046 <br /> FA0001997 PRO167535 SC333 06/06/2022 <br /> EHD 16-23 Rev.09/16/2020 Page 3 of 3 Food Program OIR <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 />