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SAN <br /> 1` ` e J O 1a Q U I N Environmental Health Department <br /> C 0 U A i `l <br /> Food Program Official Inspection Report <br /> Facility Name and Address: COLLIERVILLE COUNTRY STORE, 3706 E COLLIER RD, ACAMPO 95220 <br /> #45 Floors,Walls, Ceilings; Clean and Maintained <br /> OBSERVATIONS:Observed debris on market walk-in cooler. Clean today and maintain clean. <br /> Observed damaged flooring in restroom. Replace with approved flooring within 1 month. <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 /> 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: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> CO2 cylinders--side storage room--150.000 L market walk-in--40.00°F <br /> NOTES <br /> Re-inspection. <br /> Toilet was working properly. <br /> Time log was kept for food items in display warmer. <br /> Discussed report with Hari Singh, Owner. <br /> No signature captured. <br /> There are currently 150 lbs of carbon dioxide(CO2)cylinders at the facility. Please be aware that CO2 is an asphyxiant and <br /> is therefore considered a hazardous material subject to regulation under Chapter 6.95, Health and Safety Code, Division 20, <br /> The reportable quantity for CO2 is 137 pounds or 1,200 cubic feet in San Joaquin County(SJC). You will be placed into the <br /> SJC Environmental Health Program for Hazardous Material Business Plan (HMBP)and will be required to report your <br /> hazardous materials in the California Environmental Reporting System (CERS). For more information or to comply with the <br /> reporting requirement in CERS, please go to: http://cers.calepa.ca.gov/ <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: DARIA AFONSKAIA Phone: (209)616-3035 <br /> FA0000238 PRO161892 SC333 09/26/2022 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 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 />