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SAN JOAQUIN Environmental Health Department <br /> C0JNTY- <br /> rSc, n Greotness grows here. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: COMAL COFFEE AT BELLA TERRA PLAZA, 1110 KETTLEMAN DR , LODI <br /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:There was no air gap between floor sink and discharge hoses from 3 comp sink/hand sink and espresso <br /> machine. Provide 1 in. minimum air gap between floor sink and discharge hoses prior to operating. <br /> CALCODE DESCRIPTION:The potable water supply shall be protected with a backflow or back siphonage protection device,as required <br /> by applicable plumbing codes. (114192)All plumbing and plumbing fixtures shall be installed in compliance with local plumbing <br /> ordinances, shall be maintained so as to prevent any contamination,and shall be kept clean,fully operative,and in good repair. Any hose <br /> used for conveying potable water shall be of approved materials,labeled,properly stored,and used for no other purpose. (114171, <br /> 114189.1, 114190, 114193, 114193.1, 114199, 114201, 114269) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Zoyla Cifuentes Expiration Date:October 10,2027 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 107°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> hand sinks--M&W Restrooms--100.00°F residential chest freezer--kiosk--3.00°F <br /> 1 D Elite Kitchen--kiosk--33.00°F 3 comp sink--kiosk--120.00°F <br /> hand sink--kiosk--107.00°F <br /> NOTES <br /> Consultation inspection. <br /> Facility will serve hot/cold drinks and store bought pastries. <br /> Facility will use will plaza restroom located on 2nd floor and mop sink in janitor room located on 1 st floor. <br /> Unable to access janitor room during the inspection. <br /> Check with City of Lodi Building about 3 comp sink/hand sink plumbing requirements. <br /> Observed residential chest freezer. Provide commercial unit that is NSF or equivalent certified for sanitation when replacing <br /> this unit. <br /> Observed vinyl wall base in kiosk. Provide approved coving such as slim foot tile or Schluter cove base with tile when replacing <br /> coving. <br /> Discussed report with Zoyla Cifuentes. <br /> No signature captured. <br /> Ok to issue permit once permit fee is paid and MFR 1 &2 forms are submitted. <br /> PE 1612,fee$350 <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 /> SR0086439 SC061 03/01/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 2 Food Program Service Request Inspection Report <br />