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° r I Environmental Health Department <br /> SAN-6-JOAQU <br /> Greotness grows here. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: TAHOE'S PIZZA, 1205 PLAZA AVE , ESCALON 95320 <br /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:Pipes,draining the hand sink, prep sink and grease trap, in the floor sink, are lacking air gap. Provide air <br /> gaps at least 1 inch off the floor sink before 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 /> #45 Floors,Walls, Ceilings; Clean and Maintained <br /> OBSERVATIONS:Floor at the front and the back of the house, has build up and debris. Clean the floor before operating. <br /> I observe 2 broken floor tiles at the pizza prep line. Replace tiles before operating. <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: Required Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 131 °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Multi D reach in cooler/under prep table--Pizza prep line-- Hand sink--Rest room--100.00°F <br /> 44.00°F <br /> Walk in cooler--41.00°F Prep sink--122.00°F <br /> Mop sink--128.00°F <br /> NOTES <br /> Change of ownership. <br /> Okay to operate <br /> Obtain permit prior operating your business. <br /> PE 1623$355 to be paid for the new permit. <br /> 5021 form to be updated. <br /> FA0017640 SR0086481 SC061 03/17/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 3 Food Program Service Request Inspection Report <br />