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r I �,r Environmental Health Department <br /> SANJOAQUCUfT I� <br /> GrBCtness grows here Time In: 1224 pm <br /> Time Out: 12:54 pm <br /> Food Program Official Inspection Report <br /> Name of Facility: WOODBRIDGE GAS, MARKET&LIQUOR Date: 12/11/2023 <br /> Address: 18806 N LOWER SACRAMENTO RD,WOODBRIDGE 95258 <br /> Owner/Operator: LODI PETROLEUM INC Telephone: <br /> Program Element: 1617-RETAIL MARKET> 1000 SQ FT W/FOOD PREP <br /> Inspection Type: ROUTINE INSPECTION -Operating Permit <br /> VIOLATIONS AND CORRECTIVE ACTIONS <br /> Items listed on this report as violations do not meet the requirements set forth in the California Health and Safety Code commencing with section 7; <br /> 113700.All violations must be corrected within specified timeframe. Violations that are classified as"MAJOR"pose an immediate threat to public health <br /> and have the potential to cause foodborne illness.All major violations must be corrected immediately.Non-compliance may warrant immediate closure of <br /> the food facility. <br /> #32 Food Properly Labeled and Honestly Presented <br /> OBSERVATIONS:The facility bags the ice sold at facility on-site and is lacking signage. Provide a sign for customers <br /> stating the following information: <br /> ICE BAGGED ON-SITE <br /> FACILITY NAME <br /> FACILITY ADDRESS <br /> CALCODE DESCRIPTION:Any food is misbranded if its labeling is false or misleading, if it is offered for sale under the name of another <br /> food, or if it is an imitation of another food for which a definition and standard of identity has been established by regulation. Food facilities <br /> with 19 or more chains in the state shall disclose nutritional information. (114087, 114089, 114089.1(a, b), 114090, 114093.1, 114094) <br /> #35 Equipment/Utensils Approved and in Good Repair <br /> OBSERVATIONS:Observed buildup accumulating on the ice machine's deflector panel. Clean and sanitize this area and <br /> maintain regularly to protect ice from contamination. Correct 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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Sandeesh Kaur Bola Expiration Date: February 10,2026 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 105°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> walk in with display doors--40.00°F hand sink--restroom--102.00°F <br /> International delight creamer dispenser--counter--41.00°F mop sink--120.00°F <br /> 2 door upright display cooler--41.00°F counter hot case--146.00°F <br /> display refrigerator--41.00°F 3 comp sink--120.00°F <br /> front counter hot hold--157.00°F hand sink--across from counter warmer--105.00°F <br /> FA0003199 PRO162610 SCO01 12/11/2023 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 2 Food Program OR <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />