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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: PALETERIA Y NEVERIA TOCUMBO, 2219 W ALPINE AVE , STOCKTON 95204 <br /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:The hand sink in the front and the restroom were observed with loose faucets. Tighten faucets so that <br /> they are in good working order within two weeks. <br /> The waste pipe for the mop sink was observed disconnected. Re-connect waste pipe to the mop sink for proper disposal of <br /> waste water. Correct today. <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: Juan Saavedra Expiration Date:June 02,2026 <br /> Warewash Chlorine(Cl): 100 ppm Heat: °F Water/Hot Water Ware Sink Temp: 115°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 102°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Cantelope--Two door True prep cooler--39.00°F Hand sink--Back--103.00°F <br /> Three door True display cooler--33.00°F Hand sink--Restroom--103.00°F <br /> NOTES <br /> Consultation inspection for ownership change. No major violations.Time given for correction of minor violations. No <br /> re-inspection. <br /> Ok to issue permit once permit fee is paid ($350)and updated 5021 is received. <br /> PE 1623 <br /> Discussed inspection report with Monica Saavedra(Owner). Official inspection report was emailed to operator. <br /> To minimize person-to-person contact,the signature of the person receiving the inspection report was not captured. <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 /> FA0021638 SR0086412 SC061 03/07/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 2 Food Program Service Request Inspection Report <br />