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° ur I Environmental Health Department <br /> SAN-6-JOAQU <br /> Greotness grows here. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: CARNISERIA LUPITA, 2208 E MAIN ST, STOCKTON 95205 <br /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:The floor sink under the 3-compartment sink is lacking an air gap from the waste water line. Provide a <br /> gap distance of one-inch minimum. Correct prior to operation. <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: Needed Expiration Date: <br /> Warewash Chlorine(Cl): 100 ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Walk-in cooler--44.00°F Meat display cooler 35.00°F <br /> Mop sink--120.00°F Restroom hand sink -100.00°F <br /> NOTES <br /> No major violations. <br /> OKAY to issue permit once permit fee has been paid and 5021 is updated. <br /> Program Element: 1616 <br /> Fee: $257 <br /> Print and maintain a copy of the most current inspection report on-site. <br /> Note: 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: CLAUDIA MURO Phone: (209)561-8923 <br /> FA0018807 SR0086696 SC061 05/09/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 2 Food Program Service Request Inspection Report <br />