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°• Environmental Health Department <br /> �. �J r� SHAWN <br /> t 7Y - L. <br /> Y Time In: 7:28 am <br /> tl1r_ —COUNTY— <br /> Time Out: 8:13 am <br /> c_ t Greotrless grows he: . . <br /> Mobile Food Facility Service Request Inspection Report <br /> Name of Facility: KN INC DBA HUMMUS REPUBLIC Date: 08/30/2023 <br /> Address: 16201 S HARLAN RD , LATHROP 95330 <br /> Requestor: KANWALJIT KAUR, KN INC DBA HUMMUS REPUBLIC Telephone: (209)361-0261 <br /> Program Element: 1601 -FOOD PLAN CHECK Request#: SR0087083 <br /> Inspection Type: 523-Plan Check/Report Review <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 /> #14 Food Contact Surfaces Sanitized or Warewashing Sanitization <br /> OBSERVATIONS:A chlorine sanitizer is needed. Obtain prior to operation of the trailer. <br /> CALCODE DESCRIPTION:All food contact surfaces of utensils and equipment shall be clean and sanitized. (I 13984(e), 114097, <br /> 114099.1, 114099.4, 114099.6, 114101 (b-d), 114105, 114109, 114111, 114113, 114115(a, b, d), 114117, 114125(b), 114135, 114141) <br /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:The waste water outlet valve requires a cap. Provide prior to operation of the trailer. <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 /> #62 Not in Compliance with Commissary Requirements <br /> OBSERVATIONS:A commissary letter is needed. Provide a commissary letter. <br /> Permitting condition. <br /> CALCODE DESCRIPTION: 1. The mobile food facility fails to operate in conjunction with a commissary a mobile support unit. <br /> [§114295(a)] 2. The mobile food facility is not stored in a location approved by the enforcement agency.[§114295(c)] 3. Mobile support <br /> unit is not operated out of a commissary.[§I 14295(d)] <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Kanwaljit Kaur Expiration Date:August 21,2028 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 122°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 122°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 door Asber-left--29.00°F 2 door Icehaus--32.00°F <br /> 2 door Enhanced prep--40.00°F 1 door Asber-right--14.10°F <br /> SR0087083 SC523 08/30/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 1 of 2 Mobile Food Facility Service Request Inspection Report <br />