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°• ►I �� Illlr<I Environmental Health Department <br /> �1 <br /> �. �J r� U 111 <br /> -COUNTY <br /> COUNTY Time In: 12:50 pm <br /> - rT� <br /> Time Out: 1:05 pm <br /> <1 Greotrless grows here, <br /> Food Program Service Request Inspection Report <br /> Name of Facility: BURLINGTON#1471 Date: 11/15/2023 <br /> Address: 3150 N NAGLEE RD ,TRACY 95304 <br /> Requestor: Telephone: (609)387-7800 53145 <br /> Program Element: 1602-FOOD CONSULTATION Request#: SR0087424 <br /> Inspection Type: 061 -CONSULTATION <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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: n/a Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> mop sink-- 120.00°F women's restroom hand sink--108.00°F <br /> men's restroom hand sink--100.00°F <br /> NOTES <br /> All pre-packaged food. No food preparation <br /> OK to permit as a 1620 once the annual permit fee is paid ($107) <br /> No signature obtained <br /> Report typed in the office 2:06p-2:12p <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: discussed w/Arnold Lehman, SM <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> SR0087424 SC061 11/15/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 1 of 1 Food Program Service Request Inspection Report <br />