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J <br /> Environmental Health Department <br /> A N0 A 0 U I N <br /> t� : -�'o-- C:0U N TY <br /> Y � + Greatness grows Frere. <br /> Food Program Official Inspection Report <br /> Name of Facility:CULEBRA COFFEE LLC Date: 08/19/2025 <br /> Address: 1110 W KETTLEMAN LN, LODI 95240 <br /> Owner/Operator: CULEBRA COFFEE LLC Telephone: ()- <br /> Program Element: 1612- FOOD EST<500 SQ FT W/O SEATING <br /> Inspection Type: Routine Reinspection on or after: <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 <br /> closure of the food facility. <br /> #6 Handwashing Facilities Supplied and Accessible <br /> OBSERVATIONS:Observed paper towel dispenser is empty. Maintain paper towel dispenser stocked at all times. Correct <br /> today. <br /> CALCODE DESCRIPTION:Handwashing soap and towels or drying device shall be provided in dispensers dispensers shall be <br /> maintained in good repair. (113953.2) Adequate facilities shall be provided for hand washing,food preparation and the washing of <br /> utensils and equipment.(113953, 113953.1, 114067(f)) <br /> This is(Minor-Food)Violation. <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate Itzcoatl Friaz Expiration Dated/25/2030 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120 °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100 0 F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> hand sink--105°Fahrenheit 3 comp sink--120°Fahrenheit <br /> 2 door reach in--41°Fahrenheit hand sink--Men's restroom--100°Fahrenheit <br /> hand sink--Women's restroom--100°Fahrenheit <br /> NOTES <br /> Routine inspection. <br /> PRO548297 08/19/2025 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 2 Food Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />