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z_. Environmental Health Department <br /> SAN-JOAQUIN <br /> COUNTY <br /> lareotness groves firer€ Time In: 10:10 am <br /> Time Out: 10:25 am <br /> Food Program Complaint Inspection Report <br /> Name of Facility: JACK IN THE BOX#534 Date: 04/10/2018 <br /> Address: 2592 W MARCH LN, STOCKTON 95207 <br /> Owner/Operator: ANIL YADAV Telephone: (209)951-6424 <br /> Program Element: 1600-FOOD PROGRAM Complaint#: C00046111 <br /> DESCRIPTION OF COMPLAINT ALLEGATIONS <br /> The San Joaquin County Environmental Health Department received the following complaint: <br /> COMPLAINANT BELIEVES THEY GOT FOOD POISONING ON 3/25/2018 AFTER THEY CONSUMED A HAMBURGER <br /> WITH LETTUCE AND TOMATO, WHILE THEIR NEPHEW CONSUMED A PLAIN HAMBURGER AND DID NOT BECOME <br /> ILL. COMPLAINANT STATED THAT WAS THE ONLY FOOD THEY ATE THAT WAS DIFFERENT BEFORE THEY <br /> BECAME ILL. <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 /> #41 Plumbing Maintained; Approved Back Flow Device <br /> OBSERVATIONS:Waste line for ice machine leaks. Repair, immediately. <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: Expiration Date: <br /> Warewash Chlorine(Cl): 50 ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> Most violations were corrected. Continue to maintain a clean and sanitary facility. <br /> FA0001999 C00046111 SC404 04/10/2018 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 Food Program Complaint Inspection Report <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />