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SAN <br /> ` , J O QUI =nvironr^ <br /> CCU 1T <br /> Food Program Official Inspection Report <br /> Facility Name and Address: DUTCH BROS COFFEE, 1665 PACIFIC AVE, STOCKTON 95204 <br /> #43 Toilet Facilites Clean/Supplied/Maintained <br /> OBSERVATIONS:Rest room needs detail cleaning. Clean all surfaces, daily. <br /> CALCODE DESCRIPTION:Toilet facilities shall be maintained clean, sanitary and in good repair. Toilet rooms shall be separated by a <br /> well-fitting self-closing door. Toilet tissue shall be provided in a permanently installed dispenser at each toilet. The number of toilet <br /> facilities shall be in accordance with local building and plumbing ordinances. Toilet facilities shall be provided for patrons:in <br /> establishments with more than 20,000 sq ft. establishments offering on-site liquor consumption. (114250, 114250.1, 114276) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Gabrielle Oleri Expiration Date:October 17,2022 <br /> Warewash Chlorine(Cl): 100 ppm Heat: °F Water/Hot Water Ware Sink Temp: 107°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 107°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 door cooler--40.00°F (C)dispenser--37.00°F <br /> (L)dispenser--38.00°F walk in--37.00°F <br /> (R)dispenser--32.00°F <br /> NOTES <br /> No comment entered. <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: gabrielle oleari, operator <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209)953-7817 <br /> FA0024055 PR0541931 SCO01 11/28/2017 <br /> EHD 16-23 Rev.06/30/15 Page 2 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.sjcehd.com <br />