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Time In: 1 10 pm <br /> Time Out: 2:20 om <br /> o�4�tN. San Joaquin County <br /> p' Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> .., Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.socciov.org/ehd <br /> qGj P�Ri� <br /> Food Program Service Request Inspection Report <br /> Name of Facility: CHICK-FIL-A Date: 10/04/20V <br /> Address: 2628 W MARCH LN, STOCKTON 95207 <br /> Requestor: .JOEL PHILLIPS,4 G DEVELOPMENT Telephone: (951) 205-3886 <br /> Program Element: 1601 - FOOD PLAN CHECK Request#: SR0073689 <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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Erica D Hartfield Expiration Date: November 11,2018 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 114°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100 OF <br /> FOOD ITEM --LOCATION --TEMP°F --COMMENTS <br /> walk in—41.00°F All refrigerators--41.00°F <br /> NOTE <br /> Correct the following before restaurant opens: <br /> 1. Hot water shall be 120 F or higher <br /> 2. Provide splash guards of a minimum height of 6 inches on both sides of hand sinks in the kitchen <br /> 3. Provide an anti-siphon device for mop sink's faucet <br /> 4. Return to office to pay permit fee of$368 and fill out paper work (program 1626) <br /> Correct the following by 30 days: <br /> 1. Have food handler certificates for employee's <br /> 2. Register with CERS for the CO2 cylinder(program 1919 permit fee$254 + $25 process fee. Contact Lisa @468-3455 with <br /> questions <br /> Ok to issue permits once fees are paid <br /> NOTE: send me pictures hand sinks and faucet at mop sink <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: Erica Hartfield, Owner/Operator <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209) 953-7817 <br /> FA0002011 SR0073669 SC523 10/04/2016 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program Service Request Inspection Report <br />