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SAN J O A Q U I N Environmental Health Department <br /> e❑U T Y^ Time In: 9.50 am <br /> Time Out: 10:30 am <br /> i�C1FaR'' Greorness grows her". <br /> Food Program Service Request Inspection Report <br /> Name of Facility: CIRCLE K Date: 05/25/2021 <br /> Address: 2115 W YOSEMITE AVE , MANTECA 95337 <br /> Requestor: ANNIE GURPREET SINGH, CIRCLE K Telephone: (925)785-2000 <br /> Program Element: 1601 -FOOD PLAN CHECK Request#: SR0083274 <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 /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:Newly installed hand sink at the existing hand wash station, has loose faucet. Fix today. <br /> Existing 3 comp sink has the water faucet unit non functional. Only the spray nozzle is working.fix the water faucet unit <br /> today to be able to provide hot water 120F or more and cold water at the ware wash station. <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: Required Expiration Date: <br /> Warewash Chlorine(Cl): 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 /> Open case cooler/sandwiches--41.00°F Existing hand sink--Front--103.00°F <br /> New front hand sink--105.00°F 3 comp sink--Back--123.00°F <br /> NOTES <br /> Final inspection. <br /> No floor remodeling.Adding one extra hand sink at the front fully supplied with soap and paper towels from dispensers <br /> mounted to the wall. <br /> Replacing existing front hand sink with new one fully supplied with soap and paper towels from dispensers mounted to the wall. <br /> Adding 2 floor sinks; one by the coffee station and the other one draining the front 2 D True cooler.Air gaps are provided. <br /> Installing one open case cooler/sandwiches and 1 D freezer and 2 D freezer(all are self contained). <br /> There is an existing 3 comp sink at the back. <br /> No fryers on site. Installing new convection oven, hot dog roller and warmers. <br /> FA0017819 SR0083274 SC523 05/25/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 2 Food Program Service Request Inspection Report <br />