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r I �,r Environmental Health Department <br /> SANJOAQUCUfT I� <br /> Greotne55 grows here Time In: 9.50 am <br /> Time Out: 10:19 am <br /> Food Program Official Inspection Report <br /> Name of Facility: YOSEMITE AVENUE ARCO AMPM Date: 12/06/2021 <br /> Address: 1711 E YOSEMITE AVE, MANTECA 95336 <br /> Owner/Operator: JESSE&KUL ESTATE ENTERPRISE LLC Telephone: (209)823-4715 <br /> Program Element: 1616-RETAIL MARKET< 1000 SQ FT W/FOOD PREP <br /> Inspection Type: INSPECTION/REINSPECTION (Chargeable) <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:Hand sink at the prep area, is lacking air gap. Provide air gap at least 1 inch off the floor sink in 1 week. <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): 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 /> Re inspection. <br /> Mop sink and ware wash sink have consistent temp at 120F or above. <br /> Facility address is added to the sign posted on the ice display freezer. <br /> 2 comp grandfathered ware wash sink is fully accessible and all items are removed from drain boards. <br /> QUAT test strips are available. <br /> Hand sink at the prep area is not leaking (corrected by installing new draining pipe). <br /> All major and repeated violations are corrected. <br /> No more re inspection is required at this time. <br /> FA0000992 PRO161556 SC333 12/06/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 2 Food Program OR <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 />