My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO_2021
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
W
>
WATERLOO
>
5611
>
1600 - Food Program
>
PR0161896
>
COMPLIANCE INFO_2021
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/17/2021 10:57:18 AM
Creation date
11/17/2021 10:55:06 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0161896
PE
1617
FACILITY_ID
FA0002160
FACILITY_NAME
BlackHawk Petroleum Inc.
STREET_NUMBER
5611
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
08710052
CURRENT_STATUS
01
SITE_LOCATION
5611 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
3
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
Environmental Health Department <br />Facility Name and Address: BlackHawk Petroleum Inc., 5611 E WATERLOO RD, STOCKTON 95215 <br />Food Program Official Inspection Report <br /> #45 Floors, Walls, Ceilings; Clean and Maintained <br />OBSERVATIONS: Observed debris on wall and floor in back room around soda syrup shelves. Clean today and maintain <br />clean. <br />Observed damage on wall and ceiling in back room. Repair/replace within 1 month. <br />CALCODE DESCRIPTION: The walls / ceilings shall have durable, smooth, nonabsorbent, light-colored, and washable surfaces. All floor <br />surfaces, other than the customer service areas, shall be approved, smooth, durable and made of nonabsorbent material that is easily <br />cleanable. Approved base coving shall be provided in all areas, except customer service areas and where food is stored in original <br />unopened containers. Food facilities shall be fully enclosed. All food facilities shall be kept clean and in good repair. (114143 (d), <br />114266, 114268, 114268.1, 114271, 114272) <br />Chlorine (Cl): <br />Name on Food Safety Certificate:Expiration Date: <br />ppmQuaternary Ammonia (QA): <br />Heat:ppm º FWarewash Water/Hot Water Ware Sink Temp:º F <br />Hand Sink Temp:º F <br />OBSERVATIONS <br /> 200 <br /> 120 <br /> 100 <br />Nazish Hussain July 28, 2026 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />fried chicken (hot hold) -- front counter, bottom shelf -- 141.00º F Winconsin Cheese open display -- market -- 41.00º F <br />walk-in -- 40.00º F hand sink -- back room -- 100.00º F <br />3 comp sink -- back room -- 120.00º F hand sink -- restroom -- 100.00º F <br />fried chicken (hot hold) -- front counter, top shelf -- 165.00º F corn dog (hot hold) -- front counter, bottom shelf -- 130.00º F <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />Routine inspection. <br />Krispy Krunchy Chicken at this facility. <br />Discussed report with owner. <br />No signature captured. <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: <br />EH Specialist:Phone:(209) 616-3035 <br />, <br />DARIA AFONSKAIA <br />Page 3 of 3EHD 16-23 Rev. 09/16/2020 Food Program OIR <br />FA0002160 PR0161896 SC001 11/10/2021 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD
The URL can be used to link to this page
Your browser does not support the video tag.