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COMPLIANCE INFO_2022
Environmental Health - Public
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0167533
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COMPLIANCE INFO_2022
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Last modified
2/17/2022 8:47:46 AM
Creation date
2/17/2022 8:47:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0167533
PE
1618
FACILITY_ID
FA0002791
FACILITY_NAME
CVS Pharmacy #9916
STREET_NUMBER
5070
STREET_NAME
WEST
STREET_TYPE
Ln
City
Stockton
Zip
95210
APN
09614023
CURRENT_STATUS
01
SITE_LOCATION
5070 West Ln
P_LOCATION
01
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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Environmental Health Department <br />Facility Name and Address: CVS Pharmacy #9916, 5070 West Ln, STOCKTON 95210 <br />Food Program Official Inspection Report <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 />OVERALL INSPECTION NOTES AND COMMENTS <br />hand sink -- customer restroom -- 100.00º F mop sink -- 132.00º F <br />2 dr Master-Bilt display -- dairy -- 40.00º F hand sink -- employee restroom -- 100.00º F <br />2 dr Master-Bilt display -- juice -- 38.00º F <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />Routine inspection. <br />Observed out of order sign on customer restroom door. Employee restroom was available. <br />Customer restroom toilets were functioning during inspection. Per store manager they have been having plumbing issues with <br />pipes clogging due to potentially damaged piping. They are working on the issue. Per manager, currently customers can <br />access restroom for emergencies. <br />Discussed report with Kooshyar Dehkordy, Store Manager. <br />No signature captured. <br />Maintain copy of this report on site. <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 2 of 2EHD 16-23 Rev. 09/16/2020 Food Program OIR <br />FA0002791 PR0167533 SC001 02/15/2022 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD
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