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SAN ]OAQ U I N Environmental Health Department <br /> COUNTY- <br /> �c,F❑�t' Greotness grows hers. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: LODI VALLEY PETROLEUM INC, 610 S CHEROKEE LN , LODI 95240 <br /> #43 Toilet Facilites Clean/Supplied/Maintained <br /> OBSERVATIONS:The toilet paper dispenser was empty,the toilet paper was on top of the hand rail. Provide toilet paper in <br /> dispenser today. <br /> CALCODE DESCRIPTION:Toilet facilities shall be maintained clean, sanitary and in good repair. Toilet rooms shall be separated by a <br /> well-fitting self-closing door. Toilet tissue shall be provided in a permanently installed dispenser at each toilet. The number of toilet <br /> facilities shall be in accordance with local building and plumbing ordinances. Toilet facilities shall be provided for patrons:in <br /> establishments with more than 20,000 sq ft. establishments offering on-site liquor consumption. (114250, 114250.1, 114276) <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: 121 IF <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> hand sink--restroom--100.00°F walk-in--38.00°F <br /> hand sink--back room--104.00°F mop sink--120.00°F <br /> 4 dr reach-in display--market--40.00°F 3 comp sink--121.00°F <br /> NOTES <br /> Change of Ownership Inspection. <br /> Quat and chlorine test strips available. <br /> Facility will have prepackaged food, coffee, and slushy machine. <br /> Submit evidence of correction for warewashing sanitization to dafonskaia@sjgov.org by 8/26/2022 or there will be a <br /> chargeable a re-inspection. <br /> Discussed report with Primo Botilla, Manager. <br /> No signature captured. <br /> Okay to issue permit once permit fee is paid and 5021 form is updated. <br /> PE 1615,fee$275 <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: DARIA AFONSKAIA Phone: (209)616-3035 <br /> FA0014852 SR0085649 SC061 08/24/2022 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />