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1600 - Food Program
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PR0505984
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Entry Properties
Last modified
1/24/2024 11:25:14 AM
Creation date
9/13/2023 11:27:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
WORK PLANS
RECORD_ID
PR0505984
PE
1626
FACILITY_ID
FA0007125
FACILITY_NAME
GOHAN BUFFET
STREET_NUMBER
3200
Direction
N
STREET_NAME
NAGLEE
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
21205052
CURRENT_STATUS
01
SITE_LOCATION
3200 N NAGLEE RD STE 600
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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LISTING REPORT/INSPECTION PROCEDURE <br /> Botin Innovation Inc. Page 15 of 22 <br /> PROJECT NUMBER: GZ-CERT220902472 Issued:28 Jan. 2023 <br /> Revised: None <br /> Photo Item Component Manufacturer/ Type/model Technical data Mark(s)of <br /> No. No. name trademark conformity <br /> 9 30.1 Water Tank Kingfa Sci.& PP-35071 SF NSF/ANSI 51 Listed. NSF <br /> Box Tech. Co., Ltd. <br /> 9 30.2 ball float valve Kingfa Sci.& PP-35071 SF NSF/ANSI 51 Listed. NSF <br /> Tech. Co., Ltd. <br /> Silicone Tube Xiamen Maifeng <br /> 9 30.3 f Box Seal Products SIL4088F NSF/ANSI 51 Listed. NSF <br /> Co., Ltd. <br /> screws of Fujian Tsingtuo <br /> 9 30.4 Water Tank Industrial Co., Stainless steel SUS Grade 304, NSF <br /> Ltd. <br /> Dow Silicones <br /> Corporation DOWSILTm 732 NSF/ANSI 51 Listed. NSF <br /> Gap GaSealant - - - - - <br /> 2 31 GapSZ) Dow Silicones DOWSILTm 732 <br /> (Zhangjiagang) Multi-Purpose NSF/ANSI 51 Listed. NSF <br /> Co., Ltd. Sealant, Clear <br /> Notes: <br /> 1)ldentifies where on the equipment the part is used by Zone.Zone Identifiers are Food Zone(FZ), Heated Food <br /> Zone(HFZ),Splash Zone(SZ), Non-Food Zone(NFZ),or Unexposed Non-Food Zone(UNFZ). FZ and HFZ items <br /> also indicate either Food Contact(FC)or Non-Food Contact(NFC).Splash Zone parts requiring conformance to <br /> Food Zone Material requirements are denoted by the addition of the identifier for Food Zone Material(FZM). <br /> 2)"Various"means any type,from any manufacturer that complies with the"Technical Data and Acceptance"and <br /> meets the"Mark(s)of conformity"can be used. <br /> 3)Model or part number of the component,or type of material such as:Stainless Steel, Galvanized(or Zinc- <br /> Coated)Steel,Aluminum, Nylon,ABS,Silicone Rubber,etc. <br /> 4)Food Zone, Food Contact(FZ, FC)items indicate one of the following:the NSF standard(used to obtain the <br /> Mark of conformity indicated in next column); MFCR number preceded by FD;or MAF number preceded by FS <br /> with a reference to the illustration. Food Zone, Non-Food Contact(FZ, NFC)items indicate either the relevant 21 <br /> CFR number or the information as indicated for Food Zone, Food Contact(FZ, FC)items. Additionally Food Zone <br /> metallic materials indicate both the NSF standard and the clause number. <br /> 5)Indicates specific marks to be verified,which assures the agreed level of surveillance for the component. "NR"- <br /> indicates Unlisted and only visual examination is necessary. <br /> This document is issued by the Company subject to its General Conditions of Service printed overleaf, available on request or accessible at <br /> www.sgs.comfterms and conditions.htm and, for electronic format documents, subject to Terms and Conditions for Electronic Documents at <br /> www.sg-Mtenns e-document.htm. Attention is drawn to the limitation of liability,indemnification and jurisdiction issues defined therein. Any holder <br /> of this document is advised that information contained hereon reflects the Company's findings at the time of its intervention only and within the limits of <br /> Client's instructions,if any. The Company's sole responsibility is to its Client and this document does not exonerate parties to a transaction from exercising <br /> all their rights and obligations under the transaction documents. This document cannot be reproduced except in full,without prior written approval of the <br /> Company. Any unauthorized alteration,forgery or falsification of the content or appearance of this document is unlawful and offenders maybe prosecuted <br /> to the fullest extent of the law. Unless otherwise stated the results shown in this test report refer only to the sample(s)tested and such sample(s)are <br /> retained for 90 days only. <br /> STR NSF-01 Rev 1.0 Issue 2017-6-1 <br />
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