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°• Environmental Health Department <br /> �. �J r� SHAWN <br /> t 7Y - L. <br /> Y Time In: 10:13 am <br /> tl1r_ —COUNTY— <br /> Time Out: 12:00 pm <br /> <, Greolne3S grows he; . <br /> Food Program Service Request Inspection Report <br /> Name of Facility: COSTCO WHOLESALE#658 Date: 03/04/2024 <br /> Address: 3250 W GRANT LINE RD ,TRACY 95377 <br /> Requestor: RORY FITZPATRICK, MG2 CORPORATION Telephone: (206)962-6546 <br /> Program Element: 1600-FOOD PROGRAM Request#: SR0085809 <br /> Inspection Type: 523-Plan Check/Report Review <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 /> 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: 105°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> hand sink @ BOH employee -105.00°F hand sinks @ FOH men's--105.00°F <br /> hand sinks @ FOH women's -100.00°F <br /> NOTES <br /> food plan check report/restroom remodel <br /> Per Ancillary Manager, the restroom remodel has been complete for over a year and restrooms are in use <br /> No final inspection was conducted by this Dept. <br /> Front of the house customer restrooms and the back of the house employee restroom were inspected during the routine <br /> inspection of the facility this date. Finishes are proper. <br /> -OK to operate- <br /> No signature obtained <br /> Report typed in the office 3:19p-3:31 p <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: discussed w/Lorenzo R&Jeff B, Cos <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0014131 SR0085809 SC523 03/04/2024 <br /> EHD 16-23 Rev.07/05/2022 Page 1 of 1 Food Program Service Request Inspection Report <br />