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Time In: 1005 am <br /> Tme Out: 10'46@m <br /> ap,AHltt, San Joaquin County <br /> Environmental Health Department <br /> "< <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> (; Telephone: (209)468-3420 Fax: (209)464-0138 Web:www sigov org/ehd <br /> 4�1. 6•�ji <br /> Food Program Official Inspection Report <br /> Name of Facility: TRACY USD-JACOBSON SCHOOL Date: 09/29/2015 <br /> Address: 1750 W KAVANAGH AVE,TRACY 95376 <br /> Owner/Operator: TRACY UNIFIED SCHOOL DIST Telephone: (209) 830-3200 <br /> Program Element: 1632-EXEMPT FOOD <br /> Inspection Type: ROUTINE INSPECTION -Operating Permit <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: Selia Plares Expiration Date:August 28,2017 <br /> Warewash Chlorine(CD: ppm Heat: °F Water/Hot Water Ware Sink Temp: 121 OF <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION --TEMP°F--COMMENTS <br /> True(milk)--45.000 F True(milk)--39.000 F <br /> True(2-door)--41.00°F Prep Line-- 180.000 F <br /> Warmer-- 149.000 F <br /> NOTES <br /> No violations <br /> Sanitizer-200ppm quat <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: � Rl2/ Name and Title: Teresa, Food Service <br /> EH Specialist: MELISSA NISSIM Phone: (209)468-3168 <br /> FA0002968 PRO162579 SCO01 09/29/2015 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program OIR <br />