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SAN J O A Q U I N Environmental Health Department <br /> C_uoAIY <br /> •- Time In: 10:35 am <br /> GreoC�aess glows fires <br /> Time Out: 11:34 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-GEORGE LINCOLN MOSHER Date: 05/08/2018 <br /> Address: 3220 BUDDY HOLLY DR, STOCKTON 95212 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7000 <br /> Program Element: 1632-EXEMPT FOOD <br /> Inspection Type: ROUTINE INSPECTION (Chargeable) <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 /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:Pipe draining prep sink by dough mixer is lacking air gap. Provide air gap at least 1 inch off the floor sink <br /> in 1 week. <br /> CALCODE DESCRIPTION: The potable water supply shall be protected with a backflow or back siphonage protection device,as required <br /> by applicable plumbing codes. (114192)All plumbing and plumbing fixtures shall be installed in compliance with local plumbing <br /> ordinances,shall be maintained so as to prevent any contamination,and shall be kept clean,fully operative,and in good repair. Any hose <br /> used for conveying potable water shall be of approved materials,labeled,properly stored,and used for no other purpose. (114171, <br /> 114189.1, 114190, 114193, 114193.1, 114199, 114201, 114269) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Debbie Sao Expiration Date:June 02,2019 <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 126°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 108°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> prep sink--123.00°F prep sink--by the dough mixer--122.00°F <br /> 2 D cres Cor warmer--Kitchen--170.00°F Norlake cooler milk--right--44.00°F <br /> Walk in cooler--37.00°F Hand sink--Staff rest room left--102.00°F <br /> Norlake cooler milk--left--45.00°F 2 D Cres Cor warmer--Dining--168.00°F <br /> Hand sink--Staff rest room right--104.00°F <br /> NOTES <br /> Sanitizer bucket was set up with QUAT 200ppm. <br /> Time log is maintained for salad bar. <br /> OIR emailed to coliver@lodiusd.net dmead@lodiusd.net <br /> FA0018101 PRO526735 SC101 05/08/2018 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 Food Program OR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />