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Time In: 9.00 am <br /> Time Out: 9:48 am <br /> Pquin/ San Joaquin County <br /> a. Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • cq., ;a• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> �rFORN <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-DAVIS SCHOOL Date: 04/06/2017 <br /> Address: 5224 E MORADA LN, 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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Annabelle Terra Expiration Date:July 06,2021 <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 132°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> WI--39.00°F 2D Cres Cor--kitchen--145.00°F <br /> Milkbox--41.00°F 1-comp metal--storage--122.00°F <br /> 1-comp prep--126.00°F 2D Cres Cor--dining--135.00°F <br /> NOTES <br /> Sanitizer bucket 200 ppm quat <br /> Notes: <br /> -No violation noted. <br /> -Premixed handwash was initially measured to be consistent 96 F, but management showed that it eventually reached 100 F <br /> after repeated re-measurement. Ensure that hand wash reaches 100 to 108 F within a reasonable time(30 seconds)at both <br /> premixed hand wash as well as the hand wash in employee restrooms. <br /> OIR emailed to aterra@lodiusd.net and Cindy Oliver <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: Annabelle Terra, Manager <br /> EH Specialist: JEFFREY WONG Phone: (209)468-0335 <br /> FA0002855 PRO160895 SC101 04/06/2017 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program OIR <br />