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: SA NUJ FAQ U I N Environmental Health Department <br /> ._ COUNTY <br /> Tlme ln: <br /> E"ram <br /> ^'•ti7FOpt�% Greotness grows Mere, 0:1 <br /> Time Out: 10:10 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-DAVIS SCHOOL Date: 10/17/2018 <br /> Address: 5224 E MORADA LN, STOCKTON 95212 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7179 <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: Mayesah Matulac Expiration Date:June 07,2021 <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 130°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Norlake cooler--Milk--44.00°F walk in cooler--38.00°F <br /> 2 D Cres Cor warmer--Kitchen--151.00°F Prep sink--125.00°F <br /> Mop sink--123.00°F 2 D Cres Cor warmer--Dining--150.00°F <br /> NOTES <br /> Sanitizer buckets are set up with QUAT 200 ppm. <br /> Salad bar time log is maintained. <br /> No major violations are observed. <br /> OIR emailed to coliver@lodiusd.net; mmatulac@lodiusd.net <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 /> w <br /> Received by: Name and Title: Mayesah Matulac, Cafeteria Manage <br /> EH Specialist: GEHANE FAHMY Phone: (209)953-7698 <br /> FA0002855 PRO160895 SCO01 10/17/2018 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program OR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />