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Time In: 1022 am <br /> Time Out: 11:10 am <br /> op.. .. San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... _ P• Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> 4�IFO'Rt� <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-LAKEWOOD SCHOOL Date: 10/24/2016 <br /> Address: 1100 N HAM LN, LODI 95240 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7000 <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: Mark S Watkins Expiration Date:June 01,2017 <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 138°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> pizza--hot hold cabinet near serve line-- 145.00°F hand sink--men's restroom--100.00°F <br /> hand sink--100.00°F mop sink--122.00°F <br /> walk-in--38.00°F hand sink--Women's restroom--117.00°F <br /> milk box--near serve line--41.00°F milk box--near office--41.00°F <br /> prep sink--121.00°F <br /> NOTES <br /> No violations. <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: mark watkins, <br /> EH Specialist: STEPHANIE RAMIREZ Phone: (209)468-9851 <br /> FA0000167 PRO160225 SCO01 10/24/2016 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program OIR <br />