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SAN J O A Q U I N Environmental Health Department <br /> J.J U I Y <br /> yreotness grows her Time In: 11:11 am <br /> Time Out: 11:45 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-MILLSWOOD MIDDLE SCHOOL Date: 11/21/2017 <br /> Address: 233 MILLS AVE, LODI 95240 <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 /> #33 Nonfood Contact Surfaces Clean <br /> OBSERVATIONS:Observed ice accumulation on compressor pipe in walk-in freezer. Clean. <br /> CALCODE DESCRIPTION:All nonfood contact surfaces of utensils and equipment shall be clean. (114115(c)) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Jose Villanueva Expiration Date:June 03,2018 <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 129°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 125°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> milkbox--41.00°F display -39.00°F <br /> pizza near register--159.00°F walk-in 41.00°F <br /> pizza -out oven--180.00°F hand sink--125.00°F <br /> chicken noodle soup--warmer--147.00°F 3 comp--129.00°F <br /> NOTES <br /> sanitizer bucket 300ppm (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 /> y� <br /> Received by: Name and Title: jose villanueva, <br /> EH Specialist: STEPHANIE RAMIREZ Phone: (209)468-9851 <br /> FA0015558 PRO523034 SC101 11/21/2017 <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 />