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SA N'tJ D A Q U I N Environmental Health Department <br /> I��kiw <br /> —COUNTY <br /> Greorness grows here, Timeln: 11-19am <br /> Time Out: 11:55 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-LAKEWOOD SCHOOL Date: 09/14/2020 <br /> Address: 1100 N HAM LN, LODI 95240 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7121 <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: Tammy Archer Expiration Date:June 05,2024 <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 150°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> hot water--mopsink--130.00°F pizza--hot hold(in individual bag)in hot hold cabinet--148.00°F <br /> pizza--out of oven--185.00°F hot water--3 comp sink--150.00°F <br /> hot water--2 comp sink--120.00°F walk-in--40.00°F <br /> warm water--hand sink--100.00°F warm water--rest room hand sink women's restroom--104.00°F <br /> milk box--next to dry storage room--40.00°F milk box--near cafeteria entrance--41.00°F <br /> NOTES <br /> sanitizer bucket 300ppm (quat) <br /> Foods served at back door of kitchen. <br /> Men's restroom occupied during inspection. <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: Tammy Archer, cafeteria manager, s <br /> EH Specialist: STEPHANIE RAMIREZ Phone: <br /> FA0000167 PRO160225 SCO01 09/14/2020 <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 />