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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, Time In: 921 am <br /> Time Out: 9:47 am <br /> Food Program Official Inspection Report <br /> Name of Facility: ST PETER LUTHERAN SCHOOL Date: 11/18/2020 <br /> Address: 2400 OXFORD WAY, LODI 95242 <br /> Owner/Operator: ST PETER LUTHERAN CHURCH Telephone: <br /> Program Element: 1625-RESTAURANT/BAR 51-100 SEATS <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 /> #33 Nonfood Contact Surfaces Clean <br /> OBSERVATIONS:Observed slight ice accumulation oin interior wall of milkbox. Clean <br /> CALCODE DESCRIPTION:All nonfood contact surfaces of utensils and equipment shall be clean. (114115(c)) <br /> #34 Warewashing Facilites Maintained <br /> OBSERVATIONS:Sanitizer test strips have expired. Provide test strips that have not expired. <br /> CALCODE DESCRIPTION:Food facilities that prepare food shall be equipped with warewashing facilities. Testing equipment and <br /> materials shall be provided to measure the applicable sanitization method. (I14067(f,g), 114099, 114099.3, 114099.5, 114101(a), <br /> 114101.1, 114101.2, 114103, 114107, 114125) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Timothy Russell Expiration Date: February 05,2023 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 128°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 128°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> prep sink--122.00°F 2 comp/hand sink--128.00°F <br /> milk box--41.00°F 2 door upright Everest refrigerator--41.00°F <br /> NOTES <br /> Note: Dishwasher is not used. <br /> Food is not prepared everyday. <br /> Foods are brought in from different local restaurants. <br /> Only single use utensils are used. <br /> FA0018555 PR0527405 SCO01 11/18/2020 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 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 />