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r MJOA(1111 Environmental Health Department <br /> COUNTY I <br /> Gf$oLai@SSfwS hemTime In: 10.11 am <br /> Time Out: 10:45 am <br /> Food Program Official Inspection Report <br /> Name of Facility: JEFFERSON ESD-JEFFERSON SCHOOL Date: 10/05/2021 <br /> Address: 7500 LINNE RD,TRACY 95376 <br /> Owner/Operator: JEFFERSON SCHOOL DIST Telephone: (209)836-3388 <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: Diane Gottberg Expiration Date: May 16,2023 <br /> Warewash Chlorine(Cl): 100 ppm Heat: °F Water/Hot Water Ware Sink Temp: 122°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> milk cooler--41.00°F restoom hand sink--100.00°F <br /> walk-in cooler--37.00°F mini cheeseburgers(out of oven)--157.00°F <br /> popcorn chicken at hot hold(snack)--145.00°F <br /> NOTES <br /> wiping cloth bucket 100 ppm Cl/sanitizer test strips are available <br /> Snack is served 10:12am/10:35am <br /> Lunch is served 11:45am/12:35pm <br /> Food is prepped on site/no transport <br /> Turbo Air is not in use this date <br /> No signature obtained <br /> Report typed up at the office 3:27pm-3:34pm <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: Discussed w/Diane Gottberg, FS II <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0003207 PRO161531 SCO01 10/05/2021 <br /> EHD 16-23 Rev.09/16/2020 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.sjgov.org/EHD <br />