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r �I A (1111 Environmental Health Department <br /> CC)UNTY I <br /> Gf$oLn@SS 5rws hemTime In: 1149 am <br /> Time Out: 12:35 pm <br /> Food Program Official Inspection Report <br /> Name of Facility: TOM HAWKINS SCHOOL KITCHEN Date: 10/05/2021 <br /> Address: 475 DARLENE LN, TRACY 95377 <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: Barbara Leval Expiration Date:April 14,2023 <br /> Warewash Chlorine(Cl): 50 ppm Heat: °F Water/Hot Water Ware Sink Temp: 130°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> cheeseburgers at service line--161.00°F 2 door Turbo Air--37.00°F <br /> True milk cooler--41.00°F cheeseburgers at hot hold cabinets--159.00°F--159-169F <br /> walk-in cooler--40.00°F <br /> NOTES <br /> wiping cloth bucket 200 ppm Cl/sanitizer test strips are available <br /> Lunch is served 11:05a- 1:10pm <br /> Food is prepped on site/no transport <br /> Additional FSC: Jessica Kandah exp. 10-15-2024 <br /> No signature obtained <br /> Report typed up at the office 3:47pm-3:52pm <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/Barbara&Jessica, <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0014021 PR0518631 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 />