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`'.. ll � � �A�] I N Environmental Health Department <br /> `- Irl +lJ <br /> L.. v•:v COUNTY <br /> .r{ � 7fa�p[r+85S grows hire, Time In: 11.00 am <br /> Time Out: 11:42 am <br /> Food Program Official Inspection Report <br /> Name of Facility: SUSD-PULLIAM SCHOOL Date: 10/12/2021 <br /> Address: 230 PRESIDIO WAY, STOCKTON 95207 <br /> Owner/Operator: STOCKTON UNIFIED SCHOOL DIST Telephone: (209)933-7045 <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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Monica Campis Valdez Expiration Date: March 16,2024 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 3 dr California Cooking--kitchen--41.00°F Traulsen milk cooler#1 --self service--41.00°F <br /> mop sink--120.00°F 1 dr Traulsen--kitchen--41.00°F <br /> small Norlake reach-in chest--self service--41.00°F Traulsen milk cooler#2--self service--41.00°F <br /> hand sink--kitchen--100.00°F 3 comp sink--120.00°F <br /> hand sink--restroom--100.00°F 2 dr Cres Cor warmer--kitchen--136.00°F <br /> large Norlake reach-in chest--self service 41.00°F fruit/veg self serve ice block tray -self service--41.00°F <br /> NOTES <br /> Routine inspection. <br /> Sanitizer bucket-200 ppm quat. <br /> Food items are delivered by Gold Star Foods, Daylight Produce, DOD produce, and Crystal Dairy every Tuesday and <br /> Thursday. <br /> Food items are premade/prepackaged. <br /> Discussed report with Ashley Blicharz. <br /> No signature captured. <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: <br /> EH Specialist: DARIA AFONSKAIA Phone: (209)616-3035 <br /> FA0001675 PRO160901 SC101 10/12/2021 <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 />