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S A N J a A Q U I N Environmental Health Department <br /> COUNTY <br /> Food Program Official Inspection Report <br /> Facility Name and Address: LODI USD-CREEKSIDE SCHOOL, 2515 ESTATE DR, STOCKTON 95209 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: on file Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 121 °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> hand sink--Men's restroom--100.00°F hand sink--Women's restroom--100.00°F <br /> milk box--41.00°F walk-in--41.00°F <br /> 3 comp(warewash)--121.00°F 3 comp--120.00°F <br /> hand sink--100.00°F <br /> NOTES <br /> sanitizer bucket 400ppm (quat) <br /> Signature not captured due to COVID <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: Barbara Thomas, <br /> EH Specialist: STEPHANIE RAMIREZ Phone: <br /> FA0001799 PRO162094 SC101 04/01/2021 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />