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Environmental Health Department <br />Time In: <br />10:30 am <br /> 9:58 am <br />Time Out: <br />Program Element: 1632 - EXEMPT FOOD <br />Telephone: (209) 331-7000 Owner/Operator: LODI UNIFIED SCHOOL DISTRICT <br />Inspection Type: ROUTINE INSPECTION (Chargeable) <br />Address: 1290 LILAC ST, LODI 95242 <br />Date: 04/21/2021Name of Facility: LODI USD-WOODBRIDGE SCHOOL <br />Food Program Official Inspection Report <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 /> #35 Equipment/Utensils Approved and in Good Repair <br />OBSERVATIONS: Ice accumulation observed in milkbox (Norlake milkbox). <br />Clean <br />CALCODE DESCRIPTION: All utensils and equipment shall be fully operative and in good repair. (114175). All utensils and equipment <br />shall be approved, installed properly, and meet applicable standards. (114130, 114130.1, 114130.2, 114130.3, 114130.4, 114130.5, <br />114132, 114133, 114137, 114139, 114153, 114155, 114163, 114165, 114167, 114169, 114172, 114177, 114180, 114182) <br />Chlorine (Cl): <br />Name on Food Safety Certificate:Expiration Date: <br />ppmQuaternary Ammonia (QA): <br />Heat:ppm º FWarewash Water/Hot Water Ware Sink Temp:º F <br />Hand Sink Temp:º F <br />OBSERVATIONS <br /> 120 <br /> 111 <br />Maria Aguilar July 19, 2023 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />3 comp -- 120.00º F 2 door Traulsen -- near office -- 41.00º F <br />Norlake milkbox -- in hallway -- 36.00º F Bev air milkbox -- in hallway -- 41.00º F <br />hand sink -- 111.00º F hand sink -- womens' restroom -- 125.00º F <br />2 door Traulsen -- neat kitchen 'exit' -- 41.00º F <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <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: <br />EH Specialist:Phone: <br />Gary, Head Custodian, <br />STEPHANIE RAMIREZ <br />Page 1 of 1EHD 16-23 Rev. 06/30/15 Food Program OIR <br />FA0003187 PR0160238 SC101 04/21/2021 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com