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Environmental Health Department <br />Facility Name and Address: LODI ELKS LODGE #1900, 19071 LOWER SACRAMENTO RD, WOODBRIDGE 95258 <br />Food Program Official Inspection Report <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 />OVERALL INSPECTION NOTES AND COMMENTS <br />restroom hand sink -- Men's upstairs -- 120.00º F residential style refrigerator -- upstairs kitchen -- 41.00º F <br />restroom hand sink -- upstairs Women's -- 100.00º F hand sink -- next to dishwasher (main kitchen) -- 100.00º F <br />3 comp -- upstairs bar -- 121.00º F walk-in -- 41.00º F <br />restroom hand sink -- downstairs Men's -- 100.00º F 2comp/handsink -- upstairs kitchen -- 140.00º F <br />restroom hand sink -- Women's down stairs -- 100.00º F hand sink -- upstairs bar -- 110.00º F <br />3 compartment sink -- 120.00º F <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />Operator to provide proof that sanitizer dispenses from the sanitizer machine at a minimum of 50ppm (chlorine) within a week, <br />via video. If proof is not provided a re-inspection is to occur. <br />Note: Downstairs bar faucet at 3 comp sink dispenses only cold water. <br />Per operator, only disposable plastic cups are used at this sink. <br />If glass cups are to be used, then hot (and cold) water will need to be provided at this sink <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 />John, <br />STEPHANIE RAMIREZ <br />Page 2 of 2EHD 16-23 Rev. 06/30/15 Food Program OIR <br />FA0022225 PR0538710 SC001 01/26/2022 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com