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r MJOA(1111 Environmental Health Department <br /> COUNTY I <br /> Gf$oLIS@SS 5rws hemTime In: 1123 am <br /> Time Out: 11:50 am <br /> Food Program Official Inspection Report <br /> Name of Facility: JEFFERSON ESD-MONTICELLO ELEM Date: 03/22/2022 <br /> Address: 1001 CAMBRIDGE AVE, TRACY 95376 <br /> Owner/Operator: JEFFERSON SCHOOL DIST Telephone: (209)836-3388 <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: Voranoun Hardesty Expiration Date:October 15,2024 <br /> Warewash Chlorine(Cl): 50 ppm Heat: °F Water/Hot Water Ware Sink Temp: 133°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 door Turbo Air--41.00°F--re-checked from 47F 2 door Norlake AdvantEdge--38.00°F <br /> True milk cooler--36.00°F 4 door Continental--40.00°F <br /> tamales @ hot hold--150.00°F <br /> NOTES <br /> wiping cloth bucket 500 ppm Cl/Cl sanitizer test strips are available (read up to 500ppm CI) <br /> Food is prepped on site(no transport) <br /> Lunch service 10:55a-1:10p <br /> No signature obtained <br /> Report typed up at the office 4:11 p-4:18p <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/Vora& Diana, <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0003095 PRO163307 SC101 03/22/2022 <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 />