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SANOAQU I N Environmental Health Department <br /> COUNTY IY <br /> GrtoWSS grow$ here, <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: KIPP STOCKTON MIDDLE SCHOOL, 742 DALLAS AVE , STOCKTON <br /> #43 Toilet Facilites Clean/Supplied/Maintained <br /> OBSERVATIONS:The toilet paper dispenser at the restroom is empty. Properly supply this dispenser prior to operation. <br /> CALCODE DESCRIPTION:Toilet facilities shall be maintained clean, sanitary and in good repair. Toilet rooms shall be separated by a <br /> well-fitting self-closing door. Toilet tissue shall be provided in a permanently installed dispenser at each toilet. The number of toilet <br /> facilities shall be in accordance with local building and plumbing ordinances. Toilet facilities shall be provided for patrons:in <br /> establishments with more than 20,000 sq ft. establishments offering on-site liquor consumption. (114250, 114250.1, 114276) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Veronica Goodman Bustle Expiration Date:April 21,2027 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 door Metro C5 hot hold cabinet--138.00°F restroom hand sink--107.00°F <br /> 1 comp food prep sink--120.00°F mop sink--121.00°F <br /> 1 door Crescor retherm--160.00°F 2 door Hoshizaki--41.00°F <br /> NOTES <br /> Food Plan check final inspection <br /> Hot water heater: HTP 80 gallon PH 130-80 <br /> OK to operate new kitchen <br /> School starts Monday,August 1, 2022 <br /> No signature obtained <br /> Report typed up in the office 2:18p-2:25p <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/Roger Williams, F&H C <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> SR0084259 SC523 07/29/2022 <br /> EHD 16-23 Rev.07/05/2022 Page 2 of 2 Food Program Service Request Inspection Report <br />