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COMPLIANCE INFO_2022
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0160225
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COMPLIANCE INFO_2022
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Last modified
10/5/2022 1:14:18 PM
Creation date
4/5/2022 7:37:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0160225
PE
1632
FACILITY_ID
FA0000167
FACILITY_NAME
LODI USD-LAKEWOOD SCHOOL
STREET_NUMBER
1100
Direction
N
STREET_NAME
HAM
STREET_TYPE
LN
City
LODI
Zip
95240
APN
03910012
CURRENT_STATUS
01
SITE_LOCATION
1100 N HAM LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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SA N'tJ D A Q U I N Environmental Health Department <br /> I��kiw <br /> —COUNTY <br /> Greorness grows here, Time In: 10.33 am <br /> Time Out: 11:07 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-LAKEWOOD SCHOOL Date: 09/29/2022 <br /> Address: 1100 N HAM LN, LODI 95240 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7179 <br /> Program Element: 1632-EXEMPT FOOD <br /> Inspection Type: ROUTINE INSPECTION -Operating Permit <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: Tammy archer Expiration Date:June 05,2024 <br /> Warewash Chlorine(Cl): ppm Heat: 170°F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 comp--120.00°F 3 comp--128.00°F <br /> walk-in--41.00°F hand sink--women's restroom--116.00°F <br /> Texas straw hat--warmer--170.00°F milkbox--34.00°F <br /> burrito--warmer--161.00°F hand sink--men's restroom--103.00°F <br /> milkbox--45.00°F in counter prep sink--128.00°F <br /> hand sink--104.00°F <br /> NOTES <br /> No Violations <br /> sanitizer bucket 300ppm/quat <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: Tammy, <br /> EH Specialist: STEPHANIE RAMIREZ Phone: <br /> FA0000167 PRO160225 SCO01 09/29/2022 <br /> EHD 16-23 Rev.06/30/15 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.sjcehd.com <br />
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