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r �I A (1111 Environmental Health Department <br /> CC)UNTY I <br /> Gf$oLn@SSfwS hemTime In: 11.31 am <br /> Time Out: 11:51 am <br /> Food Program Official Inspection Report <br /> Name of Facility: MUSD-GREAT VALLEY ANNEX ELEM SCHOOL Date: 10/25/2022 <br /> Address: 4550 STAR WAY, STOCKTON 95206 <br /> Owner/Operator: MANTECA UNIFIED SCHOOL DISTRICT Telephone: (209)825-3200 <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: Kim Olivari-McClure Expiration Date:July 30,2025 <br /> Warewash Chlorine(Cl): 100 ppm Heat: °F Water/Hot Water Ware Sink Temp: 127°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 127°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> cheese enchilada-hot hold--148.00°F 2 door Traulsen-kitchen--39.00°F <br /> cheeseburger-line--128.00°F 2 door Traulsen-cafeteria--40.00°F <br /> cheese enchilada-line--138.00°F cafeteria milk cooler--41.00°F <br /> cheeseburger-hot hold--138.00°F <br /> NOTES <br /> wiping cloth bucket 100 ppm Cl/Cl sanitizer test strips are available <br /> Food comes from Weston Ranch HS(MUSD)/delivered around 10:45a today <br /> Lunch service times: 11:30a-12:19p <br /> No signature obtained <br /> report typed up in the office 2:20p-2:27p <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/Kim &Cydia, NSL <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0015649 PR0523181 SCO01 10/25/2022 <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 />