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r MJOA(1111 Environmental Health Department <br /> COUNTY I <br /> Gf$oLIS@SS 5rws hemTime In: 10.20 am <br /> Time Out: 10:44 am <br /> Food Program Official Inspection Report <br /> Name of Facility: MUSD-GEORGE Y KOMURE ELEMENTARY Date: 04/05/2022 <br /> Address: 2121 HENRY LONG BLVD, STOCKTON 95206 <br /> Owner/Operator: MANTECA UNIFIED SCHOOL DISTRICT Telephone: (209)825-3200 <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: Victoria Nieves Expiration Date: December 04,2024 <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 /> Norlake milk cooler-cafeteria-left--41.00°F 2 door Traulsen-right--41.00°F <br /> Norlake milk cooler-kitchen--43.00°F--milk only cheese quesadilla @ hot hold--153.00°F <br /> restroom hand sink--100.00°F hot dog @ hot hold--153.00°F <br /> walk-in cooler--38.00°F Norlake milk cooler-cafeteria-right(empty)--41.00°F <br /> 2 door Traulsen-left--41.00°F <br /> NOTES <br /> Chlorine and chlorine sanitizer test strips are available <br /> Food is transported from Weston Ranch High School/arrives around 10am <br /> Lunch service: 10:52a-12:50p <br /> No signature obtained <br /> Report typed up in the office 1:38p-1:43p <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/Victoria Nieves, NSA <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0014810 PR0521810 SC101 04/05/2022 <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 />