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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, Timeln: 1116am <br /> Time Out: 11:41 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-MILLSWOOD MIDDLE SCHOOL Date: 04/13/2022 <br /> Address: 233 MILLS AVE, LODI 95240 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7000 <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 /> #35 Equipment/Utensils Approved and in Good Repair <br /> OBSERVATIONS:Slight ice accumulation on interior milkbox walls. <br /> Clean. <br /> CALCODE DESCRIPTION:All utensils and equipment shall be fully operative and in good repair. (114175).All utensils and equipment <br /> shall be approved,installed properly,and meet applicable standards. (114130, 114130.1, 114130.2, 114130.3, 114130.4, 114130.5, <br /> 114132, 114133, 114137, 114139, 114153, 114155, 114163, 114165, 114167, 114169, 114172, 114177, 114180, 114182) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Cristopher Beach Expiration Date:July 29,2026 <br /> Warewash Chlorine(Cl): ppm Heat: 170°F Water/Hot Water Ware Sink Temp: 121 °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 113°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> walk-in--41.00°F hand sink--113.00°F <br /> in counter one compartment sink--123.00°F 3 comp--121.00°F <br /> pizza(Dominos)--warmer--161.00°F milkbox--41.00°F <br /> 2 compartment in counter sink--120.00°F <br /> NOTES <br /> sanitizer bucket 400ppm (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: Cristopher Beach, <br /> EH Specialist: STEPHANIE RAMIREZ Phone: <br /> FA0015558 PR0523034 SC101 04/13/2022 <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 />