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`'.. ll � � �A�] I N Environmental Health Department <br /> `- Irl +lJ <br /> L.. v•:v COUNTY <br /> 7fa�p[�+855 grows here. Time In: 9.30 am <br /> Time Out: 10:07 am <br /> Food Program Official Inspection Report <br /> Name of Facility: SUSD-JOHN ADAMS SCHOOL Date: 09/05/2023 <br /> Address: 6402 INGLEWOOD AVE, STOCKTON 95207 <br /> Owner/Operator: STOCKTON UNIFIED SCHOOL DIST Telephone: (209)933-7000 <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:Spilled milk was observed in the bottom of the True milk box. Clean and sanitize inside of milk box. <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: Eydie Beceria Expiration Date: May 19,2027 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): 400 ppm Hand Sink Temp: 130°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Traulsen milk box--41.00°F 3 door California Cooking cooler--40.00°F <br /> prep sink--120.00°F 2 door Victory cooler--41.00°F <br /> 2 door California Cooking cooler--41.00°F True milk box--41.00°F <br /> 2 door warmer--138.00°F Norlake milk box--41.00°F <br /> 1 compartment prep sink--120.00°F hand sink--restroom--120.00°F <br /> NOTES <br /> Routine chargeable inspection. No major violations. No re-inspection. <br /> Official inspection report was emailed to the operator. <br /> Maintain a copy of official inspection report on-site. <br /> To minimize person-to-person contact,the signature of the person receiving the inspection report was not captured. <br /> FA0002403 PRO160894 SC101 09/05/2023 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 2 Food Program OIR <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 />