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r �I A (1111 Environmental Health Department <br /> CC)UNTY I <br /> Gf$oLIS@SS 5rws hemTime In: 1103 am <br /> Time Out: 11:22 am <br /> Food Program Official Inspection Report <br /> Name of Facility: TRACY USD-JACOBSON SCHOOL Date: 04/05/2023 <br /> Address: 1750 W KAVANAGH AVE, TRACY 95376 <br /> Owner/Operator: TRACY UNIFIED SCHOOL DISTRICT Telephone: (209)830-3200 <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 /> #40 Proper Use and Storage of Wiping Cloths <br /> OBSERVATIONS:The wiping cloths are being stored in the sanitizing solution of the 3-comp sink. Store wiping cloths in a <br /> separate bucket of sanitizer solution. Correct today. <br /> CALCODE DESCRIPTION:Wiping cloths used to wipe service counters,scales or other surfaces that may come into contact with food <br /> shall be used only once unless kept in clean water with sanitizes (114135, 114185.1 114185.3(d-e)) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Geraldine Knoernschild Expiration Date:October 22,2023 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 131 °F <br /> Quaternary Ammonia(QA): 400 ppm Hand Sink Temp: 123°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> rice @ hot hold cabinet--186.00°F 2 door True--39.00°F <br /> milk cooler at student exit--40.00°F orange chicken @ serving line--138.00°F <br /> rice @ serving line 163.00°F orange chicken @ hot hold cabinet--140.00°F <br /> milk cooler by Geri--38.00°F <br /> NOTES <br /> wiping cloths @ 3-comp sink 400 pm Quat/Quat sanitizer test strips are available(QT-10) <br /> Food comes from West High School-arrives approximately 10:15a <br /> Lunch service 11:10a-12:25p <br /> No signature obtained <br /> Report typed 3:45p-3:54p <br /> FA0002968 PRO162579 SC101 04/05/2023 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 2 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 />