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Environmental Health Department <br />Facility Name and Address: ICE CREAM STORE, 14900 W HWY 12 , LODI 95242 <br />Food Program Official Inspection Report <br />Chlorine (Cl): <br />Name on Food Safety Certificate:Expiration Date: <br />ppmQuaternary Ammonia (QA): <br />Heat:ppm º FWarewash Water/Hot Water Ware Sink Temp:º F <br />Hand Sink Temp:º F <br />OBSERVATIONS <br /> 120 <br /> 101 <br />Sara Torres November 17, 2027 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />hand sinks -- women's restroom -- 101.00º F mop sink -- 120.00º F <br />3 comp sink -- 120.00º F hand sink -- next to 3 comp sink -- 101.00º F <br />2 D Avantco reach-in -- 41.00º F hand sinks -- men's restroom -- 106.00º F <br />hand sink -- front counter -- 102.00º F front counter open display -- 36.00º F <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />Routine inspection. <br />The 3 comp sink dispenser provided 704 ppm lactic acid. <br />Lactic acid and chlorine test strips were available. <br />Discussed report with Kathy DeGoede, Assistant general manager. <br />No signature captured. <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: <br />EH Specialist:Phone:(209) 616-3035 <br />, <br />DARIA AFONSKAIA <br />Page 2 of 2EHD 16-23 Rev. 09/16/2020 Food Program OIR <br />FA0006879 PR0505582 SC001 05/05/2023 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD