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r I Environmental Health Department <br /> SANJOAQU <br /> C UNT <br /> Greotrre55 grows here Time In: 1020 am <br /> Time Out: 10:45 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-ANSEL ADAMS ELEMENTARY Date: 12/21/2023 <br /> Address: 9275 GLACIER POINT DR, STOCKTON 95212 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7000 <br /> Program Element: 1632-EXEMPT FOOD <br /> Inspection Type: ROUTINE INSPECTION -Operating Permit <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: Rocio Garcia Sanchez Expiration Date:October 12,2028 <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 130°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 door Crescor Warmer--kitchen--157.00°F hand sink--staff restroom--104.00°F <br /> Beverage Air Milk Cooler#2--cafeteria--41.00°F prep sink--124.00°F <br /> walk in--41.00°F 2 Door Crescor Warmer--cafeteria--150.00°F <br /> NOTES <br /> Routine inspection. <br /> Sanitizer Bucket-400 ppm 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: <br /> EH Specialist: FRANCISCO RUIZ Phone: (209)616-3032 <br /> FA0015582 PR0523085 SCO01 12/21/2023 <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 />