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`'.. ll � � �A�] I N Environmental Health Department <br /> `- Irl +lJ <br /> L.. v•:v COUNTY <br /> 7fa�p[r+85S growshere. Time In: 922 am <br /> Time Out: 9:53 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LUSD-SIERRA MIDDLE SCHOOL Date: 04/25/2023 <br /> Address: 6768 ALEXANDRIA PL, STOCKTON 95207 <br /> Owner/Operator: LINCOLN UNIFIED SCHOOL DIST Telephone: (209)953-8700 <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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Pamela Thomas Expiration Date:October 04,2026 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): 300 ppm Hand Sink Temp: 106°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Crescor two door warmer--Side kitchen--141.00°F Traulsen two door cooler--Kitchen--41.00°F <br /> True milk box--Cafeteria--41.00°F Victory two door cooler--Side storage room--39.00°F <br /> True milk box--Cafeteria--41.00°F One door cooler--Side storage room--41.00°F <br /> Potato wedges--Steam table--135.00°F Two door Trualsen cooler--Side kitchen--41.00°F <br /> Trualsen two door cooler--Side storage room--41.00°F Pizza warmer--139.00°F <br /> Crescor two door warmer--Kitchen--138.00°F <br /> NOTES <br /> Routine chargeable inspection. No violations. No re-inspection. <br /> Discussed inspection report with Pamela Thomas(Kitchen Lead). Official inspection report was emailed to operator. <br /> Maintain copy of inspection report on site. <br /> To minimize person-to-person contact,the signature of the person receiving the inspection report was not 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: LYDIA BAKER Phone: (209)616-3046 <br /> FA0006818 PR0505501 SC101 04/25/2023 <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 />