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r �I A (1111 Environmental Health Department <br /> CC)UNTY I <br /> Gf$oLIS@SS 5rW& hemTime In: 11.06 am <br /> Time Out: 11:16 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-LIBERTY HIGH SCHOOL Date: 09/25/2023 <br /> Address: 660 W WALNUT, LODI 95240 <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: Sherene Villanueva Expiration Date:June 26,2026 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Norlake milk cooler--40.00°F mop/hand sink--hallway outside restroom--126.00°F <br /> NOTES <br /> Facility receives premade/prepackaged meals from Lodi USD Kitchen daily. No food prep or warewashing occurs on site. <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 /> FA0014368 PR0519215 SCO01 09/25/2023 <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 />