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r �I A (1111 Environmental Health Department <br /> CC)UNTY I <br /> Gf$oLIS@SS 5rws hemTime In: 935 am <br /> Time Out: 10:00 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-LAKEWOOD SCHOOL Date: 09/12/2023 <br /> Address: 1100 N HAM LN, 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 /> #21 Hot and Cold Potable Water Not Available <br /> OBSERVATIONS:The water temperature at the hand sink was 110 F.Adjust the hand wash sinks'water temperature to <br /> maintain 100- 108 F as they are non-adjustable faucets. Correct today. <br /> CALCODE DESCRIPTION:An adequate,protected,pressurized,potable supply of hot water and cold water shall be provided at all times. <br /> (113953(c), 114099.2(b) 114101(a), 114189, 114192, 114192.1, 114195) <br /> 2111 <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Tammy Archer Expiration Date:June 05,2024 <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 110°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> hand sink--Men's restroom-- 100.00°F Hand sink--Women's restroom--100.00°F <br /> prep sink--120.00°F hot hold--kitchen--135.00°F <br /> 3 comp--140.00°F mop sink--137.00°F <br /> walk in--41.00°F burgers--hot hold--135.00°F <br /> Norlake milk cooler--cafeteria--41.00°F corn dogs--hot hold--135.00°F <br /> NOTES <br /> Sanitizer bucket-200 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 /> FA0000167 PRO160225 SCO01 09/12/2023 <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 />