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r SANJOAQUI Environmental Health Department <br /> C U N T Time In: 9:04 am <br /> }' Time Out: 9:40 am <br /> G <br /> i�lFOSi4,k reatness grows here, <br /> Food Program Service Request Inspection Report <br /> Name of Facility: LINDEN USD-CHARTVILLE SCHOOL Date: 06/29/2023 <br /> Address: 100 N JACK TONE RD , STOCKTON 95215 <br /> Requestor: CARBIE K.WAGNER, SAN JOAQUIN COUNTY OFFICE OF EDUCATION Telephone: (209)468-9018 <br /> Program Element: 1602-FOOD CONSULTATION Request#: SR0086865 <br /> Inspection Type: 061 -CONSULTATION <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: Carline Wagner Expiration Date:July 30,2024 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> No violations identified. No reinspection. Facility currently receives shelf stable non-PHF individually packaged breakfast and <br /> lunch food items from Lodi Unified School. Breakfast is food items are stored on site at a designated area in the classroom. No <br /> food prep or warewashing occurs on site. <br /> Okay to issue permit once permit fees are paid and 5021 is updated. <br /> Print and maintain a copy of the most current inspection report on-site. <br /> Note: The signature of the person receiving the inspection report was not obtained during the inspection. <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: CLAUDIA MURO Phone: (209)561-8923 <br /> FA0000832 SR0086865 SC061 06/29/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 1 of 1 Food Program Service Request Inspection Report <br />