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Environmental Health Department <br />Time In: <br />11:45 am <br />11:15 am <br />Time Out: <br />Program Element: 1625 - RESTAURANT/BAR 51-100 SEATS <br />Telephone: Owner/Operator: MAR, ELIZABETH <br />Inspection Type: ROUTINE INSPECTION - Operating Permit <br />Address: 200 S PLEASANT AVE, LODI 95240 <br />Date: 09/27/2023Name of Facility: ST ANNES SCHOOL DOMINICAN HALL <br />Food Program Official Inspection Report <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 />Chlorine (Cl): <br />Name on Food Safety Certificate:Expiration Date: <br />ppmQuaternary Ammonia (QA): <br />Heat:ppm º FWarewash Water/Hot Water Ware Sink Temp:º F <br />Hand Sink Temp:º F <br />OBSERVATIONS <br /> 123 <br /> 100 <br />Jennifer Silvereira October 18, 2023 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />Prep sink -- 100.00º F 3 comp sink -- 123.00º F <br />mop sink -- 127.00º F prep sink -- 120.00º F <br />2 door True cooler -- 41.00º F Hand sink -- kitchen -- 100.00º F <br />hand sink -- warewash area -- 100.00º F <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />No food is prepared on site for the school. <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:Phone:(209) 616-3032 <br />, <br />FRANCISCO RUIZ <br />Page 1 of 1EHD 16-23 Rev. 09/16/2020 Food Program OIR <br />FA0021199 PR0536930 SC001 09/27/2023 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD