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Environmental Health Department <br />Food Program Service Request Inspection Report <br />Name of Facility: MASAYAMA Date: 02/02/2026 <br />Address: 235 LAKEWOOD MALL LODI 95240 <br />Requestor:Telephone: () - <br />Program Element: 1602 - FOOD PROGRAM CHANGE OF OWNER Request#: SR2601841 <br />Inspection Type: 521 - Plan Check/Report Review <br />VIOLATIONSAND CORRECTIVE ACTIONS <br />JOVERALL INSPECTION NOTESAND COMMENTS <br />OBSERVATIONS <br />Name on Food Safety Certificate Expiration Date: <br />Warewash Chlorine (Cl): Heat •F Ware Sink Temp: 123Water/Hot WaterPpm •F <br />Quaternary Ammonia (QA):Hand Sink Temp: 100 °FPPm <br />NOTES <br />OK to issue permit once permit fee is paid and 5021 form is submitted. <br />Received by: Name and Title: <br />EH Specialist FRANCISCO RUiZ (209)616-3032Phone: <br />EHD 16-23 Rev 09/16/2020 Page 1 of 1 <br />mt <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 />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; 113700. <br />All violations must be corrected within specified timeframe. Violations that are classified as "MAJOR" pose an immediate threat to public health and have the <br />potential to cause foodbome illness. All major violations must be corrected immedratety Non-compliance may warrant immediate closure of the food facility <br />2 door Slue air refrigerator - 41° Fahrenheit <br />2 door reach in w prep top — 41° Fahrenheit <br />hand sink - cook line - 100° Fahrenheit <br />Change of owner. <br />PE 1623 ($379) <br />SANJOAOUIN <br />COUNTY <br />ITEM - LOCATION - TEMP 8 F - COMMENTS <br />hand sink - restroom - 100° Fahrenheit <br />3 comp sink - 123° Fahrenheit <br />mop sink - 120° Fahrenheit <br />3 door True upright refrigerator - 41° Fahrenheit <br />_________________FA0000749 SR2601641 SC521 02/02/20^ <br />Food Program Service Request Inspection Repor?