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r �I A (1111 Environmental Health Department <br /> CC)UNTY I <br /> Gf$oLIS@SS 5rws hemTime In: 11.22 am <br /> Time Out: 11:39 am <br /> Food Program Official Inspection Report <br /> Name of Facility: TRACY USD-JACOBSON SCHOOL Date: 10/08/2021 <br /> Address: 1750 W KAVANAGH AVE, TRACY 95376 <br /> Owner/Operator: TRACY UNIFIED SCHOOL DISTRICT Telephone: (209)830-3200 <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: Geraldine Knoernschild Expiration Date:October 22,2023 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 126°F <br /> Quaternary Ammonia(QA): 400 ppm Hand Sink Temp: 126°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> True milk cooler#2--41.00°F mini burgers--157.00°F <br /> Crescor hot hold cabinet--157.00°F True milk cooler#1 --41.00°F <br /> 2 door True--1.00°F quesadilla--147.00°F <br /> NOTES <br /> wiping cloths at 3-comp sink 400 ppm Quat/Quat sanitizer test strips are available <br /> Lunch is served at 11:10am-12:25am <br /> Food is received from West High School <br /> No signature obtained <br /> Report typed up at the office: 2:51 pm-2:57pm <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: Discussed w/Geri&Melinda, <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0002968 PRO162579 SCO01 10/08/2021 <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 />