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SA N'tJ D A Q U I N Environmental Health Department <br /> I��kiw <br /> —COUNTY <br /> Greorness grows here, Time In: 12.04 pm <br /> Time Out: 1:24 om <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-LODI HIGH SCHOOL Date: 09/29/2022 <br /> Address: 3 S PACIFIC AVE, LODI 95242 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7179 <br /> Program Element: 1632-EXEMPT FOOD <br /> Inspection Type: ROUTINE INSPECTION (Chargeable) <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: Rebecca Medina Expiration Date:July 26,2027 <br /> Warewash Chlorine(Cl): ppm Heat: 180°F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> refrigerator#1 --speed line--41.00°F hand sink--117.00°F <br /> refrigerator#2--speed line--40.00°F 3 comp--121.00°F <br /> hand sink--snack bar--120.00°F hand sink--unisex(L)restroom--101.00°F <br /> walk-in--41.00°F pizza--snack bar grab and go warmer--172.00°F <br /> hand sink--unisex restroom(R)--104.00°F in counter prep sink--121.00°F <br /> in counter pre sink--across from 3 comp--122.00°F cheese pizza--162.00°F <br /> NOTES <br /> sanitizer bucket 200ppm (quat) <br /> No Violations <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: Rebecca Medina, <br /> EH Specialist: STEPHANIE RAMIREZ Phone: <br /> FA0000915 PRO160228 SC101 09/29/2022 <br /> EHD 16-23 Rev.06/30/15 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.sjcehd.com <br />