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SA :J O Q V I + �Ips' Environmental Health Department <br /> COUNT <br /> Food Program Official Inspection Report <br /> Facility Name and Address: LODI MEMORIAL HOSPITAL, 975 S FAIRMONT AVE, LODI 95240 <br /> NOTES <br /> Routine Inspection. <br /> Sanitizer buckets-200 ppm QUAT <br /> 200 ppm QUAT-dishwasher&3 compartment sink sanitizer <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: FRANCISCO RUIZ Phone: (209)616-3032 <br /> FA0000513 PRO160152 SCO01 08/01/2023 <br /> EHD 16-23 Rev.09/16/2020 Page 3 of 3 Food Program OIR <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 />