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`'.. ll � � �A�] I N Environmental Health Department <br /> `- Irl +lJ <br /> L.. v•:v COUNTY <br /> C1 ! 7fa�p[f+85S growshere. Time In: 11.45 am <br /> Time Out: 12:30 pm <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-MILLSWOOD MIDDLE SCHOOL Date: 04/06/2023 <br /> Address: 233 MILLS AVE, LODI 95240 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7000 <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 /> #35 Equipment/Utensils Approved and in Good Repair <br /> OBSERVATIONS:Observed some ice build up on right side of Norlake milk cooler. Clean within 1 week and repair as <br /> necessary. <br /> CALCODE DESCRIPTION:All utensils and equipment shall be fully operative and in good repair. (114175).All utensils and equipment <br /> shall be approved,installed properly,and meet applicable standards. (114130, 114130.1, 114130.2, 114130.3, 114130.4, 114130.5, <br /> 114132, 114133, 114137, 114139, 114153, 114155, 114163, 114165, 114167, 114169, 114172, 114177, 114180, 114182) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Jose Villanueva Expiration Date:July 19,2023 <br /> Warewash Chlorine(Cl): ppm Heat: 180°F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 102°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Norlake milk cooler--cafeteria--33.00°F in counter prep sink--120.00°F <br /> walk-in--41.00°F hand sink--kitchen--102.00°F <br /> 2 comp sink--121.00°F 2 D Crescor warmer--near dishwasher--178.00°F <br /> 2 D Crescor warmer--center--188.00°F <br /> NOTES <br /> Routine inspection. <br /> Sanitizer bucket-200 ppm quat. <br /> Quat and thermolabel test strips available. <br /> Staff restroom does not have hand sinks inside, it uses kitchen hand sink. <br /> The two 2 D Crescor warmers were not being used during the inspection. <br /> Discussed report with Jose Villanueva. <br /> No signature captured. <br /> FA0015558 PR0523034 SC101 04/06/2023 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 2 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 />