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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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LAKEWOOD MALL
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1600 - Food Program
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PR0160198
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COMPLIANCE INFO
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Entry Properties
Last modified
5/28/2020 1:43:38 PM
Creation date
12/7/2018 6:22:37 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0160198
PE
1623
FACILITY_ID
FA0000776
FACILITY_NAME
HOUSE OF COFFEES
STREET_NUMBER
239
STREET_NAME
LAKEWOOD MALL
City
LODI
Zip
95242
APN
03534009
CURRENT_STATUS
01
SITE_LOCATION
239 LAKEWOOD MALL
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Supplemental fields
FilePath
\MIGRATIONS\L\LAKEWOOD\239\PR0160198\COMPLIANCE.PDF
QuestysFileName
COMPLIANCE
QuestysRecordDate
12/17/2015 7:42:37 PM
QuestysRecordID
2952575
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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In. SAN JOAQUIN COU!,,j <br /> *' ?� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.s6gov.org/e <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Eess <br /> ility: pI4.S c O _ S Date: 8 Z _l�2� Lf►-K�r•�9 MW-u-- City: Zip Code: —ZY UTelephone: 3ator: J:N Ai t -IQ L.o2F4�% Nment: &®2 Program Record: Gn,..,i33�A Inspection Type: 4)���d Yes -t No Permh Posted - as No Re4nspection on or After: <br /> NATIONS AN <br /> 7a ECiw..vgT� <br /> Bob $'ova 14,ME I>i 7?` <br /> 6b 04� Ila e rb CY5 , 5� AA,4. 61663 Ps /AIAt $e rc " 37fo/z� <br /> f}ND /VUU-40:9*FI/j o/u � u6 AX, MCI <br /> Q S/NK 4 , ee DRafju5 w SrpPFkRs /H/h <br /> oww <br /> tz TO R67-Rjzk 'a (too 6. MAlu 5r5w6"00u , <br /> Thi uu kora- R< AND 6u7- E AA/GF a OWOJOZ <br /> OK T6 155 u<- 6Rw, I7- ow uF9W P LD <br /> Temperature <br /> gExp.Date: <br /> M�-'JeQsand Sink: aF hlorine: ppm Heat: >F <br /> �- I arewashing Sink: / aF uat.Amm.: PPM ther: eF <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: r epoTime Out: /;55- :Pag:e1o;f ] <br /> EHD1624 (2mpg) 11t2M FOOD PROGRAM OIR CONTINUATION <br />
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