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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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239
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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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av1" SAN JOAQUIN COUNrf' <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.siaov.ora/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: _ _ v <br /> dress: �3c� oo City: Zip Code: 1-y� <br /> caner/Operator. C',.Q17 t-i 6o),1A Telephone: <br /> Program Element: l Program Record: P 0/-2 g Inspection Type: �1, <br /> 8180 Posted Yes ❑ No Permit Posted Yes ❑NO Re-Inspection on or After: <br /> AYI -b <br /> ui-A--Le_ CIO rr <br /> :EL <br /> ° <br /> pe: <br /> 'r ° Ke/� /D�t C-tLZ <br /> Hand Sink: of hlorine: ppm eat: .F <br /> NarewaVj= <br /> /U =F uat.Am m.: ppm her: of <br /> Received By/Title: // <br /> H Specialist: / 1 Phone: <br /> me in: N/Vit�f Time Out: ✓O / O Page)of i <br /> Cv <br /> EHO 16-24(2a pg) 1=9 FOOD PROGRAM OR CONTINUATION <br />
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