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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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SAN JOAQUIN COUNTT•' <br /> Z ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: - l' <br /> > Date: &_ 4._ D <br /> p <br /> Address: 2- cl �..0 oo ` City: �—/ _ I _ Zip Code: 62 <br /> wnerlOperator: 0. 1til ��1 Telephone: 3�g_Z'f.Co L <br /> -l <br /> Program Element: I �� Program Record: R rj I (O O I Inspection Type: '�Glnru. <br /> 8180 Posted Yes ❑ No Permit Posted Yes ❑No Re-Inspection on or After: <br /> t a r vl -I Co L <br /> d 4-I IbF o r- <br /> { CA.-A�? �- YL�p vi'd, e n 01A o,+- IGof� <br /> (D-0 'F Or — — I <br /> re0. &1 P-1 { CLr bt0 ra <br /> Y!0,v 2 I 0 -[ � Qvtf r <br /> or rl ri I OU C h a, cl <br /> r a <br /> Iv 4- n k"v1p- aLL -Foof <br /> n LL ace.S <br /> R P co rk,12 ha5 a'p-6A-1 s / <br /> ahi -A2_e, <br /> b Y-a CLAA L3 nCtl? r- 6 s !a�'ywf <br /> LD rn m.er <:l� r Rr2 how <br /> C m o w i 44-x or~n r F <br /> Pro 6 <br /> ra =Date- / <br /> Hand Sink: /03of hlorine: ppm eat: .F <br /> � / arewashing Slnk: /Dp =F uat.Amm.: ppm her: eF <br /> E <br /> lved By/Title: /pecialist: I_ _ I_ Pho e:In: I D' 15 V WJ 1 Time Out: lio, Ll� / Pageyf <br /> EHD16-24 (2n0pg) 1112109 FOOD PROGRAM OR CONTINUATION <br />
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