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CO0032230
EnvironmentalHealth
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1600 - Food Program
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CO0032230
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Entry Properties
Last modified
9/9/2021 3:11:16 PM
Creation date
2/1/2019 2:59:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0032230
PE
1600
FACILITY_ID
FA0022709
FACILITY_NAME
SAFEWAY #1769
STREET_NUMBER
2808
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12118043
ENTERED_DATE
6/23/2010 12:00:00 AM
SITE_LOCATION
2808 COUNTRY CLUB BLVD
RECEIVED_DATE
6/23/2010 12:00:00 AM
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\C\COUNTRY CLUB\2808\CO0032230.PDF
Tags
EHD - Public
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g41'" SAN JOAQUIN COUNTY <br /> 0 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209} 468-3420 Fax: (209) 464-0138 Web:www.ssjgov.orglehd <br /> �IxpR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ! �'Date: 9 �p <br /> Address: F� ' City: `�` Zip Code: sZ0�f <br /> Owner/Operator: C A Fe W A �� �e-� � - e-& Telephone: �G <br /> Program Element: to �� FIrogram Record: 3b Inspection Type:am <br /> 1SB18G Posted ❑Yes ❑ No Permit Posted ❑Yes ❑ No Re-Inspection on or After: <br /> 4 <br /> A+ 9 P •v► baa/ �o � !� C of s.� p��-�kc� <br /> -- rte <br /> s. r u e rssk, MSC - C� V1 .5 4- <br /> Co CC IRLAA t lzl <br /> ! <br /> -Seue <br /> Pte-� � - �• <br /> Name. Hand Sink: of chlorine: ppm Heat: aF <br /> Exp.Date: arewashing Sink: of Quat.Amm,: ppm ther: of <br /> Received By 1 Title: <br /> EH Specialist: Phone: <br /> Time in://" G Time Out:fes. Page of <br /> EHD 16-24 [211 pg]'1112109 FOOD PROGRAM OIR CONTINUATION <br />
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