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CO0033847
EnvironmentalHealth
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1600 - Food Program
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CO0033847
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Entry Properties
Last modified
11/19/2024 10:21:02 AM
Creation date
2/7/2019 12:52:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0033847
PE
1600
FACILITY_ID
FA0003221
FACILITY_NAME
JACKS PLACE
STREET_NUMBER
7939
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
25014009
ENTERED_DATE
7/19/2011 12:00:00 AM
SITE_LOCATION
7939 W 11TH ST
RECEIVED_DATE
7/19/2011 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\E\ELEVENTH\7939\CO0033847.PDF
Tags
EHD - Public
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I <br /> xo �oG SAN JOAQUIN COUNTY <br /> x y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> ��•..,•.g,.�;:� Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www_siaov.orp/ehd <br /> irFose <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: V-5 S r J <br /> �a G. Date- <br /> Address: 3 G 3 G1 j + City: Zip Code: <br /> Owner/Operator: Telephone: 8-3 .2 _ ]92Program Element: Program Record: Inspection Type: ! L/_SI <br /> SB180 Posted ❑Yes ❑ No Permit Posted ❑Yes L7 No Re-Inspection on or After: <br /> r _ <br /> 0BS RVAT�IbNS AND CORt�ECTJNE ACTIONS- <br /> , 3 <br /> rn N r & <br /> ' I <br /> I <br /> i <br /> i <br /> i <br /> I <br /> ..._.__:%ltemlLocattort Terttperxture.. �.a _.Item)Location Tem{serturs r,. Item./Location. Temperature„` <br /> I <br /> Food Sa€ety Certification: 'r 4r :facility Hot Water�empe�ature Warewaslamg <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: P J arewashing Sink: `F uat.Amm.: ppm ther: aF <br /> Received By/Title: `J <br /> EH Specialist: G-2 _ Phone: y / /� <br /> ime in: l�- 0 �-4� Time Out: O v Page of <br /> EFi01624 12^d pA1 11009 I F000 PROGRAM OR CONTIN ATION <br />
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