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CO0028778
EnvironmentalHealth
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1600 - Food Program
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CO0028778
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Entry Properties
Last modified
5/1/2019 11:37:29 AM
Creation date
2/8/2019 5:59:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0028778
PE
1600
FACILITY_ID
FA0012662
FACILITY_NAME
JACK IN THE BOX #4301
STREET_NUMBER
2425
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95242
APN
02741008
ENTERED_DATE
8/5/2008 12:00:00 AM
SITE_LOCATION
2425 W KETTLEMAN LN
RECEIVED_DATE
8/5/2008 12:00:00 AM
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Supplemental fields
FilePath
\MIGRATIONS\K\KETTLEMAN\2425\CO0028778.PDF
Tags
EHD - Public
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- 'SAN .JOAOUIN CO6- .�TY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> co% 600 EAST MAIN STREET,STOCKTON, CA 95202-3029 <br /> '7. <br /> j'r C:17� / TELEPHONE:(209)468-3420 FAx.(209)464-0138 Wes:WWW.SJGOV.ORGIEHD <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: L--&-09 <br /> ddress: J m� , City: 9 _ 1 , Zip Code: � <br /> Owner 1 Operator: I t�c[� Telephone: <br /> Program Element: �� Program Record. Co a Inspection Type: <br /> B180 Posted des ❑ No Per Posted ❑Yes © No Reinspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Lain + c- t t 1 ro u5 . d-r ivt -441 r u <br /> Vn r rt.'n ` <br /> Lobi J 0'- t✓ <br /> rYL&-L rpt.• `t t2 z <br /> 1A A-6 <br /> t--4 ri LnJ CA <br /> �. Y d a,f- <br /> Item 1 Location Temperature Item 1 Location Temperature item 1 Location Temperature <br /> Food Safety Certification FaeilityMot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title. <br /> EH Specialist: b�-Ja� Phone: 7g I,7 <br /> Time in: Time Out: Page t of <br /> 1:HD 16-23 (21d pg) FOOD PROGRAM OR <br /> D5115ID8 <br />
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