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COMPLIANCE INFO_2017-2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0542438
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COMPLIANCE INFO_2017-2019
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Entry Properties
Last modified
9/29/2020 3:50:46 PM
Creation date
2/15/2019 9:10:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2017-2019
RECORD_ID
PR0542438
PE
1623
FACILITY_ID
FA0024390
FACILITY_NAME
FUNCTIONAL 4 NUTRITION
STREET_NUMBER
5403
Direction
N
STREET_NAME
PERSHING
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
5403 N PERSHING AVE STE 10
P_LOCATION
01
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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Pa�'y San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... P Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> ��fFORa <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: 174NUTRITION, 5403 N PERSHING AVE , STOCKTON <br /> The person in charge is responsible for ensuring that the above mentioned facility is in compliance with all applicable sections of the California Health and <br /> Safety Code.If a reinspection is required,fees will be assessed at the current hourly rate. <br /> UJA�lw <br /> Received by: Name and Title: ernie federico, <br /> EH Specialist: STEPHANIE RAMIREZ Phone: (209)468-9851 <br /> SR0078464 SC523 12/08/2017 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program Service Request Inspection Report <br />
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