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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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KETTLEMAN
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1110
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1600 - Food Program
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PR0160142
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COMPLIANCE INFO
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Entry Properties
Last modified
5/22/2020 2:47:54 PM
Creation date
3/8/2019 11:44:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0160142
PE
1626
FACILITY_ID
FA0000189
FACILITY_NAME
CASA MEXICANA
STREET_NUMBER
1110
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06037001
CURRENT_STATUS
01
SITE_LOCATION
1110 W KETTLEMAN LN 1
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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SAN JOAQUIN COUN" <br /> 4 ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> �ia=iiRa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: a oilM'E' /C.(It iA 06- Date: <br /> Address: I11D , I City: L__3d j, Zip Code: <br /> Owner/Operator: 45PicL- Telephone: 3 <br /> Program Element: ProgramRecord: U Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> _., <br /> ._.._.._.L_.__—_. .:.TrkA-C 2 P Qtz r r IS Sir• <br /> /44t✓1 " t-f_ CGT- alC ot- `s4 .-4W 40 clay <br /> 50 <br /> c�Lea.t�l.le <br /> I Vim► �\ V� ^ T ca 1 '� ^ <br /> b �Qda <br /> Iv 4oAls cvvs K' Sft �- ectna� <br /> 4-a r-a r-o a-" i c, cLa 2 W <br /> z Ite;lEocation ^1 TemperatureItem/Location Temperature <br /> - - , 3F <br /> T -2 130- cCC_rA�co QkI. <br /> ^S - -- <br /> ------ ---- - --- --- <br /> Food Safety Certification Facility Hot Water Temperature VJarewashing <br /> Name: SNC P7i and Sink: (DC7,t of Chlorine: PP- [H:eat F <br /> Exp.Date: arewashing Sink: f 'F Ouat.Amm.: PPM Other. 'F <br /> Received By/T' le: <br /> EH Specialist: .` Phone: <br /> Time in: 0 i Time Out: `1 ,15-0 <br /> Page?of Z <br /> EHD 16-24 (2n°pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />
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