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COMPLIANCE INFO_2015-2019
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PR0162407
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COMPLIANCE INFO_2015-2019
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Last modified
9/22/2020 4:13:16 PM
Creation date
3/12/2019 9:36:22 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2015-2019
RECORD_ID
PR0162407
PE
1615
FACILITY_ID
FA0001074
FACILITY_NAME
KWIK MART
STREET_NUMBER
224
STREET_NAME
PARK
STREET_TYPE
AVE
City
MANTECA
Zip
95337
APN
21938106
CURRENT_STATUS
01
SITE_LOCATION
224 PARK AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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JCastaneda
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EHD - Public
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PAT. San Joaquin County <br /> ya Environmental Health Department <br /> W . X <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 /> Food Program Service Request Inspection Report <br /> Facility Name and Address: KWIK MART, 224 PARK AVE, MANTECA 95337 <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: n/a Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 108°F <br /> FOOD ITEM—LOCATION—TEMP°F—COMMENTS <br /> walk in—44.00°F 3 dr True Pepsi—43.00°F <br /> 2 dr Mira Cool Pepsi—37.00°F mop--120.00°F <br /> 2 dr Imbera Coke—40.00°F 2 dr Habco 7 Up—41.00°F <br /> 1 dr True dairy—41.00°F <br /> NOTES <br /> Change of ownership consultation. <br /> New owner to return to 1868 E. Hazelton Ave., Stockton to pay for permit and complete change of ownership form. <br /> Ok to issue permit once all fees have been paid. <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 /> 4-L� <br /> Received by: Name and Title: nazish hussain, new owner(requesto <br /> EH Specialist: SCOTT SANGALANG Phone: (209)468-3452 <br /> FA0001074 SR0080051 SCO61 01/07/2019 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program Service Request Inspection Report <br />
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