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COMPLIANCE INFO_2011-2019
EnvironmentalHealth
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1600 - Food Program
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PR0160640
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COMPLIANCE INFO_2011-2019
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Last modified
9/30/2020 3:32:57 PM
Creation date
3/19/2019 9:24:11 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2011-2019
RECORD_ID
PR0160640
PE
1615
FACILITY_ID
FA0001332
FACILITY_NAME
SIMON FOOD MARKET
STREET_NUMBER
201
Direction
W
STREET_NAME
POPLAR
STREET_TYPE
ST
City
STOCKTON
Zip
95203
APN
13714030
CURRENT_STATUS
01
SITE_LOCATION
201 W POPLAR ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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JCastaneda
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EHD - Public
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SAN JOAQUIN COUIIii,.X <br /> z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> q: < <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ... ;a Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s'gov.org/ehd <br /> <cikCtit' <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 1 Date: ` _ _ <br /> Address: aZ,n 1� r City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: ' Program Record: Q O I �� D Inspection Type:740 14 'fi <br /> SB180 PostedYes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVEACTIONS <br /> C1 <br /> qre /►O� c n i �' r o f <br /> C Co r r 4- Air, /- -1 <br /> MLC, <br /> of n <br /> 0 Ll P1 r2mri akiA C_6 U o315 tin v-e, of yteg? <br /> 1;q 04 114le 0 <br /> rie7 mo -e . ver <br /> 5-0 ne A o d c h hA' r <br /> ig DOY r1f nner- Y <br /> Item/Location Temperature item l Location 'Temperature'' <br /> ctooje - L3 7 d6- �i GV G<-C 9r r '7 y SAF <br /> Food Safety Certification Facility Hot Water Temperature ; Warewashing <br /> Name Hand Sink: / 01 O of Chlorine: PPM Heat: -F <br /> Exp. Date: arewashing Sink: vt� aF Quat.Amm.: PPM ther: - ,F <br /> Received By/Title: <br /> EH Spec ialis . Al <br /> Phone: 5 —701-7 <br /> Time In:/j-10 Time Out: / 3 Pageiofz <br /> EHD 16-24 (2^Pg) 4013 / FOOD PROGRAM OIR CONTINUATION <br />
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