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COMPLIANCE INFO_2015-2019
EnvironmentalHealth
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1600 - Food Program
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PR0527299
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COMPLIANCE INFO_2015-2019
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Entry Properties
Last modified
9/18/2020 3:46:23 PM
Creation date
3/21/2019 2:26:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2015-2019
RECORD_ID
PR0527299
PE
1628
FACILITY_ID
FA0011262
FACILITY_NAME
WINDSOR ELMHAVEN CARE CENTER
STREET_NUMBER
6940
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
08126030
CURRENT_STATUS
01
SITE_LOCATION
6940 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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JCastaneda
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EHD - Public
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SAN JOAQUIN COL Y <br /> 4 Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> - _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �q...• ,.�;;P Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.siQov.or /q ehd <br /> L�POR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Lh 50 r. (:;rYY 1 Ot L-'-f Date: I„ <br /> Address: /_ Q e4 O QG r'• c- A-u-t— City: I „f.on Zip Code: 9�5 2-4-7 <br /> Owner/Operator: Wir'66or eff4t ^ _r-e— &LP Telephone: '477_14$ 17 <br /> Program Element: 102-8 Program Record: P(2-0'j21 2 4? 9 Inspection Type: l�m. L)-h 1��— <br /> SB180 Posted Yes No Permit Posted VYes No Re-Inspection on or After: d y�•�/�6 <br /> AM <br /> OBSERVATIONS AND CORRECTIVE ACTIONS e <br /> -- <br /> ut a WS a n_d c.0'4 (-4 n-0, S -E-.............h.e <br /> _l _. U_(ok- �►Z- iZ�r _c ► '�- . _ . .e .......... _iso✓ lye �-�+ a <br /> n- i 5 k� o+ YI-OL cc t n-1-cal U)t-+4-i S-e m-c - <br /> a FlnoyY- dA Sbutj a skt <br /> a he rru a-5h I U-0 n yjt <br /> Ltd a.o n _w_ -Kr <br /> '�^ a„ fit°. 1#HrrtILOC8ti4t1 ."r , .i= �;�. � Temperature o.�s�a '��� Item 1;Locabon ��'�� TEfl7peratiJr@ <br /> p <br /> y 1I= 1'V1tzsG dPo 1- 40 5 <br /> YO -,&52F <br /> 6100 'ra u hw. n y OPF — - <br /> Y� 18D <br /> _.. -v c ._ .� a <br /> 1 <br /> F ;Safety Gert�fict an cility,Hot Water temperature -1Narean►ashmg <br /> Name: Marl � Hand Sink: =...._._._., -F'CCN�Y!!PJ"0- <br /> Exp. <br /> PPM Heat: -- °F <br /> Exp.Date: J areasho Sink: �� of Ouat.Amm.: O ppm Other: of <br /> Received By/Title: / - GUi1 <br /> EH Specialist: ) Phone: <br /> Time in: Time out: Pae of <br /> EHD 16-24 (2^d pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />
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