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COMPLIANCE INFO_2016-2019
EnvironmentalHealth
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1600 - Food Program
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PR0539880
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COMPLIANCE INFO_2016-2019
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Entry Properties
Last modified
9/18/2020 2:52:42 PM
Creation date
4/4/2019 2:11:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2016-2019
RECORD_ID
PR0539880
PE
1632
FACILITY_ID
FA0022811
FACILITY_NAME
HUMPHREYS COLLEGE ACADEMY OF BUSINESS, LAW & EDUCATION
STREET_NUMBER
6504
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
6504 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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SAN ,10AQUIN COL.. t"Y <br /> 2. Z ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c -.aiP Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> 4t/FD.R <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT .3-5-/s <br /> Name of Facility: �` Date: 2�7 <br /> ddress: / I�00 ) City: � Zip Code: <br /> Owner/Operator: s Ctj1-,/ / _171Telephone: C/ /60D <br /> Program Element: b3Z Pr gram Record: Pk-653677,3 <br /> n5 77 Inspection Type:a hd �fkG71nQ <br /> 8180 Posted Yes ❑ Rermit Posted ,C (Yes ❑ 1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> d�� 1't oo v �z ru d mac% ZD I L-t <br /> r0 v-•+`dc, ctA- oLLl- --4--i .- e3 <br /> & 5e y-Ike Lt eu,_ -z e, a-m -,4 <br /> 0' z 0'"r, <br /> OAd2 S5 C4 y1 �- <br /> o - 3 fol 15 <br /> Zo ve s k,'o o►-n I u2.lc s w cL Y", <br /> 6►ti +-c,,r, 5 h eLtL ho-* I vo"`F o r T <br /> % Po,5 4- jet Lo -e-w Y-zm I d Lij cz_� h <br /> (Q Gj o Po-Gf -Fi L AU <br /> 6--Oc:1L�n G15 -2-0'7 <br /> Item/Locationh SGho ----emperature Item/Location j�hi(c[c1t'C Tvnoerature <br /> --- - -— - ----, ---- - <br /> cor �rr►K LCtAr ��F` Cl' cov ;,�c2i ✓ Lo-+ -� '4. 00 - <br /> `3 lu e i r coo Le 1' 37 F <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: H d Sink: Chlorine. Heat: <br /> Qn z401 � //� °F ----- - ppm11 <br /> °F <br /> Exp.Date: �1 \ Sin : 'F i at;Ar m.:11 :Z,-0 ppm Other: °F <br /> Received By/Titl <br /> EH Specialist: j_ � Phone: <br /> ime in: Time Out: ® Page,e <br /> EHD 16-24 (21d pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />
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