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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0522240
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COMPLIANCE INFO
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Entry Properties
Last modified
11/19/2020 2:07:56 PM
Creation date
5/7/2019 9:33:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0522240
PE
1633
FACILITY_ID
FA0015151
FACILITY_NAME
BLACKWATER ON WHEELS #4GA6786
STREET_NUMBER
912
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
CURRENT_STATUS
02
SITE_LOCATION
912 YOSEMITE AVE
P_LOCATION
01
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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�op,4 ,Fo` San Joaquin County <br /> P. �a Environmental Health Department <br /> ` 1868 East Hazelton Avenue, Stockton, CA95205-6232 <br /> Telephone: (209)468-3420 Fax: (209) 464-0138 Web:www.sjgov.ora/ehd <br /> �crFdN" <br /> Mobile Food Facility Service Request Inspection Report <br /> Facility Name and Address: BLACKWATER ON WHEELS#4GA6786, 912 N YOSEMITE AVE , STOCKTON 95206 <br /> $169 <br /> PE: 1633 <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 <br /> isrequired,fees will be assessed at the current hourly rate. <br /> 44�Received by: Name and Title: Patrick Salisbury, Owner <br /> EH Specialist: LEYNA HUYNH Phone: (209) 468-3446 <br /> FA0015151 SR0078249 SC061 10/12/2017 <br /> EHE 16-23 Rev.06/30/15 Page 2 of 2 Mobile Food Facility Service Request Inspection Report <br />
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