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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELEVENTH
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1600 - Food Program
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PR0161568
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COMPLIANCE INFO
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Entry Properties
Last modified
11/19/2024 10:19:28 AM
Creation date
5/10/2019 2:49:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0161568
PE
1624
FACILITY_ID
FA0003143
FACILITY_NAME
KOVALAM GROCERY & RESTAURANT
STREET_NUMBER
1200
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
1200 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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ServS <br /> CERTIFICATION <br /> PHILIP JOSEPH <br /> for successfully completing Ike standards set forth for the ServSafe5 Food Protection Manager Certification Examination, <br /> which is accredited 6y the American National Standards Institute(ANSIf-Conference for Food Protedion(CFP). <br /> 14988137 10551 <br /> CERTIFICATE NUMBER EXAM FORM NUMBER <br /> 4/21/2017-. 4/21/2022 <br /> DATE OF EXAMINATION DATE OF EXPIRATION <br /> Local kms apply.Check with your local regulatory,agency for recertification requirements. <br /> 13 C71, <br /> Sherman Brown <br /> SVP,Nationcl Restaurant Association Solutions <br /> p <br /> dh"taboo CN—&n 2W&R■d"'On ACM N 068-201 Me%kdw 1Z S4.x1ad 0.121.• ti.. <br /> mart AaodoEen Eamcf"F—Allim"An Al rVft mmve4 S&v5d t ad the SeNsc"690 oe WadmW6 of Ike NO&. ■ <br /> WdaI aao erd the an&S;M ae k'adae+orkr of�w Nmbrd Rrxm�axodmbn <br /> �rey0d�xed or ahered, , <br /> v,1d0t' <br /> C bd v+-6 qu im a 175 W bekan B$.d.Sto 1500.Chkgp,IL 6WA a Sw.•kioe,0a70■ianeasy <br />
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