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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0506307
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COMPLIANCE INFO
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Entry Properties
Last modified
5/7/2020 1:31:51 PM
Creation date
7/12/2019 2:20:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0506307
PE
1618
FACILITY_ID
FA0003711
FACILITY_NAME
LAKEWOOD CHEVRON
STREET_NUMBER
236
Direction
N
STREET_NAME
HAM
STREET_TYPE
LN
City
LODI
Zip
95240
APN
03710028
CURRENT_STATUS
01
SITE_LOCATION
236 N HAM LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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oPq�1N SAN JOAQUIN COUt <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> /FORIN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: e v� VU C h Date: <br /> kA- <br /> Address: 21l„ 1 1 City: i�1 u Zip Code: q S-2"40 <br /> Owner/Operator: Be- �1^� Telephone: 323_b3CL2�' <br /> Program Element: `koI' 1 Program Record: ��� Inspection Type: - <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> oin <br /> Item/Location Temperature Item/Location Temperature <br /> - . . ... ........---- -- <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> -. —.._.... .......................... <br /> —.. -- -._.. -Ch- - --- PP -- _- <br /> Name: Hand Sink: I i of lorine: m Heat: of <br /> Exp.Date: arewashing Sink: of Ouat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: 1O�© Time Out: bJ � , Page of <br /> EHD 16-24 (2n0 pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />
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