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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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GRANT LINE
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3250
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1600 - Food Program
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PR0518777
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COMPLIANCE INFO
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Entry Properties
Last modified
5/6/2020 11:33:36 AM
Creation date
7/18/2019 2:40:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0518777
PE
1619
FACILITY_ID
FA0014131
FACILITY_NAME
COSTCO WHOLESALE #658
STREET_NUMBER
3250
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95377
APN
23860006
CURRENT_STATUS
01
SITE_LOCATION
3250 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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SAN JOAQUIN COUN . <br /> � •.pG <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 /> �IFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: _ `)i J /, _41r(5 f Date: I_`y . j <br /> Address: r ,1 / r iA C� n City: r Zip Code: 953.7 7 <br /> Owner/Operator: W 19 Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Q CG v1 _ <br /> G�lor ccr � i I jdeeK. <br /> 0 C� n t .-/1 r� /GC/k, .� 4 W P,n <br /> Door Ae5 !+ lace i 1 rY1GnIh <br /> 7c, b o te s Q 1 lDO / CC r rPck <br /> )ri j /1 2 eeleJ . <br /> ra✓► � <br /> 3 1A)0yYI ',s PsJr crri cunei r c, 6 7-7 c, r►4o ; <br /> 64) G r r✓1 W of h e 4 W e C Gr rn j h-da <br /> Oup/ hQ5 IQ 12 e ab c 4 c,7 <br /> raRe7pej i n 2Wee <br /> Now, tb i rd iiw c 1*I . } r Chir o5 nei-Aql <br /> ,/tic + 0A c,bhe la CACC Pr; S r cc-1621 <br /> Item/Location Temperature Item/Location Temperature <br /> !odor c- X -i 4/ f pi,S /g rj <br /> 3- G+loGr r� �l I' i Z 2 r,, I �O <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: ;yI <br /> EH Specialist: - i Phone: /O f J/b <br /> Time in: Time Out: a Page of <br /> EHD 16-24 (21"pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />
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