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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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KETTLEMAN
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1600 - Food Program
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PR0527848
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COMPLIANCE INFO
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Entry Properties
Last modified
5/22/2020 2:20:08 PM
Creation date
2/28/2020 4:32:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0527848
PE
1615
FACILITY_ID
FA0018879
FACILITY_NAME
HEALTHY WAYS
STREET_NUMBER
762
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06004014
CURRENT_STATUS
01
SITE_LOCATION
762 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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SAN JOAQUIN COUNTY <br /> ya ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: a <br /> r . 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> eq ;PTelephone: (209)468-3420 Fax: (209) 464-0138 Web:www.s4gov.org/ehd <br /> �/PORN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: kc"C Date: 3 _5 1 <br /> Address: / 2- ', 1 e_ ) City: LOC-6 <br /> .. l6 Zip Code: qsZ-to <br /> l7 W . u, �--C.JC_ <br /> Owner/Operator: /8 h C A ker% Telephone: 333_,2 S- <br /> Program Element: 6l 5— Program Record: &W sLi QO Inspection Type: RO(Af Wk.0- <br /> SB180 Posted Yes ❑ No Permit Posted (Yes ❑ No Re-inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> I se I - s etr -t�.r a5 ( ems► a <br /> Rei - cb ct <br /> Z- k Vl_ i C.<r ( 'n <br /> � Z r Drsp 'F <br /> Name: Hand Sink: t oco f, of Chlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: I ZC of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: n J Phone: Lt c� _34•y� <br /> Time in: C) Time Out: / PageZpfZ <br /> EHD 16-24 (2nd pg) 413/13 FOOD PROGRAM OIR CONTINUATION <br />
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