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CO0053718 (2)
EnvironmentalHealth
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1600 - Food Program
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CO0053718 (2)
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Last modified
5/20/2021 11:42:07 AM
Creation date
5/20/2021 9:58:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0053718
PE
1600
FACILITY_ID
FA0007274
FACILITY_NAME
FARMERBOYS #1088
STREET_NUMBER
2312
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95242
APN
05814048
ENTERED_DATE
4/22/2021 12:00:00 AM
SITE_LOCATION
2312 W KETTLEMAN LN
RECEIVED_DATE
4/21/2021 12:00:00 AM
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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investigation. <br /> Signature not captured due to COVID <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 required,fees will be assessed at the current hourly rate. <br /> Received by: Name and Title: Noriko Montgomery, Person In Charc <br /> EH Specialist: STEPHANIE RAMIREZ Phone: (209) 616-3069 <br /> FA0007274 000053718 SCO04 04/22/2021 <br /> EHD 16-23 Rev.01/07/2021 Page 2 of 2 Complaint Inspection Report <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br />
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