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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0160198
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COMPLIANCE INFO_2021
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Last modified
9/16/2021 8:41:42 AM
Creation date
9/16/2021 8:40:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0160198
PE
1623
FACILITY_ID
FA0000776
FACILITY_NAME
HOUSE OF COFFEES
STREET_NUMBER
239
STREET_NAME
LAKEWOOD MALL
City
LODI
Zip
95242
APN
03534009
CURRENT_STATUS
01
SITE_LOCATION
239 LAKEWOOD MALL
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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Environmental Health Department <br />Facility Name and Address: HOUSE OF COFFEES, 239 LAKEWOOD MALL , LODI 95242 <br />Food Program Official Inspection Report <br />Chlorine (Cl): <br />Name on Food Safety Certificate:Expiration Date: <br />ppmQuaternary Ammonia (QA): <br />Heat:ppm º FWarewash Water/Hot Water Ware Sink Temp:º F <br />Hand Sink Temp:º F <br />OBSERVATIONS <br />Ciara Marie Saco <br />OVERALL INSPECTION NOTES AND COMMENTS <br />Two door reach in display -- 38.00º F hand sink -- Restroom -- 100.00º F <br />Three compartment sink -- 120.00º F Display refrigerator -- under front counter -- 41.00º F <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />Sanitizer spray bottle 200-300ppm (quat) <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: <br />EH Specialist:Phone: <br />Ciara, Person In Charge, <br />STEPHANIE RAMIREZ <br />Page 2 of 2EHD 16-23 Rev. 06/30/15 Food Program OIR <br />FA0000776 PR0160198 SC001 08/27/2021 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com
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