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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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PR0160289
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COMPLIANCE INFO_2021
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Last modified
10/20/2021 2:10:01 PM
Creation date
10/20/2021 2:07:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0160289
PE
1615
FACILITY_ID
FA0000121
FACILITY_NAME
CVS Pharmacy #9261
STREET_NUMBER
100
Direction
W
STREET_NAME
LODI
STREET_TYPE
Ave
City
Lodi
Zip
95240
APN
04521002
CURRENT_STATUS
01
SITE_LOCATION
100 W Lodi Ave
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Environmental Health Department <br />Facility Name and Address: CVS Pharmacy #9261, 100 W Lodi Ave, LODI 95240 <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 />OVERALL INSPECTION NOTES AND COMMENTS <br />Mopsink -- 120.00º F customers rr -- 109.00º F <br />Employee rr -- 111.00º F Walk-in w display doors -- 37.00º F <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />No comment entered. <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 />Jessica, manager, <br />STEPHANIE RAMIREZ <br />Page 2 of 2EHD 16-23 Rev. 06/30/15 Food Program OIR <br />FA0000121 PR0160289 SC001 10/07/2021 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com
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