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COMPLIANCE INFO_2022
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0545218
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
2/17/2022 11:33:05 AM
Creation date
2/17/2022 11:31:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0545218
PE
1636
FACILITY_ID
FA0025708
FACILITY_NAME
LA POBLANA RESTAURANTE #39665W1
STREET_NUMBER
600
Direction
S
STREET_NAME
CENTRAL
STREET_TYPE
AVE
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
600 S CENTRAL AVE
P_LOCATION
02
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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Environmental Health Department <br />Time In: <br />10:50 am <br />10:30 am <br />Time Out: <br />Program Element: 1636 - LTD FOOD VEHICLE (PRODUCE/WHOLE FISH) <br />Telephone: Owner/Operator: JIMENEZ SANCHEZ, FERNANDO <br />Inspection Type: ROUTINE INSPECTION - Operating Permit <br />Address: 600 S CENTRAL AVE, LODI 95240 <br />Date: 02/11/2022Name of Facility: LA POBLANA RESTAURANTE #39665W1 <br />Mobile Food Facility Official Inspection Report <br />VIOLATIONS AND CORRECTIVE ACTIONS <br />Items listed on this report as violations do not meet the requirements set forth in the California Health and Safety Code commencing with section 7; <br />113700. All violations must be corrected within specified timeframe. Violations that are classified as "MAJOR" pose an immediate threat to public health <br />and have the potential to cause foodborne illness. All major violations must be corrected immediately. Non-compliance may warrant immediate closure of <br />the food facility. <br /> #64 Lack of Proper Owner Identification <br />OBSERVATIONS: Owner identification not provided on the vehicle. Per owner it fell. Provide prior to operating the business. <br />CALCODE DESCRIPTION: 1. The business name or the name of the operator, city state and ZIP code, and the name of the permittee if <br />different from the business name is not clearly visible on the customer side of the mobile food facility. [§114299(a)] 2. Business or <br />operator name is not at least 3 inches high and address is not one inch high. [§114299(b)] 3. Sign is not in contrasting color with the <br />vehicle exterior. [§114299(b)] 4. For a motorized vehicle and a mobile support unit, the sign is not present on both sides of vehicle. <br />[§114299(c)] <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 />No Temperature Data Collected <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />The permit is for prepackaged, non potentially hazardous foods, <br />Lic # 39665W1 <br />Ok to issue permit for 2022. <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:(209) 616-3020 <br />, <br />VIDAL PEDRAZA <br />Page 1 of 1EHD 16-23 Rev. 09/16/2020 Mobile Food Facility OIR <br />FA0025708 PR0545218 SC001 02/11/2022 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD
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