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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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ROBINHOOD
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1025
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1900 - Hazardous Materials Program
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PR0520721
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COMPLIANCE INFO
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Entry Properties
Last modified
12/10/2024 2:00:36 PM
Creation date
6/11/2018 5:25:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0520721
PE
1919
FACILITY_ID
FA0001056
FACILITY_NAME
HOMETOWN BUFFET #707
STREET_NUMBER
1025
Direction
W
STREET_NAME
ROBINHOOD
STREET_TYPE
DR
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
1025 W ROBINHOOD DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
EJimenez
Supplemental fields
FilePath
\MIGRATIONS\R\ROBINHOOD\1025\PR0520721\COMPLIANCE INFO.PDF
QuestysFileName
COMPLIANCE INFO
QuestysRecordDate
11/2/2016 3:41:19 PM
QuestysRecordID
3247643
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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fu1-30-2018 11:38 AM Food Monargement Partners, Inc. 2104033580 <br />SANNJOA1 <br />�iEnvironmental HealtVff* 4rV" <br />._ <br />cot"ITY-lw--- JUL 30 20'3 <br />v .._ r..: k'x. 5P Ld. <br />4/4 <br />RETURN TO COMPLIANCE CERTIFICATION�NvuzDFAIA � NIEFAL Itetu'ru <br />o ra>;� Irr nl e n'r <br />Any MINOR violations noted in the "Notice to Comply" in the attached Inspection Report must be corrected within 30 days of <br />receipt of this inspection. This certification form must be submitted to the Environmental Health Department (EHD) address <br />at the top of this form within 30 days of receipt of the Inspection Report. HSC 25404.1.2(c)(1) <br />All corrections to other violations noted in the attached Inspection Report (IR) or Continuation Form, or disputes to any <br />violations, are to be submitted using this certification and returned to EHD within 30 days unless otherwise specified in the <br />Inspection Report. HSC 25185(c)(3) <br />Note: All EHD staff time associated with failing to comply by the above noted dates will be <br />billed at the current hourly rate. <br />For this certification to be complete, the operator of the site must include: <br />A statement documenting what corrective actions were taken or will be taken for each violation <br />Copies of sample results/manifests/training records/other appropriate paperwork, and/or photos verifying <br />corrections <br />Operator's certification <br />Inspection Date: July 19, 2018 Inspected By <br />Facility Address: 1025 W ROBINHOOD DR, STOCKTON CER5 ID: <br />I certify under penalty of law that: <br />JAMIE LIMA <br />10180693 <br />1. 1 have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. <br />2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br />and I believe the information to be true, accurate, and complete: <br />Photos Paperwork Statement <br />3. 1 am authorized to submit this certification on behalf of the Respondent. <br />4. 1 am aware that there are significant penalties for submitting false information, including the possibility of a fine <br />and/ori i�imprisonment for <br />�,known violations. (HSC 25191) <br />4c 1) t (' <br />Name:/ ff Ne6rl n Title: JQTCTLX AQ(10c1ee, <br />7139/20 i x <br />1868 E Hazelton Avenue I Stockton. California 95205 1 T 209 468-3420 i F 209 464-0138 1 www.sjcehd. com <br />Received Time Ju1.30, 2018 11:41AM No -3938 <br />
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