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CO0028965
Environmental Health - Public
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1600 - Food Program
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CO0028965
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Last modified
9/9/2021 3:11:43 PM
Creation date
2/1/2019 2:59:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0028965
PE
1600
FACILITY_ID
FA0022709
FACILITY_NAME
SAFEWAY #1769
STREET_NUMBER
2808
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12118043
ENTERED_DATE
9/2/2008 12:00:00 AM
SITE_LOCATION
2808 COUNTRY CLUB BLVD
RECEIVED_DATE
9/2/2008 12:00:00 AM
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\C\COUNTRY CLUB\2808\CO0028965.PDF
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EHD - Public
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,Z <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 3 •' 600 EAST MAIN STREET,STOCKTON, CA 95202-3029 <br /> � Q TELEPHONE:(209)468-3420 FAX:(209)464-0138 WEB:WWW.SJGOV.ORG/EHD <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Me Date: _4171 <br /> Address: a$ S �� I v City: Zip Code: �p Owner 1 Operator: nTelephoner <br /> Program Element: /i ®� Program Record: Q Jr, Inspection Type: <br /> B180 Posted p Yes ❑ No Permit Posted ❑Yes ❑ No Reinspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> �< <br /> -A5n-e ovr Azn aa^d. hl o_S an is • <br /> C i n s,de -e <br /> lorb Au as n �� � !eh Dl! <br /> 0 1 <br /> Gia Aaw au-l- r 2r ` e^ <1 c G zxkt w h a. 10 d e <br /> v,_- jj bo-mle <br /> d-YI d u ems- e ee t&Ae ha- <br /> h a,,� Ike- e4 <br /> A -- <br /> wZ <br /> 04 r,+..l <br /> r,fl /F � k-9- m-` a- S <br /> �c.�r O <br /> Item 1 Location Temperature Item/Location Temperature Item 1 Location Temperature <br /> Food Safety Certification Facility Not Water Temperature, Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: y arewashing Sink: aF Quat.Amm.: Ppm ther: of <br /> Received By 1 Title: <br /> EH Specialist: Phone: <br /> i <br /> Time in: 'y Time Out: �S n Page,of/ <br /> r f FOOD PROGRAM OR <br /> 16-23(214 pg) <br /> W15138 <br />
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