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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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GLACIER POINT
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9275
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1600 - Food Program
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PR0523085
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COMPLIANCE INFO
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Entry Properties
Last modified
5/1/2020 1:48:09 PM
Creation date
2/21/2019 2:06:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0523085
PE
1632
FACILITY_ID
FA0015582
FACILITY_NAME
LODI USD-ANSEL ADAMS ELEMENTARY
STREET_NUMBER
9275
STREET_NAME
GLACIER POINT
STREET_TYPE
DR
City
STOCKTON
Zip
95212
APN
12430007
CURRENT_STATUS
01
SITE_LOCATION
9275 GLACIER POINT DR
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Scanner
JCastaneda
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EHD - Public
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SAN JOAQUIN COUP <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> --__ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.slpov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: a VVL f Date: <br /> Address: 1 (14(,Q,-- <br /> , �v��r City: 54 <br /> G Zip Code: <br /> Owner/Operator:✓ „/, VVI LFUA <br /> Telephone: <br /> Program Element: Program Record: 2- Inspection TypeIN q 11 n`TV-6 IU <br /> SB180 Posted Yes No Permit Posted es No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> )JI <br /> atl - Y1 A 0 vt uwev <br /> >! uvt <br /> Item/Location temperaturd Item 1 Location Temperature <br /> cj4(tVtm_ i/ W rill! h <br /> �� <br /> Food afety Cirtification Facility Hot Water Temperature Warewashing <br /> Name: q 0 v Hand Sink: of Chlorine: ppm Heat: y of <br /> Exp.Date: Warewashing Sink: j of Qt. mm.: ppm Other: of <br /> Received By/Title: 1 <br /> EH Specialist: 1 Phone: <br /> VIA Time in: t� Time Out: Page'of <br /> EHD 16-24 (2nd pg) 413/13 FOOD PROGRAM OIR CONTINUATION <br />
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