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COMPLIANCE INFO_2016-2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0522562
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COMPLIANCE INFO_2016-2019
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Entry Properties
Last modified
2/24/2021 2:18:17 PM
Creation date
2/21/2019 2:15:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2016-2019
RECORD_ID
PR0522562
PE
1619
FACILITY_ID
FA0015371
FACILITY_NAME
PAQ Inc DBA Rancho San Miguel
STREET_NUMBER
1409
Direction
S
STREET_NAME
AIRPORT
STREET_TYPE
WAY
City
STOCKTON
Zip
95206
APN
16902020
CURRENT_STATUS
01
SITE_LOCATION
1409 S AIRPORT WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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oPggI" SAN JOAQUIN COUN" <br /> � . <br /> Z-' ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.si4ov.orq/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: -WO, • Ci` M; Vee k �4 L Date: �' <br /> Address: 14 A S tti r cct City: :ypA_) Zip Code: <br /> Owner/Operator: IMC \NL t� Telephone: /1A _q-+Cj C <br /> Program Element: 1 viYv Program Record: U G�L� U-2- ,Inspection Type: � /�,,-k r `" <br /> SB180 Posted Yes No 1 Permit Posted 1Yes No Re-Inspection on or After: ��t,`, <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> C Ct 4U`� 5eCA V-tO c CA W— - G° - Y-( w MQa+ (uke • t'F (vovn a <br /> Mot caV u CQgp1T <br /> `N WK in 0d ` "F fiA LP <br /> CCcW �nh1 S Uj crf\ � cmt_" U -S- Coc tef <br /> ss r 0 . Lh06 eco ik-d1 VlGkO a&K- inb <br /> wC�1� �� �d S� d�s��n cc 6 ex- 1� LT �e,lovv . <br /> G�vv ' &e a 4 cbscooI�f I(, Ckt s b-d ' S+- 4-b [cf- Gr <br /> 00v4 . 0ACAV1n M U-� ) <br /> VI CUSe OW h " a Y- Mn cCfV-(, hG e buy raLP. <br /> CVO) bUi Ids U 1 s 0A0 00 V S <br /> Mlai� S17J'G2 <br /> 1 ID,Lat op- -nSi& 111sz- tr Trie- �uf S urd <br /> Vvu�inlS sect 1� . <br /> S(11�QkAi Uv(it Inci(.1s2 C1W% WC/1 uAa t Gice <br /> c tC,�(✓KCS - AGI �n �- tiv� -��-� . <br /> cQ ti IGIw wad K ► n e��, �R i�-nw Q- AOda <br /> � tCA <br /> Item/Location Temperature Item/Location Temperature <br /> ---- —.J....._.. <br /> WU I� �n <br /> K M l l� di i IG <br /> gel f e wee �p�, 4 - -V t i� <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of (Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of �Quat.Amm.: ppm Other: of <br /> Received By/Title: S 1/ C i Z v f 3�? �-1 <br /> EH Specialist: Phone: <br /> Time in: Time Out: Paget�of <br /> EHD 16-24 (2-Pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />
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