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COMPLIANCE INFO_2015-2019
Environmental Health - Public
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1600 - Food Program
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PR0162407
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COMPLIANCE INFO_2015-2019
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Entry Properties
Last modified
9/22/2020 4:13:16 PM
Creation date
3/12/2019 9:36:22 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2015-2019
RECORD_ID
PR0162407
PE
1615
FACILITY_ID
FA0001074
FACILITY_NAME
KWIK MART
STREET_NUMBER
224
STREET_NAME
PARK
STREET_TYPE
AVE
City
MANTECA
Zip
95337
APN
21938106
CURRENT_STATUS
01
SITE_LOCATION
224 PARK AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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SAN JOAQUIN COUR <br /> •.oG <br /> y< ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �;...• ;..a;P Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> �/FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: �� 2-v Date: �-4 <br /> Address: 2l'- City: Zip Code: 9 <br /> Owner/Operator: �mG ni VDCA ( Telephone: 2_69 I <br /> Program Element: 1 b S Program Record: , ,2. Lt 0-4 Inspection Type: Ve_; (1 e <br /> G- <br /> SB180 Posted ❑Yes ❑ Rermit Posted ❑Yes ❑ I Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 2 sib <br /> c 1 <br /> 21-IR:.142,11MMIN <br /> ! <br /> Food Safety Certification Facility Hot Water Temperature 'Warewashing <br /> Name: Hand Sink: F !Chlorine: PPrn '!Heat: F <br /> Exp.Date: acgwashing Sink- 1 of �Quat. Amm.: ppm I!Other: of <br /> Received By/Title: <br /> EH Specialist: - Phone: ' ^� <br /> Time in: 'Z: ' Time Out: 2 2 Paget f <br /> EHD 16-24 (2° pg) 4,'3;13 J FOOD PROGRAM OR CONTINUATION <br />
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