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COMPLIANCE INFO_2015-2019
Environmental Health - Public
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1600 - Food Program
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PR0538083
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COMPLIANCE INFO_2015-2019
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Entry Properties
Last modified
9/23/2020 5:00:02 PM
Creation date
3/15/2019 9:40:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2015-2019
RECORD_ID
PR0538083
PE
1608
FACILITY_ID
FA0021998
FACILITY_NAME
KIM DUKES OLD VINE BAKESHOP
STREET_NUMBER
1991
Direction
E
STREET_NAME
PELTIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00318010
CURRENT_STATUS
01
SITE_LOCATION
1991 E PELTIER RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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July 26, 2018 Lab ID : STK1839399 <br /> David Duke Customer : 3-17313 <br /> Certification:: I certify that this data package is in compliance with ELAP standards,both technically <br /> and for completeness, except for any conditions listed above. Release of the data contained in this data <br /> package is authorized by the Laboratory Director or his designee, as verified by the following electronic <br /> signature. <br /> KD:DMB <br /> Digitally signal by Kdly A.Dunnalmq B.S. <br /> Approved By Kelly A.Dunnahoo,B.S. ( DW.:2018-0rory Di—- <br /> Approved <br /> Dwr.2D1l11)7-16 <br /> Page 2 of 5 <br />
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