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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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KETTLEMAN
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1600 - Food Program
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PR0160320
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COMPLIANCE INFO
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Last modified
4/12/2022 8:59:58 AM
Creation date
7/24/2019 8:20:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0160320
PE
1618
FACILITY_ID
FA0000917
FACILITY_NAME
99 Cents Only Stores #157
STREET_NUMBER
300
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
Ln
City
Lodi
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
300 W Kettleman Ln
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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am" SAN JOAQUIN COUt <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> �q. <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s'gov.org/ehd <br /> �/FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 117 7 777 77 <br /> G. 477,27e Date: -7777/7 <br /> Address: j ` City: Zip Code: <br /> Owner/Operator: 1 V n y Telephone: <br /> Program Element: /e Program Recor "��--�J ?, � Inspection Type• <br /> SB180 Posted Yes GC No Permit Posted Yes Nov v Re-Inspection on or After: <br /> � _ G'fJGIG r�lJzc C 'orA-" <br /> � u <br /> blot <br /> Gt' J' �f d1-r J'� �✓ r <br /> Pkl 71 1 tit— &reaa rlp 5 <br /> u� [P. • <br /> P-711 iY-Z <br /> nto Ci <br /> Item/Location Temperature Item/Location Temperature <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: <br /> EH Specialist: -(JAL Phone: <br /> Time in: t Time Out: c� Page/of/ <br /> EHD 16-24 (2W Pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />
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