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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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TULSA
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396
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1600 - Food Program
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PR0540655
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COMPLIANCE INFO
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Entry Properties
Last modified
7/23/2020 11:19:24 AM
Creation date
4/7/2020 1:59:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0540655
PE
1636
FACILITY_ID
FA0020513
FACILITY_NAME
LA BENDICION PRODUCE #4PF2122
STREET_NUMBER
396
Direction
N
STREET_NAME
TULSA
STREET_TYPE
AVE
City
STOCKTON
Zip
95215
APN
15128017
CURRENT_STATUS
01
SITE_LOCATION
396 N TULSA AVE
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
JCastaneda
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EHD - Public
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A�'N•. SAN JOAOUIN CO, f'Y <br /> �°arm fob <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> q.... ,..;6 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> 41Fdd� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: '� I u Date: (- <br /> Address: 2-� S .h 1�/ City: Zip Code: <br /> Owner/Operator: - ` �� -� �1V 1_ Telephone: <br /> Program Element: `(0Program Record: G2 Inspection Type: vl n <br /> B180 Posted YesNo Permit Posted QD <br /> No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> t S <br /> Wing Can n S <br /> Lc rr3'fl it�e �T •�y�{ v`, U <br /> /L ce ace on <br /> y of akACK 1h� <br /> � oK rsSvt� �„ tfi 2G 14� <br /> Res c <br /> 1 G1Ya� e:� Qe. lAcme i F v t �S <br /> c�ti n <br /> rPivitla 4 CM ce <br /> Item/Location ' Temperature Item/Location Temperature <br /> .. Food Safety Certification _ Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of hlorine: ppm Heat: >F <br /> Exp.Date: arewashing Sink: eF uat.Amm.: ppm they: =F <br /> Received By/Title: <br /> EH Specialist: Phone: _ <br /> Time in: /_ Time Out: •� Page of <br /> EHD 16-24 (2^Pg) 41313 FOOD PROGRAM OIR CONTINUATION <br />
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