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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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PERSHING
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4555
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1600 - Food Program
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PR0160551
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COMPLIANCE INFO
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Last modified
7/1/2020 10:38:02 AM
Creation date
7/1/2020 10:36:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0160551
PE
1626
FACILITY_ID
FA0002529
FACILITY_NAME
IN-SHAPE / MARCH LN
STREET_NUMBER
4555
Direction
N
STREET_NAME
PERSHING
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11017001
CURRENT_STATUS
02
SITE_LOCATION
4555 N PERSHING AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
JCastaneda
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EHD - Public
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SAN JOAQUIN COU.. , Y <br /> Q` y+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> . cq. ��P• Telephone:(209)468-3420 Fax:(209) 464-0138 Web:www.sAgov.org/ehd <br /> L%FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Z�L Date: <br /> Address: / ,555 City: Zip Code: 5O <br /> Owner/Operaattor:'j—'0 <br /> Q)-L y2 f� Telephone: 42'5a-6537 <br /> Program Element: Program Record: PR 0/6Q Jcr� / Inspection Type: Zia _9_111L,��� <br /> SB180 Posted)(Yes ❑ No Permit Posted `i Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> ds� <br /> ® Low-e ,- <br /> d:26 <br /> w-e r <br /> a eL 4 rt,-- vox c •-r <br /> s Pr <br /> cW <br /> �. <br /> f~ I <br /> Fr-0 h <br /> j4 I -{n qua I d a f <br /> Ov v C/t.PQM Pd -�D S*.60n 31"..r— <br /> Temperature Item/Location Temperature Item/Location <br /> D 2 4.' 7l <br /> 40.0 Y- e ,J <br /> t <br /> I! <br /> ood Safe Certification Facility Hot Water Temperatur Warewashing <br /> Name: ( Ha d S+ lorine: <br /> i°2"v "04er 11 /c �F /C ppm '�&Loz'tvr % F <br /> Exp.Date: rewas ing fzSin :�or 'F Quat.Amm.: 20 <br /> Gtppm Other: OF <br /> Received By/Title: �� +Y <br /> EH Specialist: Phone: <br /> Gwi 53 - <br /> Time in: % / ime Out: _O Page.hof 9 <br /> EHD 16-24 (2-Pg) 11/2/09 FOOD PROGRAM OIR CONTINUATION <br />
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