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COMPLIANCE INFO_2022
Environmental Health - Public
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EHD Program Facility Records by Street Name
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PAVILION
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2706
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1600 - Food Program
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PR0539516
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
6/7/2022 2:33:21 PM
Creation date
3/17/2022 11:02:53 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0539516
PE
1625
FACILITY_ID
FA0022600
FACILITY_NAME
LEIA'S
STREET_NUMBER
2706
STREET_NAME
PAVILION
STREET_TYPE
PKWY
City
TRACY
Zip
95304
APN
21228020
CURRENT_STATUS
01
SITE_LOCATION
2706 PAVILION PKWY
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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SA N J O A Q U I N Environmental Health Department <br /> —COUNTY- <br />-- _ • • • Production <br /> 1. Indicate the location where youwillstore food and equipment at the end of the day. <br /> Commissary <br /> nName: "N 66'W- `��uy��4 OW 61';'' 14e-e Facility II-D 4::'/ VXLJ22�Q�� <br /> Address: s.7vf0 10AVVjju&7 Dir/v+"`�t it /P� L%" �• frc00 <br /> MENU DESCRIPTION <br /> Indicate all the food and beverage items for sale. WHERE WILL THE FOOD BE PREPARED? <br /> COMMISSARY ON-SITE <br /> FOOD ITEM <br /> �inu9ua+1, C�rt,+llP� lQ Sd7�-kS ❑ <br /> U��Sz=k.Ts � ❑ <br /> e biz) AF;n , AVS wzes ❑ <br /> Gua,v;a UtIA N p� U TA6l ❑ <br /> dW- <br /> kf'��tJir� �Tuhr�+1 ❑ <br /> 2. List equipment and utensils that will be used. Please be specific on equipment's use and function. <br /> For example: Equipment: Blender Intended use: Make Smoothies <br /> Equipment Intended use during food preparation or catering event <br /> Refrigerator A&/ ; & /A,.r <br /> Velm 4id b mf4' , bre, efp m� s&w Acc4cls <br /> of <br /> %bye 1p ) p Lrn A (4pwe xt ,A o/n, kilap;n .eAW^4; <br /> I;kl4d cep al/Au,4,e �� �,{� , ,ne.t e <br /> C47h 014"V gr1fi, kAila4l* , 4AY r 1"4-rjR <br /> I of <br />
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