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SAN JOAQUIN COU'` Y <br /> W :< <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • cq:iFoa��r• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siQoy.or0/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: s ` Date: 2 <br /> Address: �{ �f� J0__ City: Zip Code: t 1 <br /> Owner/Operator: 1" /r\ Telephone: 3- 73S( <br /> - 1 <br /> Program Element: Program Record: Inspection Type: {�f ('� <br /> B180 Posted as No Permit Posted as [] No Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed WA=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Ma for violations ose a threat to public health and must be eonacted immedlete lance nov wafMnt closure of the food facilit <br /> -i. Demonstration of K: <br /> 1. Demonstration of knowledge,food safety certificate 4. Person In Charge k present 8fK1 partorms dNies <br /> IN&Irployee <br /> Communicable disease; reporting,restrictions&exclusions 5. Personal cleanliness and hair restraints <br /> rklNo discharge from eyes,nose,or mouth;no open wounds <br /> Proper eating,tasting,tlriin ng,or tobacco use . Approved thawing methotls used <br /> 7. Food protected from contamination during storage <br /> FHandwashing <br /> n and properly washed;proper glove use 8. Washing fruits and vegetables before use <br /> facilities supplied and accessible . Toxic substances properly Identified,stored,and used <br /> and cold holding temperatures Food storage;food storage containers labeled of time as a public health control 1. Customer self-service food protected;individual utensils provided <br /> ling methods 2. Food properly labeled and honestly presented <br /> F. <br /> Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding Nonfood contact surfaces clean <br /> . Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 5. Equipmentlutensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 7. Vending machines maintained <br /> 8. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations <br /> "'°% Wiiia With Approve 1. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed <br /> '.,..sumer Advisory 3. Toilet facilities clean,supplied,and maintained <br /> 19. Ativisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations - Permanent Food Facilities <br /> . Prohibited foods not offered at high risk facilities 45. Floors,walls and coiling are maintained and kept clean <br /> Water/Hot Water 46. No living or sleeping quarters Inside facility <br /> 1.Hot and cold potable water available- Ccmgp14*M#S9Prcement <br /> Waste Disposal 47. Signs posted; last inspection report available <br /> . Sewage/wastewater properly disposed;toilet facility uses 48. Compliance with plan review requirements <br /> min 49. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 1. Permit Suspension <br /> Received By/Title: / <br /> H Specialist: Phone: (Zipe- <br /> Page 1 of <br /> EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OIR <br />