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naW n., SAN JOAQUIN COUNTY <br /> ¢` ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:wiviniv.sig v.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: SA �( s�� Date: [/-/_tp <br /> ddress: ! ( W Itr"Sr, City: ge Zip Code: 7 <br /> wner/Operator: l t1�'L Telephone: 3'J-�5 p <br /> rogram Element: Pro grem Record: /Zo 1-3 Inspection Type: t.J o4 nrtrf <br /> 8180 Posted AYes ❑ No Permit Posted es ❑No Re-Inspection on or After: ,/C-40 <br /> IN=In Compliance N/O=Not Observed NIA=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 /> M or violatfons ose a threat to ublic health and must be corrected I eall tell . Non-corn Ilanee ma warrant closure of the food facility <br /> Demonstration of knowledge;food safety certificate 4. Person In Charge is present and performs duties <br /> 1( Communicable disease;reporting,restrictions&exclusions 5. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds <br /> "Hnpdesr <br /> ng,tasting,drinking,or tobacco use 6. Approved thawing methods used <br /> 7. Food protected from contamination during storage <br /> 1tn and properlywashed;proper glove use 8. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 1( 9. Toxic substances property identified,stored,and used <br /> Proper hot and cold holding temperatures 0. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 1. Customer self-service food protected:individual utensils <br /> Provided <br /> Proper cooling methods 2. Food properly labeled and honestly presented <br /> r( 10. Proper cooking time and temperatures <br /> X 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean <br /> . Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 5. EquipmenVutensils approved;installed;dean;good repair <br /> 13. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use <br /> J)[ 014. Food contact surface cleaned antl sanitlzedhvarewashing procedures 7. Vending machines maintained <br /> 8. Approved and sufficient ventilation antl lighting <br /> K 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 /> 1. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed <br /> 3. Toilet facilities clean,supplied.and maintained <br /> 19. Advisory provided for raw or undercooked food . Premises;personal/cleaning items;vermin-proofing <br /> 0. Prohibited foods not offered at high risk facilities 5. Floors,walls and calling are maintained and kept clean J` <br /> No living or sleeping quarters inside facility <br /> K 1.Hot and cold potable water available. <br /> 7. Signs posted;last inspection report available <br /> 2. Sewage/wastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements <br /> 9. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 0. Impoundment <br /> 1. Permit Suspension <br /> ecelved Byrntle: <br /> EH Specialist: _ ' hone: 4 J6S_I/ v. Page 1 of <br /> EHD 16-23 list pg) 12/15/9 FOOD PROGRAM OR <br />