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SAN JOAQUIN COUNT' <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �4u ear;� Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sioov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: �Y <br /> Address: / City: Zip Code: per- <br /> wner/Operator: ( Telephone: /J <br /> Program Element: Program Rel Inspection Type: <br /> 8180 Posted des -. No Permit Posted --Yes No Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed N/A=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 /> vio=Demonstration <br /> a U~to heaah end must be corrected immedla may warini Bosuns of Nre food fadft <br /> 1. of knowledge;food safety certificate 4. Person In Charge is present and performs duties <br /> disease;reporting,restrictions 8 exclusions Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds <br /> Proper eating,tasting,drinking,or tobacco use . Approved thawing methods used <br /> 7. Food protected from contamination during storage <br /> Hands dean and property washed;proper glove use e. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 29. Toxic substances properly identified.stored.and used <br /> torage/Dispfay/Service <br /> Proper hot and cold holding temperatures . Food storage;food storage containers labeled <br /> Proper use of time as a public health control 1. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 2. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> 1. Proper reheating procedures for hot holding 3. Nonfood contact surfaces dean <br /> 4. 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 /> 6. Compliance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths <br /> . Compliance with Gulf oyster regulations <br /> :.........:.....,,....; ..,y....... 1. Plumbing maintained;proper back flow prevention <br /> 8. Compliance with HACCP plan or variance corMitions 2. Garbage and refuse properly disposed <br /> 43. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food 4. Premises;personaVcleaning items;vermin-proofing <br /> . Prohibited fends not offered at him risk fadjibes 45. Floors,walls and ceiling are maintained and kept Clean <br /> .. _. <br /> 46. No living or sleeping quarters insole facility <br /> V3. <br /> potable water available. Compliance <br /> 30000M '� 47. Signs posted;last inspection report available <br /> stewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> 9. Facility operating with a valid health permit <br /> insects,birds or animals inside facility 5o. Impoundment <br /> 1. Permit Suspension <br /> Received By/Title: <br /> EH Speciali Pho 3 Page 1 of <br /> EHD 16-23(1st P9) 4/9/12 FOOD PROGRAM OR <br />