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aRi1k!!!. SAN JOAQUIN COUNTS( <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> �a Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siaov.org/ehd <br /> G/FGM1 <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Date: �_ - I Z <br /> Name of Facility: <br /> ddress: City: Zip Code: <br /> �2 \ re <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: 'S Inspection Type: w �� <br /> 8180 Posted Yes No Permit Posted _ Yes ._ No Re-Inspection on or After: <br /> IN=In Compliance WO=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 /> or violations a threat to public health and must be corrected/mmed/atel . Non-compliance may warrant closure of the food facility <br /> Demonstration of knowledge;food safety certificate 4, Person In Charge is present and performs duties <br /> Communicable disease;reporting,restrictions&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 6. Approved thawing methods used <br /> 7. Food protected from contamination during storage <br /> Hands clean end property washed;proper glove use 8. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 9. Toxic substances properly 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 provided <br /> Proper cooling methods Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding 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 /> 16. Compliance with shell stock regulations;tagstdisplay . Proper use and storage of wiping cloths <br /> 7. Compliance with Gulf oyster regulations <br /> 1. Plumbing maintained;Proper beds 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 /> 9. Advisory provided for raw or undercooked food Premises;personal/deaning ftems;vermin-proofing <br /> 0. Prohibited foods not offered at high risk fadtitles . Floors,walls and ceiling are maintained and kept clean <br /> . No living or sleeping quavers inside facility <br /> 1.Hot and cold potable water available. <br /> 7. Signs posted;last inspection report available <br /> . Sewage/wastewater property disposed;toilet facility useable . Compliance with plan review requirements <br /> 9. 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 ByRltle: <br /> EH Specialist: Phone: l , _ Page 1 of 2 <br /> EHD 16-23 fist pgf 12/15/09 "1 FOOD PROGRAM OR <br />