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oP�'gtk••c SAN JOAQUIN COUNTY <br /> P ?A ENVIRONMENTAL HEALTH DEPARTMENT <br /> b: :K <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209) 464-0138 Web:www.siaov.org/ehd <br /> �rFORN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: oDWF�QS Date: <br /> Address: Zl CLM S T- City: �o� Zip Code: ?s-Z <br /> caner/Operator: 57M17-7a/ K Telephone: 36 _ / Up <br /> Program Element: / 'z Program Record: 20 / '05--3 Inspection Type: "/(/E <br /> Bl 80 Posted XYes ❑ No Permit PostedrQ'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 /> Ma or violations ose a threat to public health and must be corrected fmmediatel . Non-com fiance may warrant closure of the food facili[y_ _ <br /> .Supervision <br /> 1. Demonstration of knowledge;food safety certificate 4. Person In Charge is present and performs duties <br /> Personal Cleanliness :`` <br /> Communicable disease;reporting,restrictions&exclusions 5. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds General Food Safet Requirements <br /> �( Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used <br /> ;preJenting Contamination'by Han 7. Food protected from contamination during storage <br /> �C 5. Hands clean and properly washed proper glove use 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 29. Toxic substances properly identifiedstoredand used <br /> F emperature Relationship, -'.Food`Sto Lage/�isplay,(So <br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled )( <br /> Proper use of time as a public health control 31. customer self-service food protected;individual utensils provided <br /> )< Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces dean <br /> . Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 5. Equipment(utensils approved;installed;dean;good repair <br /> 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 7/ 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 /> 'a, `el roved Proced 1. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed <br /> ,Advisory' - 3. Toilet facilities clean,supplied,and maintained <br /> 19.Advisory provided for raw or undercooked food 4. Premises;personal/leaning items;vermin-proofing <br /> oputad <br /> J( 0. Prohibited footle not offered at high disk facilities 5. Floors,walls and ceiling are maintained and kept Gean <br /> titer B. No living or sleeping quarters Inside facility <br /> 1.Hot and cold potable water available. <br /> -Ispose 7. Signs posted;last inspection report available <br /> . Sewage/wastewater property 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 /> Received Byrritle: <br /> EH Specialist: 11.E Phone: f c/ Page 7 of 2, <br /> 116-23(1st pill 12/15109 7 FOOD PROGRAM OR <br />