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ata{1N. SAN JOAQUIN COUN',_,) <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • i<4tlso*ia• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siaov.oro/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> [Address: <br /> e of Facility: �S Date: (—( —I <br /> Z� \ I City: 1 ... n Zip Code: CtS 2�'I z <br /> er/Operator: �N� Telephone: <br /> ram Element: \ \ Program Record: Inspection Type:0 Posted ❑Yes No Permit Posted C Yes ❑ No Re-Inspection on or After: <br /> IN=In Compliance WO=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 /> Major violations Posts a throat to public health and must be corrected lmmed earront closure of the food <br /> filicillififf <br /> IN <br /> 1. Demonstration of knowledge;food safety certificate 4. Person In Charge is presets and pe nim duties <br /> FF <br /> . Communicable disease;reporting,restrictions&exclusions 2s. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds "? <br /> Proper eating,tasting,drinking,or tobacco use 26 Approved thawing methods used <br /> 27. Food protected from contamination during storage <br /> Hands clean and properly washed;proper glove use 28. Washing fmfts and vegetables before use <br /> Handwashing facilities supplied and accessible 129. Toxic substances properly identified,stored,and used <br /> rvice i <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 2. Food property labeled and honestly presented <br /> 10. Proper cooking time and temperatures sils/Linens <br /> 1;1d <br /> r reheating procedures for hot holding 3. Nonfood contact surfaces clean <br /> . Warewashing facilities maintained;test strips available <br /> 1eservice of returned food 5. Equipmentlutensils approved;installed;clean;good repair <br /> 1free from contamination and adulteration 6. Equipment,utensils and linens:storage and use <br /> 1contact surface cleaned and sanitizedrwarewashing procedures 7. Vending machines maintained <br /> . Approved and sufficient ventilation and lighting <br /> 1obtained tram approved sou,ce 9. Thermometers provided,accurate,antl easily visible <br /> 1pliance with shell stock regulations:tagedisplay 0. Proper use and storage of wiping cloths <br /> 1liance with Gulf oyster regwatwns Physical Facilities <br /> :Approved Procedures 1. Plumbing maintaineQ proper back flow prevention <br /> 1pliance w8h HACCP plan or variance contliaons 2. Garbage antl refuse properly disposetl <br /> r Advisory 43. Toilet facilities clean,supplied,and maintained <br /> 1ory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> €_ Permanent Food Facilities <br /> 0. Prohibited foods notoffered at high as facilities 4S. Floors,walls and ceiling are maintained and kept clean <br /> �ateF ater 46. No living or sleeping quarters inside facility <br /> WNCI <br /> d cold potable water available Compliance and Enforcement <br /> Waste: 47. Signs posted. last inspection report available <br /> e/wastewater properly disposed:toilet facility useable 48. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> ents,insects,birds or animals inside(acilily 50. Impoundment <br /> 1. Permit Suspension <br /> Received By/Title: <br /> H Specialist: Phone: t , bI;V_o'2J� Page 1 of Z <br /> EHD 1623 (1 st pg) 4/9/12 R FOOD PROGRAM 067 <br />