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oP4 ufn. SAN JOAQUIN COUNT <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.si(lov.org/e <br /> 4CicSa`' <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> EAddress: <br /> Facility: ; <br /> City: Zip Code: pl S 33 <br /> Telephone: <br /> perator: Pro ram Record: pection Type:Element: 9 `osted Yes 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 /> Major violations pose a threat to public health and must be corrected immediatel . Non-com fiance ma warrant closure of the food facility <br /> 1. Demonstration of knowledge;food safety certificate a Person in Charge is present and performs duties <br /> s <br /> Communicable disease;reporting,restrictions&exclusions 5. 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 and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <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 3Z Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperaturesq .J <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> 34. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 35. Equipmentlutensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 7. Vending machines maintained <br /> I No 8. Approvedand sufficient ventilation and lighting <br /> 15. Food obtained from approved source 39. 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 42. Garbage and refuse property disposed <br /> 3. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food 4. Premises;persona Vdeaning items;vermin-proofing <br /> -_- ,-her-- <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> =H.. Will <br /> 6. No living or sleeping quarters inside facility <br /> X 1.Hot and cold potable water available. <br /> __ _ <br /> .. ,. _... 7 Signs posted;Iasi inspection report available <br /> . Sewage/wastewater property disposed;toilet facility useable 48. 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 /> eceived Byfritle: <br /> EH Specialist: t y - Phone: _ ,� 3 Page 1 of <br /> EHD 16-23 list pg) 4/9/12 FOOD PROGRAM OR <br />