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otka't" SAN JOAQUIN COUNT'- 1 <br /> YNVIRONMENTAL HEALTH DEPARTMENT <br /> W. :< <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 , <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> 4LlFQ�� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Y e=r Rate: <br /> Address: / City. Zip Code: <br /> OwnerlOperator: Telephone: <br /> Program Element: %J Program Record: Inspection Type: <br /> 81 So Posted No Permit Posted 0,Yes No Re-inspection on or After: . <br /> IN=1n 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 ease a threat to public health and must be corrected immediately. Non-corn !lance ma warrant closure of the food facility <br /> .� <br /> 3. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> �1et� M <br /> Communicable disease;reporting,restrictions 8 exclusions 25. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds Y <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> m A 7. Food protected from contamination during storage <br /> Hands c€ear and properly washed;proper glove uses 8. Washing fruits and vegetables before use <br /> Ha 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 2. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures , rq <br /> i 1. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> . Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 35. Equipment/utensils approved;installed;dean;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 sanitizedlwarewashing procedures 37, Vending machines maintained <br /> 38. Approved and sufficient ventilation and lighting <br /> ' 16. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations WE, u�'} <br /> v� <br /> 1. Plumbing maintained;proper back flow prevention <br /> MINA11 Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> .� 3. Toilet facilities dean,supplied,and maintained <br /> . Advisory provided for raw or undercooked food m 4. Premises;personal/cleaning items;vermin-proofing <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> ,. ;v 6. No living or sleeping 9 Gua ers inside facility <br /> 1.Hot and cold potable water available. _ a <br /> W H tee: <br /> - 7. Signs posted;last inspection report avai€abie <br /> 2. Sewage/wastewater properly disposed;toilet facility useable 48, Compliance with plan review requirements <br /> - 9. Facility operating with a valid health permit <br /> 3. No rodents,in ects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: <br /> EH Specialist: Pho : �j {' Page 1 of <br /> EHD 1&23 {1st pg} 419112 [7 !' FOOD PROGRAM OIR <br /> -w <br />