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SAN JOAQUIN COUNTY <br /> ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> d�... ....;P Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.oro/ehd <br /> �r FOrr� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> E;kddress: <br /> : m Date: <br /> 3o City: Zip Code: <br /> : 5 ^ Telephone: G -D(1371nt: /-+ Program Record: (Z Inspection Type: 3./ 7n,`•LJYes No Permit Posted .Yes P 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 e a threat to ublic health and must be corrected immediatel . Noncompliance maywarrant closure of the food/stili <br /> 1. Demonstration of knowledge;food safety wrI icats %L.. 4. Person In Charge is present and performs duties <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 8. Washing fruits and vegetables before use <br /> Handwashfng facilities supplied and accessible 9. Toxic substances properly identified,stored,and used <br /> Proper hot and cold holding temperatures 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 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures Equipment/Utensils/Linens _ <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> ion 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 6. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br /> 36. Approved and sufficient ventilation and lighting <br /> 7715. 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 Physk:A Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained:.proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory - 43. Toilet facilities clean,supplied,and maintained <br /> '9(,19. Advisory provided for raw or undercooked food 44_ Premises:personal/cleaning items:vermin proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water 46. No living or sleeping quarters inside facility <br /> 21. Hot and cold potable water available. Compliance and Enforcement <br /> Liquid Waste Disposal 47. Signs posted;last inspection report available <br /> 122 Sewage wastewater properly disposed,toilet facility useable 48. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> °'' ' 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 1. Permit Suspension <br /> fleceived By/Title: <br /> H Specialist: Tn ii Phone: ]lf� I Page 1 of 2 <br /> EHD 16-23 fill pill 4912 -1 L� FOOD PROGRAM Off <br />