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oRo 4!ry, SAN .JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �°GFati'� Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> OOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: G _�b <br /> ddress: N <br /> S T S (l) C love r ctry` r a 1 zip code: 9S 3 6- <br /> wner/Operator: Telephone: <br /> Program Element: a Program Record: S b l InspectionType: CIA 4;A 1, <br /> 8180 Posted BoYes 0 Permit Posted ,e'Yes ❑P 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 immediate/ . Non-compliance may warrant closure of the food facility <br /> Demonstration of knowledge;food safety certificate 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 /> Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used <br /> Proper hot and cold holding temperatures 0. Food storage;food storage containers labeled <br /> X Proper use of time as a public health control 1. Customer self-service food protected;individual utensils provided <br /> �( Proper cooling methods 2. Food properly labeled and honestly presented <br /> t0. Proper cooking time and temperatures <br /> J( 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean <br /> . Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 5. Equipmentfutensils approved;installed;dean;good repair <br /> X 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 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;tagstdisplay 0. Proper use and storage of wiping cloths <br /> J( 7. Compliance with Gulf oyster regulations <br /> 1. Plumbing maintained;proper back flow prevention <br /> 8. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed <br /> 3. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food Premises;personal/cleaning items;vermin-proofing <br /> 0. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean <br /> . No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. <br /> 7. Signs posted;last inspection report available <br /> 2. Sewage/wastewater properly disposed;toilet facility useable 1 8. Compliance with plan review requirements <br /> 9. Facility operating with a valid health permit <br /> X 3. No rodents,insects,birds or animals inside facility 1 0. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: <br /> SSI M a-t o. C+- <br /> EH <br /> EH Specialist: .. Phone: p, 7// Page 1 of 2 <br /> ly <br /> EHD 16-23(1st pg) 4/9/12 0 J O FOOD PROGRAM OR <br />