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SAN JOAQUIN COUP <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �4.., c,.�;�P• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.orq/ehd <br /> L/FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: CA 00 d 6a ma r l+rL V1 I-k& kta 0 q- CeL A, Date: <br /> Address: 1 &30 Fd-1 SO `3-4 . City: 6+0 c*-' 40 ki Zip Code: 95 20 CI <br /> Owner/Operator: 1 Ig Telephone: 4ig-8 p 76 X <br /> Program Element: (O'2. Program Record: (Z 05 02 O 1 Inspection Type: TZ-0 6 '-1' vLA- <br /> SB180 Posted 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 immediately. Non-compliance may warrant closure of the food facility <br /> r, N,o xn Demonstration of Knowledge + our cos Supervision ouT <br /> 1. Demonstration of knowledge:food safety certificate 24. Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> 2. Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> 3. No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> 4. Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Preventing Contamination by Hands 27. Food protected from contamination during storage <br /> 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> V-1 I Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> Time and Temperature Relationship Food Storage/Display/Service <br /> 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> 8. Proper use of time as a public health control 31. 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 /> Protection From Contamination 34. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 35. Equipment/utensils 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 37. Vending machines maintained <br /> Food From Approved Source 38. Approved and 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 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention <br /> 8. 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. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> 20. 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 /> / 22. Sewage;wastewater properly disposed:toilet facility useable 48. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> 23. No rodents, insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received Bylritle: ( �� <br /> EH Specialist: A: Phone: _ c� ^1 Page 1 of <br /> EHD 16-23 (1st pg) 4/9/12 w"` O 1 FOOD PROGRAM OIR <br />