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SAN JOAQUIN COUN' <br /> N: X <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c4.. ip Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> �ii'oR`' <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: �� ��� Date: I r <br /> Address: City: Zip Code: <br /> Owner/Operator: �r Telephone: Q C/a 4 <br /> -7 <br /> Program Element: Program Record: �l J Z Inspection Type: l Jif <br /> SB180 Postedl Yes No Permit Poste aLs <br /> 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 /> 1. Demonstration of knowledge;food safety certificate Y ,. 4. Person In Charge is present and performs duties <br /> t �fness. e�,.,e$�e`w� 4 <br /> ` Communicable disease;reporting,restrictions&exclusions "` 5. Personal cleanliness and hair restraints <br /> 3. No discharge from eyes,nose,or mouth;no open wounds <br /> 4. Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Food protected from contamination during storage <br /> 5. 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 /> 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> B. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> 9. Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperaturesFi7rlEt11t `\ <br /> 11. Proper reheating procedures for hot holding33. Nonfood contact surfaces clean <br /> a� 3 ft OtllGtir7iCi1i - 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/warewash ing procedures 37. Vending machines maintained <br /> �M t�, A} tu4d' tiKCe, ?; 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 /> 7. 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 properly disposed <br /> 3. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> AY{$�� <br /> \. �� �n113A1#W ii.11aL Him i3 <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> . , . <br /> Yy� l: dtVe6. No living or sleeping quarters inside facility11. <br /> 1.Hot and cold potable water available. ` <br /> H <br /> \ l.igad Waste C?ti " ` ., 7. Signs posted;last inspection report available <br /> F 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> v # v 9. Facility <br /> operating with a valid health permit <br /> Y P 9 <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: <br /> EH Specialist. Phone: Page 1 of <br /> EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OIR <br />