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SAN JOAQUIN COUN <br /> y-+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> Q _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> q Fo.a4 <br /> ;P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:Www.sigov.Orq/g d <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: h n "t + Date: I-/- <br /> Address: a (..-1 O W <br /> 'Mm vr-r✓h Lvi City: 6+-o c ef-t-v h Zip Code: 520-7 2fl <br /> Owner/Operator: irl� I a lT Telephone: L1-7?-1aa3 <br /> Program Element: 2 Probrdm Record: P� d (o d ({ 9 Inspection Type: u y',L <br /> SB180 Posted Yes No Permit Posted (Yes No Re-Inspection on or After: 3w",.r-�:. <br /> IN=In Compliance N/O=Not Observed NIA=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 <br /> violations ose a threat to eublic health and must be corrected immediate/ . Non-com /lance may warrant closure of the food facility <br /> wn Demonstration of Knowledge 7, ncA 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 /> Communicable disease;reporting,restrictions 8 exclusions 25. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> 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 /> 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 /> Time and Tem erature Belationshi 3 <br /> p P .. Food Slot Is 1a IService <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 /> 9. 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. Equip ment/utensiIs 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 /> 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 /> 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations e. 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 /> I.Hot and cold potable water available. Compliance and Enforcement <br /> liquid Waste Disp `tixb 7. Signs posted;last inspection report available <br /> 2. 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 /> 51, Permit Suspension <br /> Received itie: <br /> EH Specialist: f c''+� Phone: C),5., - , 1, Page 1 of <br /> EHD 16.23 (1st pg) 4,19/12 l�M /tit FOOD PROGRAM OIR <br />