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SAN JOAQUIN COON"
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<br /> ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232
<br /> Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd
<br /> �r FOR
<br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT
<br /> Name of Facility: C i _ Date: . �! 11.f
<br /> Address: � ��� y1/1'r C ty: _ Zip Code:
<br /> Owner/Operator: Telephone:
<br /> Program Element: Program Record: Fro
<br /> Inspection Type: `7 C
<br /> B180 Posted es No Permit Posted Yes Nd 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 aose a threat to ublic health and must be corrected immediately. Nan-com )tante maK warrant closure of the food facili
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<br /> 1. Demonstration of knowledge;food safety certificate MINI', 24. Person In Charge is present and performs duties
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<br /> Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints
<br /> No discharge from eyes,nose,or mouth;no open wounds ✓ ; � + �� s,„,.
<br /> kti Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used
<br /> 7. Food protected from contamination during storage
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<br /> Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use
<br /> ✓ `4 Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used
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<br /> 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 a Wi v
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<br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean
<br /> 34. Warewashing facilities maintained;test strips available
<br /> 12. No re-service of returned foody 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 /> 38. Approved and sufficient ventilation and lighting
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<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 ✓
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<br /> , i�tatance WtYh Appratti ', fi, � , 1. Plumbing maintained;proper back flow prevention
<br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed
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<br /> 1h 3. Toilet facilities clean,supplied,and maintained
<br /> EX19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing
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<br /> 0. Prohibited foods not offered at high risk facilitiesAl5. Floors,walls and ceiling are maintained and kept clean
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<br /> 3fllater ,,,,, _ 6. No living or sleeping quarters inside facility
<br /> 1.Hot and cold potable water available. ��`���_ ��_„ - ,,��, ,✓„a,.
<br /> a ` ��` "A. ON- OW., � 7. Signs posted;last inspection report available
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<br /> 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements
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<br /> �� r: VEl17tllty . 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 By/Titl �.
<br /> EH Specialist: i Phone: i Page 1 of
<br /> EHD 19-23 (1 sl pg) 4/9/12 FOOD PROGRAM OIR
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