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,;•. SAN JOAQUIN COUNT <br /> a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siaov.ora/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: r A(- Tl-vi c K FI N{d 4 c Date: Y: �S- l� <br /> ddress: 3 9 40 I rCA ( City: q ( Zip Code: q/S3oY <br /> Owner/Operator: C O S 0. I 7, G Telephone: <br /> 10 ,Program Element: L I 3 Program Record: Q f 'o,' Inspection Type: ou a;ne <br /> 8180 Posted 1. es 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 immed . Non-compliance mav warrant closure of the food facility <br /> -:>.. ledge >. <br /> 1. Demonstration of knowledge;food safety certificate 4. Person In Charge is present and performs duties <br /> Communicable disease;reporting,restrictions&exclusions Personal cleanliness and hair restraints <br /> No discharge from eyes,now,or mouth;no open wountls <br /> Proper eating,tasting,drinking,or tobacco use . Approved thawing methods used <br /> 7. Food protected from contamination during storage <br /> Hands clean and property washed;proper glove use 8. Washing fruits and vegetables before use <br /> ". Handwashing facilities supplied antl accessible . Toxic substances property identifietl,stored,and usedand cold holding temperatures Food storage;food storage containers labeled <br /> 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 /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding Nonfood contact surfaces clean <br /> . Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 5. Equipment/utensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitizedtwarewashing 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;tags/display Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations <br /> 1. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse property disposed <br /> ,.' " hsu 3. Toilet facilities clean,supplied,and maintained <br /> 9. Advisory provided for raw or undercooked food Premises;personaticleaning items;vermin-proofing <br /> Highly Susceptible Popu <br /> 0. Prohibited foods not offered at high risk facilities Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available- amd <br /> Liquid Waste Disposal 7. Signs posted;last inspection report available <br /> 2 Sewage wastewater properly disposed:toilet facility useable 8. Compliance with plan review requirements <br /> Vermin 9. Facility operating with a valid health permit <br /> 3. No rodentsinsects,birds or animals inside facility 50. Impoundment <br /> 1. Permit Suspension <br /> Received Byrritle: <br /> L <br /> H Specialist: - V Phone: i/ 3/6 Page 1 of ;7 <br /> t Y v2- <br /> FOOD PROGRAM OIR <br /> EHD 16-23 (lst pg) 49/12 <br />