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SAN .JOAQUIN COUP <br /> X ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> :P Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.orglehd <br /> QLt FijR� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: _/ v Ci �� y� ��`` a. Date: �j S <br /> Address: 2/p „/t+ City: Zip Code: <br /> Owner/Operator: 1n,1 r(J/v , A ,tv� Telephone: <br /> Program Elemen) : 73 Program Record: / 1)1_T Inspection Type: <br /> SB180 Posted 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 2ose a threat to gublic health and must be corrected immediatel . Non-com liance may warrant closure of the food facility <br /> aw wo wn Dernorkstration of Knowledge - ov cos Supervision. arra <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 /> f i3. 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 /> Pteventl»g CAntsminatls�t� y Herds 7. 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`Temperature Relationship Food Stora*Dispiay/SeMCe <br /> 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> 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 EquipmentTlUtensils ILinens <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 retumed food 35. Equipment/utensils approved;installed;clean;good repair <br /> 11 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 /> 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 Facitities <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 Permanent food Facilities <br /> 0. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept dean <br /> Waterl Hot Water, 46. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. ^ ComptiarlcB and Eiiforeement <br /> Uquid Waste Disposal = 7. Signs posted;last inspection report available <br /> 2. Sewage/wastewater properly disposed;toilet facility useable j 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 /> ESpecialist: <br /> y/Title. <br /> / G� Phone: Page 1 of <br /> EHD 16-23 (1st pg) 4119/12 FOOD PROGRAM OR <br />