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�F- soG SAN JOAQUIN COUNT <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> :P Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.si-ov.org/ehd <br /> AL%FORS <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility UC J C._,p` I 3c c y Date: <br /> Address: 1 ,,r.�, 1 City: I ,3 x_pN` Zip Code: c 2"-4G <br /> Owner/Operator: V � Telephone: J <br /> Program Element: `� Program Record: ` �G2 ' 2 Inspection Type: <br /> SB180 Posted Yes 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 /> Mabr violations 2ose a threat to public health and must be corrected immediatel . Non-corn liance may warrant closure of the food facilit <br /> ruo wa 'Demonstration of Knowledge out cas Supervisiari <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&exclusions 25. Personal cleanliness and hair restraints <br /> X 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 /> Contamination by Hands 7. Food protected from contamination during storage <br /> Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> n'191 M1 Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> Time and TemperatureRelationship .. :, __... lsplaylSe <br /> 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 /> Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures A "; T1 , ,Equipment/,"Utensils/Linens <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> • ?rotection From Contatnigatlon w, 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/warewashing procedures 37. Vending machines maintained <br /> 38. Approved and sufficient ventilation and lighting <br /> r,e <br /> 15. Food obtained from approved source 9- 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 ,, _ Physicalacihties - <br /> 121 <br /> -... - <br /> Conformance With Approved Proc6dures ' e 1. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> s <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 45. Floors,walls and ceiling are maintained and kept clean <br /> Water?Hot Water 4 <br /> 46. No living or sleeping quarters inside facility <br /> t.Hot and cold potable water available. <br /> Licftlid Wase Disposal 7. Signs posted;last inspection report available <br /> 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> Vermin49. 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/Title: <br /> EH Specialist: C� - ` Phone: �-- Page 1 of <br /> I <br /> EHD 16-23 (1st pg) 419/12 FOOT}PROGRAM OIR <br />