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af`4u''"•� SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />a 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />�4�I Fe N;P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sogov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: / Date: <br />,n 1_ City: Zip Code: <br />Address: 4/0,96[ <br />Owner/Operator: Telephone: <br />Program Element: Program Record: 0 1A 11 L Inspection Type: <br />SB180 Posted 0 Yes 0 No Permit Posted 0 Yes 0 No I Re -Inspection on or After: <br />IN = In Compliance NIO = 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 ose a threat to uc health and must be corrected immediately Non-compliance may warrant closure of the food facility <br />N 3; ....:... _ De o strmio0 o 9 MONNOW013 <br />1. Demonstration of knowledge; food safety certificate <br />24. Person In Charge is present and performs duties <br />-m yee a gee <br />al Glean 1 e <br />25. Personal cleanliness and hair restraints <br />2. communicable disease; reporting, restrictions & exclusions <br />No discharge from eyes, nose, or mouth; no open wounds <br />;Safety Require e <br />26. Approved thawing methods used <br />Proper eating, tasting, drinking, or tobacco use <br />Preventing Contamination by,Ha <br />Hands clean and properly washed; proper glove use <br />7. Food protected from contamination during storage <br />28. Washing fruits and vegetables before use <br />SE16. Handwashing facilities supplied and accessible <br />29. Toxic substances properly identified, stored, and used <br />stumejand-16elUggra u <br />7. Proper hot and cold holding temperatures NJ <br />.0 o elDrsp e e <br />30. Food storage; food storage containers labeled <br />8. Proper use of time as a public health control <br />31. Customer self-service food protected; individual utensils provided <br />9. Proper cooling methods <br />10. Proper cooking time and temperatures <br />32. Food properly labeled and honestly presented r� <br />-Equipment I Utensils I Linens <br />33. Nonfood contact surfaces clean <br />11. Proper reheating procedures for hot holding - . <br />0 <br />12. No re -service of returned food <br />34. Warewashing facilities maintained; test strips available <br />35. Equipment/utensils approved; Installed; clean; good repair <br />13. Food free from contamination and adulteration <br />36. Equipment, utensils and linens: storage and use <br />14. Food contact surface cleaned and sanitized/warewashing procedures <br />37. Vending machines maintained <br />o p o o <br />38. Approved and sufficient ventilation and lighting <br />15. Food obtained from approved source <br />39. Thermometers provided, accurate, and easily visible <br />16. Compliance with shell stock regulations; tags/display <br />40. Proper use and storage of wiping cloths <br />17. Compliance with Gulf oyster regulations <br />1. Plumbing maintained; proper back flow preventlon <br />ron r a -!610oved c es <br />18. Compliance with HACCP plan or variance conditions <br />m o , <br />42. Garbage and refuse properly disposed <br />3. Toilet facilities clean, supplied, and maintained <br />44. Premises; personalldeaning Items; vermin -proofing <br />19. Advisory provided for raw or undercooked food <br />�- ig usce i o <br />45. Floors, walls and ceiling are maintained and kept clean <br />20. Prohibited foods not offered at high risk facilities <br />6. No living or sleeping quarters inside facility <br />e a e <br />JOEL Hot and cold potable water available. <br />s s osa <br />7. Signs posted; last inspection report available <br />48. Compliance with plan review requirements <br />2. Sewage/wastewater properly disposed; toilet facility useable <br />9. Facility operating with a valid health permit <br />er i <br />_403. No rodents, Insects, birds or animals inside facility <br />50. Impoundment <br />1. Permit Suspension <br />Received BylTitle. l(� / CJ�u a -�9-sb z� <br />_ L0'- 3 OS^y Page 1 of <br />EH Specialist: � � Phone: .20 <br />EHD 1&23 list pg) 119112 FOOD PROGRAM OR <br />