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a°'" SAN JOAQUIN COUNTY <br /> �°di 'coc <br /> ` `fir ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �,Crcdai+�? Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: .--1 Date: -\- Z <br /> Address: 2® City: -rte�. Zip Code: G1 173SO14 <br /> Owner/Operator: `nom a e Telephone: <br /> Program Element: Program Record: 5 Z't Inspection Type: <br /> SB180 Posted D Yes D Remit Posted Dyes 0P 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 /> Malo violations ose a threat to Publ c health and must be corrected immediately. Non-compliance may warrant closure of the food facility <br /> e: wdwa Demonstration of Knowledge 1 n.<..� ov cui Supervision Doti" <br /> 1. Demonstration of knowledgerood safety certificate 24. Person In Charge is present and performs,depdupes <br /> ployee Health and-Atene Personal Cleanliness <br /> 2. Convnunicable disease.reporting_restrictions&exclusions �� 25. Personal cleanliness and hair restraints <br /> tlischarge 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 /> Preventing Contamination by Hands 27. Food protected from contamination during storage <br /> d Hands clean and properly washed,proper glove use 28. Washing fruits and vegetables before use <br /> I MIM. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> Time and TemperatureRelationsht(Y -- '°�?'- - <br /> Proper not and cold holding temperatures x 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 nent/utensils!Linen <br /> 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean <br /> ,PJ[okectiort;EaT Contamination ' 4. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 5. Equipment/utensils approved;installed;dean;good repair <br /> 13. Food free from contamination and adulteration 6. Equipment,.utensils and linens:storage and use <br /> 14. Food contact sur•ace cleaned and sau4¢ed rcerev eshing procedures 7. Vending machines maintained <br /> MEMEL 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;tagstdisplay 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained.proper back now prevention <br /> \,J15. Com phance with I iACCP plan or variance conditions 2. Garbage and refuse properly disposed <br /> Consumer Advisory 3. Toilet facilities clean.supplied,and maintained <br /> �19. 4dvisory provided for raw or undercooked food 44. Premisespersonal/leaning items. vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> 77710 Prohibited foods not offered at high risk facilities 4E. Floorswalls and ceiling are maintained and kept clean X <br /> Water/Hot Water 46. No living or sleeping quarters inside facility <br /> 1121. Hot and cold potable water available Compliance and Enforcement <br /> Liquid Waste Disposal 4,. Signs posted;last inspection report available <br /> i22. Sewagelwastewater properly Disposed.toilet faalily useable 1 8. Compliance with plan review requirements <br /> Vermin AIL 49. Facility operating vrith a valid health permit <br /> __k3. No rodents insectsbirds or animals inside facility 50. Impoundment <br /> i. Permit Suspension <br /> Received By/Title: ,.1 ` , ` ( ,� <br /> EH S eciali hone: 02S Page 1 of <br /> EHD 16-23 (1st pg) 419112 FOOD PROGRAM OR <br /> S <br />