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SAN JOAQUIN COUNTY <br /> b ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �gciFd i P Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.siaov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: L r c,c z r4 OtAl It t O r -Fre.r Date: <br /> Address: $ ;IS w, IJ_ 54- city- Trac Zip Code: 9S 37.6 <br /> Owner/Operator: W W L Tf1 (. Telephone: 8 3 6 „ 2I Y Z <br /> W <br /> Program Element I y Program Record: Inspection Type: <br /> SB180 Posted es ❑ No Permit Posted es 0 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 /> Ma or violations ose a threat to public health and must be corrected immediate) . Non-cont fiance may warrant closure of the rood facilitv <br /> emonstrz[_tl of Knowledge <br /> Demonstration of knowledge,food safet,cortificale 4. Person In Charge is present and performs duties <br /> ,ployee Health and Hygiehe� <br /> Communicable disease;reporting,restrictions&exclusions 5. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds <br /> . Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used <br /> 7. Food protected from contamination during storage <br /> Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used <br /> yrs <br /> Proper hot and WW"as <br /> holding temperatures 30. 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 /> 1. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> 4. 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 36. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 7. Vending machines maintained <br /> odTFrom ppro a ourpe8. 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.lags/display 0. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations <br /> onfg ranee W 6'4pprov o ures ; 1. Plumbing maintained;proper back flow prevention <br /> 8. Compliance with HACCP plan er varian.e conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory _ - -tl 3. Toilet facilities clean,supplied,and maintained <br /> 9.Advisory provided for raw or undercook=d food 44. Premises;personal/cleaning items;vermin-proofing <br /> ''.Highly Susceptible Populations <br /> 0. Prohibited foods not offered at high risk Facilities 5. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water - 6. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available <br /> Liquid Waste Disposal 4 7. Signs posted;last inspection report available <br /> . Sewage/wastewater properly disposed;toilet facility useutd, 48. Compliance with plan review requirements <br /> 9. Facility operating with a valid health permit <br /> 3. No rodents,Insects,birds or animals inside facility 50. Impoundment <br /> 1. Permit Suspension <br /> Received BylTitle: <br /> EH Specialist: , Phone: /// �/L y Page 1 of Z <br /> �/v G F000 PROGRAM OIR <br /> EHD 1623(lst pg) 4/9/12 <br />