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tAuln.. SAN JOAQUIN COUNTY <br /> aq�Eo'FP <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www Siaov org/ehd <br /> '� lit iSN`v <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Date: <br /> Ewner/Operator: <br /> cility: City. Zip Code: / <br /> O /� <br /> J itTelephone: 7/7 _?, <br /> /r 7�ey <br /> ement: 1. Program Record: Inspection Type:ted es ."1 No Permit Posted es ❑ No Re-Inspection on or After: <br /> IN=In Compliance NIO=Not Observed NIA=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 /> M or violations des a threat to public health and must be corrected fmmedlatel . Non-compliance may warrant closure of the tood facility <br /> 1. Demonstration of knowledge;food safety certificate 4. Person In Charge is present and performs duties <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 dean 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 /> Proper hot and mid holding temperatures 0. Food storage;food storage containers labeled <br /> 1. Customer self-service food protected;individual utensils <br /> Proper use of time as a public health control rovided <br /> Proper cooling methods 2. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean <br /> . Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 5. Equipmentlutensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 7. Vending machines maintained <br /> B. Approved and sufficient ventilation and lighting <br /> 11111U. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible <br /> 6. Compliance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths <br /> . Compliance with Gulf oyster regulations <br /> 1. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HA CCP plan or varlanoe oontlitions 2. Garbage and refuse property disposed <br /> 3. Toilet facilities clean,supplied,and maintained <br /> Advisory provided for raw or undercooks food . Premises;personavGeaning Items;vermin-proofing <br /> 0. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean <br /> 6. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. <br /> 7. Signs posted;last inspection report available <br /> 2. Sewagelwastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements <br /> 9. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals Inside facility 0. Impoundment <br /> 1. Permit Suspension <br /> ecelved By/Ti <br /> EH SpeclalfPage 1 of <br /> EHD 16-23 list pg) 12/15109 O FOOD PROGRAM OR <br />