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autn. SAN JOAQUIN COUNT`S <br /> q` tNVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ... :P Telephone:(209)468-3420 Fax:(209) 464-0138 Web:www.siaov.ora/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: � Ll <br /> O C <br /> City; Zip Code: <br /> daress: 23 L4 e W �' a <br /> wner/Operator: Telephone: (.$_ZG'' <br /> CAtnr <br /> Program Element: Program Reeord: Inspection Type: <br /> B180 Posted X es ❑ No Permit Posted es ❑ No - Re-Inspection on or After: <br /> IN=In Compliance WO=Not Observed WA=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 a threat t0 public haelth and must be coneaNd Lr1 taenillt clea"of fire food <br /> G1.=Demnstrationms of knowledge;food safety certificate 4. Person In Charge is present and perform duties <br /> Communicable disease;reporting,restrictions&exclusions Personal cleanness and heir restraints <br /> No discharge from eyes,now,or mouth;no open wounds <br /> Proper eating,tasting,drinking,or tobacco use 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 /> 5 <br /> Handwashing facilities supplied and accessible . Toxic substances properly identified,stored,and used <br /> Proper hot and cold folding temperatures Food storage;food storage containers labeled <br /> Proper use of time as a public health control 1. Customer sett-service food protected;individual utensils provided <br /> Proper cooling methods 2. Food properly labeled and honesty presented <br /> 10. Proper cooking time and temperatures <br /> it. Proper reheating procedures for hot holding 3. 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 6. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 7. Vending machines maintained <br /> .., it, lip", prow <br /> ,, Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved sow cc 9. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/tlisplay 0. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations Physical Facilities <br /> ➢' cedu're§ 41. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> 43. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food 4. Premises;personal/cleaning items;vemtin-proofing <br /> hly., nt F <br /> 0. Prohibited foods not offered at high risk facilities . Floors,walls antl ceiling are maintained and kept clean <br /> Hot WateFa No living or sleeping quavers inside facility <br /> 1.Hot and cold potable water available. pHance a <br /> iquid Waste Dispo 7. Signs posted;last inspection report available <br /> Sewage/wastewaler properly disposed:toilet facility useable 48. Compliance with plan review requirements <br /> Vermin A 49. Facility operating with a valid health permit <br /> 23. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 1. Permit Suspension <br /> Received By/ritl <br /> EH Specialist: A L _ Phone: -3449 <br /> Page 1 of <br /> EHD 1623 (tst pg) 419112 FOOD PROGRAM OIR <br />