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oPAw!N SAN JOAQUIN COUNTY <br /> m' ?t ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> .,. F. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.siciov.org/ehd <br /> '1uFaw:� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: (j 6 Date: <br /> Gr <br /> ddress: <br /> City: Zip Code: <br /> KI S. a w FrOnl s fKn 9S2I <br /> wner/Operator: Ce Telephone: <br /> }r 41 Ile rc� lZ Tr-) <br /> Program Element: 16 2 Program Record S 4 Inspection Type: Kc� 4; h <br /> 8180 Posted Yes ❑ No Permit Posted Yes G 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 violations ose a threat to Public health and must be corrected immediate) . Non-com liance ma warrant closure of the food 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 X <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 /> �( Proper hot and cold holding temperatures 0. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 1 provided <br /> CustomerCustomesett-service food protected;individual utensils <br /> )( Proper cooling methods 32. Food properly labeled and honestly presented <br /> X 10. Proper cooking time and temperatures <br /> >( 11. 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;dean;good repair <br /> X 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 /> 8. Approved and sufficient ventilation and lighting <br /> X 15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible <br /> �( 16. Compliance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths <br /> k 17. Compliance with Gulf oyster regulations <br /> 1. Plumbing maintained:proper back flow prevention )( <br /> 18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed <br /> 3. Toilet facilities clean,supplied,and maintained <br /> tX <br /> isory provided for raw or undercooketl food 4. Premises;personal/leaning items:vermin-proofing <br /> hibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept dean x6. No living or sleeping quarters inside facility <br /> and cold potable water available. <br /> 7. Signs posted;last inspection report available <br /> age/wastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements <br /> 9. Facility operating with a valid health permit <br /> rodents,insects,birds or animals inside facility 50. Impoundment <br /> 1 51. Permit Suspension <br /> Received BylTitle: S_klle - <br /> EHSpecialist: -- --- - QNone: k�., 7/�S. Pagel of 2 <br /> J FOOD PROGRAM OR <br /> EHD 16-23 ([st pg) 12115109 <br />