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�A�tN•. �' SAN JOAQUIN COUNrY <br /> za ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> .. p.. Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sioov.oro/ehd <br /> •ftiYC•A" <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: we, <br /> Data: �✓ <br /> Address: C r City: Zip code: 26 C <br /> Owner/Operator: GVH 9rlG T �pne: il� ? M <br /> v �5 <br /> Program Element: Program Record: t ;7:7 Inspection ype: <br /> 8180 Posted iJ Yes ❑ No Permit Posted _ Yes -- 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 /> Ma or violations ose a threat to ublic health and must be corrected immediate) . Non-compliance 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 tlischarge 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 /> Proper hot and cold holding temperatures 0. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 1. Customer self-service food protected;individual utensils <br /> provided <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 /> 4. 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 sanifted/warewashing procedures 7. Vending machines maintained <br /> 8. Approve4andstorage <br /> and4backflow <br /> and lighting <br /> 15. Food obtained from approved source 9. Thermoeand easily visible <br /> 16. Compliance with shell stock regulations;tags/display 0. Proper uloths17. Compliance with Gulf oyster regulationst. PlumbinBow prevention <br /> 18. Compliance with HACCP plan or variance conditions 2. Garbagesed <br /> 3. Toilet facilities clean,supplied,and maintained <br /> 9. Advisory provided for raw or undercooked food 4. Premises;personal cleaning items;vermin-proofing <br /> 0. Prohibited foods not offered at high risk facilities 45. 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 /> J! <br /> 2. Sewage/wastewater 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 animIs inside facility 0. Impoundment <br /> 1. Permit Suspension <br /> Received By/rille: <br /> EH Specialist: Phone: _ ,/,! ry 0 Ja 7 Page 1 of <br /> EHD 1823 (1st Dg) 11106108 fit"f9 Q'� J FOOD PROGRAM OR <br />