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SAN JOAQUIN COUNT <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> a: a <br /> x a <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.ora/ehd <br /> a�rFOa� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT "1 <br /> Name of Facility: Date: �s <br /> Address: - City: - Zip Code: <br /> Owner/Operator: Telephone: 6 <br /> Program Eleme t: Prog m Record: Inspection Type: _l Of <br /> 8180 Posted Yes No Permit Poste 2Yes 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 /> Major violations ose a threat to public health and must be corrected immediate) . Non-com fiance marwarrant closure of the food facility <br /> 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> ; 1ttf.9t111 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 30. Food storage;food storage containers;1abeleduse oftime as a public health control 1. Customer selfservice food protected;inditensils providedcooling methods 2. Food properly labeled and honestly pre <br /> 10. Proper cooking time and temperatures '',, q... <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> _ 34. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 35. Equipmentlutensils 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 37. Vending machines maintained <br /> 38. Approved and sufficient ventilation and lighting <br /> 6 ±s 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/display 40. 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 HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> 3. Toilet facilities clean,supplied,and maintained <br /> 19.Advisory provided for raw or undercooked food 4. Premises;personal/Leaning items;vermin-Drooling <br /> . Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> . No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. 0-I"-?_„� _ <br /> 7. Signs posted;last inspection report available <br /> . Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> s:.V _ 9. Facility operating with a valid health permit <br /> rotlents,insects,birds or animals inside facility 0. Impoundment <br /> 51. Permit Suspension <br /> aceived Byfritte: <br /> EH Specialist: Phone: _ �/ Page 1 of <br /> EHD 1623 list pg) 4/9/12 FOOD PROGRAM 018 <br />