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SAN JOAQUIN COUN' <br /> y� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c.... F . :P Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> 4C) ORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: m. o do r-t-, '5+OL4--t-0h isy_, LIS Date: <br /> Address: a.�a I GVIA. of n Tn/`e- City: +o cX+o r) Zip Code: �20 9 <br /> Owner/Operator: L u�D Telephone: q,3a_Jq is <br /> Program Element: v�b Z Program Record: (L 111.0 p 15 (0 a Inspecti -v2-(7v.h n <br /> 6180 Posted Yes No Permit Posted Yes 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 <br /> or violations pose a threat to eublic health and must be corrected immediatel . Non-com liance may warrant closure of the food facility <br /> r wa Demonstration of Knowledge M our cos Supervision; OUT <br /> 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> Communicable disease;reporting,restrictions&exclusions 1 25. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Preventing Contamination by Hands - 27. Food protected from contamination during storage <br /> Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible v 29. Toxic substances properly identified,stored,and used <br /> aySeTime and Tem erature Relationship cyice <br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures Equipment/Utensils f Linens <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> Protection From Contamination,:._,,, 34. Warewashing facilities maintained;test strips available ✓ <br /> 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair <br /> ]l 3. 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 /> Food From Approved Source;. z 38. Approved and sufficient ventilation and lighting <br /> S. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained:proper back flow prevention <br /> 8. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> HighlySusceptible Populations P <br /> ermane»t Food Facilities~ ` <br /> - P P <br /> t 3 <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> Water?Hot Water <br /> 6. No living or sleeping quarters inside facility <br /> < 1.Hot and cold potable water available. Complianlce and Enforcement <br /> " liquid Waste Disposai 7. Signs posted;last inspection report available it <br /> 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> Vertnm 9. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received Byfritle: <br /> EH S ecialist: Phone: /, Pagel of Z <br /> EHD 16-23 (1st pg) 4/9112 T �l FOOD PROGRAM OIR <br />