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Environmental Health - Public
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EHD Program Facility Records by Street Name
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GLACIER POINT
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1600 - Food Program
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PR0523085
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COMPLIANCE INFO
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Last modified
5/1/2020 1:48:09 PM
Creation date
2/21/2019 2:06:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0523085
PE
1632
FACILITY_ID
FA0015582
FACILITY_NAME
LODI USD-ANSEL ADAMS ELEMENTARY
STREET_NUMBER
9275
STREET_NAME
GLACIER POINT
STREET_TYPE
DR
City
STOCKTON
Zip
95212
APN
12430007
CURRENT_STATUS
01
SITE_LOCATION
9275 GLACIER POINT DR
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Scanner
JCastaneda
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EHD - Public
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SAN JOAQUIN COUN" <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> /POR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: u a Date: <br /> Address: ? G��.� �� City: t Zip Code: <br /> Owner/Operator: G�/ v�L 4, Telephone: ;Y V,W <br /> Program Element: ^ ?�L Progrdfn Record: 061 Inspection Type: T r <br /> 8180 Posted es No Permit Poste 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 /> Major violations ose a threat to ublic health and must be corrected immediate/ii. Non-compliance may warrant closure of the food facili <br /> IN <br /> rxoA onstrattgn u#Knowledge our giros Supervtslo�t . <br /> _. M. <br /> 1. Demonstration of knowledge;food safety certificate ` 24. Person In Charge is present and performs duties <br /> Employ liealtft and Hygiene Persvt i Cleanliness <br /> Communicable disease;reporting,restrictions 8 exclusions 25. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds e 1aBlt1# dDt#`i52tfe T s <br /> �`� �+EY13t1EYl1� <br /> . Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> P< ?# tttigfipntami P ( 7. 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 29. Toxic substances properly identified,stored,and used <br /> I w r `l` �a <br /> - <br /> 7. <br /> �.M - <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 <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> fibrrt5>COntBi �� " �' 34. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair <br /> 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 /> ;, } ► ,' r - 38. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> Compliance with Gulf oyster regulations = PlZysal ties <br /> Carifvtinance>Jyith•,A .r2ctures x „ 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 /> a .> <br /> 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> _.. fgftly Suscepfhle tons. . 'p ermanatfood Facilites �.. ;: <br /> O. Prohibited foods not offered al high risk facilities 5. Floors,walls and ceiling are maintained and kept clean <br /> Water-4o r �,__... r ...,, 6. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. "gig l 3Qaf1CC idT1 f�r�lf rt#e11f <br /> ` �x 3 ic}jtid WBste Dispstaf „-,`y7. Signs posted;last inspection report available <br /> • 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> Vermin w � 9. Facility operating with a valid health permit <br /> M . <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: <br /> c A <br /> EH Specialist: Phone: { _ S Page 1 of <br /> EHD 16-23 (1st pg) 4/9112 FOOD PROGRAM OIR <br />
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