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SAN JOAQUIN COUNTY <br /> 2r ' ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> °9rlFda " Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.ora/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: JA c k bo)( Date:�� <br /> Address: 13 /0 G O ar f t ALA-C' City: mt4 Zip Code: q� 33 <br /> Owner/Operator: N l L I V Telephone: 8� _�r35� <br /> Program Element: Sr_ Program Record: of Inspection Type: 49 t. YL.I? <br /> SB180 Posted Ayes ❑ No Permit Posted XYes ❑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 /> us'or violations ose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facility <br /> Demonstration of Know <br /> 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> Employee Health an ygiene . <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 /> Preventing Contaminatio 7. Food protected from contamination during storage <br /> x 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 /> "'Je and Temp. -Relationship . _o 1 ora'ge/Dil§ <br /> Proper hot and cold holding temperatures 0. Food storage;fsort storage containers labeled <br /> 8. Proper use of time as a public health control 1. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 2. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> it. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> Protection From Contamination, . Wamwashing 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 7. Vending machines maintained <br /> 8. Approved and sufficient ventilation and lighting <br /> 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 /> 17. Compliance with Gulf oyster regulations <br /> 1. Plumbing maintained;proper back flow prevention <br /> 18. Compliance wllh HACCP plan or variance conditions 2. Garbage and refuse properly disposed <br /> 3. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food Premises;personallcleaning items;vermin-proofing <br /> an <br /> 0. Prohibited foods not offered at high risk fatalities 5. Floors,walls and ceiling are maintained and kept clean x <br /> 6. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. Compliance and. <br /> 7. Signs posted; last inspection report available <br /> 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> 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 By/Title I-filt"Zi <br /> v - <br /> EH Specialist: Phone: 2 Page 1 of <br /> EHD16-23 (lstpg) 12/15/09 FOOD PROGRAM OR <br />