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°"``"'" • SAN JOAQUIN COUP.. <br /> z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 3 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> •C4�IF0•R�,P• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siciov.ora/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: _ Date: ! <br /> ddress: �� I City: L ' C'r Zip Code: �2Zy <br /> Owner/Operator: - f (J Telephone: <br /> Program Element: ZS Program Record: (�6 Inspection Type: 7_l7 r7 <br /> Set 80 Posted Yes No Permit Posted (jeV No Re-Inspection on or After: 2� <br /> IN=In Compliance N/O=Not Observed WA=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 /> corrected immediately <br /> Ma/or violations pose a threat to public health and must be cor __Non-compliance may_warrant closure of the a food facility _ <br /> T. _- _ -- _ _ <br /> u,t , Demonstration of Knowledge r.+a. - <br /> --� I._ 9 1 - -- Supervision. . <br /> I). Demonstration of knowledge:food safety certificate 24 Person In Charge is present and performs.duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> _ <br /> 3 No di I-ou-_ fror s nose. <br /> z or mouth;no open wo Bions 25 Personal cl n rliness and hair; st mints <br /> �. Gomm;rnoable rise r'? mnn t,ict�ons&exclusions <br /> J _ y <br /> _ - General Food Safety Rceuirements <br /> 1_ P;opci eking.tas,ing dunking,or tobacco use 26. Approved thawing methods used <br /> 'Preventing Contamination by Hands ' 27. Food protected from contamination during storage <br /> '15. Hands clean and propedy washed:proper glove use 28. Washing fruits and vegetables before use <br /> ^S. Hondmashing facilities supplied and accessible L 29Toxic substances properly identified,stored.and used <br /> Time and Temperature Relationship. - Food Storage/Display/Service <br /> 17. Proper hot and cold holding tcmpera.ures 30. ..rood storage,food storage containers labeled <br /> Proper use of time as a public health control 31. C.;scmer 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/linens <br /> 11. Proper reheating procedures for hot holding I 33. Nonfood contact surfaces clean <br /> Protection From Contamination 34. Warewashing facilities maintained;test strips available <br /> X72. No re-service of returned food 5. Equipment/utensils approved;installed;clean;good repair <br /> ✓� i 13. Food free from contamination and adulteration -� 36. Equipment,utensils and linens:storage and use ✓ <br /> 14. Food contact surface cleaned and sant zod:'v✓e w.adh ,r.ro:,e"ums 37. Vending machines maintained <br /> Food From.Approved Source - 38. Approved and sufficient ventilation and lighting <br /> t/ 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 6. Compliance with shell stock regulations;tags/display t 40- Proper use and storage of wiping cloths <br /> 17. Compliancewith Gulf oyster regulations �� Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention <br /> _I, �8. Compliance with HACCP plan or variance conations 42. Garbage and refuse properly disposed <br /> Consumer Advisory; 43. Toilet facilities clean,supplied,and maintained <br /> !19. Advisory provided for rare or undercooked food 44. Premises:personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> �20- Prohibited foods not(ttercd at high risk facilities j 45. Floors,walls and ceiling are maintained and kept clean <br /> Water l Hot Water 46. No living or sleeping quarters inside facility <br /> 21. Hot and cold potable veater available. Compliance and Enforcement <br /> Liquid Waste Disposal 47 Signs posted;last inspection report available <br /> 92. Se+ u to A wastewater properly osposcdtoilet facility useable 48. Compliance with plan review requirements <br /> Vermin 49, Facility operating with a valid health permit <br /> 23. No rodents. Insects,birds or animals insde faciii;y y/ 50. Impoundment <br /> 1. Permit Suspension <br /> Received ByTitle: <br /> EH Specialist: L -- - Phone: 3e 72 I PagEd <br /> 1 <br /> EHD 16-23 pst pg) 4/9!12 FOOD PROGRAM OR <br />