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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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FORT DONELSON
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3708
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1600 - Food Program
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PR0522657
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COMPLIANCE INFO
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Last modified
6/6/2019 2:11:50 PM
Creation date
6/6/2019 2:10:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0522657
PE
1620
FACILITY_ID
FA0002318
FACILITY_NAME
NORTH LAKE HOMEOWNERS ASSN
STREET_NUMBER
3708
STREET_NAME
FORT DONELSON
STREET_TYPE
DR
City
STOCKTON
Zip
95219
APN
09806055
CURRENT_STATUS
01
SITE_LOCATION
3708 FORT DONELSON DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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°"'" SAN JOAQUIN COUP. <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.s'gov.org/ehd <br /> �%FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 1_ Ta Date: <br /> Address: 3 � 17 1 0 r City: 1:5 J626,k7�0)2 Zip Code: 91 <br /> Owner/Operator: 316214 Telephone: L _ <br /> Program Element: IPro-gram Record: Inspection Type: 7 _ <br /> B180 Posted ❑Yes Rermit Posted Yes ❑t Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed NIA=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 pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facility <br /> n� rr Demonstration of Knowledge Supervision I co <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 /> 2. Communicable disease: reporting. restrictions&exclusions 25 Personal cleanliness and hair restraints <br /> i3 No discharge from eyes,nose,or mouth:no open wounds General.Food Safety Requirements <br /> 4Proper eating,tasting.drinking.or tobacco use 26. Approved thawing methods used <br /> Preventing Contamination by Hands 27. Food protected from contamination during storage <br /> 5. 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 /> Time and Temperature Relationship <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 I Utensils Ilinens <br /> Vr 11 Proper reheating procedures for hot holding "` 33. Nonfood contact surfaces clean <br /> Protection From Contamination 34. Warewashing facilities maintained;test strips available r/ <br /> 12. No re-service of returned food 77- 35. Equipment/utensils 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 /> Food From Approved Source 38. Approved and sufficient ventilation and lighting <br /> r v 15. 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 /> 17. Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention <br /> I 13 Compliance with HACCP plan or variance condi 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> I19 Advisory provided for raw or undercooked food 44. Premises:personal/cleaning items:vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> 0. Prohibited foods not offered at high risk facilities 45 Floors,walls and ceiling are maintained and kept clean <br /> Water I Hot Water 45 No living or sleeping quarters inside facility <br /> 21 Hot and cold potable water available Compliance and Enforcement <br /> Liquid Waste Disposal 47, Signs posted,last inspection report available <br /> 22 Sewage/wastewater properly disposed.toilet facility useable 48. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> P3. No rodents insects.birds or animals inside facility _ 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: r� ��ei1 t `' <br /> J -- 14) /'I7.-41 <br /> EH Specialist: ;iMPhone: r Page 1 of <br /> EHD 16-23(1st pg) 4/9/12 FOOD PROGRAM OIR <br /> a►-fi YrA I)Ct ) :,5 C - YY1Q 1 co�'7 <br />
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