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r' 4 <br /> SAN .10AQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> . c.. ; '• Telephone: (209)468-3420 Fax: (209) 464-0138 Web:www.s'qov.org/ehd <br /> RCfFOR� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT ; <br /> Name of Facility: �� ��, Date: (po-2/1�D , <br /> Address: City:: Zip Code: <br /> (J1 <br /> �� <br /> (o N - Vv � (�1`i w �Z � <br /> Owner/Operator: `u Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> 8180 Posted es L1 Rermit PostedYes ❑ P Re-Inspection on or After:/10 <br /> IN=In Compliance NIO=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 /> Ma-or violations aose a threat to aublic health and must be corrected immediate! . Non-compliance ma warrant closure of the food facility <br /> �z�: .....lhwf� `:: f' �.��l �e:ev•:'`;...�.;° _, o _ ��ttx �� - <br /> 1. demonstration of knowledge;food safety certificate wq 4. Person In Charge is present and performs duties <br /> y. <br /> at. <br /> Communicable disease;reporting,restrictions&exclusions5. 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 /> „ . _.... - », -• ..: 07. Food protected from contamination during 9 storage <br /> Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> a Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> N TV <br /> ®a. <br /> M. . _ <br /> bifittt .. ... re: <br /> _.. <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 /> 9. Proper cooling methods 32. Food property labeled and honestly presented <br /> _.,.. , <br /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> 34. Warewashing 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 sanitizedlwarewashing procedures 37. Vending machines maintained <br /> MA. 38. Approved and sufficient ventilation and lighting <br /> :X 5. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> i 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17.-Compliance with Gulf oyster regulations <br /> y ,. <br /> _- 1. Plumbing maintained;proper back flow prevention <br /> 11I 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> if #3tt': 5 ? 3. Toilet facilities clean,supplied,and maintained <br /> t 19. Advisory provided for raw or undercooked food 44. Premises;personalicleaning items;vermin-proofing <br /> 0. Prohibited foods not offered at high risk facilities ,:.Y- 5. Floors,walls and ceiling are maintained and kept clean <br /> 6. No living or sleeping quarters inside facility <br /> ?�,.. ... ... .::.�. , >;� ;,> e..............aa.....,..M. ..,�; �y. <br /> <.=,tee;. <br /> 1.Hot and cold potable water available. , .. <br /> m� <br /> y 2. Sewagelwastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> 9. Facility operating with a valid health permit <br /> VIP,A <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: A <br />++� EH Specialist: tN Phone: eQr, �y �j Pagel of 45 <br /> 1 EHD 16-23(1st pg) 4191 2 FOOD PRGGRAM OR <br />