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SAN JOAQUIN COUN <br /> Vi K <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • dq. ~ �;;a Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sicov.oro/ehd <br /> �IFsw <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: IV Avk G e oe Date: <br /> Address: City: C _ Zip Code: <br /> Owner/Operator: ,�J Telephone: Ti <br /> Program Element: Program Record: Inspection Type: J <br /> 8180 Posted Yes No Permit Posted Yeg 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 /> Ma'or violations pose a threat to public health and must be corrected immediately. Non-corn )lane may warrant closure of the food facili <br /> e, nr <br /> 1-1 <br /> n Demonstration of Knowledge Gw our COS Supervision an <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 /> Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements, _ <br /> j Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Preventing Contamination by Hands 27. Food protected from contamination during storage <br /> . Hands clean and property 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 /> _ <br /> Time and Temperature Relationship Food Storage/Display/Service <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 property labeled and honestly presented <br /> 10. Proper cooking time and temperatures Equipment/Utensils/Linens <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> 777,112. <br /> Protection From Contamination 4. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 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 sanitizedfwarewashing procedures 37. vending machines maintained <br /> Food From Approved Source ___ 38. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source �_ 39. Thermometers provided,accurate,and easily visible <br /> 16. 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 /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 3. Toilet facilities clean,supplied,and maintained <br /> 19. 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/Hol Water _ 6. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. _Compliance and Enforcement <br /> Liquid Waste Disposal _ 7. Signs posted;last inspection report available <br /> 2. Sewagetwastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> _Vermin _ 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/Ti,_ <br /> EH Specialist: J &A4 <br /> Phone: - Page 1 of <br /> EHD 1623 list pg) 4012 FOOD PROGRAM OR <br />