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i SAN JOAQUIN COUNT ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sjgov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: /r Date: 7/,f Address: Ci Zip Code: I Owner/Operator: / - - Telephone: Program Element: Program Record: Q / -� Inspection Type: B180 Posted _ es ❑ No Permit Posted ❑Yes 44K Re-Inspection on or After: IN=In Compliance WO=Not Observed NIA=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance See reverse side for code sections and general requirements that correspond to each violation listed below. Major violations pose a threat to public health and must be corrected immediately. Non-com fiance maX warrant closure of the food facility 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties 30110 0" > tf1 Wit ' i .` lett Cteeiritss _ Communicable disease;reporting,restrictions&exclusions F„ 5. Personal cleanliness and hair restraints . No discharge from eyes,nose,or mouth;no open wounds d; e _i?egr, nts° 4. Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used PIYt3lr# �! �,�ma� Wmnm 7. Food protected from contamination during storage 5. i Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used liliJisp 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided 9. I Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures :a � m�<,; �r�ii�J iri �f f�:��€efsls 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean to btl K#11E ,or"ft 4. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipmentlutensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use i 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained „��15.°Food obtained from aapprovedsource8 Approved and sufficient ventilation and lighting 9. Thermometers provided,accurate,and easily visible 1 . Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths �e 17. Compliance with Gulf oyster regulations WEmy.1m � i#I , etfr!1C�1Ci9rytlmjt,'.. ,. e . 1. Plumbing maintained;proper back flow prevention �.... 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed ' °° Of1lFJ1f' v#so � 3. Toilet facilities clean,supplied,and maintained i 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing ""Otti�� c111t ..�% . 66x �s ae 1340`1 0. Prohibited foods not offered at high risk facilities I NO 5. Floors,walls and ceiling are maintained and kept clean a ##bt i0r, r z'`' 6. No living or sleeping quarters inside facility 1 1.Hot and cold potable water available. CopClrst3it, ii#ArIe#t " i iild Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vrgittr 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 0. Impoundment I 1. Permit Suspension Received ByIT' EH Speciali t: Phon r Page 1 of C5,0 EHD 16-23 (1st pg) 4!9112 VFOOD PROGRAM OIR I