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Rel" SAN JOAQUIN COUI"� ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �j....... " Telephone:(209) 46B-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: ddress: S rl 1 d - City: Zip Code: wner/Operator: S• i�c Telephone: Program Element: L- Program Recor Inspection Type: B180 Posted es No Permit Posted Nyes ❑ No Re-Inspection on or After: IN=In Compliance N/O=Not Observed N/A= 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_ Afa or violations Poss,a threat to ublic health and must be corrected immediately. Non-compliance maYwarrant closure of the food facilit - -- 'af Knowled Supervision our 1. Demom aatbn of knowledge;food safety certificate 4. Person In Charge is present and pertorrns duties Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 5. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds `Food Safety Requirements Proper eating,tasting,drinking,or tobacco use Approved thawing methods used 7. Food protected from contamination during storage Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used Proper hot and cokl holding temperatures . Food storage;food storage containers labeled Proper use of time as a public health control 1. Customer self-service food protected;individual utensils provided Proper cooling methods Food properly labeled and honestly presented 10. Proper cooking time and temperatures 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean 4. Warewashing facilities maintained;test strips available 12. No m-service of returned food 5. Equipment/utensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surtace clean„d and snnniized/warewashing procedures 37. Vending machines maintained Food From Approved 38. Approved and sufficient ventilation and lighting 15. Food obtained from apprcvnd source 39. Thermometers provided,accurate,and easily visible 6. Compliance with shell stork regulations;tags/display 40. Proper use and storage of wiping cloths 7. Compliance with Gulf oys cr regulations Physical Facilities ance With Approved Procedures 41. Plumbing maintained;proper back flow prevention 119 !Aftso ce with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained provided for raw x undercooked food 44. Premises:personal/cleaning items;vermin-proofing "hly Susceptible Popul" Permanent Food Facilities d foods not offered at high risk facilities 45. Floors.walls and ceiling arc marntainec: c d krIt ccesrr of Water 46. No living or sleeping yuaiters inside facthty old potable water available. Compliance and Enforcement�pisposal 47. Signs posted;last inspection report available wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements 49. Facility operating with a valid health permit ns.insects,birds or animals Inside facility 50. Impoundment 51. Permit Suspension Received ByfTitle. f ____. _ __ EH Specialist: _ 1�V Phone: Page 1 0 Ali- FOOD PROGRAM OIR l 16-23 list pg) 4/9/12