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pur" SAN JOAQUIN COUNTY'' z< ENVIRONMENTAL HEALTH DEPARTMENT r_ 600 East Main Street, Stockton, CA 95202-3029 `4ziFoariP Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: T L$ yi y1 } Date: O _ (' -r Y 2 Li r')") l / _ ' Address: T U � S k Com• ) Zip Code: ;?L Owner/Operator: V r 1 A } N xZ V � -2 Telephone: q L �3 G Program Element: Program Record: Inspection Type: .1 r B180 Posted Yes ❑ No Permit Posted ❑ es = No Re-Inspection on or Aker: 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. Ma'or violations pose a threat to public health and must be corrected immediate) . Non-compliance may warrant closure of the food facility _ Demonstration of Knowledge om cos Supervision uur 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties l Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No tlischarge from eyes,nose,or mouth;no open wounds < General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used k- Preventing Contamination by Hands 27. Food protected from contamination during storage Hands clean and properly washed:proper glove use 8. Washing fruits and vegetables before use Hentlwashing facilities supplied and accessible HiTT 29. Toxic substances properly itlentified,stored,and used Time and Temperature Relationship. Food Storage/Dispiay/Service IX o Proper hot and cold holding temperatures 0. Food storage;food storage containers labeled r Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided N Proper cooling methods 32. Food properly labeled and honestly presented X 10. Proper cooking time and temperatures Equipment/Utensils/Linens ifl 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available X 12. No_re-service of returned food 35. Equipmentlutensils approved;installed;clean;good repair f( 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained d f6oiApproved Source' 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible X 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths *17. Compliance with Gulf oyster regulations Physical FaciBties ith Approved Procedures 41. Plumbing maintained,propel back flow prevention . Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory. 43. Toilet facilities clean,supplied,and maintained . Advisory provided for raw or undercooked food 44. Promises;personal/cleaning items;vermin-proofing .,q__b1e Populations Permanent Food Facilities . Prohibited foods not offered at high risk facilities 45. Floors.walls and ceiling are maintained and kept clean -' 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Compliance and Enforcement W Liqui aste Disposal 7. Signs posted;last inspection report available . Sewage/wastewater properly disposed:roller facility useable 8. Compliance with plan review requirements m 9. Facility operating with a valid health permit 3. No rotlents,insects,bills or animals inside facility 0. Impoundment 1. Permit Suspension Received By/Title: EH Specialist: � Phone: Page 1 of 2 EHD 16-23(1st pg) 12/15/09 FOOD PROGRAM OIR