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a¢4"tfr•.� SAN aJOAQUIN COUNTY <br /> ?a ENVIRONMENTAL HEALTH DEPARTMENT <br /> yr :� <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 84Y/. bks;a Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sig V.Ofg/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ( W. <br /> Date: <br /> Address: I ro - W. ) I h S {' City: Zip f cl Code: / 5 7 <br /> Owner/Operator. S �", T_ U Telephone: Mo-21q S r, <br /> r <br /> Program Element: (; Program Record: s / Inspection Type: c, Ii , n <br /> SBt 80 Posted es 0 No Permit Posted O Yes o Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed N/A=Not Applicable COS=Corrected onsite 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 /> Maier violations ose a threat to ublic health and must be corrected tely. Non-cora fiance may warrant closure ofthe food facility <br /> r ion o 'now <br /> 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> ✓ Communicable disease;reporting,restrictions&exclusions 5. 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 /> a 7. Food protected from contamination during storage <br /> Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used <br /> s a <br /> 7. <br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> 8. Proper use of time as a public health control 1. Customer self-service food protected;individual utensils provided <br /> 9. Proper cooling methods 2. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> 0 34. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 5. Equipmentlutensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br /> 38. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tagstdisplay 0. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations <br /> e 1. Plumbing maintained;prop:backow prevention8. Compliance with HACCP plan or variance conditions 2. Garbage and refuse propeed3. Toilet facilities clean,suppmaintained19. Advisory provided for raw or undercooked food Premises;pemonalideaninvermin-proofing <br /> 0 <br /> Mal <br /> 0. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept dean <br /> e 6. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. <br /> 7. Signs posted;last inspection report available <br /> . Sewage/wastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements <br /> er I 9. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 0. Impoundment <br /> 1. Permit Suspension <br /> Received By/Title: <br /> EH Specialist: Phone: L Fi• 316r Page 1 of <br /> 7 FOOD PROGRAM CIR <br /> EHD 1623 list pa) 45112 <br />