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o.4+�gIN• c SAN JOAQUIN COUNTY G ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �q�i�b•A�:P Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd FooR PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: 310 Address: // f'f City: Zip Code: 4? 5'•l-�/ Owner/Operator: 3 i J Telephone: 4... 'Jp!C7 Program Element: b Program Record: Inspection Type: Kt: SB180 Posted'(Yes ❑ No Permit Posted Was ❑ 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. Major violations pose a threat to public health and must be corrected immediafel . Mon-compliance mary warrant closure of the food facility _ 1111111111111M I NO .Demonstratiori of Knowledge Oemonstralion of knowledge, food safety certificate 24. Person In Charge is present and perforans duties - ployee Hs nd`Hygiene 'k. a an in MMN,'discharge able disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints from eyes,nose,or mouth;no open wounds er -oo Sa eng,tasting,drinking,or tobacco use 26. Approved thawing methods used lie, AVOWN"'ann- 27. Food protected from contamination during storage 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 e Dr Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled Proper use of time as a public health control 1. customer self-service food protected;individual utensils provided 9. Proper cooling methods 2. Food properly labeled and honestly presented 10. Proper cooking time and temperatures 1 i. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean 0 0 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. 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 surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained Food;From ApproveWig ource 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display 140. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations a'nce With Approved Prop 41. Plumbing maintained;proper back flow prevention 8. Compliance with HACCP plan or varianee conditions 42. Garbage and refuse properly disposed Consums;ory 43. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personallcleaning items;vermin-proofing Highly Susceptible Populations 0. Prohibited foods not offered at high risk facifit a 45. Floors,walls and ceiling are maintained and kept clean Water/Hat Water 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. ';Liquid Waste Disposal 7. Signs posted;last It report available . Sewage/wastewater properly disposed,toilet facility useable 8. Compliance with plan review requirements Vermin �. " 'r r. 9. Facility operating with a valid health permit 3. No rodents,Insects,birds or animals inside facility 60. Impoundment 51. Permit Suspension Received By/Title: -z- (1----�� EH Specialist: Phone: Page 1 of EHO 1623(Is[pg) 4/9112 FOOD PROGRAM OR