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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siooy.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: _ J L�L (� o Date: Address: - City: Zip Code: q S - Owner/Operator: Telephone: Program Element: Program Record: Inspection Type: 8180 Posted yes No Permit Posted yes No Re-Inspection on or After: IN=In Compliance WO=Not Observed WA=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-com liance ma warrant closure of the food facility . 'M ++Pery R 1. Demonstration of knowledge;food safety mitificat 24. Person In Charge is present and performs duties _Hygiene ! Communicable disease,reporting,restrictions 6 exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,now,or mouth;no open wounds Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used _ 7. 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 Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled Proper use of time as a public health control 31. Customer sell-service food protected,individual utensils provided Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures _ - 11. Proper reheating procedures for hot holding 31 Nonfood contact surfaces clean x, 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 correct surface clewed and switized/warewashing procedures 37. Vending machines maintained 8. Approved and sufficient ventilation and lighting x X; 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations -- ii.wroth„ 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed _ 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food . Premises;personal/cleaning items;vermin-proofing ,., ]( 0. Prohibited foods not offered at high risk facilities _ 5. Floors,walls and ceiling are maintained and kept clean 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. `>3,--_ _ t.;.v 7. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements }..,. x E- y - 9. Facility operating with a valid health permit - 3. No rodents,insects,birds or animals inside facility 0. Impoundment 11. Permit Suspension receivetl By/Title: r r 'Yl EH Specialist: O - IPhone: "A Q _ v Page 1:-fzl r V EHD 1623 (191 pg)4/9/12 FOOD PROGRAM DIP