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SAN JOAQUIN COUNTY---' ENVIRONMENTAL HEALTH DEPARTMENT _r 600 East Main Street, Stockton, CA 95202-3029 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sicov.or0/ehd 9�rFORN FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: ! o O ' f Yl Date:/77/771777 ddress: .2347 L �� City: (. Zip Code: Owner/Operator: �0✓e ZPh1 ' T. one: Program Element: aA 3 Program Record: j�aInspectionType: {�{ 8180 Posted []Yes ❑ No Permit Posted ❑Yes ❑ 110 Re-Inspection on or After: IN=In Compliance N/O=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-compliance may warrant closure of the food facility w mro wA Demonstration of Knowledge wai oirr cos - Supervision cn.: 1. Demonstration of knowledge:food safety certificate 24. Person In Charge is present and performs duties I Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements ' . Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used - Preventing Contamination by Hands 27. Food protected from contamination during storage S Hands clean and properly washed, proper glove use 28. Washing twits and vegetables before use 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used Time and Temperature Relationship Food Storage/Display/Service Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided Proper cooling methods 32. Food properly labeled and honestly presented _ 10. Proper cooking time and temperatures Equipment/Utensils/Linens It 11_ Proper rehearing procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available 12 No re- rvicr a recur it d t:od 35. Equipment/utensils approved;installed:clean;good repair a3. FooJ free from contamination and idulturat 36. Equipment,utensils and linens:storage and use 14 -oon a e .sunace de�nom.in s ,n dlwarew s in,procedures 37. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 9. 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 Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention ` 118. compliance with HACCP plan or variance conditions77 2. Garbage and refuse properly disposed Consumer Advisory 3. Toilet facilities clean,supplied,and maintained �1 S. Advisory provided for raw or undercooked food 4. Premises;personal/cleaning Items;vermin-proofing Highly Susceptible Populations y<- Permanent Food Facilities 120- Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean Water I Hot Water 6. No living or sleeping quarters inside facility 21 Hot and cold pc abic-water available. Compliance and Enforcement Liquid Waste Disposal 7. Signs posted;last inspection report available 122. Sewage wastewater properly disposed toilet facility useatcl 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit I23. No rodents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Received ByrTitle: EH Specialist: Phone: L4 Lt Page 1 of EHO 1623 (1st pg) 12/15/09 FOOD PROGRAM OR