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i SAN JOAQUIN COUNT ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 • `�'�i a �'�p Telephone:(209)468-3420 Fax.(209)464-0138 Web:www.sigov.oMLE hd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: p Date: Address: / City: /' Zip Code: 9� Owner/Operator: ( Telephon� _ Program Element: G Program Record: /0 Inspection Type: B180 Posted fifes ❑ No Permit Posted.,E! s ElNo Re-Inspection on or After: IN=In Compliance NIO=Not Observed NIA=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. Maio r violations pose a threat to ublic health and must be corrected immediate! . Non-Com !lance may warrant closure of the food facility ,ti.. CtertltttltlatioKl K> '71� `3 77g, m .. .. -, ._.. ... 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties m Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No dischar a tram a es,nose,or mouth;no o en wounds 9 Y P .: Proper eating,tasting,drinking or tobacco use 26. Approved thawing met hods used M s: 7. Food protected from contamination during storage t�fYer�It�IC1Atr�la��if_r�t lltl�'.. . Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use �;� Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used `�'�lilt� tf 1'i1>eii`at�it�l'3�;atT�t#1�f� , Proper hot and co0 11111 30. Food storage;food storage containers labeled B. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided 9. Proper cooling methods 32. Food properly labeled and honestly presented r is 10. Proper cooking time and temperaturessi1r 11. Proper reheating procedures for hot holding W- 4 33. Nonfood contact surfaces clean m; 34. Warewashing facilities maintained;test strips available i 12. No 35. EquipmenVutensils approved;installed;clean;good repair r 13. Foo 36. Equipment,utensils and linens:storage and use 14. Foo 37. Vending machines maintained •;:;gib' t'oatl e�� tgtt�sY�aulr�i •� , 38. Approved and sufficient ventilation and lighting ,a � - ,At 5. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 11-1 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations Jim 6C Cd OrdY1 Wl ti" Ved P11d Ogren- 41. Plumbing maintained;proper back flow prevention ° ol18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed 43. Toilet facilities clean,supplied,and maintained � . t. A_1 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing IySusuepble Fsplxo :` ,: art>rff"tlatcirt : y� 0. Prohibited foods not offered at high risk facilities 5. Floors,wails and ceiling are maintained and kept clean ng o sleeping 6 No living r sle in quarters inside facility ,ee '14 1.Hot and cold potable water available. z . ttl�ranice arrd; ortrt ,x. �87. Signsposted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements 1i�rrttt(la " ` '" 9. Facility operating with a valid health permit �' 3. No rodents,insects,birds ar animals inside facility 50, Impoundment 1. Permit Suspension Received By/Till EH Specia' V Phon .�� Page 1 of a FHD 16-23 (1 sl pg) 419112 FOOD PROGRAM OR