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auly SAN JOAQUIN COUNT a: ?, ENVIRONMENTAL HEALTH DEPARTMENT a :< 1868 East Hazelton Avenue, Stockton, CA 95205-623 �..,. p Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.siclov.org/ehd <</FORS FOOD PROGRAM OFFICIAL INSPECTION REPORT Date: -I -t 0- ( S Name of Facility. �Q "- - S S City: Zip Code: 37Jko Address: Z� Ie�ke 1S Telephone: wner/Operator: Program Pr ram Record: "� 1 �. Inspection Type: Element: q o9 S �- 8180 Posted Yes No Permit Posted Yes No 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. Major violations ose a threat to public health and must be corrected fmmediatel . Non-corn fiance me warrant closure of the food facility -__ -__• Wim.acas .<rx -�cr..SuPenr.= '1u(' 1. Demonstration of knowledge;food safely certificate 24. Person In Charge is present and performs duties - - Communicable disease:reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds 'o. --- -- _ - Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used -- 7. Food protected from contamination during storage Hantls clean and properly washed;proper glove use 2& Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 8. 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 10. Proper cooking time and temperatures w9. 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean 4. 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 u j 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained x- 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 With 41. 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 44. Premises;personal/cleaning items;vermin-proofing impys.,a�„s .•per WE less 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean "= No living or sleeping sorters inside facility 'YlFfeter�l�tOt;,. � 9 P n9 q rtY 1.Hot and cold potable water available. 7. Signs posted;last inspection report available M. Sewage/wastewater properly disposed;toilet facility useable 1 1 P8. Compliance with plan review requirements 9. Facility operating with a valid health permit 23. No rodents,insects,birds or animals inside facility _ Impoundment 51. Permit Suspension rH' eived By/Title: e Specialis •-- -- -- `� one: ♦t b Page 1 of cn; y l EHD 1623 rat pg) 49/12 FOODPROGRAMOIR