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e "e•.�� SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.s_jgov.ora/ehd <br /> 1r1sw <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: /%� 3� - Date: y <br /> Address: ` - {, ; City: Zip Code: <br /> Owner/Operator: T /t Telephone: <br /> Program Element: Progre Record: t Inspection Type. <br /> 4 hid, <br /> Set80 Posted Yes 1 No Permit Posted ❑Yes ❑ No Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed N/A-Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Ma or violations ose a threat to public health and must be corrected/mmediateI . Non-com llance may warrant closure of the food facility <br /> 1. Demonstration of knowledge;food safety certificate 4. Person In Charge is present and performs duties <br /> Communicable disease;reporting,restrictions&exclusions 5. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds <br /> Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used <br /> 7. Food protected from contamination during storage <br /> Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used <br /> Proper hot and cold holding temperatures 0. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 1 provided <br /> Customer self-service food protected;individual utensils <br /> Proper cooling methods 2. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> 1. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean <br /> . Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 5. Equipmentlutensils approved;installed;clean;good repair <br /> 3. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use <br /> Or <br /> 14. Food contact surface cleaned and sanftWxbWarewashing procedures 7. Vending machines maintained <br /> 8. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations <br /> 1. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed <br /> 3. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food Premises;personal/cleaning items;vermin-proofing <br /> 0. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean <br /> No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. <br /> 7. Signs posted;last inspection report available <br /> 2. Sewage/wastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements <br /> 9. Facility operating with a valid health permit <br /> . No rodents,ins birds or mals inside facility 0. Impoundment <br /> 1. Permit Suspension <br /> Received By/Title: <br /> Phone: - Page 1 of <br /> H Specialist: ..� <br /> FOOD PROGRAM OIR <br /> EHD 16-23 JIM p9) 12115109 <br />