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SAN JOAQUIN COUI,.) ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 dclob ';v • Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT ame of Facility: - Date: ddress: 1-1� C k City. t'Yl _ \ _ Zip Code: Ci S wner/Operator: t `GY\�'�-C .:� Telephone: Program Element: 'Z Program Record: S2 Inspection Type: 8180 Posted Yes No Permit Posted Yes No Re-Inspection on or Afte IN=In Compliance N/O=Not Observed N/A=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. Meor violations use a threat to ublic health and must be corrected immediatel Non-compliance may warrant closure of the food fa_cilir castration of Knowledge fw' our rps Supervision our 1. Demonstration of knowledge;food safety certificate 24_ Person In Charge is present and performs duties Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25 Personal cleanliness and hair re straints 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 ` 27. Food protected from contamination during storage Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use Hentlwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used ,unship,;>-'_ Proper hot and celfl holding temperatures Food storage;food storage containers labeled Proper use of time as a public health control 1. Customer self-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 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available 12 No re-service of returned food 5. EquipmentJutensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use kF 14 Food conlact sudors cleaned end sanib.ed/warewashing procedures 37. Vending machines maintained Foodrdr ;,Approved Source - 38. Approved and sufficient ventilation and lighting 39. Thermometers provided,accurate,and easily visible E\��15 Food obtained f rum approved source bc 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 18. Compliance with HAOCP plan a variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises:personal/cleaning items:vermin-proofing ...Highly Susceptible Populations Permanent Food Facilities . Prohibited foods not off`>red at high m,k facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Compliance and Enforcement id Waste Disposal 47. Signs posted;last inspection report available X . Sewage/wastewater properly disposei..toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit illpW3. No rodents, insects-birds or anirrals reside facility50. Impoundment 1. Permit Suspension Received By/Title: Y iGNt/� EH Specialist: Phone: � '^ _ Page 1 of C EHD16231151 pg) 41.512 V FOODPROGRAMOIR