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a4"ate�A� SAN JOAQUIN COUNTI..." L ENVIRONMENTAL HEALTH DEPARTMENT r •< 600 East Main Street, Stockton, CA 95202-3029 ��If aapp Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siaov.orci/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Q r Date: L4 _ I Z / 2 Address: 'VyOs (2City: i�0n Zip Code: `YS21 D caner/Operator: Lodr' Urk ,, Pl o oir 0 5.4 r c (- Telephone: Program Element: �,2_ Program Record: d/ Inspection Type: R oil .'. B180 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 pose a threat to ub/ic health and must be corrected immediatel . Non-cora liance may warrant closure of the food fac/lit w Demonstration of Knowledge `° wu our cos - Supervision OUT 1. Demonstration of knowledge:food saf 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting, restrictions 8 exclusions 5. 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 Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use 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 property labeled and honestly presented 10. Proper cooking time and temperatures Equipment/Utensils/Linens 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 35. Equipmentlutensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. 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 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied and mainttcl�,an 19. Advisory provided for raw or undercooked food 4. Premises;personal/cleaning items;vermi Highly Susceptible Populations Parmenarnt FdodFacB0. Prohibited foods not offered at high risk facilities 5. Floors,walls antl ceiling are maintained aWater/Hot Water 6. No living or sleeping quarters inside facili1.Hot and cold potable water available. Compliance and EnforcLiquid Waste Disposal 7. Signs posted; last inspection report availa 2. Sewage/wastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements Vermin 9. Facility operating with a valid health permit 3. No rotlents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Received By/Title: r H Specialist: +.nom hone: d -3`4,fS Page 1 of EHD 1623(1st pg) 12/15/09 FOOD PROGRAM OIR