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SAN JOAQUIN COUNT" y 'tNVIRONMENTAL HEALTH DEPOTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 e4tipohMvF• Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: /U L3 Address: , City: Zi Code: O 1�FUit P Owner/Operator: - ft,R G�;11 Telephone: Ctn� \ S Program Element: ZS Program Record: Inspection Type: 8780 Posted j1'es No Permit Posted Yes No Re-Inspection on or After: 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. Major violation pose a throat to Public health and must be corrected immediate/ . Non-compliance may warrant closure of the food facility Knowledge Supervision our 1. Demonstration of knowledge;food safety certificate 24. Person In Charge Ic present and performs duties ;Hygiene Personal Cleanliness Communicable disease;reporting,restrictions 8 exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds =General. 00-Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used RTrTIM 'oWpontarnination by. 27. Food protected from contamination during storage Hands dean 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 Proper hot and cold 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 2. Food properly labeled and honestly presented 10. Proper cooking time and temperatures 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean { Protection From Contamination $;; 4. Warewashing facilities maintained;test strips available 12. No re-service of returned food 5. Equipment/utensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sani!i�el Warewashing procedures 7. Vending machines maintained ,,... ._ _ '.... d From Approved Source 38. Approved and sufficient ventilation and lighting 15 Food obtained from approved spurt_ _ -I 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 41. Plumbing maintained;proper back flow prevention 16. Compliance with HACCP plan or variance conditions 42- Garbage and refuse properly disposed 41 nil Consumer Advisory 43. Toilet facilities clean,supplied,and maintained 9. Advisonprovided for raw or undo rcoowzd food 44. Premises:personal/cleaning items;vermin-proofing Highly Susceptible Populations Permanent Food Facilities . Prohibited foods not offered at h>„h risk facilities 45. Floors,walls and ceiling are maintained and kept clean MEMENJiler/Hot Water 46. No living or sleeping quarters inside taclhty 1.Hot and cold potable water available. Cordi"0 p a and Enforcement Disposal 47_ Signs posted; last inspection report available . Sewage/wastewater properly disposed:toilei facility useable 48. Compliance with plan review requirements ermin 49. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 1 50, Impoundment 51. Permit Suspension Received By/Title: EH Specialist: _/e - Phone: � _ Page 1 of EHD 16-23 (1st Pg) 4/9/12 �r�t'�- FOOD PROGRAM DIR