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o�Quf" SAN JOAQUIN COUN', r z ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd '�rFORe� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: �� \ .\�C 'P_1 ? Date: i-2 Address:2`b City: Zip Code: q 5 3__77 Owner/Operator: O Telephone:r6AO -c-89 0c Program Element: 1U2 Program Record: S ` �j ? S Inspection Type: ` v SB180 Posted Yes 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 violations 2ose a threat to ublic health and must be corrected immediate/ . Non-compliance may warrant closure of the food facili t>stca+onf fCr�owf 1ge pervrslbi3 carr 1. Demonstration of knowledge;food safety certificate "a IM. 24. Person In Charge is present and performs duties yg"e: F .... �?� r"�BRJ1 Irl@SSS a :,_s Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used �;n f `' #�d1i3t11{itltitemixy �r � P 9 9 7. Food protected from contamination Burin storage Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use £= Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used 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 19. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperaturesaga� _ e 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean 01$rtf�Orl�B a " 34. 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 use 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained w _ - 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 w 1I'-iwm .. lWca!#ac nce ••- .•� �x 1. 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 , w PP 19. Advisory provided for raw or undercooked food ON 1 44. Premises;personal/cleaning items;vermin-proofing fySustxeptjple _ Pe Factfe§.. 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean « 1Neter " #vi F , ..; vw q w" 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. 7. Signs posted;last inspection report available • �� 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements - 7F -- .d;_ 9. Facility operating with a valid health permit Verma'iMEMO Y 3. No rodents,insects,birds or animals inside facility 0. Impoundment 51. Permit Suspension Received By/Titie: EH Specialist: t Phone: y _O3O Page 1 of 2 EHD 16-23 (1sl pg) 4/9/12 b FOOD PROGRAM OR