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D Q tM. SAN JOAQUIN COUNTY ll ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209)464-0138 Web:vvww.s ov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Date: ``,�, Name of Facility: `U` ��,b ddress: City: Zip Code: 045 3 i 7 I i Telephone: Owner/Operator: ` n Program Element: Program Record: IS Inspection Type: 8180 Posted; ❑Yes ❑ Rermit Posted ❑Yes ❑P Redrispection on or After: IN=In Compliance NIO=Not Observed NIA=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 vid�lations Eose a threat to aublic health and must be corrected immediate! Non-com liance max warrant closure of the food facility iku iW 1. Demonstration of knowledge;food safety certificate 4. Person In Charge is present and performs duties Communicable disease;reporting,restrictions&exclusions 5. Personal cleanliness and hair restraints t - No discharge from eyes,nose,or mouth;no open wounds > "" ............. � ;.._q...-.... . Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used 7 Food protected from contamination during storage _ ........: 111-lands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use M-1 5F It IiHandwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used . IlProper hot and cold holding temperatures 30, Food storage;food storage containers labeled I S. 11Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided 9. IlProper cooling methods 32. Food properly labeled and honestly presented 10.'iProper cooking time and temperatures ;oma 11 1."Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean 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 ,. q ......::.. 38. Approved and sufficient ventilation and lighting 15'iFood obtained from approved source 39. Thermometers provided,accurate,and easily visible 16'1Compliance with shell stock regulations;tags/display 40, Proper use and storage of wiping cloths 17':Compliance with Gulf oyster regulations 11 "7�a.......,�...: .�e back flow prevention ---- 1 Plumbing maintained;proper b I 18.'iCompliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed _ 3. Toilet facilities clean,supplied,and maintained 19."Advisory provided for raw or undercooked food '> 4. Premises;personal/cleaning items;vermin-proofing FA ' �ialfE�li { O'�Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean r fi. No living or sleeping quarters inside facility m.. 1';Hoand cold potable water available. at � . ,�. ✓��,�. �J°--;�'"°�'°" "°" ':` � 7. Signs posted;last inspection report available 2..'Sewagelwastewaterp-operly disposed;toilet facility useable 8. Compliance with plan review requirements 9. Facility operating with a valid health permit 3'jNo rodents,insects,birds or animals inside facility 50. Impoundment 1 51. Permit Suspension } Received BylTitle: 3i EH Specialists _ Phone: Page 1 of 2 EHD 16-23 (1 s1 pg)1419112 i FOOD PROGRAM OIR 9 �i