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Q�a"t" c • SAN JOAQUIN COU& a•�'o Z ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209)468-3420 Fax:(209) 464-0138 Web:www.sioov.ora/ehd �rFOR� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: b e/71vt 7• Date: _ l�- Address: Y City: D _`� Zip Code: Owner/Operator: c/� Telephone: Program Element: .S Program Record: PR 0! Inspection Type: TIDO u I SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: IN=In Compliance N/0=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 pose a threat to public health and must be corrected immediately...Non-compliance-ma- warrant closure of the food facility w.!n Iwn u.:...MW .Demonstration of Knowledge 1 11 „ u r...., Supervision S:r: 1_ Demonstration of knowledge:food safety certificate 24 Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness ciiij �13. No discharge from eyes.nose,or mouth;no open wounds -- F !s a clGeneral Food Safety R 1s pii 9 Y P egmrements . Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used j Preventing Contaminatiohby Hands : 27. Food protected from contamination during storage ✓ Hands clean and properly washed:proper glove use 28. Washing fruits and vegetables before use 16. Handwashing facilities supplied and accessible t/ 29. Toxic substances properly identified.storedand used Time and Temperature Relationship Food StoragelDisplay/Service ✓ 7 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 properly labeled and honestly presented J 0. 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 t/12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair 3. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use X114. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained Food From Approved Source 'I 38. Approved and sufficient ventilation and lighting Foo^obtained from approved source 39. Thermometers provided,accurate,and easily visible ✓13- Compliance with shell stock renalations tags.display 1 40. Proper use and storage of wiping cloths t/,17- Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention 'l 8, Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained 119- Advisory provided for ramor undercooked food _ 44. Premises;personal/cleaning items;vermin-proofing Highly Susceptible Populations. ^' Permanent:Food Facilities f20- Prohibited food=_not of s-red at high risk 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 Liquid Waste Disposal 47. Signs posted;last inspection report available 22. See age+wastewater properly disposedtoilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit '.23. No rodents. insods,b rds or animals inside facility 50. Impoundment 1Permit Suspension Received ByfTitle: EH Specialist: Phon : Page 1 of EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OR