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4"' • SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �•..- `P.. Telephone:(209)468-3420 Fax: (209) 464-0138 Web:www.si oc v.org/ehd <br /> 4GI FO.Ri.1 <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: L Date: 7/. <br /> dd-res s: f � , r sty: / Zip Code: <br /> Owner/Operator: •! l/ Telephone:13 j- 1 ) '7 <br /> Program Element: /VED Program Record: Inspection Type / <br /> SB180 Posted Yes ❑ o Permit Posted Yes ❑ No Re-Inspection on or After: <br /> IN=In Compliance N/0=Not Observed N/A=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Major violations pose a threat to public health and must be corrected immediate! Non-compliance may warrant closure of the food facilit <br /> OU C ` - <br /> iN Demonstration of Knowledge SU pervision OUT <br /> 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> mployee Health and Hygiene = Personal Cleanliness <br /> 2. Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> 3. No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Pareventing Contamination by Hands 27. Food protected from contamination during storage <br /> 5. Hands clean and properly washed;proper glove use <br /> 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> o6dd 012 1 <br /> Time and Temperature Relationship <br /> . 'Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> 31. customer self-service food protected;individual utensils provided <br /> 8. Proper use of time as a public health control <br /> 32. Food properly labeled and honestly presented <br /> Proper cooling methods ,Equipment/Utensils/Linens <br /> 10. Proper cooking time and temperatures 33. Nonfood contact surfaces clean <br /> 11. Proper reheating procedures for hot holding 34. Warewashing facilities maintained;test strips available <br /> Prote.ct'o ation <br /> 35. EquipmenUutensils approved;Installed;clean;good repair <br /> 12. No re-service of returned food 36. Equipment,utensils and linens:storage and use <br /> 13. Food free from contamination and adulteration procedures 37. Vending machines maintained <br /> 14. Food contact surface cleaned and sanitized/warewashing p e y _ 38 Approved and sufficient ventilation and lighting <br /> Food From Approved Source te,and easily visible <br /> 39. Thermometers provided,accura <br /> 15. Food obtained from approved source 0, proper use and storage of wiping cloths <br /> 16. Compliance with shell stock regulations;tags/display <br /> Physical Facilities <br /> 17. Compliance with Gulf oyster regulations <br /> 41. Plumbing maintained;proper back flow prevention <br /> - roved Procedures <br /> Conformance With App 2. Garbage and refuse properly dispose <br /> 18. Compliance with HACCP plan or variance conditions 3• Toilet facilities clean,supplied,and maintained <br /> u <br /> Consumer'Advisory 4. premises;personal/cleaning items vermin-proofing <br /> rovided for raw or undercooked food Permanent Food Facili4ies_ <br /> 19. Advisory p ulations a <br /> Ig ly Susceptible Pop,.. 5. Floors,walls and ceiling are maintained and kept clean <br /> „-,. <br /> 20. Prohibited foods not offered at high risk facilities <br /> 6. No living or sleeping quarters inside facility <br /> Water/Hot Water Compliance and Enforcemen <br /> 21.Hot and cold potable water available. <br /> 7. Signs posted;last inspection report available <br /> !.squid Waste Disposal.:, < 8. Compliance with plan review requirements <br /> 9. Facility operating with a valid health permit <br /> 22. Sewagelwastewaterproper!y disposed;toilet facility useable <br /> er t 50. Impoundment <br /> 23. No rodents,insects,birds or animals inside facility 51 permit Suspension <br /> Received By/Title: Phone: S <br /> �C-�Q 1_ FOOD PROGRAM OIR <br /> EH Specialist: <br /> EHD16-23 (1st pg) 4/9112 <br /> Paadedun oN <br /> Nilnod ' r��Pa)t000 sPool snopie"nze 'ZL <br /> leave/4sU Paltnis'tillnod Painuf�y9Qua`lod Auy l t <br /> lwwoo e <br /> Ali I "gyp _ „�llnouVll^ ^t <br />