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0. SAN JOAQUIN COUN1 � ._f4fr.CO ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd ��FOR FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Or)o I G W 3( ,4 2 y Date: 2 2,1 Address: 3 )r I h Sk City: Tri Crip Code: Owner/Operator: N I S h r c, Ad e r- Telephone: ;.2 1, j 2 Program Element: l/ Program Record3�rz Inspection Type: �c�f ;��L SB180 Posted ,/Yes No Permit Posted Oes 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. Ma"or violations.pose a threat to eublic health and must be corrected immediatel . Non-compliance may warrant closure of the food facififiv I 1N wo VA Demonstration of Knowledge. - � � �.n, ;,�ir1 c�us Supervision cru7.. 1. Demonstration of knowled e;food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene f Personal Cleanliness _ Communicable disease;reporting,restrictions&exclusions 5. Personal cleanlinessand hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements w. Proper eating,tasting,drinking,or tobacco use j 26. Approved thawing methods used I� Preventing Contaminatioil;by Hands 27. Food protected from contamination during storage i?. 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 Time and Temperature Relationship Food StoragefDisplay/Service , ✓ Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 8. 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 10. Proper cooking time and temperatures ? Equipment l Utensils/Linens' 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean From Contamination 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 Food Front Approved Source 38. Approved and sufficient ventilation and lighting v 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 Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention + ' _ 18. Compliance with HACCP plan or variance conditions 7 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained F-7-T9.19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing Highly Susceptible Populations Permanent Food'Facilities 0. Prohibited foods not offered 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 2. Sewage.'wastewater properly disposed:toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Phone: h, / /�- Page 1 of1� EHD 16-23 (is[pg) 4/9/12 0 f7 FOOD PROGRAM OIR