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oPQ,tf"'•� SAN JOAQUIN COON" .z� ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 .. ;a Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd �I F O Rte FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: JG� G S Date: Address: Z City: 1 Zip Code: cj 5 Owner/Operator: Y O L �/�� Telephone: 3b t'T Program Element: Program Record: � 1 Inspection Type: 12,3\7r_S-4_ IS 8180 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. Ma-or violations eose a threat to public health and must be corrected immediately. Non-compfiance maX warrant closure of the food facility �: ^' r1:Q1`ICnGWI@ � �a; m a -Y?UT GD5 �, ,Y a4�,it `:.rY15 s' rxTl, 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties �r ErrtRYttdY9 � frness 7 Communicable disease;reporting,restrictions&exclusions _ 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds k == aiD :S►fe . : Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used 09-cAA��1 , 7. Food protected from contamination during storage X I Hands clean and property washed;proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used 4 Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled Y, Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided X Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean ... =y w 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 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 x � .�r 17. Compliance with Gulf oyster regulations M; n= rnience Withy r�� Ltu�� ,`. �p� �.�� . 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 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing )( lP@r11'1� 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean o. s „Yitaterttt� , ~ ,�.,s 6. No living or sleeping quarters inside facility :. 1.Hot and cold potable water available. - '�� „ �� • _ � � ,:�: fJj/8b"t3x max. 7. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements z Vernon Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 0. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Phone: 1� Page 1 of� �lJ1C'� Ci V EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OR