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oga!!tN• c SAN JOAQUIN COUNTY �+ ENVIRONMENTAL HEALTH DEPARTMENT J. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �•.. `PTelephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd 4LIFORt.1 FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: i ddress. M City: Zip Code: r n/ Il Owner/Operator: r Telephone: 2 _ bj •7 Program Element: Program Record: Inspection Type: SB180 Posted VYes ❑ N6 Permit Posted 17 Yes ❑ No Re-Inspection on or After: IN=In Compliance N/O=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 violations pose a threat to public health and must be corrected immediately, Non-compliance may warrant closure of the food facilit IN wo NIA Demonstration of Knowledgecos Supervrn nAd cur sion 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties MK E" ogee Health Fad a§onal.Cleanfi es %V=Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints 3. No discharge from eyes,nose,or mouth;no open wounds General,Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used F_Preventing Contaminatlo.n_by Hands 7. Food protected from contamination during storage 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used >ime and Temperature Rel7; ationship- ood o a Uis a e 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 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures q G Utensils/Linen,. 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From m_ 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 __- ood From Approved`- -ice 38. 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 17. Compliance with Gulf oyster regulations Conformance With Approved_ Procedures 41. Plumbing maintained;proper back flow prevention FIRZI, Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained 419. Advisory provided for raw or undercooked food . Premises;personal/cleaning items;vermin-proofing -7' hly Susceptible Populations er ne odFaci-ties 20. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean =Water/Hot Water 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Compliance and Enforcement ;Liquid Waste_Disposa 7. Signs posted;last inspection report available 22. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements 9. Facility operating with a valid health permit IXIW3. No rodents,inset , irds or animals inside f ility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Phone: 4�9Page 1 of EHD 16-23(1st pg) 4/9112FOOD PROGRAM ORv'