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,o� .saG SAN JOAQUIN COUI �iI' �a ENVIRONMENTAL HEALTH DEPARTMENT W. X =» 1868 East Hazelton Avenue, Stockton, CA 95265-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siciov.or,/q ehd tlFbR FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: Address: Q � /L ,� City: /� Zip Code: Owner/Operator- T[� Telephone: Program Element:...d&;?9 Program Record: Inspection Type: B180 Posted a No Permit Posted es 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!9_public health and must be corrected immediate! . Non-compliance may warrant closure of the food facility N 7IK� �;:,.:: g �t��31i$�t��Cs1��ICi � @ �. ,._._ 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties .... ,...,.::" �rnpioye��]e�t�'i � �?�'r��. _ _` �m -" � .�. ;. ��`s�taaj(��anit►�e�s .�;fie .w Communicable disease;reporting,restrictions&exclusions °° 5. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open woundsr►etat f=ood Sfetyr3egireKnents „" ` Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used f'c �tetitit OttittiiDil } d _-_e mM 27, Food protected from contamination during storage Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use ;r Handwashin facilities supplied and accessible 9. Toxic substancesproperly 9 identified,stored,and used Tune and T4t1lFtf Rela#etr+srR... a cr Ftao+ ioag> 3aylrvlc ti _ _ _ _ _._.... __..u.. 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 10. Proper cookie time and tem P 9 temperatures p ;;.. : _ -" �€quipmen#1 Utet3srts 1 Ctrtetts... X11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean �Pti�tCtAflYi171at1ft�1f1�ra18t1 tial 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equip ment/utensiis approved;installed;clean;good repair e, 13. Food tree from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitized/warewashing procedures 7. Vending machines maintained taodrorrt 1tprosl5saurce 36. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 16. Comptiance with shell stock regulations;tagsldisplay 40. Proper use and storage of wiping cloths actldi - 17. Compliance with Gulf oyster regulations P;hystCaf es Ot1tt#of-Mgt 4CO;ljtiWi Appt Sred p ts( rduves" m 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed . Ortt>► i w 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin proofing �v�-z ightspittfmfFa e �...,..A , f 0. Prohibited foods not offered at high risk facilities °"` erraaarnlciF�t%es Kr..r.^ 5. Floors,walls and ceiling are maintained and kept clean 3NY M _ 6. No living or sleeping quarters inside facility w 1.Hot and cold potable water available. y: _ : tfrotg _ ted t 3 ma7. Signs posted;last inspection report available0 '=a � r° __....._...._.,..._.._...m_r.. I/Pl, :.a 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals ins facility 0. Impoundment 51. Permit Suspension Received ByfTitle: EH Specialist: Phone: (1 15,3-.17 t1� Page t of ,Z EHD 16-23 (1st pg) 419112 f FOOD PROGRAM,OIR