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SAN JOAQUIN COUNT,; k°P4 c'Oa ENVIRONMENTAL HEALTH DEPARTMENT: Ur -6232 , J. 1868 East Hazelton Avenue, Stockton, CA 95205-8232 Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.sig(5v.org Iehd fi FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: -- , Ij Date, Address: City: t - Zip Code: 9 5 Owner/Operator: Telephone: 1 Program Element: ` Program Record: (�M9__ _ Inspection Typ YLQ_ 8180 Posted es No Permit Pasted Wes No Re-inspection on or After: [N=In Compliance N/O=Not Observed N/A=Not Applicable COS=Corrected on-site MA.[=Major Violation OUT=Not in Compliance See reverse side for code sections and genera[requirements that correspond to each violation listed below. I Major violations ose a threat to ublic health and must be corrected immediatel . on-compliance ma warrant closure of the food facility 1. Demonstration of knowledge;food safety certificate 124. Person In Charge is present and performs duties " Y9r m -_. stiliksm Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,.nose,or mouth;no open wounds Proper eating,tasting,drinking,or tobacco use rob. Approved thawing methods used �rF. 7. Food protected from contamination during storage 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 00, Wam PER _ 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 cooking time and temperaturesgi u. - 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food _ 35. Equipment/utensils approved;installed;clean;good rdpair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitizedlwarewashing procedures 37. Vending machines maintained 38 Approved and sufficient ventilation and lighting 15. Food obtained from approved source Y 9. Thermometers provided,accurate,and Basil visible 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of,wiping cloths 7. Compliance with Gulf oyster regulations :a : - epi. -W 41.<. 1. Plumbing maintained;proper back flow prevention jo 8. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed e 2, p 3. Toilet facilities clean,supplied,and maintained 19.Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing � .,� .^"r"` '=y-, a. x..;:c.,w" .:ef'.1118 �Cs1:l�d. ."• .a,^ra: p. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean «.. pja 1957'�W1 . _,- 6 No living or sleeping quarters inside facility 1.Hot and cold potable water available. e - 1 _ 7. Signs posted;last inspection report available 2. Sewagelwastewater"properly disposed;toilet facility useable 48. Compliance with plan review requirements Vertu T6 9. Facility operating with a valid health permit m- 3. No rodents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Igeceived By/Title 1�� EH Specia[i _ r_ Phone: •�^/� Page 1 of EHE 1G23 (is1 pg) 419112 Ci�'LN iJ i F001)PROGRAM OR .j