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�o FSG SAN JOAQUIN COUN ?� ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 :p Telephone: (209) 468-3420 Fax.(209) 464-0138 Web:www.s' ov.or lehd 4tj�o}Ri+ FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: / Date: S l Address: 1 City: Zip Code. Q 5 Telephone: 10 0 Owner/Operator: Program Element: `lq PrograRecord; , >,l s Inspection Type: m B1 SO Posted 0 Yes d No Permit Posted 0 Yes [] No Re-Inspection on or After: IN=In Compliance NIO=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 ose a threat to public health and must be corrected immediate! . Mon-compliance may warrant closure of the food facile ty aim 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties ° m ° Communicable disease;reporting,restrictions&exclusionsV-1 25. Personal cleanliness and hair restraints INt ho. No discharge from eyes,nose,or mouth;no open wounds �° _ ;" �tf, pf1j111 tt't1f ° Proper eating,tasting,drinking,or tobacco use 26, Approved thawing methods used Pa_ � fC3r1f: LS '" 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 it a Tptret #iohafp .. - # " gelllpfa vl fie 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 temperatures41i1�# n : ]L 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean 4. Warewashin facilities maintained;test strips available �> ..;-; �>°> ..�oteCbrxit1�t%PrtS�us�i:m.m� 9 P 12. No re-service of returned foodm S. Equi pmentlutensils approved;installed;clean;good repair s°"G 13. Food free from contamination and adulteration 38. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitizedlwarewashing procedures 37. Vending machines maintained t►0ot�ro1d_ of `` 8. Approved and sufficient ventilation and lighting 15. Food obtained from.{ approved source 9. 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 -- .,,,.,...r._" Y ------t�� 3flCjl [as _' e.. lydttt ftiV#t [kree i 1. Plumbing maintained;proper back flow prevention w . _... 1 a. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed W..-....._..__ ". gfEr e" = 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food °�°`�1 ' 4. Premises;personal/cleaning items;vermin-proofing � k « 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Wr; lAr " 6 No or sleeping quarters inside facility 00 Hot and cold potable water available. altrpratltttllrl3rr11erttV. u$s$ g3fgi m ' . 7. Signs posted;last inspection report available 2. Sewagelwastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements ::tealf' mm, ° 9. Facility operating with a valid health permit'I =__... MOW 3. No rodents,insects,birds or animals inside facility 50. Impoundment IFE IN 1. Permit Suspension Received BylFftle: ( } EH Specialist: - Phone: Page 1 of �CJ�T I FHD 16-23 (1 st pg) 419112 FOOD PROGRAM OIR �j