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SAN JOAOUIN COUI, r N: X ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ��•. a�P Telephone: (209) 468-3420 Fax: (209) 454-0138 Web:www.slgov.oro/ehd �l FOR FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: E 4' e") Date: / J 66 Address: City: Zip Code: !-7 LA_) ✓ m0•-7 .t 5 Owner/Operator: Telephone: Program Element: Program Record: PJ Inspection Type' G I1sZ_ SB180 Posted es No Permit Postedes No Re-Inspection on or After: t 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 jor violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facility _ Demonstration of Knowledge Supervision =. 1. Demonstration of knowledge:food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness 2. Communicable disease: repciling, restrictions&exclusions 25. Personal cleanliness and hair restraints 1� 3. No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements + 4. Proper eating,tasting.d-inking.or tobacco use 26. Approved thawing methods used Preventing Contamination by Hands 27. Food protected from contamination during storage ✓ 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use "1 6. Handwashing facilities supplie( 29. Toxic substances properly identified,stored,and used Time and Temperature Relationship Food Storage/Display/Service 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 I 0. Proper cooking time and temperatures Equipment IUtensils/Linens it 1. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean V Protection From Contamination 34. Warewashing facilities maintained;test strips available .12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair X13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use hhh 4. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting f/ 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible ✓I16. Compliance with shell stock regulations;tags/display _ 0. Proper use and storage of vdpin^cloths x1-7. Compliance with Gulf evsterreou,atiors _� _ Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention --18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained L-�l2. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing mm Highly Susceptible Populations Permanent Food Facilities ti 2H. Prohibited foods not offered at high risk facilities 1 '4 5. Floors,walls and ceiling are maintained and kept clean Water 1 Hot Water 46. No living or sleeping quarters inside facility 21. Hot and cold potable water availableCompliance and Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available 22. Sewage waste^ater p n-,er'\ disposed:toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit `23. No rodents.insects.birds_,i inside facility 50. Impoundment 1. Permit Suspension Received By/Title- EH Specialist: - / ✓J L Phone: N Page 1 of 2 =HD 16-23Itst pg) 4/9/2 G f 7 FOOD PROGRAM OIR