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oa4"t... SAN JOAQUIN COUNTY { ENVIRONMENTAL HEALTH DEPARTMENT r 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ca ;P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sj oq_v.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: .,S p�h G r ¢ Date: Address: /Q / (11 S City: Zip Code: 9S3 z'(- Owner/Operator: I /�G i Z 'C4 R � ?'yl G en vA e4 Telephone: 3 2 _0 kiL& Program Element: 1L 2 y Program Record: y y Inspection Type: C SB180 Posted D es ❑ No Permit Posted p es FIN, Re-Inspection on or After: 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'or violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food Facilit -- _ IN N10 N/A Demonstration of Knowledge Supervision ouT, f 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Employee Health-h gienea so al•Clean iness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints 43. No discharge from eyes,nose,or mouth;no open wounds G neral-Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used ting Con o a 27. Food protected from contamination during storage 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use V101016. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used Time and Temperature Relatio �-' Food Storage! s• a /Servic Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 8. 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 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean 0 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food . 35. Equipment/utensils approved;installed;clean;good repair V00113. 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 o_od From Approved Sourc 38. Approved and sufficient ventilation and lighting VUE115. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths 7. Compliance with Gulf oyster regulations 1212L eja p 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed Consuur dvisory 3. To facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food . Premises;personal/cleaning items;vermin-proofing Highly Suscepfifbl-e Populations - Permane d-Facilities. 20. Prohibited foods not offered at high risk facilities IL 5. Floors,walls and ceiling are maintained and kept clean Water/Hater 6. No living or sleeping quarters inside facility �21.Hot and cold potable water available. a c - e Ligwd Waste Disposal 47. Signs posted;last inspection report available 22. Sewage/wastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements 9. Facility operating with a valid health permit 23. Nc rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: i EH Specialist: Phone: J-j =1of EHD 16-23(1st pg) 419/12 FOOD PROGRAM OR