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SAN JOAQUIN COUN .Z� ENVIRONMENTAL HEALTH DEPARTMENT W .. X 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siQov.orq/ehd (/FOyal1 FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: \ / �, Z C� Date: ---"2., Address: '�r 5 \ City: Zip Code: g S C q G Owner/Operator: Telephone: Program Element: Program Record: rooc'\ I Inspection Type: )i Lo B180 Posted Yes No Permit Posted Yes No 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. Major violations pose a threat to Eublic health and must be corrected immediately. Non-compfiance may warrant closure of the food facility pef� R - 11 O 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties ZV0 : ,� ,.� y Ent _ :zc.'"� - f1yg18A1'4�: ,_ __... .. x ax, ._.^ -,.3,,£ a. £. --, e '•. .., eaitslines <'`afi { x Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints a from eyes,nose,or mouth;no open wounds 9 Y P S&et+: No discharge / ten Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used 27. 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 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. Pro er cookin time and tem eratures P 9 P m <>,.Equa 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean u. YJStt1 IrC34. Warewashing facilities maintained;test strips available �� v 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair 13. 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 x " � ; ,; 38. Approved and sufficient ventilation and lighting K 15. Food obtained from approved source '. 39. 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 ° Mr {titltapC°1Nith_,, _�_ L1fPvS 41. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed x M 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 4. Premises;personal/cleaning items;vermin-proofing IM a: Perma acri „"s� ., ri 0. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept cleannw, )C ;- x YYaterii ,•, _ % r 6. No living or sleeping quarters inside facility ", . 1.Hot and cold potable water available. ; lt:l tattiltlt .. NlasteaT „. @� x.. 7. Signs posted;last inspection report available"µ 3 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements k 49. Facility operating with a valid health permit 3. No rodents,insects ' s oEaui4pals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist:` C V1 Phone: Page 1 of.� Y �- EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OIR