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,oPao; .C, SAN JOAOUIN COU ' ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd �iFORa FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: V0 U vy Date: Address: 1 r 0 L City: ( Z y, Zip Code: Owner/Operator: 7 C- f-i^ m� ' ��f �`-7 C- Telephone: Program Element: Program Record: J O Inspection Type: �I SB180 Posted Yes No Permit Posted es 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 ublic health and must be corrected immediatel . Non-compliance may warrant closure of the food facility wa run polnorls 2iii Knovv?fe�„ cau ears Supervision r3uT 1. Demonstration of knowledge;food safety certificate e g y 24. Person In Charge is present and performs duties •a .i' Perrsonat Cieanlrness Communicable disease;reporting,restrictions&exclusions " 25. Personal cleanliness and hair restraints `3. No discharge from eyes,nose,or mouth;no open wounds ' GeneraloodSafety Requirements 4. Proper eating,tasting,drinking,or tobacco use „ ' " 26. Approved thawing methods used # eYe11t CrBDi#i+ i211d5 27. Food protected from contamination during storage � e LEE 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used to 731RL 1rrlTor a#utetatiors}illp Fo; nt:x �spla i'�ex 7. 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 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures s, EgLrlprltt?111tItet181STr1h 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean �', _ti _ �,r Irotec�rrsn �rtr CDiltatt�iars�rOri � m•,,,. 34 Warewashing facilities maintained;test strips available 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/warewash ing procedures 37. Vending machines maintained Ctsj?pTtiy 38. Approved and sufficient ventilation and lighting ,.r. .. ,r.. h 5. 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 P 3; cnfr�nceth Approved Proresrrres`,,; 41 Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed ... r r OftSitrll@ll 1 d 5t} r _ me Q11'11,p, 4 supplied, 3 Toilet facilities clean, and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing ;argtlsbte Po}xcrtir�ns x? Permanent Food Fa�crlrtres 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean 46. No living or sleeping quarters inside facility ..�..:. �. ,fin.,. . , =i' .;'21.Hot and cold potable water available. t13p1iariCeTrd• t3fTCrrtrllr , Uq770 utd 1laste°Disposal 47. Signs posted;last inspection report available Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements � lermr �- 49. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: f �^^ ^ - Phone: C (� Page 1 of Z EHD 16-23 (Is'pg) 4/9/12 FOOD PROGRAM OIR