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SAN JOAQUIN COUK � •.OG ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s*gov.org/ehd LIFOR� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: rvt-L+ T ,r i c- ic_�ei Date: Address: -;�-Z�!1 '�r`4 Hick L K" ngzY„ 1� City: � � Zip Code: Owner/Operator: Telephone: Program Element: 2 Program Record: -,7-2 L40 Inspection Type: SB180 Posted <ESDNo Permit Posted a No Re-Inspection on or After: P 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 faci/it l#+ ere j K.fi' Demonstration of Knowledge a ou: Supervisionm 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. reporting.restrictions&exclusions 25. Personal cleanliness and hair restraints 3. No discharge from eyes,nose,or mouth:no open wounds General Food Safety Requirements 4 Paper eating tasting,drinking.or tobacco_ise _ 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 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified.stored,and used Time and Temperature Relationship Food Storage/D i sp[a y/Sery ice i 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 . Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Equipment/Utensils/Linens j11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available 1 112. 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 Food From Approved Source 38. Approved and sufficient ventilation and lighting 115. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 6. Compliance with shell stock regulations;tags/display i 40. Proper use and storage of v✓iping cloths f7. Compliance with Gulf oyster regulations i Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention /I F'. Compilance with HACCP plan or varian;e conditions j 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained Advisory provided for raw or undercooked fool 44. Premises:personal/cleaning items:vermin-proofing Highly Susceptible Populations Permanent Food Facilities V,"20_ Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 11.Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted:last inspection report available 22. Sev:age wastewater properly disposed:toile;facility sr '_1e 48. Compliance with plan review requirements m v; Vermin 49. Facility operating with a valid health permit 23. No rodents.insects,birds or animals insider facility 50. Impoundment 51. Permit Suspension F d By/Title: On ...... nn ialist P one: CIS 3, / 2 ' Page 1 of C� EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OIR