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t�Qy� SAN JOAQUIN COUNT X ENVIRONMENTAL HEALTH DEPARTMENT . ...... 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:wA1w.siqov.orq/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: =il � 19 Date: Address: lam, CN' 72 -S -Al- 12 1, city: Zip Code: C�;A Q7 r Owner/Operator: Telephone: cl S-2 --729 2 Program Element: �\<1�'2_'-2, Program Record: � Inspection Type: B180 Posted Yes No Permit Posted Yes No Re-inspection on or After: IN=In Compliance N/0=Not Observed NIA= 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 2ose a threat toleublic health and must be corrected immediate/ . Non-com Bance ma X warrant closure of the food facility ruo vA IDernomtration of Knowledge 1 cos Supervision 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used Preventing Contamination y Han27. 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 oodStorage/D ct" Time and Tempeirature Retaitionshi F isiplay/siii�l P 7. 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 Equipment/'Utensils I Linens & 11. Proper reheating procedures for hot holding 33- Nonfood contact surfaces clean 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 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 114. Food contact surface cleaned and sainit ized/wa rewash ing procedures 37. Vending machines maintained Food l+rom proved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations Physical FaCtlities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention 4,18.Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed 1111k&wsumer Advisory 43. Toilet facilities clean,supplied,and maintained 0119. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing ly Susceptible Populations Permanent food Facilities Kko. 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 21.Hot and cold potable water available. Compliance and Enforcement Uquid Waste Disposal-_ 47. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin -pt'- 49. Facility operating with a valid health permit k3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: Ell-Specialist; Phone: Page I of EHD 16-23 (1st pg) 4/9112 FOOD PROGRAN,OIR