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QUrN SAN JOAQUIN COON' y-� ENVIRONMENTAL HEALTH DEFHRTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ;a Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd A�iFOfta FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: 2 2 3 Address: o -o P, City: ' Zip Code: Owner/Operator: �`��" 'a Telephone: Program Element: Program Record: v Inspection Type , 11 __eJ V IS 8180 Posted Ye No Permit Posted es 140 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 2ose a threat to Eublic health and must be corrected immediately. Non-corn /lance may warrant closure of the food facility >�o rua flemoitstration.of Knowledge tmw our "cosSupervision ��` 1. Demonstration of knowledge;food safety certificate ��sy ��F� 24. Person In Charge is present and performs duties f=mployee Health and Hygiene_ ` _ =Persati t Ctear;liness r �° Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open woundse .tlsaodSa#ety ;� `n Proper eating,tasting,drinking,or tobacco use W 6. Approved thawing methods used qf 7. Food protected from contamination during storage WA Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use z Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used w gw SIX 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 P 9 -Equiptne# y lenSIs ,1'11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean !'>Ftaisi'CariPEetAt `�. 34. Warewashing facilities maintained;test strips available w � 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. �t# y , } . Approved and sufficient ventilation and lighting 38 15. Food obtained from approved source ; 39. Thermometers provided,accurate,and easily visible Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations ' ,s r buirl ante 1NiYb ► ,� � _ , � 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed ux ` . �tiTh'd A@t .; 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing oe ., p - Perma„ M _ -. - n,tri# aodiwacifittes �~ - 411 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean "`• ='gam� Yitater HbZ `ss . No living or sleeping quarters inside facility 6 1.Hot and cold potable water available. td YV�ste flux` 7. Signs posted;last inspection report available 0, a 2. sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements 9. 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: Phone: Page 1 of EHD 16-23 (1st pg) 419/12 FOOD PROGRAM OF