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P4"'" SAN JOAQUIN COUN ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd LiPbR FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: / bL' ' {�/ `�(�,• �(;viGi J��- Date: - l / Address: 713y �r City: Zip Code: Owner/Operator: ea �i Telephone: ITM t Program Element: rogram Record: S Inspection Type: S131 80 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 ublic health and must be corrected immediate/ . Non-compliance may warrant closure of the food facility -L tIYtOl1St1'+a't[G1]4f KpO*Iedg LZUT s a. .: +tf iL3!i'' `•. : `� .t�U7! �a.. 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties ,3y.. O� r. eCSCitd� i�erR�tILS86 Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints 3. No discharge from eyes,nose,or mouth;no open wounds �� ` (general IF iiS�fe�+�3 uFelments " Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used ``'t irenfng Contatnlnaflon byAtS ` 7. 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 Oil Sipa Aspltr�ilre 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 Ctf€13�Br1I8R81531i7@@i810. Proper cookingtime and temperatures tl 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean \ ' \` 34 Warewashing facilities maintained;test strips available . a 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 ' 38. Approved and sufficient ventilation and lighting 1 .. PP 9 9 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 agg � � � arrrtaiN#( pprol Ptr 11a , „ 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed 3. Toilet facilities clean,supplied,and maintained 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing lit hl bus ble Pii uta#Ions \\ berm dcac,,u . _ �, . ..� 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean u O 46. No living or sleeping quarters inside facility ,. v� 21.Hot and cold potable water available. antl-Eawc a 47. Signs osted;last inspection report availableLier 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements fflo Trrih ° r _ 49. Facility operating with a valid health permit 23. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: V EH Specialist: i �L Phone: 14 _ff- Page 1 of EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OIR