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P41'" SAN JOAQUIN COUNTY �o.�.Q�G a ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 .. `P.. Telephone:(209) 468-3420 Fax: (209)464-0138 Web;www.sigov.org/ehd a�iFORta FOOD PROGRAM OFFICIALINSPECTIONINSPECTION REPORT Name of Facility: ZZ U ,t ) -1 i/0 - -S �S 25 Date: 3 ZS-J ddress. 710 O t.1 '�h S� City: rQA � Zip Code: G/ 7 Owner/Operator:•C r W Telephone: c6 �/J-54 00 1. I Z L Program Element: 162Program Record: q Inspection Type: 4;n SB180 Posted es ❑ No Permit Posted 111,Ws ❑No Re-Inspection on or After: IN=In Compliance N/O=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 pose a threat to public health and must be corrected immediatel . Non-compliance may warrant closure of the food facility IN o NIA De o st tion of Knowledge Mff 'cos -_' Supervisions` out 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties ! ployee Health and Hygiene "NEWPersonal Cleanliness `j 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 Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used Preventing Contamination.by Hands 7. 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 9. Toxic substances properly identified,stored,and used at'o i nod Sto!age/Display Proper hot and cold holding temperatures 0. 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 Proper cooling methods 2. 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 0 4. Warewashing facilities maintained;test strips available 17,.7 of returned food 35. Equipment/utensils approved;installed;clean;good repair 1contamination and adulteration 6. Equipment,utensils and linens:storage and use 1urface cleaned and sanitized/warewashing procedures 37. Vending machines maintained Food From Approyed�Source - - 38. Approved and sufficient ventilation and lighting - 1d 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 7. Compliance with Gulf oyster regulations Physical Facilities. Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention O8. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed - 3. Toilet facilities clean,supplied,and maintained Consumer Adv_sory PP 19. Advisory provided for raw or undercooked food . Premises;persona[/cleaning items;vermin-proofing HighlySusceptible Population, ermanent Food Facilities 20. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 6. No living or sleeping quarters inside facility 21.Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal J- 7. Signs posted;last inspection report available 22. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements 9. Facility operating with a valid health permit WPM 23. 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) 4/9/12 FOOD PROGRAM OR