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SAN JQAQUIN COUNT F 4 �.• • � `z ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-8232 • . u �� Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.si-gov.org/ehd '9 ci F iiaa FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: /� Date: Address: ZO, /�C City: Zip Code: E OwneriOperatar: /" Telephone: Program Element: Program Record: Q Inspection Type: B180 Posted !-hers- No Permit Posted fifes No Re-Inspection on or After: !R IN=In Compliance NIO=Not Observed NIA=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance i See reverse side for code sections and general requirements that correspond to each violation listed below. i Major violations gose a threat to eublic health and must be corrected immediate! Non-corn liance may warrant closure of the food facilityf ..mem far ' . t OIt f iI 1df ;fes± tis s im KIPS ii nr�8 1. Demonstration of knowledge;food safety certificate 24 Person In Charge is present and performs duties M sffi®_ :1 . Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints gNo discharge from eyes,nose,or mouth;no open wounds .' Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used 7. Food protected from contaminaffon during storage f 1 Hands cleanandproperly washed;proper glove use 28, washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled Proper use of time as a public health control 31. Customer sell-service food protected;individual utensils provided } Proper cooling methods 32. Food properly labeled and honestly presented I 10. Proper cooking time and temperatures E. 1. Proper reheating procedures for hot holding 3- Nonfood contact surfaces clean 34, warewashing facilities maintained;test strips available , 12. No re-service of returned food v 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 ;gam ` ._ 8. Approved and sufficient ventilation and lighting 1 15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible 6. Compliance witft shop stock regulations;tags/display 0. Proper use and storage of wiping cloths �-..., 17. N. Compliance with Gulf oyster regulationss- atiV .1Plumbing maintained: proper back flow prevention i e. Compliance with HACCP plan or variance conditions 2- Garbage and refuse property disposed 3. Toilet facilities clean,supplied,and maintained 13. Advisory provided for raw or undercooked food M 4. Premises;personal/cleaning items;vermin-proofing _ 'ller . _ rna , I Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean M 6. No living or sleeping quarters inside facility - 1.Hot and cold potable water available. R,a_ � . '_� e_...,.__ e ,.__�• _:.m� . .. 7. Signs posted;last inspection report available w, 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements V m 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 0. Impoundment 51. Permit Suspension Received Bylritle: Eli Specialist: Phon rrG Page t of FOOD PROGRAM OR i EHD*23 (1sl pg} 41911 2