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SAN JOAQUIN CO( 'Y ?a ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 C4 �P Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sielov.orq/ehd ., �i Fj w* FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: C L �� Date: r �� Address: 3J-, -3 LLT,r��Y�Z City: 77 }'1 Zip Code: Owner/Operator: e/7 �� G/G�� /1�`� `,tel �L Telephone: U c. 1 Program Element: Program Record: X I Inspection Type 2ti -- B180 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 immediatel . Non-corn liance may warrant closure of the food facility u rxo ruA ; ernorasratiOn of Knowledge 1wu our oos _ upervfso» i? 1. Demonstration of knowledge;food safety certificate ``� ? 24. Person In Charge is present and performs duties Erri d 1ealti.arif l iene it3n Y9 - .:� �;:. - •. ' ' `� .��.�rt�' s Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints s No discharge from eyes,nose,or mouth;no open wounds ?\ G tfot Safety l3egtirera7ents '':, Proper eating,tasting,drinking,or tobacco use 01 26. Approved thawing methods used 7 Foo protected d pro from contamination during storage w� � �" v ��. •, � w,,,y�g -,;r•_x.• 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 pik" pro 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 _:;,£qutpmeta �Jtetils' 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean tOrYfL+DittB . 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 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained 38. A ` x _ � roved and sufficient ventilation and lighting M,W11 PP 9 15. Food obtained from approved source 39. Thermometers providedf 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 yah ; Co�ifc�rrnanEe 1Nith,Apprc� PJure __ 1. Plumbing maintained;proper back flow prevention B. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed r s � 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing _ Hlgf�lfy�.auscep#ble_ apilati+aits` 3 Permafacdttfe�clean a;0. Prohibited foods not offered at high risk facilities ' 5. Floors,walls and ceiling are maintained and� fffaterlrlot z ` 6. No livingor sleeping quarters inside facility vti �AElCR i 1.Hot and cold potable water available. _ x• 't5 ►a Y ;H ,,rF 7. Signs posted;last inspection report available tea'; 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements = Vernutt 9. Facility operating with a valid health permit .y -, � ".."" ,. .,- x4; 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: 11ti EH Specialist: Phone: C Page 1 of j EHD 16-23 (is[pg) 4/9/12 �� ' FOOD PROGRAM OIR