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Q�rH SAN JOAQUIN COUN• CtUej <br /> roe- .... <br /> ENVIRONMENTAL HEALTH DEPARTMENTi �5 <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c :P Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> 'q G.jFpRi� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Q ` �n Q 1S l PL- fir- 1�Jol h t/ -�- Date: 3 <br /> Address: '� [� �-,�'L A-v e. City: 4mt +0,-,1 Zip Code: '5 20.7 <br /> Owner/Operator: 1' C 5 i n Telephone: 476 <br /> -1- h <br /> Program Element: (014 Program Record: F, (Z d I(o d Z Inspection Type: v-H YL-,L <br /> SB180 Posted 1-Yes No Permit Postedi Yes No Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed N/A=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Ma"or violations pose a threat to public health and must be corrected immediatel . Non-compliance may warrant closure of the food facilit <br /> it"I* NIA Demonstration of Knowledge x+a ouT cos Supervision out <br /> 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> 12. Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> 3. No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Preventing Contamination by Hands 27. Food protected from contamination during storage <br /> Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible V29. Toxic substances properly identified,stored,and used <br /> _Time and Temperature Relationship Food Storage/Display/Service" <br /> 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> 9. Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures Equipment!Utensils/Linens <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> Protection FromContamination- <br /> it <br /> ontaminatfon,a 34. Warewashing facilities maintained;test strips available <br /> t2. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair <br /> 1EFodree from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 1ontact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br /> Farad Fr6ni Approved Source 38. Approved and sufficient ventilation and lighting <br /> 15- Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained:proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> { 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities " <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water . 46. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. Compliance and Enforcement <br /> ,Liquid Waste Disposal 47. Signs posted;last inspection report available <br /> 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: �� <br /> EH Specialist: /y 1 _ (� 1 Phone: q ^ I . ) Page 1 of z <br /> EHD 16-23 (1 s1 pg) 0/12 t�vv\ C/1 t ! FOOD PROGRAM OIIR <br />