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ot4�lry..c SAN JOAQUIN COUNT <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> . :P Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: r Date: <br /> Address: /(��-� City: Zip Code: <br /> Owner/Operator: Y Telephone: <br /> Program Element: Program Record: 75-19 Inspection Type: <br /> 6180 Poste es No Permit Posted es 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 /> Major violations pose a threat to ublic health and must be corrected immediate! . Non-corn Bance ma warrant closure of the food facility <br /> quoion of fSno er ff pervfs , <br /> ids <br /> 1. Demonstration of knowledge;food safety certificate, aa � 24. Person In Charge is present and performs duties <br /> ..- <br /> � . Communicable disease;reporting,restrictions 8 exclusions �� 25. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> 111" e � 7. Food protected from contamination during stora e <br /> Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 29, Toxic substances properly identified,stored,and used <br /> 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 /> Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean -122 <br /> 34. Warewashing facilities maintained;test strips av ilable <br /> 12. No re-service of returned food 35. Equipmentlutensils approved;installed;clean;good repair <br /> Al Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br /> � <br /> s�. 38. Approved and sufficient ventilation and lighting <br /> -M _ <br /> >'15. Food obtained from approved source ,; 39. Thermometers provided,accurate,and easily visible <br /> i6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations <br /> � �.Y ttlCe'ilyi)!It " 1. Plumbing maintained;proper back flow preventio <br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> g,� � � <br /> 3. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Q, <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> ft <br /> Water __ 6. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. @ _ <br /> 7. Signs posted;last inspection report available <br /> 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> `ry MW <br /> Vertu - 9. Facility operating with a valid health permit <br /> 4 r 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: 1 i <br /> EH Special' t: ,4 Pho d9 r, Page 1 of <br /> EHD 16-23 (1st pg) !12 \ L / FOOD PROGRAM OIR <br />