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SAN JOAQUIN COUNTY ..� ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: \ Date: Address: 1 v \ 5 Clty. '��.� (a/l Zip Code: Owner/Operator: Telephone: Program Element: Program Record: SZ b Inspection Type: 6180 Posted Yes No Permit Posted Yes 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. Mi violations ose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facility pe t. Demonstration of knowledge:food safety certificate Y 24. Person In Charge is present and performs duties �,.. Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds _ Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used 7. Food protected from contamination during storage Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used jCV Proper hot and cold holding temperatures 130, Food storage,food storage containers labeled it er use of time as a public health control 1. Customer self-service food protected;individual utensils provided er cooling methods 2. Food properly labeled and honestly presented er cooking time and temperatures er reheating procedures for hot holding 33. Nonfood contact surfaces clean MRS! - 34. Warewashing facilities maintained;test strips available -service of returned food 35. Equipment/utensils approved;installed;clean;good repair free from contamination antl atlulteration 36. Equipment,utensils and linens:storage antl use contact surface cleaned and sanitized/wamwashing Procedures 37. Vending machines maintained 38. Approved and sufficient ventilation and lighting Food obtained from approved source 9. Thermometers provided,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 - ;.=�;;r 181tdl; t. Plumbing maintained;proper back Flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing u Pe _ 0. Prohibited foods not offered at high risk facilities - , , 5. Floors,walls and ceiling are maintained and kept clean 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. "`., ., 11 _ 11 011111i 7. Signs posted;last inspection report available . Sewagetwastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received Byffit( . r EH Specialist: Phone: _ Page 1 of EHD 16-23 (1sl pg) 4/9/12 FOOD PROGRAM OIR