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q�rh SAN JOAQUIN COUY r ?.r ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 •'��Cii cR�'��.� Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siaoy.orrg/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: Address: 1' City: Zip Code: Owner/Operator: r ^ Telephone: 7�3 Program Element: Program Record: Inspection Type: 8180 Poste Yes L1o PerPosted Yes ❑ o 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. A a'or violations ose a threat to public health and must be corrected immediatel . Nan-corn Bance'i ri oy warrant closure of the food facility itFratt air. ifs _ 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties iwrlbp��;Healttt�1�d.. i � .df3 Ri#S Communicable disease;reporting,restrictions&exclusio 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used . ft Contfipr fids ..s 7. Food protected from contamination during storage 0 .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 Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided Proper cooling methods 32. Food properly labeled and honestly presented e.ee 10. Proper cooking time and temperatures IN t r'' - 11. Proper reheating procedures for hot holding i'`N 3. Nonfood contact surfaces clean q. � rsiteti Sf1aGoialt' 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 sanitizedlwarewashing procedures 37. Vending machines maintained A;> FrIftt q 'red, d bfi ,;> y' 8. Approved and sufficient ventilation and lighting�....... "JA15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible 6. Compliance with shell stock regulations;tags/display 40, Proper use and storage of wiping cloths t7. Compliance with Gulf oyster regulations P, �,�_ t�ohfo�ttalltcffi� �v��idxir ee�� a 1. Ptumbing maintained;proper back how prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed m si1�i'i 14t!tPe 43. Toilet facilities clean,supplied,and maintained 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing lfliSu4b 3�tstulatit3ra> etartrat Frrclfacaiitte� y 0. Prohibited foods not offered at high risk facilities 46. Floors,walls and ceiling are maintained and kept clean W ` . 6. No living or sleeping quarters inside facility « 1.Hot and cold potable water available. ? tlitlilt pfd ri#drenfaf .....n d __ 7. Signs posted;last inspection report available age/wastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements Sew ..... .. _............. W W7 9. Facility operating with a valid health permit ..._mmn..m 3. No rodents,insects,birds or animals inside facility 50. Impoundment a� P 1. Permit Suspension Received Byrritie: EH Specialist: yyl,f p Phone: /1. Page 1 of EHD 16-23 (1st pg) 419/12 ► , V V (� [Y FOOD PROGRAM 01R