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oPQuf"' SAN JOAQUIN COUNT �.•Asa''PG Z-� ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 AClFpRia �a Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.si-ov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: �/ /�� ` Date: Address: /G G ` City: Zip Code: Owner/Operator: l �LC Telephone: - i G� Program Element: Program Record: Z Inspection Type: yt-F B180 Posted es No Permit Poste iYes 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 Cose a threat to public health and must be corrected immediately. Non-compJiance max warrant closure of the food facility tvb ZY!' ; _ ., flOi)_Of Kr+Owj$CfgQ` OkIT "7S NN-� a�ttllerVlS� ��W x r:. 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties "ern r+ a And} rQteRe a c a a �"f@iA[3 fne�w5 a tih,° vn, - Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds r-` eh+ n 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 29. 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 10. Proper cooking time and temperatures sgtt� ; 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean W CoiAq 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 roved and sufficient ventilation and li htin PP 9 9 15. Food obtained from approved source39. 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 _. 8 P Y 9 _.._ w- W - . x 1. Plumbing maintained;proper back flow prevention RAN Y, 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed "Milk _ 3 Toilet facilities clean,su lied,and maintained . -._z PP 19. Advisory provided for raw or undercooked food O" 4. Premises;personal/cleaning items;vermin-proofing ? '.,n. -.Perma +rlf -, NNI�0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean �- Vilafett_ -_v - �� 6. No living or sleeping quarters inside facility Rte. 1.Hot and cold potable water available. �• r �1!/ 61e1F3 '�"'! 7. Signs posted;last inspection report available - `:' 2. Sewage/wastewater 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 By/Title: 1J� EH Specialist: 1l� Phone: L 1 G Page 1 of EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OIR