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SAN JOAQUIN CO!" -Y ENVIRONMENTAL HEALTH DEPARTMENT 0: X 1868 East Hazelton Avenue, Stockton, CA 95205-6232 -3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd 4 Telephone: (209) 468 FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: /'D Z) "f Zk') � Date: _2_ Zj �' Address: City: Zip Code: 4 N- 15-7 Owner/Operator: �uiTelephone: Program Element: Program Record: 09 2-Ll' Inspection Type: SB180 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. t ajor violations pose a threat to eublic health and must be corrected immediately. Non-compliance may warrant closure of the food fact'lir Nit-K--1 VA Demonstration of Knowledge 'U4-i OUT cos Supervision OUT_' I ��'r 11 1 Demonstration of knowledge,food safety certificate i 24. Person In Charge is present and performs duties I ---I- I Employee Healtb and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 1 26. Approved thawing methods used Preventing Contamination by Hands 27. 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 Time and Temperature Relationship Food Storagef0iisplay/Service ME Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled IN6. 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 1-0. Proper cooking time and temperatures Equipment I Utensils/.Linens 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean -Protection From Contamination 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 114. Food contact surface cleaned and s anitized/wa rewash i ng procedures 37. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source j 39. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 7. Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention 8. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained 19 - Advisor', provided for raw or undercooked 44- d food Premises:personal/cleaning items:vermin-proofing Highly Susceptible Populations Permanent Food Facilil4es' -,0. Pruhil-wed foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 1. Hot and cold potable water available. I Compliance and Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available P2. Sewage/wastewater property disposed;toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 5o. impoundment f\ 151. Permit Suspension Received By/Title: /\ y/TitleNA EH Specialist- Phone: Page 1 of I q va EHD 16-23 (1st pg) 419/12 t/ FOOD PROGRAM OIR