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V . SAN JOAQUIN COUN J m ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209)468-3420 Fax:(209) 464-0138 Web:www.s' ovv.or lehd 4LiFd�i+ FOOD PROGRAM OFFICIAL INSPECTION REPORT Date: ;5 Ille Name of Facility: City: Zip Code: J Address: �L 1 Owner/Operator: Telephone: Program Element: Program Record: f Inspection Type: (/jQ Bi 80 Posted ❑Yesmo Permit Paste 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 j See reverse side for code sections and general requirements that correspond to each violation listed below. Ma'or violations ose a threat to ublic health and must be corrected immediate! . Non-con liance may warrant closure of the food facility aim tt+tt `" Clt $tt1 o#_ t !►1� est fmIS t o 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Communicable disease;reporting,restrictions&exclusions 26. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds _--rietHl, O � a ;iq1(F@11tt1is 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 frrt� 1 int ata_refiao ' _.q Y� e... �.. ,. �tttfd Stc)t�i ispla `v�oe 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 ili nt 1 tri rliaens me �,' 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean 34. Warewashin facilities maintained;test strips available 9 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 38. Approved and sufficient ventilation and lighting M t� 15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tagsidisplay 40. Proper use and storage of wiping cloths KC17. Compliance with Gulf oyster regulationsNo [ crti >Ctisfr€ttaIl� lpprprd Prr w1. Plumbingmaintained;properbackflow prevention �• 1 µ Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed lt M 43. Toilet facilities clean,supplied,and maintained csrasxtrAdtrtsocy ;� ° 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing -. gjsly Susrtile Poputatrri ot�efataentoocFacrt�f;es 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean ® :° IAikfa€iititi d6. No living or sleeping quarters inside facility °° 1.Hot and cold ot" • a p able water available- m E- �� > 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 ...,ti 3. No rodents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Received By/Titl X EH specialist: I� VJ�Ia^wr^�•�(xV i Phone: Pagel of EHD 1&23 list pg} 4/9112 r+' i. ;a F000 PROGRAM OIR