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SAN .JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 r ;P Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sugov.org/ehd 4C1. b.A�i FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: a A Ga Sd C Date: 7 Address: 2- S City: Zip Code: An �lG Owner/Operator: _Aef, 0 f i n Telephone: Program Element: •(P Program Record: Inspection Type: -� SB180 Posted ❑Yes ❑ No Permit Posted ❑Yes ❑No Re-Inspection on or After: IN=In Compliance WO=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. Major violations pose a threat to public health and must be corrected immediatel . Non-compliance maV warrant closure of the food facilif e o to o ow tie o Suglillgiblull 1. Demonstration of knowledge;food safety certiflcate 24. Person In Charge is present and performs duties o e e a o a C a lines 2. Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open woundsa +Foo S fete ewe a is Proper eating,testing,drinking,or tobacco use 26. Approved thawing methods used 01 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 property identified,stored,and used a e e u e a o s oo Sto •is a 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 q 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean '0 34. Warewashing facil@les maintained;test strips available 12. No re-service of returned food 35. Equipmenttutensils 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 sanlfaed/warewashing procedures 37. Vending machines maintained d o a a 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible 6. Compliance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths 7. Compliance with Gulf oyster regulations s cal a e p ov d P oce u e 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed d o 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing e P ul t e e O. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean 1E1gW=hotjWate 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. o s s os 7. Signs posted;last Inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements e 9. Facility operating with a valid health permit 3. No rodents,Insects,birds or animals Inside facility 50. Impoundment 1. Permit Suspension Received ByTtle. EH Specialist: Phon!, g - S p Page 1 of Z EHD 16-23 list pg) Oil ll... O FOOD PROGRAM OIR