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SAN JOAQUIN COUN j ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 c4��o Nip• Telephone:(209)468-3420 Fax:(209) 464-0138 Web:www.s9ciov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: 5Q3 Date: Address: 11 City: M Zip Code: of 5 3 Owner/Operator: 11(�(v C - Telephone: 'V Z-�n�r' M!/� Program Element: ` ` Pr4ram Record: j 1,09 1 Inspection Type: B180 Posted ❑Yes ❑ No Permit Posted L 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. Major violations pose a threat to public health and must be corrected immedlatel . Non-cam liance ma warrant closure of the fond facility "_ _ _ [)edtbtl # 4ntited ..:._.... ._ `'"°' 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties �;. Communicable disease;reporting,restrictions&exclusions _ 5. Personal cleanliness and hair restraints �( No discharge from eyes,nose,or mouth;no open wounds _ rratety. teclrtinent K.. Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used tij7 ttldCtl E#�IFEtI � 7. Food protected from contamination during storage K 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 � meraf � e�trtsa11h1 x, ; + JE ?�u Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled Proper use of lime 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 11. Proper reheating procedures for hot holding 3. ^Nonfood contact surfaces clean t oi9 €3 �tWvinid t _ = 4. 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 3T Vending machines maintained _. Approved and sufficient ventilation and lighting 15. Food obtained from approved source "'i 9. 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 - dp) s a^ynftua WrM,;A7et[ reedyi! ra 1. Plumbing maintained;proper back flow prevention € 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed nsamifA[ 43. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44, Premises;personal/cleaning items;vermin-proofing . ..�....,. -.............._. . ..... . ...... _ .. .._.... . -.m. . ... ., .... ..rte ��.' 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean --- _ °. ......._......... .... _,._:..,.._... .. 6. Na living or sleeping quarters inside facility Not 'IA 1.Hot and cold potable water available. X I 3 r �n M Was_7 , � 7. Signs posted;last inspection report available x m.-.-mm 2. sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements 9. Facility operating with a valid health permit 2t&_,., 3. No rodents,insects,birds or animals inside facility 50. Impoundment 1, Permit Suspension Received By/Title: EH Specialist: _ Phone: 3730 Page 1 of 2 EHD 1&23 (1 s1 pgk 4/9/12 FOOD PROGRAM OIR