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SAN JOAQUIN COUNT _. X cNVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 •. T ;a Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siclov.orq/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date:--) Address: S City: Zip Code: Owner/Operator: CUA 1 L �QY (, 1 Q S Telephone: 021 Program Element: 2 -,z� ogram Record: ` `0 I Inspection Type: �1 B180 Posted Yes `ru Permit Posted Yes , 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 12ose a threat to Eublic health and must be corrected immediately. Non-com fiance max warrant closure of the food facility ryog nitons ratwn,of Knowledge ' our cos v!sibn ' Super 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties and. rgiatt� ....� t� ti ' ttilpess Communicable disease;reporting,restrictions&exclusions 25. PersonaI cleanliness and hair restraints 3. No discharge from eyes,nose,or mouth;no open wounds �,' - i - xtaocSafiety ;+� _ e» x Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used ^ � �° :DJtt11f ag 7. Food rotected from contamination during storage ._,. ,,.a 9. p 9 9 Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use m Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used 74 IF 7. 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 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures - x,,Equ�pm_ RMII e flirts �� 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean ., . 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. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. 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 regulationsSCalB _ stance YYtth Apia• _ x_w 1. Plumbing maintained;proper back flow prevention - ' x Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed • �- 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing mow,_ s,rgu s .e;s ti ? ': eifl78 ]L�i1� $ts1�11,: 7 - -... .,., Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean - 1Nate - 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. 7. Signs posted;last inspection report available �,. �xMAN, -K 0. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements -m... .- � Vermin z 9. Facility operating with a valid health permit &IJ3. No rodents,insects,birds or als inside facility 50. Impoundment 51. Permit Suspension Received By/Title; EH Specialist: Phone: ,\� _ Page 1 of Z EHD 16-23 (1st pg) 4/9/,f2 ✓-V FOOD PROGRAM OIR