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P4"'" SAN JOAQUIN COUNTY �o.�'f�.coo Z� ENVIRONMENTAL HEALTH DEPARTMENT N: r :< 1868 East Hazelton Avenue, Stockton, CA 95205-6232 .•cq .,-'.•;P Telephone:(209) 468-3420 Fax: (209)464-0138 Web:wwwJgov.org/ehd ��FORa FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: L , K I Date: 3 1/-/3 , ddress: C� I S O ndd City' f1 G M Zip Code: 712 3 I o rrn � Owner/Operator: Telephone: 2-G& 7 LAen;w OU ur 1e I dt Program Element: Program Record: V Inspection Type: SB180 Posted TrYes ❑ No Permit Posted es ❑ No Re-Inspection on or After: IN=In Compliance N/0=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. Mao violations pose a threat to public health and must be corrected immediatel . Non-compliance may warrant closure of the food facility iN wo NIA Demonstration of Knowledge MAS our cos �pervision ;; = x aur 1. Demonstration of knowledge;food safety certificates 1 1 24. Person In Charge is present and performs duties Employee ndHygiene PerSonCleanliness ealth a V 2. Communicable disease;reporting,restrictions&exclusions I 11L 1 1 25. Personal cleanliness and hair restraints 3. No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used _ IN memingLUM 27. Food protected from contamination during storage 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used im a.d a peaIowa Food Storage/Display/Servic 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 8. 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 temperaturesEquipment!Utensils I Linens 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contaminatioi 34. Warewashing facilities maintained;test strips available 12. No re service of returned food 35. Equipmentlutensils 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 Food From Appro Source _ 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 regulations Physical Facilities .- Conforma�rce With Approved.ProcedLre 41. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed ConsumerAdvisory' 43. Toilet facilities clean,supplied,and maintained 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing Highly Susceptible Populations - __ Permanent Food Faci itres 0. Prohibited 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 Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available 22. Sewage/wastewaterr properly disposed;toilet facility useable 48. Compliance with plan review requirements Ver i 9. Facility operating with a valid health permit 23. No rodents,insects,birds or animals inside facility 50. Impoundment 1.11 51. Permit Suspension Received By/Title: Ai Ar EH Specialist: Phone: /y,T// Page 1 of EHD 16-23(1st pg) 4/9/12 FOOD PROGRAM OR