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SAN JOAQUIN COUNTY <br /> }: ENVIRUNMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> • • •� Telephone:(209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: a, Date: <br /> Address: ,City: Zip Code: p <br /> Owner/Operator: Telephone: Yg 3 <br /> Program Element: Program Record: Se Y — Inspection Type: <br /> SB180 Posted ❑Yes ❑ No Permit Posted ❑Yes ❑ No Reinspection on or After: <br /> The items marked and/or listed below are violations detailed in the California 1 lealth&Satety Code(CFISC),commencing§113700. "Major"is a critical violation that <br /> poses an imminent risk to public health. Unless otherwise specified,violations marked"Major"must be corrected immediately or warrant immediate closure of the food <br /> establishment. "Minor"indicates a violation that does not pose an imminent public health risk,but warrants timely correction as noted. <br /> Critical Risk Factors Major Minor The marked violations represent Health&Safety Code Violations and must be corrected as follows: <br /> Improper holding temperature of potentially 1 2 31 <br /> a hazardous food 0 <br /> 0 Inadequate cooking temperatures/practices 3 4 � � © O / C <br /> F- <br /> c Improper reheating temperatures/practices 5 6of <br /> d e <br /> 0 <br /> u.. <br /> Improper cooling practices 7 8 Y rf--04 <br /> Adulturated/Contaminated food 9 10 <br /> c <br /> Reused/retumed food 11 12 <br /> v <br /> o Cross contamination or improper handling <br /> 0 13 14 , Lf! lj(J�it� —/r <br /> 0 °� of Food/Utensils/Equipment / <br /> o Unapproved food source 15 16 <br /> 0 <br /> w Improper thawing of potentially hazardous <br /> f 17 18 <br /> food <br /> ,!l III employee/cuts/rashes 19 20 <br /> auco <br /> N F <br /> Lack of proper hand washing procedure 21 224-0 <br /> m <br /> n` Required sink(s)/dish washing machine <br /> 23 24 <br /> o = removed,inoperable,inaccessible <br /> r <br /> _ Unsanitary Food Facility Conditions- 25 26 <br /> Critical/Non-Critical Area <br /> 00 Hot water not available 27 28 <br /> G <br /> lu <br /> Lack of potable water supply 29 30 <br /> 3 <br /> N Improper sanitizer concentration/methods/ 31 32 <br /> test <br /> ingequipment Ak _z ws17�'C— <br /> Sewage system failure/back up 33 34 !S ah /��O/ /tit/t1(I•` e <br /> � c <br /> 00 <br /> ad E No operable/accessible toilets 35 36 L <br /> 3 /L <br /> > Rodent/Cockroach/Other vermin infestation 37 1 38 Mae <br /> _p3 — <br /> ENVIRONMEN"IAL HEALTH AND SERVICE CHARGE FEES ARE AUTHORIZE') I3Y' RESOLUTION OF S N JOAQUIN COUNTY BOARD OF SUPERVISORS. ALL <br /> DOCUMENTED CRITICAL HEALTH VIOLATIONS OR REPEAT VIOLATIONS ARE SUBJECT TO A REINSPECTION AND REINSPECTION FEE. ALL UNPAID CHARGES <br /> ASSOCIATED WITH THE FAC'ILI'TY OWNER OF RECORD OR APPLICANT SHALL BE PAID PRIOR TO THE ISSUANCE OF A PERMIT TO OPERATE. <br /> ITEM/LOCATION TEMP ITEM/LOCATION TENIP ITEWLOCATION TEMP <br /> 1' )�/JGis C <br /> O'F <br /> Food Safety Certification'Required: ❑ YesoNo Time in: - 'e) a p irrie ut <br /> Certificate Issued By: Date:_/_/ Received By: <br /> Name on Certificate: Inspected By: <br /> EHD 16-023 <br /> 3117/2004 See Reverse Side For Additional Information Page Iof__ <br />