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oP4" SAN JOAQUIN COUNTY Z-� ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: 1<- t41.77W /.-/9dK Date: Address: 22-'4(5, `! ro S�` City: 71 ," Zip Code: Owner/Operator: Telephone: Ur f01&1_r55/+ ,J9, Program Element: 14.12 Program Record: (Z.a1j Z'7 51yS Inspection Type: SB180 Posted Yes No Permit Posted Yes ANo 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 pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facility Demonstration of KnovAedgen J OUT cos Supervision OUT 'A 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness 2. Communicable disease;reporting,restrictions&exclusions 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 Preventing Contamination byMwds 27. Food protected from contamination during storage K 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible X29. Toxic substances properly identified,stored,and used Time and Temperature RW$WnsWp Food Storage/Display/Service X 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled X 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided x 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Equipment/Utensils/Linens 11. Proper reheating procedures for hot holding :' 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available jC 112. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair K )C 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 K FI�ORf FiOved 5 ;:.' 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 Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consume[At; 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;persona[/cleaning items;vermin-proofing - NOW S'4Sc0Pd'W1P*X140oM. Permanent Foos)Facilities _( O. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean Water f Hot Water 46. No living or sleeping quarters inside facility 21.Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin 49, Facility operating with a valid health permit Y\� 23. No rodents,insects,birds or animals ins' acility 50. Impoundment 51. Permit Suspension Received By/Title: (/ EH Specialist: Ph n : !� + p�� 7� Page 1 of EHD 16-23 (1st pg) 11/06/08 7 ) FOOD PROGRAM OIR