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SAN JOAQUIN COUNT <br /> Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> L7FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ( +�l`L fi-L Q 1�t T U � Date: ;�/S 0 <br /> Address: ��X2 � t� r.VIelvalit (_�_ City: 5-'rbc"�Tnq Zip Coder<-76'1 - <br /> Owner/Operator: Ma\_W <br /> p er _J N C" Telephone:"�4-_ I v <br /> F-� , <br /> Program Element-.__, Program Record: 1-i- Inspection Type: W <br /> B180 Posted L <br /> es No Permit Posted Yes No Re-Inspection on or After: <br /> IN=In Compliance N/O= Not Observed N/A=Not Applicable COS=Corrected on-site MAJ= Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Major violations pose a threat to eublic health and must be corrected immediatel . Non-corn /lance may warrant closure of the food facilit <br /> - ---------- <br /> : Demonstration of Knowledge OUT cos Supervision out <br /> �1. Demonstration of knowledge;food safety ce#ificate - 24-7 . Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> - Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints -� <br /> No discharge from eyes,nose,or mouth;no open wounds General Food Safety(Requirements <br /> ' Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Preventing Contamiin�by Hands 27. Food protected from contamination during storage <br /> �5. Hands clean and properly washed;proper glove use 28. washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> Time and Temperature Relationship Food StoragefDisplay/Service <br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 32. Food properly labeled and honestly presented <br /> /10. Proper cooking time and temperatures Egbtpmt sols <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> Protection From Contamination 34. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food _ 35. Equipment/utensils approved;installed;clean;good repair <br /> 3. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> j 114. Food contact surface cleaned and sanitized'warev:ashing procedures 37. Vending machines maintained <br /> Food From Approved Source 38. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> LH�16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention <br /> 8. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water 46. No living or sleeping quarters inside facility <br /> 21.Hot and cold potable water available. Compliance and Enforcement <br /> Liquid Waste Disposal 47. Signs posted;last inspection report available <br /> P�2. Sewage wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: <br /> EH Specialist: Phone: /;, Page 1 of 2 <br /> EHD 16-23 (1st pg) 419/lY--j �1 I FOOD PROGRAM OR <br />