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o�4tf"' SAN JOAQUIN COUNT'" cNVIRONMENTAL HEALTH DEPArt'TMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �q...... .. :P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd LlFORt� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: � ' _ Date: _ r' Address: �� 111 Z City: Zip Code: s�y It Owner/Operator. ( ` Telephone: how'7 Program Element: Pr gram Record: 7 Inspection Type: 1 B180 Posted ees No Permit Posted, s 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 pose a threat to public health and must be corrected immediately. Non-corn fiance ma warrant closure of the food facility +'` � � n.of Kow1e .. F t sur cos Upervi 1 t, 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Jc >+.` aed H iera�a � rlilir�es . � y9 . .. �.._. .. . . _.. _ _ ..- y .ems. .. � �. . ,. . �. .. "<: . w..... +. _ Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints �= No discharge from eyes,nose,or mouth;no open wounds e ,. Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used 7. Food protected from contamination during storage Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used x mx a- r Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled i Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperaturesq'ai„ 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 +,ti 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 �,_ _ �x3 �'� , _��°�,� ;, 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 9. 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 e' rs anCelNittl.AP 1. Plumbing maintained;proper back flow prevention d... _ .. . 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Mw . 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing WIs �. Derma cthbes,.. P in A 0. Prohibited foods not offered at high risk facilities 45, Floors,walls and ceiling are maintained and kept clean Wafterftrlf 6. No living or sleeping quarters inside facility ' 1.Hot and cold potable water available. �. ,: ra - ter. 7. Signs posted;last inspection report available " 2. Sewage/wastewater properly disposed;toilet facility useable 48, Compliance with plan review requirements .. K W - Verrtmt w gy=p r 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received ByrTitle: EH Specialist: 1 Phone: r Page 1 of EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OR