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SAN JOAQUIN COUNT' y cNVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 •. �a Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd 4Ci FORi� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: ' V Date: Address: U. Ma ( SCJ City:s C*1fin Zip Code: C41�-720 Owner/Operator: Lo CC,rr) Telephone: Program Eleme - l 25 Program Record: Inspection Type: IS8180 Posted Yes No Permit Posted Yes k,,No/ Re-Inspection on or After: I w PeT 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. Ma or violations pose a threat to ublic health and must be corrected immediatel . Non-corn liance may warrant closure of the food facility Nro � � Demonstration of Knowledge .7- oue cos .;: . b _ Supervision out 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness j2. Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints 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 L'�?fllSfitl Hands 7. Food protected from contamination Burin storage . y =- P 9 9 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 Will ..._. _ ., Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 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 temperatures Equipment f Utensils f linens Ill. 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 M13. 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/approved 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 Cordonmance With Approvedprocedures 41. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Adlris"'r. g ;' 3. Toilet facilities clean,supplied,and maintained �§ a-� 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing Highly,Susceptibie Populations Permanent Food Facilities 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot after, 6. No living or sleeping quarters inside facility 12 1.Hot and cold potable water available. � CE�A rErit ,Liquid Waste 47. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin �� e� .,, 9. Facility operating with a valid health permit _123. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Tiile: EH Specialist: Phone: QfP c Pagel of EHD 16-23 (1st pg) 4412, 1 FOOD PROGRAM OR