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�pe4 coa SAN JOAQUIN COUN' Tl ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: ` �t kf'f oy 1 iii-&o v t-e* Date: Address: 13v"C -V_ . -Vor City, S i-. Zip Code: 0'52_0 r �� Owner/Operator: nlt iiAt Telephone: Program Element: ` G) Program Record: (�'j 1 Inspection Type: SB180 Posted Yes o t Permit Posted ✓Yes 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-compliance may warrant closure of the food facility Fl-g"I.All Demonstration of Knowledge MAA OUT cos Supervision out. 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 v" 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 by Hands 27. Food protected from contamination during storage y 5. 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 ^ Time and Temperature Relationship Food Storage/Display/Service 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/Utensils/Linens 1. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipmentlutensils approved;installed;clean;good repair ," 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 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 _111 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 Consumer Advisory 43. Toilet facilities clean,supplied,and maintained ✓i9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing Highly Susceptible Populations Permanent Food Facilities V 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 1. Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available 22. Sewage/wastewater properly disposed:toilet facility useable 8. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit ' 23. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Phone: Page 1 of 2 EHD 16-23 (1st pg) 4/9/12' FOOD PROGRAM OR