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P°"t"• SAN JOAQUIN COUNTY <br /> Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> .. ;P• Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> A��FOR� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: � � k AA__NA�J1 i Date: '0����4 <br /> Address: Z City: ��y_-�m Zip Code: <br /> Owner/Operator: I GnM0 S Telephone:Ff�jg4(01-o:wf4 <br /> Program Element: I (0 VA Program Record: Inspection Type: - <br /> SB180 Posted 11 Yes ❑ No Permit Posted C 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 public health and must be corrected immediately. Non-compliance may warrant closure of the food facility <br /> N wo Nin Demonstration of Knowledge_ MAS OUT cos Supervision <br /> 1. Demonstration of knowledge;food safety certificate - 24. Person In Charge is present and performs duties <br /> mployee Health and-Hygiene Personal Cleanliness <br /> / 2. Communicable disease;reporting,restrictioE&exclusions 25. Personal cleanliness and hair restraints <br /> 3. No discharge from eyes,nose,or mouth;nonds General Food Safety Requirements <br /> Proper eating,tasting,drinking,or tobacco u 6. Approved thawing methods used <br /> Preventing Contamination b 7. Food protected from contamination during storage <br /> 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> X 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> r od Stora a/Dis�. ,. <br /> Time and�mperafure Relationship g play/Service <br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> 8. 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 - Equipment l Utensils/Linens A <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 /> 13. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br /> Food From Approved Soouurc'ff -- _ 38. Approved and sufficient ventilation and lighting <br /> nliiU115. Food obtained from approved source = 39. Thermometers provided,accurate,and easily visible <br /> /16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations ysical Facilities <br /> Conformance With Approved Procedures` 41. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> £ Consumer Ad�ory 43. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food 44. Premises;personallcleaning items;vermin-proofing <br /> Highly Suscep <br /> _ x-: <br /> rmanent Food Fa"i - <br /> ies <br /> 1 matible Populations •-...., , ,. P,._ + .�. *, <br /> 20. 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 /> mss.. <br /> F2. <br /> .Hot and cold potable water available. Compliance and Enforcement <br /> quid Waste Disposal 7. Signs posted;last inspection report available <br /> Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> e 9. Facility operating with a valid health permit <br /> W123. !N(o rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: ���, M(T(L <br /> EH Specialist: Phone: ri no --� /071 Page 1 of 2 <br /> EHD 16-23 (1st pg) 419 21; f�Ilf V FOOD PROGRAM OIR <br />