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0 0 SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd LlFd R� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: . Address: City: Zip Code: Owner/Operator: bu elephone: r Program Element' Program Record: inspection Type: SB180 Posted es ❑ Permit Posted es 0 No Re-Inspection on or After: IN=In Compliance N/O=Not Observed NIA=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 immediate! . Non-compliance mU warrant closure of the food facilit { �N Nro .n _ :Demonstration of Knowledge IYi' 1. *Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties ployee:HealttH,`ygie - a ^ean ne 2. Communicable disease;reporting,restrictions&exclusions 5. Personal cleanliness and hair restraints 3. No discharge from eyes,nose,or mouth;no open wounds o Sae Re 1 e eUT 4. Proper eating,lasting,drinking,or tobacco use 26. Approved thawing methods used pev g•Go r a io b a 7. Food protected from contamination during storage 5. Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use `.- 6. Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used Rind Te a e elation_shipv o- 1s a e Proper hot and cold holding temperatures ^ 30. Food storage;food storage containers labeled 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures 00000 qiipment/Utensils/°Li en 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination;1 34. Warewashing facilities maintained;test strips available A ervice of returned food 5. Equipmentfutensils approved;installed;clean;good repair ee from contamination and adulteration 6. Equipment,utensils and linens:storage and use ntact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained d o ApprovedSour ee 38. Approved and sufficient ventilation and lighting btained from approved source 9. Thermometers provided,accurate,and easily visible ance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths ance with Gulf oyster regulations s -a acr ih o. o. a e :With'App -edproc ua 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed ^onsumer Advi-0 43. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing .. ghly Susceptible Poprions�: e '�� Permanent Food Facilities 20. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean titer/Hot Water `_ * 6. No living or sleeping quarters inside facility 21.Hot Nand cold potable water available. %reportavai[able ment^ u'd-Waste Disposal': 7. Signs posted;last inspecti 22. Sewage/wastewater properly disposed;toilet facility useable 8. Compliance with plan revieating with a va yj . 23. No rodents,Insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: /1/ /; l/1 EH Specialist: (V V Phone Page 1 of rd EHD 16-23(1st pg) 419112 FOOD PROGRAM OIR