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oP. SAN .10AQUIN COUNT ........o y< cNVIRONMENTAL 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: 1'�t � Cif rk V1-,1 1 q-:(_-i rq Date: -_ L Address: 'ICAO 11L�� l^1� City: r �y U� Zip Code: L �C, Owner/Operator: CA l' t[p,�r4 .t 1l`` �� Telephone: j,j %t 516 Program Element: t C��,t Program Record: - f ?y l>�� Inspection Type: K(�;�-r j"tt l B180 Posted Yes o 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. Ma'or violations aose a threat to ublic health and must be corrected immediately. Non-corn fiance m2X �warrant closure of the food facili X11' iYD ?JlA ^r �iSxrltJOT#Of lSfiOwiletlg�` r lata fltY7 G65 „ ,c., upervl3 #k w 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties v Er�F � a�zi F�ygierte `� R PBrSAt :3e8frImES3� ° ,. � s Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints / No discharge from eyes,nose,or mouth;no open wounds €gOdety} 1Tettf Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used 1 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 c . 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 /'9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures F £gtliptll 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean T.J^ - rssrn 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipment/utensils 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 W �- 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 7. Compliance with Gulf oyster regulations "� _ WE` # rafi� . CT€oiance�Ntth x ,', 1. Plumbing maintained;proper back flow prevention 77 AP( 8. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed yr r ,'ti <� - ,� 3. Toilet facilities clean,supplied,and maintained /l9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing Perm8G11�t'1.,. a; 3. 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean x =,- . 6. No living or sleeping quarters inside facility ` 1.Hot and cold potable water available. 7. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements < Ve9. Facility operating with a valid health permit rmin 3. No rodents,insects,birds or animals inside facility 50. Impoundment 151. Permit Suspension Received By(ritle: Z � ! /ter• EH Specialist: Phone: Page 1 of .HD 16-23 11st pg) 4/9/2 ' V FOOD PROGRAM OIR