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SAN JOAQUIN COUNT e ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siQov.orq/etld FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: P 1 �'- /' Date: Address: / / ` City: Zip Code: Owner/Operator: / Telephone, Program Element: Program Record: �j�3 Inspection Type: B180 Posted Yes No Permit Posted s 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. C_7(C" /6311' Ma-or violations pose a threat to ublic health and must be corrected immediate/r. Non-corn fiance may warrant closure of the food faci/f f_ t a+rnr o. 4rt Qf fC1r#raYred8 - v ... sur cosupervisx y _" �. . 1. Demonstration of knowledge;food safety certificate ti 24. Person In Charge is present and performs duties �..m... i. ygteAn �.. N.k .. ,_ v n a.K q r ,titi " >'i3k>:k'�1rJ sA �'". .tis aw max` Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds '-� Tf4 . .. Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used M If ER N 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 a INU KIM x 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 1 11. Proper reheating procedures for hot holding 33 Nonfood contact surfaces clean _ Hm am_, - 34. Warewashing facilities maintained;test strips available 1tStfl t.`Or(1 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 ST Vending machines maintained ask, _ •._.. �_ y�,q• „' 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 :.>� �`rrllAnL'e aflfittl __. *"its r..S z F.... .�.: •�,1,� �„ vw.:;: „, 1. Plumbing maintained;proper back flowpreventio 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed III � 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food -- 44. Premises;personal/cleaning items;vermin-proofing "WOR" derma �M "8G7�71a 0. Prohibited foods not offered at high risk facilitiesI 45. Floors,walls and ceiling are maintained and kept clean ;Pm tVater- T 6. No living or sleeping quarters inside facility 1 Hot and cold potable water available 17, - 7. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements a_.. .. Lilly�•..., Ye .. 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Pho Page 1 of END 16-23 (tsl pg 9112/ l FOOD PROGRAM OR