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SAN JOAQUIN COUN* ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd �/FORM FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: ct� f a 2 0115 Date: (!? Address: • U,o W f City: Tt Zip Code: IS Owner/Operator: �-�4v�� Telephone: Program Element: ktM U Program Recorde �'7� iI Inspection Type: SB180 Posted Yes No 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 immediate/ . Non-compliance may warrant closure of the food facility �,_ '46 61 r. i vl mtr' 1. Demonstration of knowledge;food safety 24. Person In Charge is present and pe w, ° �`� � �� rforms duties : rni +ee 1e tt i i tt�s Personal Cleanliness . Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints 3. No discharge from eyes,nose,or mouth;no open woundsIn 0V Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used Pre p s t911 �#iaE3d 27. 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 Tim aria Tei�tu 'FratfA wRolationii- p `� : Food St irag ispfaylSet�rlce `a R8 ,, a 7. 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 a vyf�tttl3tid8 Utensils l inertia 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Crttnatii ft 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/warewash ing procedures 37. Vending machines maintained e .•MWload l=rQtn AppiYttred`SouCCe , 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations y a Poysicht♦es ��' a C 8ttity`W �Apj9F>aV,erl 3?!]CGedu]r4S . 41. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed a :. i ,rtEr YISOCi 43. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing �11",}l� hiy vusceoub Populations oOtl 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean aterJ![otYYater 46. No living or sleeping quarters inside facility _ � .. e� 9 P 9 q Y info F � n�r r 77 77 21.Hot and cold potable water available. � €f 47. Signs posted;last inspection report available 22. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements * ti 49.. v <; 49. Facility operating with a valid health permit rr23. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received Byrritle: 6 EH Specialist: Phone: Page 1 of V� EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM 01R