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CLU 114 • SAN JOAQUIN COUNO ?� ENVIRONMENTAL HEALTH DEPARTMENT ;. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 a Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.$' __ lehd FOOD PROGRAM OFFICIAL INSPECTION REPORT ` Date: �7�! Name of Facility: ddress: r / - City: zip Code: aZ 11 mo n ! Telephone: owner/Operator: 41-73-.2 �� Program Element: (0/2 Program Record: f !J Inspection Type: _ 6180 Posted 5 ❑ Kermit Posted Yes ❑f Re-Inspection on or After: IN=In Compliance NIO=Not Observed NIA=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT Notompliance See reverse side for code sections and general requirements that correspond to each violation listed below. Ma'or violations ose a threat to ublic health and must be corrected immediate! . Nan-corn fiancema warrant closurfood facilitno rua Demonstration of Knowledge � COS Supervision Demonstration of knowledge;food safety certificate 4. Person In Charge is present and perfors Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26, Approved thawing methods used Preventing Contamination by Hands 27. Food protected from contamination during storage Wands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use e Handwashing facilities supplied and accessible 9. Toxic substances property identified,stored,and used lk Time and Temperature Relationship Food Storage/Display/Service Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled Proper use of time as a public health control 1. Customer self-service food protected;individual utensils provided Proper cooling methods 2. Food properly labeled and honestly presented 0. Proper cooking time and temperatures Equipment!Utensils!Linens 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean Protection From Contamination _ Warewashing facilities maintained;test strips available No re-service of returned food 5. Equipmentlutensils approved;installed;dean:good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanilized/warewashing procedures 7. Vending machines maintained Food From Approved Source _ 8. Approved and sufficient ventilation and lighting t. Food obtained from approved source 39. Thermometers provided.accurate,and easily visible . Compliance with shell stock regulations;tagsidisplay 0. Proper use and storage of wiping cloths Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention 8. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory3. Toilet facilities clean,supplied.and maintained Advisory provided for raw or undercooked food _ 4. Premises;personalldeaning items;vermin-proofing Highly Susceptible Populations Permanent Food Facilities 0. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept dean Water)Hot Water 46. No living or sleeping quarters inside facility 1.Mot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 7. Signs posted;last inspection report available 2. Sewagehvastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements i 9. Facility operating with a valid health permit Vermin 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Re ivedy H ialist: - Phone: Page 1 of FOOD PROGRAM OREH416.23 list pg) 4l41t2