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oPg"',f" SAN .IOAQUIN C.OUN' <br /> �. � .o� <br /> .. .Z„ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.orq/ehd <br /> �%FORD <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: `i��-'��-t Date: 7 <br /> Address: �L�,/J City: Zip Code: <br /> Owner/Operator: V�r��/r n Telephone: <br /> Program Element: t LP( Program Record: Inspection Type: 14-6-2-C PC-,- <br /> 8180 Posted Yes o Permit Posted Yes No Re-Inspection on or After: <br /> 12 <br /> IN=In Compliance N/O=Not Observed N/A=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Major violations ose a threat to ub/ic health and must be corrected immediate)r. Non-compliance may warrant closure of the food facility <br /> no run ;'Demonstration of Knowledge Supervision <br /> 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Preventir►g Contamination by Hands 27. Food protected from contamination during storage <br /> Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> 71 , <br /> Time andP Food`Temperature Relationship "�` � Stot ' is "la ISgr <br /> e9� P Y vice <br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures Equipment,/Utensils/Linens <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> ProtectionFrom Contamination': 34. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 35. Equipmentlutensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> V 14. Food contact surface cleaned and sanitized/warewashirig procedures 37. Vending machines maintained <br /> = Food From Approved Source . 38. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water 6. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. "Compliance aniEnforcement <br /> Liquid Waste Disposal7. Signs posted;last inspection report available <br /> 2. Sewagelwastewaterproperty disposed;toilet facility useable 48. Compliance with plan review requirements <br /> i Vermin 9. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> F-1--1 1151. Permit Suspension <br /> Received By/Titl <br /> EH Specialist: ^� Phone: Page 1 of T 21 <br /> EHD 16-23 (1st pg) 4/942 FOOD PROGRAM OR <br />