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aR4H'" SAN JOAQUIN COUNO r.• ENVIRONMENTAL HEALTH DEPARTMENT N 600 East Main Street, Stockton, CA 95202-3029 Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: � � Date: 7 Ld1t ddress: -/] /_ / City: Zip Code: Owner/Operator. V Telephone: Y ' Program Element: V 7,3 Program eco Inspection Type: J SB180 Posted D Yes R No Permit Postetl Yes D 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 mav warrant closure of the food facillt iu coo sw Demonstration of Knowledge _ sw air cos Supervision - OUT Demonstration of knowledge;footlsafety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions 8 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 Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances property identified,stored,and used _ Time and Temperature Relationship _ Food Storage/Display/Service Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 18. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided 9. Proper cooling methods 32. Food property labeled and honesty presented 10. Proper cooking time and temperatures Equipment/Utensils/_Linens_ 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces dean Protection From Contamination 34. Warewashing facilities maintained;test strips available 2. No re-service of returned food 35. Equipment utensils approved;installed;dean;good repair 13. Food free from contamination and adulteration ,36. Equipment,utensils and linens:storage and use 4. Food contact sudace cleaned and sanitzed/warewashing procedures 37. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting T _ 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 7. Compliance with Gulf oyster regulations - Physical Facilities Conformance With Approved P 41. Plumbing maintained;proper bade flow prevention - 4,L8- with HACCP plan or variance conditions 42. Garbage and refuse property disposed Consumer Advisory 43. Toilet facilities dean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personatdeaning Items;vermin-proofing Highly Susceptible Populations - .Permanent Food Facilities - DAI0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal F7. Signs posted;last Inspection report available 71 1 2. Sewagetwastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit _ 3. No rodents,insects,birds or animals Inside facility 50. Impoundment Ar 51. Permit Suspension Received By/Title: EH Specialist: __ Phone: 1_ ,G fL('- Page 1 of EHD 1&23(1st pg) 12/15109 l!i C JJ FOOD PROGRAM OIR