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SAN JOAQUIN COUNTY <br /> P Z <br /> a: ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.Sigov.Org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: <br /> 1.Z� Date: � <br /> Address: O N City: LG Zip Code: <br /> Owner/Operator. J� <br /> VIr:Am k Telephone: 7 2-7_ ll 19 <br /> Program Element: Program Record: Inspection Type: <br /> S6180 Posted Yes Permit Posted Yes ONO Re-Inspection on or After: <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 pose a threat to public health and must be corrected immediate) . Aron-compliance ni warrant closure of the food facility <br /> r from.. <br /> 1. Demonstration of knowledge;food safety certificate 4. Person In Charge is present and performs duties <br /> an in <br /> Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> 3. No discharge from eyes,nose,or mouth;no open wounds <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> 7. Food protected from contamination during storage <br /> 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use 7 <br /> Handwashing facilities supplied and accessible 9. Toxic substances property identified,stored,and used <br /> T1s <br /> Proper hot and mid 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 /> 9. Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> 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 /> 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br /> M Fo-dWr5m Approved Source "-° ' 38. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source l _ <br /> 39. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;lags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations P <br /> vert P 41. Plumbing maintained;proper backflow prevention <br /> E'Xiiii. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> n:Advisory.l.,, 3. Toilet facilities clean,supplied,and maintained <br /> il 19.Advisory provided for raw or undercooked food 44. Premises;personalldeaning items;vermin-proofing <br /> c ;Highly Sus. t61e Populations II <br /> 0. Prohibited foods not offered at high risk facilities 5. 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 availablo. a+ o p ra - - o <br /> Liquid Waste Disposal'-* 7. Signs posted;last inspection report available <br /> . Sewagelwastewater properly disposed,toilet facility useable 8. Compliance with plan review requirements <br /> r- Vermin 9. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility _ 0. Impoundment <br /> 1. Permit Suspension <br /> Received By/Title. <br /> EH Specialist: �` Ai/'L Phone: � Page 1 of Z <br /> !'C F000 PROGRAM OR <br /> EHO 16.23(1st pg) 4012 <br />