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�o�a .soG SAN JOAQUIN COUNTY 2� ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd �lFOR FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility:-�� (ThZ� c Date: 2_ Address: C City: Zip Code: cA S 2--4 C Owner/Operator: Telephone: Program Element: 1 Program Record: 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 ublic health and must be corrected immediate! . Non-corn liance may warrant closure of the food facili -]VA `: � ile"monsriation of Knowte8ge � :� our COS Supervision �i ,00T 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Employee tieaith and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints X 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 Contami 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 =`1 Tie era atst�7etnpture Relationship traT Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 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 qniP tensils/Line res 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean m.. _ t<ynlf Q �- 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/warewashing procedures 37. Vending machines maintained a � r _tis Food from ApprflvedSource . 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations 1?f eysical Facit3es 777i3i`iriance With Appra� WureS�,• x 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisa y _ pp 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing 7 Highfy atisceptiPopulations pe ufations Permanent Food Facilities ": , j 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean ' Water/Hat Water 46 No living or sleeping quarters inside facility 1.Hot and cold potable water available. CtEttttplia»ce ante " liquid Waste Disposal 47. Signs posted;last inspection report available 2. Sewage/wastewater 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 51. Permit Suspension Received By/Title: EH Specialist: Phone: � 7� -2 Page 1 of 2 EHD 16-23 (1 sl pg) 4/9/12 \7 J FOOD PROGRAM 0!R