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SAN JOAQUIN COUP' yENVIRONMENTAL HEALTH DEI-ARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209} 464-0138 Web:www.sigoy.orp/ehd %FOR FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: Address: W, ' l City: Zip Code. Owner/Operator: Telephone: A Program Element: Progr m cord: r Inspection Type: IS8180 Posted Xes No Permit Posted es 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. Pma'or violations ose a threat to ublic health and must be corrected immediatel . Nrnon-cofiance ma warrant closure of the food facilit Demonstration of Knowled e ' - our eosg Supervision OUT. Demonstration of knowledge,food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints N3. o discharge from eyes,nose,or mouth;no open wounds 1 General�aod Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used x 7. Food protected from contamination during storage Ni P 9 9 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 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 Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures g £qqi t 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean a r 34. Warewashing facilities maintained;test strips available .._. My 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair m 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 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 �.,._. Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 41 Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing -Highly Susceptible Populations Perm � crl 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean s Water/Hot Water, , 6. No living or sleeping quarters inside facility P . � � #fp*ce arr i �forcemex 1.Hot and cold potable water available. '�� e, Liquid Waste Dispose) 7. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vn_ 49. Facility operating with a valid health permit 3. No rodents,insects,b Ids okaninA191-ifiside facility 50. Impoundment 51. Permit Suspension Received By/Titi EH Specialist: Phone: Page 1 of EHD 16•23(1stpg)4/W12 FOOD PROGRANI OIR