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oPg"f"'•� SAN JOAQUIN COUNT ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ;P Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd 4L/Fa.ti� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: _ •en&e G A 14�:;roGli I Date: c� Address: 4,2G C a1` Or- `C IClty: r C��-� Zip Code: 2o(o Owner/Operator: t p cxylt-p / q:27 c� Telephone: 7AC6- Program Element: 1"t � 11 Prolgram Record: _ Inspection Type: (� �l B180 Posted Yes No + Permit Posted Yes N 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 immediatel . Non-compliance ma warrant closure of the food facili f ij ..wM� -. on oKnowledge 1uk� our ..... �. .,,. 9 cos Supervision: `oa,r- 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties a �.. p ealth ar�d Hygiene Personal Cleanliness >_ . Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints / . No discharge from eyes,nose,or mouth;no open wounds Get ) ssodSafety�R itements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used RtttN1R! s 7. Food protected from contamination during storage Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use Vis° 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 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Eq%% � = 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean = 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/warewashi rig procedures 37. Vending machines maintained . '5438. 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 l 17. Compliance with Gulf oyster regulations � apoelNl sires ., 1. Plumbing maintained;proper back flow prevention y< 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed �r�� • �, _ `�_ " '� •;, ��„� 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 4. Premises;personal/cleaning items;vermin-proofing 'a" Al 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean ` �Rli '°� � Nater � _�: 6. No living or sleeping quarters inside facility ON ,y 1.Hot and cold potable water available. 7. Signs posted;last inspection report available .mx 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements yErlillt�_ ,•„,, 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: i G EH Specialist: Phone: /L� Page 1 of `1I EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OIR