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SAN JOAQUIN COUNT <br /> _. X ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sipov.orp/ehd <br /> 4Ci�p'�ia <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: n a;� � Date: <br /> Address: --1.Z,Z W - +n !, City: �O Zip Code: G S �Z <br /> Owner/Operator: (� l C<1 < C�.\\ Ste` Telephone: L` <br /> 2Z`-1 - X32 <br /> Program Element: i t 'L�j Program Record: 1Uu 0 1 '� Inspection Type: <br /> S6180 Posted Yes No Permit Posted Yes No 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 2ose a threat to ublic health and must be corrected immediate) . Non-compliance ma warrant closure of the food facility <br /> t+I N VA demonstration of Knowledge tam+ ou cos Supervision OUT <br /> 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Pxevet tinCo�t9r irf� L , 7. Food protected from contamination during storage <br /> Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> Time and l einpelature Relationship at : <br /> b . > <br /> Proper hot and cold 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 /> Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures Equipment}Utensils/Linens <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> � <br /> _. f <br /> returned food <br /> 0Y1t ` 34. Warewashing facilities maintained;test strips available <br /> 12. No re-service of �� „ - <br /> 35. EquipmenVutensils 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 /> Food i=# av SXwfCrE`a _ 38. Approved and sufficient ventilation and lighting <br /> r115. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations Physical,Facilities <br /> Conformance With Approved Procedures 1. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> HighlySusceptibfe Populations Permanent Food Facilities ° <br /> D. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water 46. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. _� Compliance and,Enforcement <br /> Liquid Waste f)ispsal 47. Signs posted;last inspection report available <br /> 2 Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: <br /> EH Specialist; Phone: `! n Page 1 of <br /> END 1&23 (1st pg) 4/9/12 FOOD PROGRAM OR <br />