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SAN JOAQUIN COU, f z ENVIRONMENTAL HEALTH DEPARTMENT to: .�w .. X 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Qc;FORa ;P Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.s6gov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: ,� nc1 a i_ Date: / Address: J 7D� a C-4, � /L ,V� City: Zip Code: [ o Owner/Operator: j_ /2►rj!A_U Telephone: Program Element: &.2- P ogram ecord: ;Z Inspection Type: tGG SB180 Posted es) No Permit Posted es) No Re-Inspection on or After:. �r 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 public health and must be corrected immediate/ Non-com /fiance may warrant closure of the food facility I w's Demonstration of Knowledge MAA 01J7 ccs Supervision <uc ill. Demonstration of knowledge:food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness 2. Communicable disease: reporting, restrictions&exclusions - 25. Personal cleanliness and hair restraints 3. No discharge from eyes,nose,or mouth:no open wounds ( General Food Safety Requirements 4. Proper eating,tasting,drinking,or tobacco use I 26. Approved thawing methods used Preventing Contamination by Hands 27. Food protected from contamination during storage V1 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use 6. Handwashing facilities supplied and accessible ✓ 29. Toxic substances properly identified,stored,and used Time and Temperature Relationship Food Storage/Display/Service i7. 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 Equipment/Utensils/Linens 11. Proper reheating procedures for hot holding I 33. Nonfood contact surfaces clean Protection From Contamination 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 proceduresI L 37. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible lu/1 1 116. Compliance with shell stock regulations:tags/display 40. Proper use and storage of wiping cloths I y17. Compliance with Gulf oyster regulations `! Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained:proper back flow prevention 8. Compliance with HACCP plan or variance conditions 6U8P 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained t 119. Advisory provided for raw or undercooked food ( -4. Premises:personal/cleaning items;vermin-proofing Highly Susceptible Populations Permanent Food Facilities 0. Prohibited foods not offered at high risk facilities 45. Floors.vv�Ms and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 21.Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available 22. Sewage.'wastewater properly disposed.toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit :23. No rodents.insects.birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: -- -- -........---- . - -- - - EH Specialist: /_ Phone: y Page 1 of 31 EHD 16-23 (1st pg) 4/9/12 ►/V(/J FOOD PROGRAM 0111R