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SAN JOAQUIN COUNTY <br /> z ENVIRONMENTAL HEALTH DEPARTMENT <br /> .a <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> • c. ;o • Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.segov.org/ehd <br /> O <br /> 4 ici <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: A/ Date: Fr. 3 1 -'0 <br /> Address: nCity: 5 [K n Zip Code: 7,r 20 <br /> 2- <br /> Owner/Operator: �C Telephone: G/5 2- C,�U <br /> Program Element: 43 Program Record: -100 Inspection Type: -/ <br /> 0 1A I <br /> IS B180 Posted Yes i� No Permit Posted, es No Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed N1A=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 /> Ma'or violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facilit <br /> *[ 3. <br /> monstration of knowledge;food safety certificate 4. Person In Charge is present and performs duties <br /> mmunicable disease;reporting,restrictions&exclusions 5. Personal cleanliness and hair restraints <br /> discharge from eyes,nose,or mouth;no open woundsii, oper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used <br /> 7. Food protected from contamination during storage <br /> 5. Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used <br /> oragelDis '. <br /> . Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 2. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> 34. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 35. Equipment/utensils 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 /> 38. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations <br /> 1. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed <br /> 3. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food 4. Premises;personal/cleaning items;vermin-proofing <br /> �( 0. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean <br /> 6. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. <br /> 7. Signs posted;last inspection report available <br /> 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> 9. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> EEHSpecialist <br /> By/Title <br /> Phone: Jr-r 3/�d P Page 1 of <br /> EHD 16-23 (1st pg) 12115/09 7 FOOD PROGRAM OR <br />