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<br /> A
<br /> SAN JOAQUIN COUNTY
<br /> ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 600 East Main Street, Stockton, CA 95202-3029
<br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd
<br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT
<br /> Name of Facility: f, 1
<br /> Date:
<br /> Address: City: Zip Code:
<br /> Owner/Operator: 9T lepho .3�!• pC^
<br /> Program Element: / Program Record: Rd
<br /> Insp tion Type:
<br /> 8180 Posted es-O No - Permit Posted es 0 No 70 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 /> Ma or vlolatlons pose a threat to public health and must be corrected immediate) . Non-corn Ilance may warrant closure of the food facility
<br /> DeinOnatratlon"o�(�owlailg@iit„ �,a &.t�,=k g ` " >y r,y
<br /> 1. Demonstration of knowledge;food safety certificate 4. Person In Charge is present and performs duties
<br /> ZNI .."rL. NI&I 0511M (oyes'Fiealthend;Fiyglena.:3rSti}avd;.�a;4a,yy.,°F% 'y'�'t`x 1,.4 :"ks„htik?�':." Petaor"ial;CloaNf e9a,n,,. rP= B=
<br /> Communicable disease;reporting,restrictions 8 exclusions Ywi 5. Personal cleanliness and hair restraints
<br /> No discharge from eyes,nose,or mouth;no open wounds (ianeral.Fogdelf
<br /> oty.62ogUlreTapte�,tT �•' ,
<br /> . Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used
<br /> -i4'-,' ' . i3P,,reveliU_hg Conteinlfi", onitiy�}i8ntls',"-%;L, ,`:"'�r' .;_ };�x(rix'"r." 7. Food protected from contamination during storage
<br /> Hands dean and property washed:proper glove use 28. Washing fruits and vegetables before use
<br /> y Hantlwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used
<br /> +`/.'.•. ':�: "�'>SiTimetndjTem"' mture ela_tlorrehl -�'£"'XFtc`,.A r•:�-�_ c'S ,.,, u - h � '
<br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled
<br /> Proper use of time as a public health control 1. Customer selFservice food protected:individual utensils
<br /> provided
<br /> Proper cooling methods 32,Food property labeled and honestly presented
<br /> 10. Proper cooking time and temperatures - �Y1 °"Q��� "',"s„'•�Equlprflenf%.Utetittll /1,.ineris, �i�„' `$ "l,`�,,(
<br /> 11. Proper reheating procedures for hot holding 33, Nonfood contact surfaces dean
<br /> te�tloq�From'Gotrtemin"afloJt� ; - k 1tli¢r, „5 Warewashing facilities maintained;test strips available
<br /> 12. No re-service of returned food 35. Equipmentlutensils approved;Installed;dean;good repair
<br /> N'
<br /> U- 1 3. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use
<br /> 14. Food contact surface deaned and sanitized/warewashing procedures 37. Vending machines maintained
<br /> •,r ' ,_ ,r$,-:•??5 ,,OO,d{,roi�i;App-,,et!%$oUrdeiF 8. Approved and sufficient ventilation and lighting
<br /> 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible
<br /> _ 6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping Goths
<br /> 7. Compliance with Gulf oyster regulations - C�" �, ;" 'Pfl Idal� _ t`' t•r'K_�' r'
<br /> ,k
<br /> x,} ,'3 `- ahYotinaneey.NYltt((A p. meed re 1. Plumbing maintained;proper back Sow prevention`
<br /> 8. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed
<br /> • E?iti . '�a ,y •y,r,-, i�du •BP' ` �Ia ,r,C,',� • :�" •` -•F 3. Toilet facilities dean,supplied,and maintained
<br /> 9. Advisory provided for raw or undercooked food .1°v 4. Premises; ersonaUdeanin Items:vermin-proofing
<br /> ,., N P �. P 9 P 9 - .
<br /> 6, P,ertga40,Food EacllltlesR' -" z�"
<br /> •,
<br /> 0. Prohibited foods not offered at high dsk facilities 45. Floors,walls and ceiling are maintained and kept dean.
<br /> *'��a .• `_ `w,^N,���¢",• .K.-f ,a. r .V119fa r/'�HotiWate��'P. _�y"•"'�" aa 6. No living or sleeping quarters inside facility
<br /> 1.Hot'af.,nd coltl potable water available.-� 'p, :=t rJ•y,+iu�,'i;�i,Go,�p118fice and Enforementr:. -l.r w• : ;
<br /> 3Ul9yld,' a's`oisposa v `., '`�, 1 b/? ,:!q>f, j, 7. Signs posted;last Inspection report available y
<br /> N 2. Sewagelwastewater properly di 48. Compliance with plan review requirements
<br /> rff
<br /> f y✓Jye f" { ,'w i �` !�a"'Verthln' „'f _� �fJ,y,4�'';f 71r^ i'�'r-' 9. Facility operating with a valid health permit
<br /> rt't4,( .�5 3. No rodents,insects,birds or animals Inside facility 50. Impoundment
<br /> 1. Permit Suspension
<br /> Received BylTitle: _ .
<br /> EH Specialist: Pho ,? ?� Page 1 of
<br /> EHD 16-23 (1st pp) 12/15109 - J FOOD PROGRAM OIR
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