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t SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209)468-3420 Fax:(209) 464-0138 Web:www.sjgov.orolehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: t1t- DA 1,-- Date: S Address: LN City: Zip Code: Owner/Operator: _0 A e" Telephone: Program Element: Program Fecord. Inspection Type: y,l SB18O Posted O Yes No Permit Posted O Yes D No Re-Inspection on or After: IN=In Compliance N10=Not Observed NIA=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 eublic health and must be corrected immediate) . Mon-compliance mav warrant closure of the food lacllit o n Demonstratio of Knowledge S pervasion 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties 'Erfmployee'�Hep th�and .ygiene P.ersgnal Cleanliness =No disease;reporting,resUtctions 8 exclusions 5. Personal cleanliness and hair restraints cm eyes,nose,or mouth;no open woundsasting,drinking,or tobacco use 6. Approved thawing methods used27. Food protected from contaminaflon during storage d properly washed;proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used Time.and Temperature Relations ip Footl StoragelDisplaylService 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 Proper cooling methods 32. Food property labeled and honestly presented 10. Proper cooking time and temperatures 'Equipmentl.Utensils hLi ens 1. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Rrotectio �Fco - )Contamination 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. EquipmenUutenslls approved;Installed;clean;good repair Tjoall Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 4. Food contact surface cleaned and sanitizedtwarewashing procedures 37. Vending machines maintained FoodFramApproved:Sou ce 38. 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;tagstdisplay 40. Proper use and storage of wiping cloths I'fji Compliance with Gulf oyster regulations Physical Facilfties Confor an W'fh:Approved,ProcedUres 41. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities dean,supplied,and maintained 9.Advisory provided for raw or undercooked food 44. Premises;personallcleaning items;vermin-proofing KH,i61JITSKs8E n -ties eraFoFc JEN20. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept dean NNLWFtj-r-/Hot_ ater 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Cq p lance and; nfbrcement Liquid•..as-Disposa_I 7. Signs posted;last inspection report available 2. Sewagetwastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received ByTtle: �- EH Specialist: Phone: In S ! Page 1 of EHD 1623(lst pg) 419112 l!� 1 FOOD PROGRAM OIR