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oPa"" o SAN JOAQUIN COUN' }
<br /> Q ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232
<br /> •.. Telephone:(209) 468.3420 Fax:(209)464-0138 Web:www.sigov.org/ehd
<br /> 'crledi+: .
<br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT
<br /> Name of Facility: 77 -4�Ave LT770 Date: a
<br /> Address: �
<br /> ! y�� City: Zip Code:
<br /> Owner/Operator: J2! r .i A. . �� Telephone: �/. f r 3c+ q
<br /> Program Element: 7r Program Record: 2 5 Inspection Type: "l `( -
<br /> 8180 Posted x es No Permit Posted Yes No Reinspection 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 pose a threat to public health and must be corrected immedlatel . Noncom liance mat warrant closure of the food facility
<br /> ;n;mo � yix;,�Demonstratron_ofiK_now_ledg� f :wv,ode= cos "-%°',.,-,``a „�, -gu`"peryis�r,,_,,,on�`Nr"_��„�„
<br /> 1. Demonstration of knowledge;food safety certificate _w. 24. Person In Charge is present and performs duties
<br /> �PersonaltCleanliness ,�,
<br /> .F= Communicable disease;reporting,restrictions&exclusions E 5. Personal cleanliness and hair restraints
<br /> No discharge from eyes,nose,or mouth;no open wountlsz`a,`C-' g -., ,;+-,g.. G_erMraliFo_odiSefety_Aegu_itemerits`�--�_ti,z,i,"y� -
<br /> Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used
<br /> ventingiGontaminatlorifiy�Hands!3 7. Food protected Irom contamination during storage
<br /> Al 15.V
<br /> nds clean and properly washed;proper glove use 8. Washing fruits and vegetables before use
<br /> ntlwashing facilities supplied and accessible . Toxic substances progeny Identilled,stored,and used
<br /> "' TemperatureRelelionship� �I 'F-r"' 'xF,- FotlStoiaoper hot antl cold holding temperatures 0. Food storage;food storage centainers labeledoper use of time as a public health control 1. Customer self-service food protected;Individual utensils provided
<br /> oper cooling methods 2. Food properly labeled antl honestly presented
<br /> oper cooking time and temperaturestirreper reheating procedures for hot holding . Nonfood contact surfaces clean
<br /> ON
<br /> mitt �91•.. i.. �s4ontammehon _xer`�''_?`�.�--�` -�, ---- 4. Warewashing facilities maintained;test strips available
<br /> ro-service of returned food . Equipment/utensils approved;installed;clean;good repair
<br /> od free from contamination antl adulteration 6. Equipment,utensils and linens:storage and useod contact surface cleaned and fu nitized/warewashing procedures 37. Vending machines maintained
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<br /> ,rve-•:+orv!.yyy
<br /> _ e38. Approved and sut icient 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 40. Proper use and storage of wiping cloths
<br /> 17. Compliance with Gulf oyster regulations
<br /> �V* N014IFaeiliae`s
<br /> sc' �.,�,_ Co�nfo_rm_ance Wdh?Approved P_rcdetlures 't- 4 1. Plumbing maintained;proper back flow prevention
<br /> 18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse property disposed
<br /> ..._iJ-.iv4'- -F'�' -r f- S
<br /> - Con"s_um_eraABvrso ,4` 52 3. Toilet facilities clean,supplied,and maintained
<br /> 19. Advisory provided for raw or undercooked food 4. Premises;personal/cleaning Items;vermin-proofing
<br /> �: � -�'-�..•,�-HlghlySuscepiible'fPopulattans �, _��-"��� '�``i-��*3�_ as_t'*'P`er'rnanent�oodFacihbes -00,r:
<br /> 0. Prohibited foods not offered at high risk fadlifle 45. Floors,walls and ceiling are maintained and kept clean
<br /> 6. No living or sleeping quarters inside facie
<br /> 9 P' 9 q dY
<br /> y.�_,. - a •` r } ..-=rtes==-
<br /> P 1.Hot and cold potable water available. rte. r '}' otii'"lieitce_endiEnfd_rcem_ent '� y
<br /> P
<br /> 7. Signs posted;last inspection report available--� ? SewageAvastewater propedy disposed;toilet facility useable 8. Compliance with plan review requirements
<br /> ;` r=; _.wVerrtiin _ $ ,^ _,. ', 9. Facility operating with a valid health permit
<br /> :TE 3. No rodents,insects,birds or animals inside facility 50. impoundment
<br /> 1. Permit Suspension
<br /> Received Byffitle: I
<br /> H Specialist: Phone: /1d -'�/LS ) Page 1 of
<br /> EHD 16-23 list pg) 49/12 / FOOD PMGRW,0111 `
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