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�QPaulh^iA SAN JOAQUIN COUNT <br /> Q' ENVIRONMENTAL HEALTH DEPARTMENT <br /> N .< <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> `�clkati�F Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sioov.oro/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ,b,017 eP 55 '0/7 5 �-�r.5 2 Date: -' <br /> ddress: D • - 1 f,.�rn Off? t City: zip Code: 3 <br /> Owner/Operator: rr7 m Q, r Telepho <br /> CS/ a S a -32/- zu <br /> Program Element: .3 Program Record: 0 A 0 ✓F Inspection Type: '�- <br /> 8780 Posted O Yes 0 No Permit Pasted O Yes O No 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 violations pose a threat to public health and must be corrected Immediately. Non-compliance may warrant closure of the food facility <br /> w Coo w. Demonstration of Knowledge uru our Cos Supervision cur <br /> 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> L Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Preventing Contamination by Hands 27. Food protected from contamination during storage <br /> Hands dean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> LIK Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> Time and Temperature Relationship ___ Food Storage/Display/Service <br /> Proper hot and cold holding temperatures 30. Food storage;food storage Containers labeled <br /> Proper use of time as a public health Control 31. Customer self-service food protected;individual utensils provided <br /> Proper Cooling methods 32. Food properly labeled and honestly presented <br /> . Proper Cooking time and temperatures Equipment I Utensils I Linens <br /> it. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> Protection From Contamination 34. Warewashing facilities maintained;test strips available <br /> . No re-service of returned food 35. Equipmentfutensils approved;installed;clean;good repair <br /> 13. Foal free from contamination and adulteration 6. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized1warewashing procedures 37. Vending machines maintained <br /> Food From Approved Source 38. Approved and sufficient ventilation and lighting <br /> 5. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> . Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations __ Physical Facilities <br /> Conformance With Approved Procetfures 41. Plumbing maintained;proper back flow prevention <br /> I <br /> 8. Compliance with HACCP plan or variance Conditions 42. Garbage and refuse property disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> . Advisory provided for raw or underaroked food 44. Premises;personal/cleaning items;vernin-proofing <br /> __ _ Highly Susceptible Populations Permanent Food Facilities <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and calling are maintained and kept clean <br /> Water/Hot Water 46. No living or sleeping quarters inside facility <br /> .Hol and Cold potable water available. Compliance and Enforcement <br /> _ Liquid Waste Disposal 7. Signs posted;last inspection report available <br /> 2. SewageAvastewater property disposed;toilet facility useable 48. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> PI. Permit Suspension <br /> Received ByfTitle: Q r4 Q <br /> EH Specialist: n Phone: _-2 Page 1 of Z <br /> EHD 16-23(15t pg) 419112 FOOD PROGRAM OIR <br />