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aPa"'h•• SAN JOAQUIN COUN' ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 t Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd tIH6W FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: _ h :07-y' Date: Address: go q AJ re 17-f- ! City: Zip Code: �O3 Owner/Operator: e4 gra V �i�' Telephone: xO _t7 3 Program Element: Program cord: 3 Inspection Type: u K� 8180 Posted O Yes $(No Permit Posted es Wo Re-Inspection on or After: IN=In Compliance WO=Not Observed N/A=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 public health and must be corrected immediately. Non-compliance may warrant closure of the food facility rro mM Demonstration of Knowledge our cos Supervision our 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used Preventing Contamination by Hands 7. Food protected from contamination during storage Hands clean and property washed;proper glove use 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible Toxic substances properly identified,stored,and used Time and Temperature Relationship Food Storage/Display/Service Proper hot and cold holding temperatures Food storage;food storage containers labeled Proper use of time as a public health control 1. Customer sell-service food protected;individual utensils provided Proper cooling methods 2. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Equipment/Utensils/Linens . Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surtace cleaned and sanitized1warawashing procedures 7. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source _ 9. Thermometers provided,accurate,and easily visible . Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths . Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse property disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained . Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vernin-proofing _ Highly Susceptible Populations Permanent Food Facilities 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Compliance and Enforcement Uqu w-wam-ems-p-am-F 47. Signs posted;last inspection report available - E3. ge/wastewater property disposed;toilet facility useable . Compliance with plan review requirements vermin 9. Facility operating with a valid health permit dents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Received By/Title: EH Specialist: _ Phone: C3_ �y Page 1 of EHD 1623 list pg)41W12 0U / FOOD PROGRAM OR