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oe¢ Ih•.F SAN JOAQUIN COUNTY ? ENVIRONMENTAL HEALTH DEPARTMENT Y ` 1868 East Hazelton Avenue, Stockton, CA 95205-6232 .. ;4 Telephone: (209) 468-3420 Fax:(209)464-0138 Web:wvvw.sigov.org/ehd 4ti. 6.Ap FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: aUftv .( Date: I Address: I City: Zip Code: Owner/Operator: [T / Z0 Telephone: Program Element: Program Record: Inspection Type: Vic S81 80 Posted O Yes 0 No Permit Posted 0 Yes D No Re-Inspection on or After: IN=In Compliance NIO=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. Ma or violations aose a threat to public health and must be corrected immediately. Mon-compliance may warrant closure of the food facility 'iN: coos Nrn'I - D'emon`stration,.ofKgdwledge _ - riaa ,o ,chs; - _- - Sfrpenimsion 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties _ ',Empjoyee.'.Heaittiaand(Hygiene. "Pefsonal Cleanliness _ 1 Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds !General`Food Safety RequiFe7dents Proper eating,tasting,drinking,or tobacco use _ _) 26. Approved thawing methods used _ CQteve'nt'rngConta-`inatibh;6yHand§, 27. Food protected from contamination during storage Hands dean and property washed;proper glove use 28. Washing fruits and vegetables before use _ Handwashing facilities supplied and accessible 29. Toxic substances property Identified.stored,and used T[me and'aTempe`rature iRe`lat dns�ip _ 4%qd StSragelD splayl,Se 'ce 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled S. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided P. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures iEgGipment'I lltensils l.Liiaehs 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean _ IPr„6tecti!E F,rorglCo lamination _ _ TJ 34. Warewashing facilities maintained;test strips available W7112. No re-service of returned food _� 35. Equipment/utensils approved;installed;clean;good repair K-._",113. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitizedfwarewashing procedures 37. Vending machines maintained {Foo'd'Fiom_`AppioWdlSou_rc`e- - 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 6. Compliance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths 1s 17. Compliance with Gulf oyster regulations II _ ':Pyfiys cal;Faci rhes'. _ iCgfifofmaoce,W'thApproSed�P;ocedu`res __ i 1. Plumbing maintained;proper back flow prevention f18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed Consumer A`dvisb_ry 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food _ -° . Premises;personaltcleaning items;vermin-proofing Su--sce"pt"61a,Populations I _ iPeinaoerrtRFood Fa ii itt'es 0. Prohibited foods not offered at high dsk facilities _ _� 5. Floors,walls and ceiling are maintained and kept clean ilMater7.;HotiWattr 6. No living or sleeping quarters inside facility �1.Hot and cold potable water available ,9 'pliance airtl Enfo cement _ _ _I1!. ,_asfe'D s-poral 7. Signs posted;last inspection report available ?, 2. Sewagelwastewater property disposed;toilet facility useable 8. Compliance with plan review requirements _ '3e`rm�n 9. Facility operating with a valid health permit 3. No rodents,Insects,birds or animals Inside facility 50. Impoundment 51. Permit Suspension Received By/Title: 7 EH Specialist: V„t Phone: per, r Page 1 of EHD16-23(tslpq) 4/9112 G Y FOOD PROGRAM 01R