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C4, <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sogov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: i ✓c-kout_- <br />Date: 2 e" -Z <br />Address: City: <br />L O Zip Code: -1- <br />OwnerlOperator: <br />Telephone: <br />Program Element: Program Record: -2 <br />Inspection Type: <br />SB180 Posted O Yes O Rermit Posted 19,Yes ❑ f <br />Re -Inspection on or After. 2t-) Z 7 <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 <br />correspond to each violation listed below <br />Ma or violations ose a threat to public health and must be corrected immediately. <br />Non-compliance may warrant closure of the food facilit <br />- Supervision our <br />1. Demonstration of knowledge; food safety certificate <br />4. <br />Person In Charge is presem and peiorms duties <br />NOMMMIM.i <br />Personal Cleanliness - <br />Communicable disease reporting. restrictions & exclusions <br />5. <br />Personal cleanliness and hair restraints <br />No discharge from eyes, nose, or mouth; no open wounds <br />I irements <br />Proper eating, tasting, drinking, or tobacco use <br />26. <br />Approved thawing methods used <br />reventing Coptamma <br />27. <br />Food protected from contamination during storage <br />Hands clean and properly washedproper glove use <br />28. <br />Washing fruits and vegetables before use <br />Handwashing facilities supplied and accessible <br />29. <br />Toxic substances properly identifiedstored and used <br />TimetAiMMMM,lationsFi <br />"rage/Display/SiaMm, <br />Proper hot and cold holding temperatures <br />30. <br />Food storage; food storage containers labeled <br />Proper use of time as a public health control <br />31. <br />Customer self-service two protected; individual utensils provided <br />Proper cooling methods <br />32. <br />Food propedy labeled and honestly presented <br />10. Proper cooking time and temperatures <br />Equipment/ Utensils/ Linen <br />11. Proper reheating procedures for hot holding <br />33. <br />Nonfood contact surfaces clean <br />tai n F _m c_ontam_i <br />34. <br />Warewashing facilities maintained; test strips availIrepair <br />12. No re -service of returned food <br />5. <br />Equipment/utensils approved; installed; clean; goo <br />_ 13. Food free from contamination and adulteration <br />36. <br />Equipment, utensils and linens: storage and use <br />i14. Food contact surface deaned and sanitized-warewasmng procedures <br />37. <br />Vending machines maintained <br />Food From Approved Source <br />38. <br />Approved and sufficient ventilation and lighting <br />j5. Food obtained tom approved source <br />39. <br />Thermometers provided, accurate, and easily visible <br />6. Compliance with shell stock regulations; tags/display <br />0. <br />Proper use and storage of wiping cloths <br />17. Compliance with Gulf oyster regulations <br />Conformance With Approved Procedures <br />1. <br />Plumbing maintained; proper back flow prevention <br />18. Compliance with HACCP plan or variance conditions <br />2. <br />Garbage and refuse properly disposed <br />Consumer Advisory <br />3. <br />Toilet facilities clean, supplied, and maintained <br />19. Ativiscry provided for raw or undercooked food <br />4, <br />Premises; personal/cleaning items; vermin -proofing <br />Highly Susceptible Populations <br />0- Prohibited fonds not offered at high risk facilities <br />45. <br />Floors, walls and ceiling are maintained and kept dean <br />Water/ Hot Water <br />46. <br />No living or sleeping quarters inside facility <br />1. Hot and cold potable water available. <br />' Compliance and Enforcement <br />Liquid Waste Disposal <br />47, <br />Signs posted; last inspection report available <br />2 Sewage/wastewater properly disposedtoilet facility useable <br />8. <br />Compliance with plan review requirements <br />Vermin f <br />9. <br />Facility operating with a valid health permit <br />3. No rodents. insectsbirds or animals inside facility <br />50. <br />Impoundment <br />51. <br />Permit Suspension <br />Received By/Title: ce r <br />EH Specialist, - , <br />Phone: / / �0 G Page 1 of <br />metol <br />L\ <br />/ 4 rr <br />i <br />EHD 1623 list pg) 4,19112 FOOD PROGRAM OR <br />IK <br />