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ora+ 'N. SAN JOAQUIN COUNTY ? ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �..• Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.siaov.oro/ehd 9CIKOR? FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: 7fl ddress: a a City: Zip Code: Owner/Operator: l e o _1 1-` !-r Telephone:n 8 - lam_ 32 Program Element: 9 ✓Y7 Progra/m'IRecWord: 11 � Inspection Type:l�+ S6180 Posted es ❑ Rermit Postetl ❑Y ❑P Re-Inspection on or After: IN=In Compliance N/O=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 immediatel . Non-compliance may warrant closure of the food facility �n H:o N•a Demonstration of Knowledge- COSI Supervision our i7. Demonstration of knowledge.food safety ced�cale 24- Person In Charge is present and performs duties Employee Health and Hyg, Personal Cleanliness - 12. Communicable disease,reporting, restrictions&exclusions 5. Personal cleanliness and hair restraints { 13. No discharge from eyes,nose,or mouth;no open wounds Safety Requirements �. Proper eating.tasting,drinking.or tobacco use 6. Approved thawing methods used Preventing Contamination by Hand 7. Food protected from contamination during storage 5. Hands clean and properly washed;proper glove use 8. Washing fruhs and vegetables before use Hantlwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used Time and Temperature Relationsllf 7. Proper hot and cold holding temperatures 0. Food storage;food storage containers labeled Proper use of time as a public health control 1. Customer self-service food protected;individual utensils provided Proper cooling methods 2. Food properly labeled and honestly presented 10. Proper cooking time and temperatures 11 Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contaminati 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipment/utensils approved;installed;dean;good repair 13 Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use �( I14. Food contact surface cleaned and saniazedrwarewashing procedures 37. Vending machines maintained Food From Approved Source ' "-- 38. Approved and sufficient ventilation and lighting _j15. Food obtained from approved source 39. Thermometers provided,accurate.and easily visible 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures ' 1. Plumbing maintained:proper back flow prevention 118- Compliance with HACCP plan or vanznce conditions 42 Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained n 9. Advisory provided for raw or undercooked food 44. Premises.persona Idea ning items'.vermin-proofing -- Highly Susceptible Populations Permanent Food Facilit! Y 20 Prohihired foods not offered at high risk facilities 45. Floorswalls and ceiling are maintained and kept clean Water I Hot Water 46. No living or sleeping quarters Inside facility Iki Hol and cold potable water available. Compliance and Enforcement - Liquid Waste Disposal 47. Signs posted;last inspection report available 'i22 Sewage/wastewater pf cdoerly disposedtoilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit 1 23. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received BylTitle EH Specialist: W I✓a Z Phone: l n_. V11 Page l of i 'C ,� IWW EHD 1623(1st pg) 419112 FOOD PROGRAM OR