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o.FAuIN• SAN JOAQUIN COUNTY ?a ENVIRONMENTAL HEALTH DEPARTMENT tlY :K 1868 East Hazelton Avenue, Stockton, CA 95205-6232 •'�'rcladpdxp• Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: Address: q 41 City: ,� �llZip Code: ZO Owner/Operator. Telephone: Program Element: Program Record: t. ILB Z Inspection Type: SB180 Posted n Yes Kermit Posted Yes ❑P Re-Inspection on or After: IN=In Compliance N/O=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. Major violations pose a threat to public health and must be corrected immediately. Non-coin trance may warrant closure of the food facility ,p r+o r1a Demonstration of Knowledge roc. OUT cs Supeh au, L Den,onstmtion of knowledge.food safety cemficate 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,tastingr drinking,or tobacco use 26. Approved thawing methods used reyenYing Cgntamination b ' 7. Food protected from contamination during storage Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 9. Toxic substances properly Identified,stored,and used Proper hot and cold holding temperatures 26. Food storage;food storage containers labeled Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Equipment t Utensils 1 Linens 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 3 5. Equipmentlutensils approved;installed;dean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 4. Food contact surface cleaned and sanitized/warewashino procedures 37. Vending machines maintained ` ' Food From Approved Source 38. Approved and sufficient ventilation and lighting 5. Food obtained from approved source 39. Thermometers provided.accurate,and easily visible 16. Compliance with shell stock regulations;lags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations �! Physical Facilities Conformance With Approved Procedures 41 Plumbing maintained.proper back flaw prevention Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained 119. Advisory provided for raw or undercooked food 44. Premises'. personallcleaning Items:vermin-proofing Highly Susceptible Populations Permanent Food Facilities ' Po. Prohibited foods not offered at high risk facilities 5. Floorswalls and ceiling are maintained and kept clean Water I Hot Water 46. No living or sleeping quaners msde facility I21. Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available �. 22 Sewagelwastewater properly disposedtonal fac hly useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit P3. No rodents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Received By/Title: D. EH Specialist: V Phon2, Pagel El EHD 16-23(1st pg) 4/9112 FOOD PROGRAM OR