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SAN JOAQUIN COUNTY a.�ca-•.pd ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.sigov.orglehd �/Fdaa+ FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: U tC J Date: I oZ Address: City: Zip Code: Owner/Operator: Telephone: Program Element: Program Record: Inspection Type: 8180 Posted ❑Yes 6( Rermit Posted ❑Yes P Re-Inspection on or After: N 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. Moor violations pose a threat to public health and mus[be corrected immediately. Non-compliance may warrant closure of the food facility_. Im ei�o con Demonstration of Knowledgeou _os Supervision moe 1. Demonstration of knowledge-food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene - Personal Cleanliness t3. ommunicable disease, reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints [4 o discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements roper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used -- - Preventin C 27. Food protected from contamination during storage 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Tonic substances properly identified,stored,and used MEN MEME! Food s6rage/Display/service Proper hot and cold holding temperatures 30. 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 1 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Equipment/Utensils I Unans 11. Proper reheating procedures for hot holding contact surfaces clean Protection Fr' hing facilities maintained;test strips available 12. No re-service of returned food t/utensils approved;installed;clean;good repair _ ='13. Food free from contamination and adulteration t,utensils and linens:storage and use 14. Food contact surface deai,ed and sanitized/warewashing procedures47sufficient achines maintained 1-Food From Approved Source and sufficient ventilation and lighting _- 15. Food obtained from approved source 39. Thermometers provided.accurate,and easily visible 16. Compliance with shell stock regulations;tagsidisplay 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 41 Plunming maintained.proper back flow prevention 18. Compliance wim HACCP pian or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained :19. Advisory provided fol raw or undercooked food 44. Premisespersonal/cleaning items'.vermin proofing Highly Susceptible Populations Permanent Food Facilities �O Pioh,bded foods not offered at high risk factlilies _I 5. Floorswalls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility I'1 Hot and cold potable water available. Compliance and Enforcement, Liquid Waste Disposal 7. Signs posted,last Inspection report available 2_ Sewagclwastrwater property disposedtoilet facility useable 4& Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit 3. No rodents.insects. birds or animals inside facility 5o. Impoundment 51. Permit Suspension Received By/Title: nkWwy EH Specialist: Phone: Page 1 of EHD 1623 ilst pg) 4,9/12 r FOOD PROGRAM OR