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oPaut" SAN JOAQUIN COUNTY s� ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.siaov.oro/ehd �I FdF FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: `c5 Gx \ A%_r> Date: 1, ddress. City: Zip Code: owner/Operator: Telephone: Program Element: Program Record: Inspection Type: SB180 Posted 0 Yes 0 Rermit Posted 0 Yes 0 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 immediately. Non-com )tante ma warrant closure of the food facilit ��. Na u>. Demonskration of Knowledge - Supervision ou- 1 Demonstration of knowledge.food safety certificate 4. Person In Charge is present and pedorms duties Employee.Health and Hygiene Personal Cleanliness Communicable disease.reporting,restrictions&exclusions 5. Personal cleanliness and hair restraints 3. No discharge from eyes,nose,or mouth;no open woundsRequirements - Proper eating,tasting,drinking.or tobacco use 6. Approved thawing methods used Preventing Contamination b 7. Food protected from contamination during storage 5 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 "resRela 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 3. Nonfood contact surfaces clean . Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipmentlutensils approved;installed;clean;good repair .13. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use 14. F 00 contact surface ceaned and sanitizedhvarewashing procedures 7. Vending machines maintained Food Fro ad- cIr - 8. Approved and sufficient ventilation and lighting 15. Food obtained from approved source E7 39, Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 1$117. Compliance with Gulf oyster regulations Ph.sical Facilities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention X118 18_ Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed _._ h� --. Consumer Advisory 43. Toilet facilities clean,supplied,and maintained 1 119_ Advisory provided for raw or undercooked food 44. Premisespersonal/cleaning items-vermin-proofing Highly Susceptible Populations Permanent Food Facilities �9_ Prohibited foods not offered at high risk facilities 45. Floorswalls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 21 Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal i. Signs posted;last inspection report available 22 Sewage/wastewater properly disposed,toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit _ x,23. No rodentsinsectsbirds or animals inside facility 50. Impoundment 51. Permit Suspension Received BylTitle: EH Specialist: IN I Phone: Z.a_ I age 1 of EHD 16-23 pst pg) V9112 FOOD PROGRAM OR 6