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enA"•"• SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd tlFd'A FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: UOWDate: l 3 �3 ddress: / 2 t/ F7 C �, - _ _ ' e City: 77 r-yy.c-+�s'r-t 1e6� Zip Code: Owner/Operator: / / L -l- Telephone: Program Element: 11,2-1. Program Record: Inspection Type: 8180 Posted _'p Yes ❑ Rermit Posted ❑ Yes ❑ f 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. Ma or violations pose a threat to public health and must be corrected immediately_ Non-compliance may warrant closure of the food facility -_.. .. __. _ -_. ..._._ 1 I rvra Demonstration of Knowledge l 'Ll=cr cos Supervision co! 1 Demonstration of knovdedq_e'. food safety cenificale 24. Person In Charge is present and performs dupes Employiii and Hygiene -Personal Cleanliness Communicable disease, reporting, restrictions &exclusions 25. Personal cleanliness and hair restraints No discharge from eyes, now, or mouth; no open wounds - :Food Safety Requirements Proper eating. tasting, drinking, or tobacco use 26. Approved thawing methods used reventing Contamination by Hands Hands clean and properly washed, proper glove use 7. Food protected from contamination during storage 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified, stored, and used '- 1111IFirs Relationship Proper hot and cold holding temperatures Proper use of time as a public health control 30. Food StoragetDisplay/Service Food storage, food storage containers labeled 3I O_.stomer self-service food protected; individual utensils provided Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures 33. 34. Nonfood contact surfaces clean Warewashing facilities maintained; test strips available 11. Proper reheating procedures for hot holding Protecti.. 12 No re serves of returned food 35. Equipmentlutensils approved; installed; clean; good repair l 13 Food tree from contamination and adulteration 36. Equipment, utensils and linens: Storage and use 114. Food contact sirr`aco, hanc-d and s ve'lwarewash ng procedures 37. Vending machines maintained Food From Approved Source - - -=� 38. Approved and sufficient ventilation and lighting _.. 15. Food obtained from approved source _ 39. Thermometers provided, accurate, and easily visible 16. Compliance with shell stock regulations; tags/display 0. 1. Proper use and storage of wiping cloths Physical Facilities Plumbing mainlained- proper back flow prevention 17. Compliance with Gulf oyster regulations Conformance With Approved Procedures Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed Consumer Advisory 3. Toilet facilities clean, supplied, and maintained �19 Advisory provided for raw or undercooked food 4. Premises: personal/cleaning items vermin -proofing Highly Susceptible Populations _ r o. Prohibited foods not offered at high risk facilities 45. Permanent Faod Facilities.._ Floors. walls and ceiling are maintained and kept clean Water / Hot Water 46. No living or sleeping quarters inside facility 21 Hot and cold potable wa!er available. '-.' 47. Compliance and EnforCeme; Signs posted, last inspection report available Liquid Waste Disposal 2. Sewage/ wastewater properly disposed. pilot facility useable 8. Compliance with plan review requirements Vermin 3. No rodents. insects. birds or animals inside facility 9. Facility operating with a valid health permit 0. Impoundment 1. Permit Suspension Received By/Title:V t X71--�v, _ w`.r2.� (�I v -Loa) Z � 230/6 • EH Specialist: . one: 2 �sZ Page 1 of EHD 16.23 (1st pg) 4/9/12 FOOD PROGRAM OIR