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r oP°�ift•.o SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 . �'ilFsR�p Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www,sioov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: 1 dt 1't Z L Date: CA-, _'X7_3 ddress: r1 City: G O� t Zip Code: e W J 2-06 wner/Operator: I U L.I I N G Telephone: Program Element: Program Record:Ole Inspection Type: B180 Posted D Yes Rermit Posted Yes ❑ t' 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 immedratel . Non-compliance may warrant closure of the food facilit in Nrn ao Demonstration of Knowledge rt! ou- Cos Supervision 7.Demonstration of knovdedge. food safety certificate 24- Person In Charge is present antl performs duties Employee Health and Hygiene Personal Cleanliness =12. Communicable disease, reporting, restrictions 8 exclusions 25. Personal cleanliness and hair restraints No discharge from eyes, nose, or mouth; no open wounds ML General Food Safety Requirements Proper eating, tasting, drinking, or tobacco use 5. Hands clean and properly washed; proper glove use 26. Approved thawing methods used 7. 28. Food protected from contamination during storage Washing fruits and vegetables before use w. Handwashing facilities supplied and accessible Time and Tempe ' ` 7. Proper hot and cold holding temperatures 29. 30. Toxic substances properly identified, stored, and used --r- 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 property labeled and honestly presented 0. Proper cooking time and temperatures 11. Proper reheating procedures for hot holding 33. Equlpmettt;! UtensIIS J' Nonfood contact surfaces clean 4. Warawashing facilities maintained; test strips available It 2 No m -service of returned food 5. Equipment/utensils approved; installed; dean; good repair 'I13 Food free from contamination and adulteration 6. Equipment, utensils and linens: storage and use 14 I ocs mrtact surface clranetl and sanitlzetl/warewashing procedures 7. Vending machines maintained Food From � pprov .. - o rce ::: 15. Food spanned from approved source 8. 9. Approved and sufficient ventilation and lighting Thermometers provided, accurate. and easily visible 16. Compliance with shell stock regulations; tags/display 0. Proper use and storage of wiping cloths Physical Facilities , 17. Compliance with Gulf oyster regulations Conformance With Approved Procedures 1. Plumbing maintained. proper back flow prevention 18 Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean, supplied, and maintained �19 Advisory provided for raw or undercooked food 44 Premises-personal/cleaning Items -vermin -proofing Highly Susceptible Populations Permanent Food Facilities -_ I20. Prohibited foods not offered at high risk facilities 45, Floors, walls and ceiling are maintained and kept clean Water I Hot Water 46. No living or sleeping quarters inside facility ;21 Hot and cold potable water available. Compliance and Enforcement ' Liquid Waste Disposal 47. Signs posted: last inspection report available ;22- Sewage/wastewater properly disposedtoilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit .[_�J,J23_ No rodentsinsects. birds orannals msde facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: L1 L 49 L4 Q I v9- Phone: /uf rl� / ^ p 23 Page 1 of o7 EHD 16-23 list pi 419/12 FOOD PROGRAM OR