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p4H!ry c SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.siaov.org/ehd G%F QR� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: �jJ- Date: ddress: �(x/L w m 1 n P,, City: 2 �� Zip Code: wner/Operator: 8 1 n 1 S✓W+l�I1 � V Telephone: ,3A Program Element: W Program Record: Inspection Type: S C 1j�n B180 Posted ❑Yes ❑ Nermit Posted []Yes 0 P Re-Inspection on or After: K) V 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. MaL violations pose a threat to public health and must be corrected immediatel r Non-compliance may warrant closure of the food facilit IN r+•o u::. Demonstration of Knowledge cow' c+u- cus" Supervision our �I. Demonstration of knowledge_food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness ��2. Communicable disease.reporting. restrictions&exclusions 5. Personal cleanliness and hair restraints 3. No discharge from eyes.nose,or mouth:no open wounds - General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used 7. Food protected from contamination during storage Hands clean and propedy washed;proper glove use 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used :". . . .. :.' FoodSrto 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 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Equipment./Utensils`ILine 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipmentfutensils approved:installed;dean;good repair 13. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use 14 Food cartact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained Foy ,. 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations Conformance With Approved Proce 1. Plumbing maintained:proper back flow prevention 1 B Compliance with rIACCP plan or variance conditions 2. Garbage and refuse properly disposed Consumer Advisory 3. Toilet facilities dean,supplied,and maintained I19. Advisory orovlded for raw or undercooked food 44. Premisespersonal/cleaning items.verm'n-proofing Highly Susceptible Populations Permanent Food Facilities 0 Prohibited foods not offered at high risk facilities 45. Floors walls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility j 1. Hot andcold potable water available. Compliance and Enforcement Liquid Waste Disposal -' ' 7. Signs posted;Iasi inspection report available 2. Sewage/wastewater properly disposedtoilet facility useable 8. Compliance with plan review requirements u' Vermin 49, Fadlity operating with a valid health permit 3. No rodents,insectsbirds or animals inside facility 50. Impoundment 51, Permit Suspension Received By/Title: EH Specialist: UA N l/�/'1 Phone: f to Page 1 of L EHDiG23(istpg) 4/9112 FOOD PROGRAM OR