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o.P4�lyo SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 • o ... � s :P•• Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orci/ehd qGl F(S'R� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: 9 Date:141 2 ddress:• Cky: 70' Zip Code: _.T20 -F Owner/Operator: Telephone: Program Element: Program Record: Inspection B180 Posted 9yeil❑ No Permit Posted es ❑ No Re -Inspection on or After: IN = In Compliance N10 = Not Observed NIA =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 immediate! F. Non -cora /lance may warrant closure of the food facility _ w nio HiA _ •0 O t do oEMT a Supervision - col �1. Demonstration of knowledge; food safety certificate 4. Person In Charge is present and performs duties ea 25. P'�e so al Cleanliness Personal cleanliness and hair restraints 2. Communicable disease; reporting, restrictions &exclusions 3. No discharge from eyes, nose, or mouth; no open wounds 6. era'F od--Safety Requirements Approved thawing methods used Proper eating, tasting, drinking, or tobacco use ® P a a ron b 7. Food protected from contamination during storage 5. Hands clean and properly washed; proper glove use 8. Washing fruits and vegetables before use 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified, stored, and used a d -e peva ur a/ 7. Proper hat and cold holding temperatures 30. o Sto g Bffp a. l e 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 coaling methods 2. Food properly labeled and honestly presented 10. Proper cooking time and temperatures M1 Ir 3. m_ent! Utensils I Linens' Nonfood contact surfaces clean 11. Proper reheating procedures for hot holding '0 12. No re -service of returned food 34. 5. Warewashing facilities maintained; test strips available Equipmentfutensils approved; Installed; clean; good repair 13. Food free from contamination and adulteration 36. Equipment, utensils and linens: storage and use 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained 15. Food obtained from approved source 8. 39. Approved and sufficient ventilation and lighting Thermometers provided, accurate, and easily visible 6. Compliance with shell stock regulations; tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations 41. s Plumbing maintained; proper back flow prevention - - -Conformance With'Approved Procedures 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory `_ 3. Toilet facilities clean, supplied, and maintained 19. Advisory provided for raw or undercooked food 44. Premises; personal/cleaning items; vermin -proofing r c,Is. Pppulations 0.foods not offered at high risk facilities 45. Floors, walls and ceiling are maintained an;keptcdlean ' Waterl. HotWater ble. . No living or sleeping quarters inside facility •o a e a - Signs posted; last inspection report availab D sposal7. posed; toilet facility useable X.ot#cold#or 8. Compliance with plan review requirements 9. Facility operating with a valid health permit in als inside facility 50. Impoundment 1. Permit Suspension Received By/Title: Sl`_ (7, v EH Specialist: ,-� Pi P ne: a Page 1 of EHD 1623 (1st pg) 49112 FOOD PROGRAM OF