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aPayi"' f SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 carlFdRa;p Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: -� Date: Address: iS City: Zip Code: Owner/Operator: Telephone: Program Element: \ 2 Program Record: Inspection Type: SB180 Posted ❑Yes 11Nermit Posted ❑Yes ❑P Re-inspection on or After: IN=In Compliance NIO=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. Ma'or violations ose a threat toublic health and must be corrected immediatel . Non-compliance ma warrant closure of the food facilit IN a2r con De _ ledge Nu <wi ca; Supervision our 1 Demonstration of knowledge_foods afety certificate 24. Person In Charge is present and performs duties -. Employee Health and Hygiene - Personal Cleanliness �{ Communicable disease.reporting.restrictions&exclusions 25. 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 'ntami'' 7. Food protected from contamination during storage 15. 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 Tinea` . Lure Relationshi i. Proper hot and cold holding temperatures 0. 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 10. Proper Woking time and temperatures Equipment/Utensils!Linens 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean action From Contamination 34. Warewashing facilities maintained;test strips available l 2. No re-service of returned food 35. Equipmentlutensils approved;installed;dean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food conact surface cleaned and sanitizedmarewashing procedures 37. Vending machines maintained Food Fro proved Source 38. Approved and sufficient ventilation and lighting 5. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths T...._ 17. Compliance with Gulf oyster regulations Physical.EaciliUes nfotmance With Approved Procedures 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed L Co. r Advisory 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food Premises;personaVdeaning items;vermin-proofing Highly Susceptible Populations �9 Prohibited foods not offered at high risk`acihoes 5. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 6. No living or sleeping quarters inside facility j21 Hot and cold potable water available. 'Compliance and Enfioreema Liquid Waste Disposal 7. Signs posted;last inspection report available X22. Sewage/vwastewaler properly disposed-toilet facility useable 8. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit T �3 No rodents.insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Received By/Title: L EH Specialis • _ Phone: 2� 1 b, Page 1 of 2 EHD 1623 list pg) 419112 FOOD PROGRAM OR 15