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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siaov.ora/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: g_ Address: - I Q City: c_7 10 �r-N Zip Code: Q -->a I Owner/Operator: P� I Telephone: n,4 Program Element: Pro raEL Record: -�-y Inspection Type: ru "7 SB180 Posted^¢,Yes No Permit Posted" Yes ❑ No Re-Inspection on or After: ;Z,-.Q -e4C S 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. Ate or violations e a threat to public health and must be corrected immediate/ . Non-com liance ma warrant closure of the food facility nstration of Knowledge wu. OUT cos Supervision cur I. Demonstration of knowledge:food safety certificate 24. Person In Charge is present and performs duties loyee Health and Hygiene Personal Cleanliness Communicable disease, reporting, restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouti no open wounds '< General Food Safety Requirements_ Proper eating,lasting,drinking,or tobacco use 26. Approved thawing methods used ` Contamination by Hands 27. Food protected from contamination during storage ✓ Hands dean and properly washed, proper glove use 28. Washing fruits and vegetables before use ✓ Hendwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used nd Temperature Relationship r Food Storage/Display/Service v 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-serice:c vod protected:individual utensils provided Proper cooling methods 32 Food properly labeled and honestly presented L/ Proper cooking time and temperatures Equipment/Utensils/Linens . Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean .;Protectio *rm Contamination 34. Warewashing facilities maintained;test strips available Lle 12. No re-Service of returned food 35. Equipment/utensils 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 sanifized/warewashing procedures �/ 7. Vending machines maintained 8. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 7. Compliance with Guff oyster regulations 1. Plumbing maintained;proper back flow prevention . Compliance with HACCP plan or variance caMthone 42. Garbage and refuse properly disposed umer Aden ,.; „_. 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44 Premises:personal,cleaning items:vermin-proofing le Populations Permanent Food Facilities - '2mm . Prohibited foods not offered at high risk facilities 45- Floors.walls and ceiling are maintained and kept clean fiot Wafer - 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. - Compliance and"Enforeemmit :Waste Disposal 47, Signs posted;last inspection report available .Sewage/wastewater properly disposed:toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility-operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Received By/Title: EH Specialist: - L�'LU.LC� L Phone: �3, I� Page 1 of EHD 16-23 (1st 1 12/15/09 �IU FOOD PROGRAM OIR