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aq.PA a.coG SAN JOAQUIN COUN ?� ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siaov.oral uFati FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: olydl Address: Z G City: J Zip Code:Aiz- I Owner/Operator: / 1 d i2,/ Telephone: Program Element: Program Record: Inspection Type: SB180 Posted Ayes No IU Permit Posted es o 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. Major violationsposer a threat to ublic health and must be corrected immediatel . Non-compliance may warrant closure of the food facility Supervision YET 1. Dar110rlsff8l1flfl Of knowledge;food safilty certificate 24 Person In Charge is present and performs duties Personal Cleanliness Communicable disease;reporting,restrictoris&exclusions 25. Personal cleanliness end hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used Preventing Contamination by Hands 27. Food protected from contamination during storage Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible . To 'c substances properly identified,stored,and used Proper hot and cod holding temperatures Food storage;food storage containers labeled Proper use of time as a public health control 1. Customer sett-service food protected;individual utensils provided Proper cooling methods 2. Food property labeled and honestly presented t0. Proper cooking time and temperatures _ 'r 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces dean Protection From Contamination Warewashing facilities maintained;test strips available 12. No re-service of returned food 5. Equipment/utensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 114. rood rontacl surface cleaned and samtizedlwarewashing procedures 37. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations Physical.Facilities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention X18. Compliance with HACCP plan or variance conditions 42. 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 20- 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 21. Hot and cold potable water available. Co 'ce and Enforcement Liquid Waste Disposal 47. Signs posted; last inspection report available 22. Sewagemastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit i23. No rodents.insects.birds or animals I iside facility 50. Impoundment 1. Permit Suspension Received By/Title: EH Specialist: 1 11 Phone: Page 1 of EHG 1623 fist pg) W12 FOOD PROGRAM OIR