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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �Lia �';a Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> ig <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date' <br /> Cit Zip Code: <br /> Address: 1 rl _ Y <br /> Owner/Operator:CJ Telephone: <br /> Program Element: Z Program Record: j 1 Inspection Type: <br /> B180 Posted 0 Yes O No Permit Posted ❑Yes ❑ No Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed NIA=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance i <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Major violations pose a threat to public health and must be corrected immediate) . Non-com liance may warrant closure of the food facility <br /> NVI Toll", s <br /> 1. Demonstration of knowledge;food safety certificate ' 4. Person In Charge is present and performs duties <br /> Ts�tal <br /> 0 <br /> r` <br /> Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints I <br /> No discharge from eyes,nose,or mouth;no open wounds ► s <br /> Proper eating,tasting,drinking,or tobacco use 26, Approved thawing methods used <br /> °< * 7. Food protected from contamination during storage<w <br /> Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> ° Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used <br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 32. Food properly labeled and honestly presented <br /> .-. . <br /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> •. _ at>'�iR1K? 1'lt�ij�tf!'t�bf3" _m_<-� °, a... :; in facilities maintained;test stripss available4. Warewash <br /> 12. No re-service of returned food m 5. Equipmentlutensils approved;installed:clean;good repair <br /> i„ 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitizedlwarewashing procedures 37. Vending machines maintained <br /> a-. <br /> �M, � ��' �� - .�. - 8. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source39. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tagsMisplay 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations <br /> 1IIt, [b"'th]MeB . 1. Plumbing maintained;proper backflow prevention <br /> Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> YA <br /> kid <br /> 3. Toilet facilities clean,supplied,and maintained <br /> E 19. Advisory provided for raw or undercooked food 44. Premises;personallcleaning items;vermin-proofing <br /> Iectul + ss; <br /> („ D. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean <br /> i 6. No living or sleeping quarters inside facility <br /> °� ,,°x 8fel°� � l <br /> `- <br /> r' ,e. <br /> 1.Hot and cold potable water available. _ hi! 1�nd jlfbf fuer# .. <br /> f <br /> 7. Signsposted;last inspection report available <br /> E 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> re„ 49. Facility operating with a valid health permit <br /> .° <br /> �KNL4'° 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 1. Permit Suspension <br /> Received By/Title: . <br /> Phone: { Page 1 of <br /> EH Specialist: <br /> EHD 16-23 (1st pg) 419112 `O FOOD PROGRAM 01R <br />