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SAN JOAQUIN COUNTY -� ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 • �q.: ;P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd LiFORt� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: ' �3 Address: --IX-77 City: Zip Code: Owner/Operator: t 1 ' Telephone:q5 3 -47 Program Element: V Program Record: Inspection Type: W SB180 Posted es ❑ o Permit Posted es ❑ No 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 violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facilit emonstration of Knowledge MAS our cos Supervisio D 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties o ee.Hea nd iene Personal Cleanliness 1g _ VA2. 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 26. Approved thawing methods used 27. Food protected from contamination during storage 5. Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used rte: ime,and_Temperature Relatio i Food'`stora elDisp aylServic Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures qulpmenQUtensils/Lmens 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean 34. Warewashing facilities maintained;test strips available VUMnation 12. No re-service of returned food 35. Equipmentlutensils 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 Food o ApproJed Source - 38. Approved and sufficient ventilation and lighting ARK ?Wl . Food obtained from approved source 39. Thermometers provided,accurate,and easily visible . 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 backflow prevention N)ql Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory - 3. Toilet facilities clean,supplied,and maintained ENO9. Advisory provided for raw or undercooked food 44. Premises;personallcleaning items;vermin-proofing ig�ilySusceot�ble Populations anent Food Facilities:= _ 20. Prohibited foods not offered at high riskfacilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water = 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 7. Signs posted;last inspection report available 22. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements er i 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51, Permit Suspension Received By/Title. EH Specialist: Phone: Page 1 of 16-23(1st pg) 4/9/12 '"1 l•C FOOD PROGRAM OR