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aDA4i~. c SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 �a....... " Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sicov.orD/ehd �IFOr�� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: 11 IBOX #'1'303 Date: e) , Address•. LSS v/e City: a vt O Zip Code: $3 3160 Owner/Operator: Q /� A) Telephone: a Zy-S Program Element: �6 Program Record: ,j- Inspection Type: Bt 80 Posted K Yes C No Permit Posted)&Yes ❑ No Re-Inspection on or After: IN=In Compliance WO=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.-on-compliance mav warrant closure of the food facilit im uro car. Demonstration of Knowledge oar our cus Supervision car I1. Demonstration of knowledge;food safety certificate ✓ 24. Person In Charge is present and pertorms duties Employee Health and Hygiene personal Cleanliness Communicable disease;reporting, restrictions&exclusions 25- Personal cleanliness and hair restraints L 13. 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 6. Hands clean and properly mashed:proper glove use 28. Washing fruits and vegetables before use 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used Time and Temperature Relationship Food Storage/Display/Service 7. 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 Proper cooling methods 32. Food properly labeled and honestly presented �10. Proper cooking time and temperatures Equipment/Utensils/Linens 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available j12, No re-service of returned food 35. EquipmenVutensils approved;installed;clean;good repair V' -313. Food free from contamination and adulteration . Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitizedwarewashing 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 i17. Compliance with Gulf oyster regulations - ` Physical Facilities Conformance With Approved Procedures - 41. Plumbing maintained;proper back flow prevention B. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed _ =Consumer Advisory 43. Toilet facilities clean,supplied,and maintained X19- Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items:vermin-proofing Highly Susceptible Populations permanent Food Facilities . Prohibited foods not offered at high risk facilities /�0Phf9 5. 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. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available 22 Sew age, 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: Phon p W�� /7p-p Page 1 of EHD 1623 (1st pg) 12/1 - / 7 J FOOD PROGRAM OIR