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opA o� SAN JOAQUIN COUNTY i
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<br /> ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232
<br /> .., ,..; Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd
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<br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT
<br /> Name of Facility: I Date:
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<br /> Address: P 1� 7 � { � City: L(A 1 �tG Zip Code:
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<br /> caner/Operator: /►'u 5 1) Telephone:
<br /> Program Element: 37- Program Record: z U Inspection Type: j;n t,
<br /> 6180 Posted KYes ❑ No Permit Posted kYes ❑ No Re-Inspection on or After:
<br /> IN=In Compliance NIO=Not Observed N/A=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance
<br /> See reverse side for code sections and general requirements that correspond to each violation listed below.
<br /> Ma'or violations pose a threat to public health and must be corrected immediate! . Non-compliance max warrant closure of the food facility
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<br /> 1. Demonstration of knowledge;food safety certificate s 4. Person In Charge is present and performs duties
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<br /> Communicable disease;reporting,restrictions 8 exclusions 25. Personal cleanliness and hair restraints
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<br /> No discharge from eyes,nose,or mouth;no open woundst8f _ fd' t '�. h.<
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<br /> x Proper eating,tasting,drinking,or tobacco use i W., 26. Approved thawing methods used
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<br /> od protected 7 Fo from contamination during storage
<br /> X Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use
<br /> Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used
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<br /> 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled
<br /> S. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided
<br /> k . Proper cooling methods 32. Food properly labeled and honestly presented
<br /> 10. Proper cooking time and temperatures Iy
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<br /> �f 11. Proper reheating procedures for hot holding ' 3. Nonfood contact surfaces clean
<br /> " 4. Warewashin facilities maintained;test strips available
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<br /> X 12. No re-service of returned food NSA 35. Equipment/utensils approved;installed;clean;good repair
<br /> k 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use
<br /> x 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained
<br /> 8. Approved and sufficient ventilation and lighting
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<br /> 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible
<br /> X 116. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths
<br /> 17. Compliance with Gulf oyster regulations ;, q ...:.._
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<br /> „,,�#1i�ltftTat��P�.. ax�tr��X � ;� • ;3; 1. Plumbing maintained;proper back flow prevention
<br /> eti 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed
<br /> WN 43. Toilet facilities clean,supplied,and maintained
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<br /> i e 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing
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<br /> X ems,., ko. Prohibited foods not offered at high risk facilities 45. Floors,wails and ceiling are maintained and kept clean
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<br /> z r 6. No living or sleeping quarters inside facility
<br /> �( , 1.Hot and cold potable water available. Cl !? � ;
<br /> 7. Signs posted;last inspection repos available
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<br /> 2. Sewagelwastewaterproper!y disposed;toilet facility useable 8. Compliance with plan review requirements
<br /> `4 W � � �, "" - . Facility operating with a valid health permit
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<br /> EA3. No rodents,insects,birds or animals inside facility 0. Impoundment
<br /> 1. Permit Suspension
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<br /> Received By/Ti e:
<br /> EH Specialist: - Phone: / J =10f
<br /> EHD 16-23 (1st pg) 419112 p FOOD PROGRAM OIR
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