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SAN .JOAQUIN COUNTY r ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.si.gov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT 1 Name of Facility: e,r5 Old U on r f Z e Date: /4 Address: 0 `, i,f r n} )L; City: Ir r C Zip Code: GS 17 L Owner/Operator: Telephone: ess,C� V J z i Program Element: Program Record: Inspection Type: G u 1; 6180 Posted Yes ❑ Permit Posted JW'Yes ❑ WO Re-Inspection on or After: i IN=In Compliance NIO=Not Observed NIA=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance i See reverse side for code sections and general requirements that correspond to each violation listed below. Major violations ose a threat to gublic health and must be corrected immediate! . NOR-con liance ma warrant closure of the food facility � X 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties ARM X a ' ° . Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds ?fid II' tilplllt� Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used 7. Food protected from contamination during storage X Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used :.. F '. x Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided 1 } x Proper cooling methods 32. Food properly labeled and honestly presented y �t 10. Proper cooking lime and temperatures ......e... � �`� rr-�� >„-;><<,•' 11: Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean X G ��.,,, `�i� ,,t" -��" .-: .... 4. Warewashing facilities maintained;test strips available x 12. No re-service of returned food 35, Equipmentlutensils approved; installed;clean;good repair J( ' 13. Food free from contamination and adulteration 35. Equipment,utensils and linens:storage and use X 14. Food contact surface cleaned and sanilizedlwarewashing procedures 37, Vending machines maintained 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;tagsldisplay 4G. Proper use and storage of wiping cloths 17, Compliance with Gulf oyster regulations E ,�>s ;� ;:�. Tr) ..-.... ...,..,... :; Q.:. 1. Plumbing maintained;proper back flow prevention j� 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed = 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personaI/cleaning items;vermin-proofing or 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean 1 $ 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. _:•:�-•. _ _ •.. Wim_-..m a F°3fi=wow 47. Signs posted;last inspection report available 2. Sewagelwastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements 149. Facility operating with a valid health permit x 3. No rodents,insects,birds or animals inside facility 50. Impoundment i 51. Permit Suspension if a Received BylTitle: ' n r EH Specialist: Phone: J / a c- Page 1 of� EHD 16-23 (1st pg) 419112 FOOD PROGRAM OIR J