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SAN JOAQUIN COUNT' O � c�G X CNVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 c4�%FORa�P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: O Date: Address: ((13 3 0 City: Glc h Zip Code: 952 O Owner/Operator: A U!� 1:�)Ocl Ski--vt�� a r �� Telephone: e Program Element: (® Z(E, Program Record: U ( Inspection Type: /�p �f S6180 Posted s No Permit Posted es No Re-Inspection on or After: 2 we eKs 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 immediatel . Non-compliance may warrant closure of the food facility [17 NJA' - Demonstration 0 nowledge -[NAJ OUT COS ` 3 '•� '. 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene' �' A100WWROOM iH 2. Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints 3. No discharge from eyes,nose,or mouth;no open wounds :" 1 "` kll"11'11 R11", 4. Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used Preventing Contamination by Hands .°' 27. Food protected from contamination during storage FT5. 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 Time and Temperature Relationship '.o Food Storage/Display/Service 7. 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 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures rcfu[peffJ[3tEt�sls l i�3et18' � � 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination,,'` 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipment/utensils 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 From Approves)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 \17. Compliance with Gulf oyster regulations P les Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention -;,18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing Highly Susceptible Populations Permanent Food Facilities 0. Prohibited foods not offered at high risk facilities FEE 45. 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. ON Ift Liquid Waste Disposal 47. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit 23. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: j EH Specialist: i 1„ Phone: y 4�_- Page 1 of EHD 16-23 (1 st pg) 4/9/12 FOOD PROGRAM OIR