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AQUfH SAN JOAQUIN COUNT- �q. Z� =NVIRONMENTAL HEALTH DEPARTMENT �,: .. X 1868 East Hazelton Avenue, Stockton, CA 95205-6232 • ,� Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.orq/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: Address: -5 44L G��Z;7 City: '! -fO Zip Code: 9 S �0 Owner/Operator: �� 1'r/ C f Telephone: Program Element: Z Program Record: C)5-27 t - Inspection Type: fzoi f� B180 Posted ?Yes No Permit Posted -Yes 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. Mabr violations pose a threat to lZublic health and must be corrected immediatel . Non-corn liance may warrant closure of the food facilitv IN' wo VA Demonstration of Knowledge Supervision OUT jL 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints 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 T 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 l einperatusht re Retaiionp r food Stioage/DispiayfService 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 Proper cooling methods 32. Food properly labeled and honestly presented Proper cooking time and temperaturesEt�t - 1. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination; 34. Warewashing facilities maintained;test strips available 7114 12. No re-service of returned food I 6k35. 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 Approved Source 38. Approved and sufficient ventilation and lighting >- 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations Physical.Facifit4es Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention 8. Compliance with HACCP plan or variance conditions i 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained ?Ill 9. 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 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin 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: _ �tr-� Page 1 ofd EHD 16-23 (1st pg) 4/9112 FOOD PROGRAM OR