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,o .FAG SAN JOAQUIN COUNT, .y` ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 r • r4.. ip Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.smgov.org/ehd Li i=dQe+ FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: � I ' Address: 5 City. Zip Code:- Owner/Operator: , �,' Telephone: Program Element: Progralfi Record: Inspection Type: 9180 Posted ❑Yes o Permit Posted a No Re-Inspection on or After. " IN=In Compliance NIO=Not Observed NIA=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. Ma'or violations pose a threat to public health and must be corrected immediatel . Non-compliance ma warrant closure of the food facility sits fi emof fes 31r iiCilfltti3 1� w i b[4 e c - 1. Demonstration of knowledge;food safety certificate 4. Person In Charge is present and performs duties _. . ; - - "• � IEieaifh�t�t� ��i ._ '��ril8rf.frlet3in mestx: 2. Communicable disease;reporting,restrictions 8 exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds -- 9 Y P -�t)�Y3d�BfQ �fi�ll�l�tlteell€tii -,.• � 4. Proper eating,tasting,drinking,or tobacco use 26, Approved thawing methods used _'1?rearentfng£CtrfCtIIK1a;i�tkr Il3c ®.e 7. Food protected from contamination during storage Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use 3 Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used 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 10. Proper cooking time and temperatures i mm �t7eFit Cellsif9lltas 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean i #�rrti1i "Df[ntt ` 4. Warewashing facilities maintained;test strips available I 12. No re-service of returned food 5. Equipment/utensils approved;installed;clean:good repair 13. f=ood 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 . Fo©isl: om7ifQCe 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 Ott ' �t B ionform�niC:e 1Afttlti' �„��"' 1. Plumbing maintained;tarned;proper back(low prevention f 18. Compliance with HACCP plan or variance conditions 42, Garbage and refuse properly disposed ,CoxaSc�rtai(.�' 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personallcleaning items;vermin-proofing 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean WM. a 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. rziGe orbit fsnft�rt�ftieltt mm - 1 iculd� sposai; 7. Signs posted;last inspection report available _ 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements ......r..,. a , ,,,; alepmaa n .� 9. Facility operating with a valid health permit l 3. No rodents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Received ByfTitle: EH Specialis . Phone(',,,, 3 Page 1 0& It 9 FOOD PRDGRAM OiR ERD 16-23 (1st pg} 419112 1