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I t SAN .10AQUW COUNQ. ' ENVIRONMENTAL HEALTH DEPARTMENT 1' 1868 East Hazelton Avenue, Stockton, CA 95205-6232 • c.., Y ; '. Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Gid } v ,.Code:Date: 2-. Address: ''7) City: Zip, Owner/Operator: 1 �,!� „ t� Telephone: [� ®- ff �-7 �" �l �., �� " �b2 J Program Element: Pirz Program Record: L " Inspection Type: r' d i B180 Posted es No Permit Posted Yes 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. Maar violations ase a threat to ub!!c health and must be corrected immediate!_. Non-compliance ma warrant closure of the food facility ire rip 14th; Ilt1,01hS#ratios"oilS9 [let ...ztttr 1 Slrpervrsit?n 1. Demonstration of knowledge;food safety certificate 24. Person in Charge is present and performs duties R m °_ w i�ers a l Cle ess. :. - id Heait �d.. � : < Communicable disease;reporling,1 restrictions&exclusio 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds taeit3ra1 t'ood Sa#ety_"iegairmenl °a i Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used A. N -_ Pirenti "fitrtt81Y1ffia#�f5tt Marrds 7. Food protected from contamination during storage Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use Handwashin facilities supplied and accessible 9. Toxic substances properly identified,g PP p p y tied,stored,and used " x' �. Di3d' CaisFsleFlsPrlttCe : e.. �° m�arrd�'em rai3dr�#lelatrot>is3��p` ." 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 7;110. 11. Proper reheating procedures for hot holding OKI 33. Nonfood contact surfaces clean, m P -67"dAtliCtR FrnF �o n rttflnrifnatibra 4. 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 ; 38. Approved and sufficient ventilation and lighting e "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 7. Compliance with Gulf oyster regulations <q EI �fCilrires � snarnac �4' ravxf1��3otUr2 , = 1. Plumbing maintained;proper back flow prevention Pp 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed r e. snsar�t#ef Ad�ttory m3. Toilet facilities clean,supplied,and maintained w...., _.. 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing ,` �. � .. 1111 ly;auphbler Pogr3laticirr� ,:. .` ` ,'° m" `-t3�rrrtat'rettt F'aod Facri�tes �, W " 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean .a 'USPat�rp#Yf1 £er _ ' ' 6. No living or sleeping quarters inside facility _ 1.Hot and cold potable water available. Ggrnpir$dtid: fort »ertt� -e M lyfgs a Lltssal " 7. Signs posted;last inspection report available _. -. .. ..m��_. 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements _. ._...... ; :�. brmt 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension ,. Received Bylritle: a EH Specialist:/ Phone: �� Page 1 of L EHD 16-23 (1 s1 pg} 419112 ,li FOOD PROGRAM OR ,� II i : T