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o4ggi"' SAN JOAQUIN COUNTY <br /> � 'pG <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> t <br /> = 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> C9�iPb•PN\�'• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> EName of Facility: 4 t i s C 6115 / Date: <br /> ress: 7 rn/J _.. City: Zip Code: <br /> erlOperator: o VIle �! 8.t 3-/7Telephone:ram Element: j (� Pr gram ecord: 3 9 Inspection Type:80 Posted .Yes D No Permit Posted es D No Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed NIA=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Major violations'pose a threat to public health and must be corrected immediate/ . Non-compliance mary warrant closure of the food faciti <br /> V .wo nvn - 'Demonstration of Know e <br /> ✓ 1. Demonstration of kno.vledge;food safety certificate 24. Person in Charge is present and performs duties <br /> Employee Health and Hygiene <br /> 2. Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> 3. No discharge from eyes,nose,or mouth;no open wounds <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> rlatipn_by�Hands,�. 7. Food protected from contamination during storage <br /> FHandwashing <br /> n and properly washed;proper glove use 8. Washing fruits and vegetables before use <br /> ng facilities supplied and accessible 9. Toxic substances properly identified,stored,and used <br /> and cold holding temperatures 0. Food storage;food storage containers labeled <br /> of time as a public health control 1. Customer self-service food protected;individual utensils provided <br /> ling methods 2. Food properly labeled and honestly presented <br /> king time and temperatures <br /> 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean <br /> Pro ection glipa'o Warewashing facilities maintained;lest strips available <br /> 12. No re-service of returned food 5. Equipmentlutensils approved;Installed;dean;good repair <br /> 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br /> 8. Approved and sufficient ventilation and lighting <br /> 15. Foed obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations <br /> formance With Approved Procedures 41. Plumbing maintained;proper back flow prevention <br /> Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed <br /> Consumer Advisory _,u,_' 3. Toilet facilities clean,supplied,and maintained <br /> 19.Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations P.ermanent.Fpod Faci <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water - , ,.. - 6. No living or sleeping quarters inside facility <br /> f23, <br /> andold potable water available. -Complian- a - oe <br /> Liquid Waste Disposal 7. Signs posted;last inspection report available <br /> astewater properly disposed,toilet facility useable �_ 8. Compliance with plan review requirements <br /> Vermin x - 9. Facility operating with a valid health permit <br /> s,insects,birds or animals inside facility 50. Impoundment <br /> 1. Permit Suspension <br /> Received ByTtle: � <br /> R� <br /> EH Specialist: Phone: ' Pagel of Z <br /> EHD 1823(ist pg) 4!9/12 FOOD PROGRAM OIR <br />