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>r SAN JOAQUIN COUP' ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd �rFUR � FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: 777-777 Address: v- 3 G City: Zip Code: Owner/Operator: !� 4iQl,,IrL Telephone: IJ__ 3 Program Element: k�-�/�;L Program Record: of-Zf Inspection Type:,,JV B180 Posted Yes No Permit Posted Yes - No g -L & 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. !Wr violations pose a threat to ublic health and must be corrected immediately. Non-compliance may warrant closure of the food facility ste, n 1. Demonstration of knowledge;food safety certificate I Arm4. Person In Charge is presentand performs duties ,' yee Health and Hygiene Communicable disease;reporting,restrictions 8 exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds Proper eating,tasting.drinking,or tobacco use 6. Approved thawing methods used Contamination by H 7. Food protected from contamination during storage Hands dean and properly washed:proper glove use 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used Food Storage/Display/Service 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 Equipment/Utensils/Linens ---t1_ Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean .Protection From Contamination 34. Warewashing facilities maintained;test strips available IFT112. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair 3. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use 14. Footl contact surface cleaned and mnitizedtwarewashing procedures 7. Vending machines maintained 8. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible El NZ, 6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 1 i17. Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained.proper back flow prevention 8. Compliance with HACGP plan or variance conditions 42. Garbage and refuse properly disposed umer Advisory ,., 3. Toilet facilities clean,supplied,and maintained 9. Advisory provided for raw or undercooked food 44. Premises.personallcleaning items:vermin-proofing s Permanent Food Facilities . Proh�itetl f00ds not offered at high dsk facilities 45. Floors,walls and ceiling are maintained and kept clean 46. No living or sleeping quarters inside facility 1.Hot antl cold potable water a,olablc. Compliance and Enforcement Ay' /quid Waste Disposal 47. Signs posted;last inspection report available 2. Sewage/wastewater properly disposedtoilet 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 1. Permit Suspension Received By/Tttle: EH Specialist: Phone: Page t of 3 EHD 1623 (1st pg) 4/9/12 FOOD PROGRAM DIP