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agr+ 1. SAN JOAQUIN COUNTY �, ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 �42iFs'A';a Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siaov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: Address: !•7t ' City: Zip Code: r 7.,, Owner/Operator:)v Telephone: Program Element: Program oral: Inspection Type: / l SB180 Posted es _ No Permit Posted .Yes _ No Re-Inspection on or After: IN=In Compliance WO=Not Observed WA=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 Pow a threat to public health and must be corrected Immed/afel . Non-compliance may warrant closure of the food facility 1. Demonstration of knowledge;food safety certificate 4. Person In Charge Is present and performs dudes Communicable disease;reporting,restrictions&exclusions 5. Personal cleanliness and heir resilf No discharge from eyes,nose,or mouth;no open wounds FHondwashing ing,tasting,drinking,or tobacco use . Approved thawing methods used 7. Food protected from contamination during storage an and properly washed;proper glove use 8. Washing fruits and vegetables before use ing facilities supplied and accessible . Toxic substances properly identified,stored,and used and cold holding temperatures . Food storage;food storage containers labeled of time as a public health control 1. Customer self-service food protected;individual utensils provided oling methods Food properly labeled and honestly presented oking time and temperatures Eq. 11. Proper reheating procedures for hot holding Nonfood contact surfaces clean 4. Warewashing facilities maintained;test strips available 12. No re-service of returned food 5. Equipment/utensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sankized/warewashing procedures 7. Vending machines maintained . Approved and sufficient ventilation and lighting 15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible 6. Compliance with shell stock regulations;tags/display 0. Proper use and storage of wiping cloths 7. Compliance with Gulf oyster regulations Procedures ? 1. Plumbing maintained;proper back flow prevention 8. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed . Toilet facilities clean,supplied,and maintained Advisory provided for raw or undercooked food Premises;pereonali leaning items;vermin-proofing cls . Prohibbed foods not offered at high risk facilities Floors,walls and ceiling are maintained and kept clean . No living or sleeping quarters Inside facility 1.Hot and cold potable water available. ompliani 7. Signs posted;last inspection report available SewageAvastewarer properly disposed;tcllet facility useable Compliance with plan review requirements 9. Facility operating with a valid health permit . No rodents,insects,birds or animals inside facility 0. Impoundment L. Permit Suspension Received Byrritle: EH Specialist: Phone: 2 Page 1 of:1 EHD16-23 (lstpg) 12115/09 FOOD PROGRAM OR