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i o Q"l'v c SAN JOAQUIN COIIN .z ENVIRONMENTAL HEALTH DEPARTMENT J. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 . �4 •... ,.;�;a Telephone:(209) 468-342€3 Fax., (209) 464-0138 Web:www.si-gov.o_rg/ehd trFOti� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: C __A� 5 1-4 0'a;,- Date: Address: `, i S � �� `f1? r City: Zip Code_ S Owner/Operator: Telephone: Program Element: Program Record: " Inspection Type: 8184 Posted Yes No Permit Posted Yes No lie-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. Major violations ose a threat to public health and must be corrected Immediately. Non-corn fiance ma warrant closure of the food facill :'� Il .:,x x trp►1�Ot ,..V��:� m ��'.NGOs f � ��AErY15��. .�' .r,r .a,e. 1. Demonstration of knowledge;food safety certificate 24, Person In Charge is present and performs duties ui w _ Ifn "aYipi d gieza�s ., ess" � Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints -3 No discharge from eyes,nose,or mouth;no open wounds " Proper eating,tasting,drinking,or tobacco useKi" 6. Approved thawing methods used ry"' 1f��v rnt 7. Food protected from contamination during storage Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use 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 > 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean ar 34. Warawashing facilities maintained;test strips available - 12. No re-service of returned food 35. Equipment/utensits approved;installed;clean;good repair 10 3. 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 61 38. Approved and sufficient ventilation and fighting 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 17. Compliance with Gulf oyster regulations - C ��.�: ��m m �7srtait""e 111f�kh ,� -, :�� G 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed z r, _ µms.. 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing [fflProhibited foods not�offered at high risk facilities S. Floors,walls and ceiling are maintained and kept clean ater 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. ..°_ off- ,_..... .,.. .. . . ... .. - 7. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable . Compliance with plan review requirements y _ 9. Facility operating with a valid health permit Mum,_3. No rodents,insects,birds or animals inside facility [0. Impoundment 1. Permit Suspension Received By/Title: VU EH Specialist: Phone: 4 10 T Qs3 Page 1 of Z EtID 16.23(isl pg) 4/9112 FOOD PROGRAM 0IR