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SS9t coc SAN JOAQUIN COUNT' 'y+ ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 tea•. a�" Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd ��FOR FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: /l� y, J Date: Address: t! / vl,r 1 �y/ City: Zip Code: Owner/Operator: V _41/7qn` Telephone:q5 ti( Program Element: 6 p Program Record: Inspection Type: 7iv / t/ B180 Posted Yes No Permit Posted es No Re-Inspection on or After: S r 5- IN 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. Major violations pose a threat to ublic health and must be corrected immediately. Non-com liance maX warrant closure of the food facility iN ?BYO WA 1. Demonstration of knowledge;food safety certificateFE, 24. Person In Charge is present and performs duties Em And H ierla r'.. '8rscs[ 1ttearimessr y9. � w�..� U . Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds - Gf1tsDfFMTd Sa#ety �1t1eil9 " 1.� r r Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used � �1► Cg111K11�fS81- - = �,. 7. Food protected from contamination during storage 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use 10 Handwashing facilities supplied and accessible r� 29. Toxic substances properly identified,stored,and used +f.,,.,-, '� 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperaturesgialpatl tCt1t8 �i g..; 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean r IYr C 34. 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 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 Pfiys3caLacifd?es f>iaance VYfth,Ap, ttl _ � r 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed w e � r , _ 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing F, 9 �� i�o► iatians Permaao�iactl>ttiePERU a-21 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean k t WaterlFtof u ,<,..- w r 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. w � _ i8 >re �. �, .. i _ _ � �..; � e _ 7. Signs posted;last inspection report available A2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Phone: , (/ Page 1 of EHD 16-23 (1st pg) 4/9/12 O FOOD PROGRAM OIR