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SAN JOAQUIN COUNT X `NVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd �/FOR FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: C R`, ;G pf�U. (A Date: Address: ,z-.-)I fi r11 City: � � Zip Code: Owner/Operator: 1 G UTelephone:�i Program Element t Program Record: _ OV-_-) t Inspection Type: (V( SB180 Posted L Yes,) No Permit Posted Yes No 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. Major violations pose a threat to ublic health and must be corrected immediatel . Non-cornliance mqX warrant closure of the food facili 1�; wo wa >nons rattan of t�novrledge # our cos upervllif i Wiz: <. .r 1. Demonstration of knowledge;food safety certificate s 24. Person In Charge is present and performs duties Em 10 ee#fealthAridfi Hygiene Perssxrialfeanliness p Y Y9 t a. t. ,. .� .mac Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints -OFNo discharge from eyes,nose,or mouth;no open wounds Gsstt+Dt=3afetyl Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used 414.' ` w 7. Food protected from contamination during storage Gollitf+n .. P 9 9 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 itiotlip x; 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 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair i 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 SEE Iviftk. > }rtlarlCelAN#h,Ap1"� 1. Plumbing maintained;proper back flow prevention B. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed I,� rt Ad ,,,,t my ' 3. Toilet facilities clean,supplied,and maintained K,s. 9. Advisory provided for raw or undercooked food 4. Premises;personal/cleaning items;vermin-proofing UT I tiat>s` Per Facilt3resr ', 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean .,, • M> WaterHot � - ,, r 6. No living or sleeping quarters inside facility 9 P 9 q 1.Hot andcold potable water available. �� Z vs � xa� r>C 7. Signs posted;last inspection report available ' 77 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements RM . � Vermtrf a .mow 9. Facff ility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 5o. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Phone: - Page 1 of - EHD 16.23 (1st pg) 4 /i FOOD PROGRAM OIR