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SAN JOAQUIN COUNTY EI4\1IRONMENTAL HEALTH DEPAR I MENT 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: `^f U 77 .1 1 1 Date: 2 Address: 1 i� q �ml City: S� }� 11-� Zip Code: �2G� Owner/Operator: w 1 en� U 1 1 Telephone: Ilb(0 Program Element:_ i, Program Record: O 5 ) Inspection Type: B180 Posted Yes / No Permit Posted a No Re-inspection on or After: IN=In Compliance N/O=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 Cose a threat to public health and must be corrected immediately. Non-corn liance may warrant closure of the food facility fit: tiro xua. > .. $ �e', i10n Gf I{nG�n#1 otrrbm tlperlri5 :'_ .* fx r. 1. Demonstration of knowledge;food safety certificate m 24. Person In Charge is present and performs duties u�asp �l9e �eilflAnd ygl@fl x ` �@dlZlirlL'SS Communicable disease;reporting,restrictions&exclusions � 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds ,=tz 'Safe#►, 114 Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used 11f 'pt#tgnt; 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 1, _. ar- 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 Equipml �ts . 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 "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 WIR Ito 38. Approved and sufficient ventilation and lighting M 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 7. Compliance with Gulf oyster regulations ,, "PF� c87 . r W. - `.. .-,-^ ittr tt 1. Plumbing maintained;Proper back flow prevention -f 8. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed ` 3. Toilet facilities clean,supplied,r _ PPlied,and maintained 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing x _. .. slier Racal I-f0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean .-. Noliving or sleeping quarters inside facility 1.Hot and cold potable water available. z owl'PIN_1IC * -,; - 7. Signs posted;last inspection report availablex t 8. Compliance with plan review requirements Sewage/wastewater property disposed;toilet facilityuseable max, Vetmm - 9. Facility operating with a valid health permit 3. No rodents,insects,birds oq animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Phone: _ � ,��f Page 1 of -l C4 EHG 16-23 (1st pg) 4/9112 FOOD PROGRAM OIR