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op4U1 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> " it� ") 304 E Weber Avenue 3rd Floor Stockton • CA 95202-2708 <br /> )•/11 . (209)468-3420•Fax:(209)464-0138 • Web:www.co.san-joaquin.ca.us/ehd <br /> S\-Fo-/HsP� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: 75 21R City: Via:czq Zip Code: <br /> Owner/Operator (_411 aAa. Telephone: - <br /> Program Element: Program Record: Qiq Q J Inspection Type: f'%hQX <br /> SB180 Posted ❑Yes ❑ No Permit Posted ❑Yes ❑ No Time In: l ; OD Time Out: <br /> The items marked and/or listed below are violations detailed in the California Health&Safety Code(CHSC),commencing§113700. "Major"is a critical violation that poses <br /> an imminent risk to public health. Unless otherwise specified,violations marked"Major^must be corrected immediately or warrant immediate closure of the food <br /> establishment. "Minor"indicates a violation that does not pose an imminent public health risk,but warrants timely correction as noted. <br /> Critical Risk Factors M.or tumor The marked violations represent Health&Safety Code Violations and most be corrected as follows: <br /> Improper holding temperature of potentially 1 2 /� / <br /> a hazardous food - /� O6 tt "R� d % <br /> E <br /> d Inadequate cooking temperatures/practices 3 4 <br /> E• o dceI'O I <br /> o Improper reheating temperatures/practices 5 6 .(.-, <br /> e Qir1r <br /> 0 <br /> v' Improper cooling practices 7 B <br /> m <br /> Adulturated/Contaminated food 9 10 - tL i f ne <br /> a <br /> aReused/retumed food 11 12 _ a Gt � ,� <br /> e a Cross contamination or improper handling 13 14 <br /> of Food/Utensils/Equipment <br /> m <br /> 'O Unapproved food source 15 16 1„ l <br /> ° - <br /> 0 <br /> T open thawing of potentially hazardous 17 18 11 <br /> 0— a< I _ �0 <br /> Yl lIatt <br /> oy Ill employee/cuts/rashes 19 20 <br /> Y � = il/J <br /> Lack of proper hand washing procedure 21 22 <br /> v = Required sink(s)/dish washing machine 23 24 <br /> removed,inoperable,inaccessible <br /> u <br /> Unsanitary Food Facility Conditions- 25 26 <br /> Critical/Non-Critical Area f 1 <br /> m Hot water not available 27 28 <br /> e <br /> V N <br /> a d! ❑_ Lack of potable water supply 29 30 <br /> 3 <br /> m Improper sanitizer concentration/methods/ 31 32 <br /> testing a ui ment 6L-1 K, <br /> d Sewage system failure/back up 33 34 <br /> m <br /> 3 dJ E No operable/accessible toilets 35 36 5rna r <br /> V V <br /> Rodent/CDckmach/Other vermin infestation 37 38 <br /> f Y Y1 S -f <br /> ENVIRONMENTAL HEALTH AND SERVICE CHARGE FEES ARE AUTHORIZED BY RESOLUTION OF SAN JOAQUIN COUNTY BOARD OF SUPERVISORS. ALL DOCUMENTED <br /> CRITICAL HEALTH VIOLATIONS OR REPEAT VIOLATIONS ARE SUBJECT TO A REINSPECTION AND REMSPECTION FEE. ALL UNPAID CHARGES ASSOCIATED WITH THE <br /> FACILITY OWNER OF RECORD OR APPLICANT SHALL BE PAID PRIOR TO THE ISSUANCE OF A PERMIT TO OPERATE. <br /> ITEWLOCATION TEMP ITEWLOCATION TEMP ITEWLOCATION TEMP <br /> Food Safety Certification Required: Pes❑No - _ Reinspection on or After: <br /> Certificate Issued By: Date:_/_/_ Received By: <br /> Name on Certificate: E.H.S.: <br /> EHD 16-02-023 <br /> 6w2o03 See Reverse Side For Additional Information - Pagel of l <br />