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ij a�Q`tt"• 'i SAN JOAQUIN COUNTr x. A� ri NVIRONMENTAL HEALTH DEPARTMENT or 1868 East Hazelton Avenue, Stockton, CA 95205-6232 c ;a Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.si ov.org//ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Date: Name of Facility: �a Address: �-3 City: 0 ` Zip Code: Telephone: OwnerlOperator: Program Element: Program Record: .i Inspection Type: B180 Posted es' No Permit Posted Yes No Re-Inspection on or After: t IN=In CZTWiance N/O=Not Observed NIA=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=blot in Compliance See reverse side for code sections and general requirements that correspond to each violation listed below. War violations gose a threat to public health and must be corrected immediatel . Nan-camfiance maV warrant closure of the food facility GK W'�� - 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties 1110,0`7 6 q dt6s: ` itIr183S, a. fA e Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds Proper eating,tasting,drinking,or tobacco use ii 26. Approved thawing methods used 7. Food protected from contamination during storage��`"-'• Hands clean and property washed;proper glove use 28. washing fruits and vegetables before use Handwashing facilities supplied and accessible ;; 29. Toxic substarices properly identified,stored,and used r Proper hot and cold holding temperatures ,M 30, Food storage;food storage containers labeled4provided Proper use of time as a public.hea.11 eontrol 1. Customer self-service food protected;individual utens Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperaturesgfie 8` t; 11. Proper reheating procedures for hot holding 33.•Nonfood contact surfaces clean + IraetiCit9t! a µ 34. warewashing facilities maintained;test strips available 12. No re-service of returned food A 35. Equipmentlutensils approved;installed;clean;good repair 13. Food free front contamination and adulteration 1i 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained - s. Approved and sufficient ventilation and lighting' ` 15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible m- 4 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations = " _ . . "` "�"��®- � "'®" �' `- � � ,� 1. Plumbing maintained;proper back flaw prevention �hftttt" 18. Compliance with HACCf.plan or variance conditions 2. Garbage and refuse property disposed _ 3. Toilet facilities clean,supplied,and maintained 19. Adviso rovided for raw or undercooked food 4. Premises personal/cleaning items;vermin-proofing ; rypm �e e _ i� 'y'- hte-. +@ it7nS .:.+• .+F Y"as..�i�id=? _ .GfR1A111xC}1'1 .. GI1 0. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean 4,MUM, Nats=rltif 6. No living or sleeping quarters inside facility WAR �. r,r 1.Hot and cold potable water available. "$ $ 7. Signs posted;last inspection report available ,re 2. Sewagelwastewater property 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 �' 1. Permit Suspension 1. Received By/Title; i EH Specialist: Phone, r �-�. Page 1 of EHD 16-23 (1sl N) 4W.2 l; FOOD PROGRAM OIR