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opQ�f" SAN JOAQUIN COUNT ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: C I�C S 8 G+ i i, ` c` ` I) t Date: 2 I t{ Address: )S 3 3 r S" f 1(A r 10 1) D 1`Gi d City: L i , I ` Zip Code: 9S 3 3 O Owner/Operator: )� nc" n` Telephone: 1' K T �1 y-!6/)_ Program Element: 16 rvl Program Record: 5 3 ,,) /ql Inspection Type: R17J 4 b IS 8180 Posted v'Fes No Permit Posted V 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 immediately. Non-corn liance may warrant closure of the food facility N`rxo xrn ; Demonstration of Kno `cos $upervisi21 a V 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties u _ n ttx!H iene personal�Cleanfiness >�p _ y9`UP ME . Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety R"w ement9 Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used �; � .�plltamtnation by Hands 27. 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 ,mom a Time ''1 em erature -� andP Relationship V 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 vr 19. /v Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures „_ Eqq T 1inet3s 11. Proper reheating procedures for hot holding WE 33. Nonfood contact surfaces clean 34. Warewashing facilities maintained;test strips available VT 1 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 RR 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 Coil# rmance 1Nith, l►P '. 1. Plumbing maintained;proper back flow prevention Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Ad" 43,,," w -' 3. Toilet facilities clean,supplied,and maintained 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing - -TY", L' 0. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean 6. No living or sleeping quarters inside" afer 9 P 9 q facility 1.Hot and cold potable water available. , 2. 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: //_ (i Pagel of EHD 16-23 (1st pg) 4/9/12 (�J FOOD PROGRAM OIR