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SAN JOAQUIN COUNT
<br />ENVIRONMENTAL HEALTH DEPARTMENT
<br />1868 East HazeIton Avenue, Stockton, CA 95205-6232
<br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www .sioov .orcilehd
<br />FOOD PROGRAM OFFICIAL INSPECTION REPORT
<br />Name of Facility: -----_2.5,-.5-C Date:
<br />Address:
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<br />City: Zip Code: ,4?,,,74 6,--c,,
<br />Owner/Operator:
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<br />' / Telephone:
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<br />Program Element: 7‘5 Program Record:r ' ) q 1 0 --j - -3 , WI/ Inspection Type: ,t,,,,,,2"..
<br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After:
<br />IN = In Compliance N/O = Not Observed N/A = Not Applicable COS = Corrected
<br />See reverse side for code sections and general requirements that
<br />Major violations rose a threat to public health and must be corrected immediate!'.
<br />on-site MAJ = Major Violation OUT = Not in Compliance
<br />correspond to each violation listed below.
<br />Non-compliance may warrant closure of the food facility
<br />PR '-9- PS ,
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<br />1. Demonstration of knowledge; food safety certificate A
<br />24. Person In Charge is present and performs duties
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<br />Communicable disease; reporting, restrictions & exclusions ‘ 25. Personal cleanliness and hair restraints
<br />. No discharge from eyes, nose, or mouth; no open wounds * '.1.Sate •
<br />. Proper eating, tasting, drinking, or tobacco use 26. Approved thawing methods used
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<br />4j 27. Food protected from contamination during storage
<br />. Hands clean and properly washed; proper glove use 28. Washing fruits and vegetables before use
<br />Handwashing facilities supplied and accessible 29. Toxic substances properly identified, stored, and used
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<br />30. Food storage; food storage containers labeled r...-•"-' - 7. Proper hot and cold holding temperatures
<br />:. Proper use of time as a public health control 31. Customer self-service food protected; individual utensils provided
<br />4... Proper cooling methods 32. Food properly labeled and honestly presented
<br />Proper cooking time and temperatures Th Equt ak V 4*1t
<br />Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean
<br />b' ra -$f 34. Warewashing facilities maintained; test strips available
<br />1- 12. No re-service of returned food 35. Equipment/utensils approved; installed; clean; good repair I----
<br />13. Food free from contamination and adulteration 36. Equipment, utensils and linens: storage and use
<br />/.---" 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained
<br />-. 38. Approved and sufficient ventilation and lighting
<br />15. Food obtained from approved source 39. Thermometers provided, accurate, and easily visible
<br />6. Compliance with shell stock regulations; tags/display 40. Proper use and storage of wiping cloths
<br />s..-1I Compliance with Gulf oyster regulations *v,
<br />4: ,
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<br />J-Ili.,1,0,ce.;--W-#0, P. 41. Plumbing maintained; proper back flow prevention
<br />* . Compliance with HACCP plan or variance conditions
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<br />42. Garbage and refuse properly disposed
<br />v "--(9 --. Advisory provided for raw or undercooked food
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<br />43 Toilet facilities clean supplied and maintain::
<br />44. Premises; personal/cleaning items; vermin-proofing
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<br />4-26. Prohibited foods not offered at high risk facilities .. 45. Floors, walls and ceiling are maintained and kept clean
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<br />a r „ . 46. No living or sleeping quarters inside facility
<br />.21. Hot and cold potable water available. fx`A`e.l. 8 r De: 0
<br />,Wastef , 4P1 47. Signs posted; last inspection report available L.--
<br />.22. Sewage/wastewater properly disposed; toile facility useable 48. Compliance with plan review requirements
<br />*- , Vermin ink 49. Facility operating with a valid health permit
<br />* .23. No rodents, insects, birds or animals insi le .cility 50. Impoundment
<br />51. Permit Suspension
<br />Received Byaitle: A/fr tR4S, Vii../
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<br />EH Specialist: ,inum.---", Pho(: Page 1 of
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<br />EHD 15-23 (1st pg) 4/9112 FOOD PROGRAM OIR
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