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SAN JOAQUIN COUN-
<br />ENVIRONMENTAL HEALTH DEF-ARTMENT
<br />1868 East HazeIton Avenue, Stockton, CA 95205-6232
<br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orgiehd
<br />FOOD PROGRAM OFFICIAL INSPECTION REPORT
<br />Name of Facility: Ci" 4 _ 1.)
<br />65 c pr?-t( 0 41 ill< A) 9 Date: / h 1 --
<br />Address: CS-6 t/t/ i l ,f ek-7 1(.77v City:
<br />,SY-Pq"›/C' PI
<br />Zip Code:
<br />Telephone: Owner/Operator: p a f eut , 4 / 7, .
<br />Program Element: / 6., 7,4 Pro Record: i 6, 1---)...3t / 7 9 /Inspection Type: .,-, /// ic
<br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After:
<br />IN = In Compliance N/0 = Not Observed N/A = Not Applicable COS = Corrected
<br />See reverse side for code sections and general requirements that
<br />Major violations pose 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 />IVO VA Demonstration of Knowledge tAki OUT COS Supervision I otri• l
<br />1. Demonstration of knowledge food safety certificate 24. Person In Charge is present and performs duties
<br />Employee Health and Hygiene Personal Cleanliness
<br />2. Communicable disease; reporting, restrictions & exclusions ,,,t,zt, Personal cleanliness and hair restraints
<br />. No discharge from eyes, nose, or mouth; no open wounds sii..; i>.:,ir , General food Safety Requirements
<br />• . Proper eating, tasting, drinking, or tobacco use Approved thawing methods used 1
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<br />.. Hands clean and properly washed; proper glove use
<br />Food protected from contamination during storage
<br />Washing fruits and vegetables before use
<br />, •.f Handwashing facilities supplied and accessible Toxic substances properly identified, stored, and used
<br />
<br />..„. 4, V, • -' E r ea, , - ts., , %,,, '.0 \ \ ' 44, 44 . ,
<br />... - . Proper hot and cold holding temperatures Food storage; food storage containers labeled
<br />:,. Proper use of time as a public health control 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 Equipm
<br />Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean
<br />, 34. Warewashing facilities maintained; test strips available
<br />12. No re-service of retumed food 35. Equipment/utensils approved; installed; clean; good repair
<br />Food free from contamination and adulteration 36. Equipment, utensils and linens: storage and use
<br />4 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained
<br />,r4#. , . ° ,....-. :So..w,,,, 38. Approved and sufficient ventilation and lighting
<br />15. Food obtained from approved source 39. Thermometers provided, accurate, and easily visible
<br />16. Compliance with shell stock regulations; tas/display 40. Proper use and storage of wiping cloths
<br />17. Compliance with Gulf oyster regulations
<br />.-.
<br />Conformance With Approved Procedures , 41. Plumbing maintained; proper back flow prevention
<br />_ 8\i/\,18. Compliance with HACCP ,plan or variance conditions I 42. Garbage and refuse properly disposed
<br />Consumer Advisory 43. Toilet facilities clean, supplied, and maintained
<br />ii 19. Advisory provided for raw or undercooked food 44 Premises personal/cleaning items: vermin-proofing
<br />, -$Y,tigiqplible Populations
<br />._
<br />PermanerifFood Facilities
<br />.r +0. Prohibited foods not offered at high risk facilities Floors, walls and ceiling are maintained and kept clean
<br />Water!-- No living or sleeping quarters inside facility
<br />I 4 1. Hot and cold potable water available. orcement ,
<br />Waste Di Signs posted; last inspection report available
<br />, 2. Sewage/wastewater properly disposed; toilet facility useable Compliance with plan review requirements
<br />2., Facility operating with a valid health permit
<br />3. No rodents, insects, birds or animals inside facility Impoundment
<br />...---7 Permit Suspension
<br />Received By/Title: /
<br />EH
<br />7fii/
<br />Specialist: ) Phone: ( (44":„._,6":,pc / Page 1 of
<br />EHD 16-23 (1st pg) 4/9/12 I
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<br />FOOD PROGRAM OIR
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