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�Qp4`1!M'FA SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 ..d4tiaaaaa.. Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.oro/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date:3 i Address: City: ,l' Zlp Code: Owner/Operator: VIAAdV v u Telephone: Program Element Program Record Inspection Type: B180 Posted Wes ❑ No I Permit Posted s 0 No Re-Inspection on or After: IN=In C mpliance NIO=Not Observed NIA-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. Ma or violations pose a threat to eublic,health and must be corrected Immediately. Non-compliance may warrant closure of the food facilit IN coo con - Demonstration of Knowledge nw our cos � Supervision 1. Demonstration of knowledge;food safety certificete 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness _ Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used Preventing Contamination by Hands 27. 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 9. Toxic substances properly identified,stored,and used Time and Temperature Relationship _ Food StoragelDisplay/service 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 Proper cooling methods 32. Food properly labeled and honestly presented 0. Proper cooking time and temperatures Equipment I Utensils I Linens 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipmentlutensils approved;installed;dean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 4. Food contact surface leaned and sanitizedhvarewashing procedure;: 37. Vending machines maintained Food From Approved Source 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 Physical Facilities - Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention IT18. Compliance with HACCP plan or variance renditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning Items;verrnin-proofing Highly Susceptible Populations Permanent Fcod Facilities - 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water Hot Water 46. No Irving or sleeping quarters inside facility 77 1.Hot and cold potable watei available. Compliance and Enforcement Liquid Waste Disposal - 7. Signs posted;last inspection report available 2. sewagetwastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin 49. 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: Page 1 of EMD 1623(1st pg) 12/109 FOOD PROGRAM OR 4