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ip SAN JOAQUIN COUNTY 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: 4-,9 Date: ddress:' O !J ✓1 City: Xil I / N Zip Codeyr . l� o(/ Owner/Operator: Telephone: -75 Program Element: Program Record:Inspection It 20 Type: SB180 Posted KYes ❑ Rermit Posted ❑ Re -Inspection on or After: N in IN = In Compliance NIO = 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. Mafor violations ose a threat to uhlic health and must be corrected immediatel . Non-com liance may warrant closure of the food facilit rv' wc..N, Demonstration of Knowledge ere Cos Supervision 1. Demonstration of knowledge- food safety certificate 24. Person In Charge is present and performs duties ". Emplo .ee Heahh and Hygiene _ - Communicable disease, reporting, restrictions & exclusions ' 25. - Personal Cleanliness' Personal cleanliness and hair restraints 3. No discharge from eyes, nose, or mouth; no open wounds -- 6. Gen Fogg Safety Requirements Approved thawing methods used Proper eating. tasting, drinking. or icbacce use Preveak Contamination 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 - Time and Temperature Relationship Proper hot and cold holding temperatures 29. Toxic substances properly identifiedstored. and used .._. Food Storage/Display/Service 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 property labeled and honestly presented 10. Proper cooking time and temperatures amt f Utensils 1 Linens. 11. Proper reheating procedures for hot holding Contamination r - ! 12. No re -service of returned food p-` 33. Nonfood contact surfaces clean 34. Warewashing facilities maintained; test strips available 35. Equipment/utensils approved; installed; clean; good repad< 13. Food free from contamination and adulteration 36. Equipment, utensils and linens: storage and use 14. Food contact surface cleaned and sanitized/warewashing procedures 15. Food obtained from approved source 37. Vending machines maintained 8. 39. Approved and sufficient ventilation and lighting 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 4 i. Plumbing maintained, proper back flow prevention " 18. Compliance with iplan or variance conditions " 2. Garbage and refuse properly disposed Consumer Advisory 3. Toilet facilities clean, supplied, and maintained 19. Advisory provided for raw or undercooked food 44. Premises; personal/cleaning items: vermin -proofing ...._. Highly Susceptible Populations . """ Permanent Food Facilities P0. Prohibited foods not offered at high risk facilities 45. Floors. walls and ceiling are maintained and kept clean 'n Water / Hot Water 46. No living or stepping quarters inside facility 1. Hot and cold potable water available. Compliance and Enforcement .Liquid Waste Disposal 47. Signs postedlast inspection report available �22. Sewage/wastewater properly disposed. toilet facility useable 48. Compliance with plan review requirements Vermin 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: VA EH Specialist:. Phone: Page 1 of EHD 1623 (1st pg) 0112 `J FOOD PROGRAM OR