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SAN JOAQUIN COUNTY
<br />ENVIRONMENTAL HEALTH DEPARTMENT
<br />1868 East HazeIton Avenue, Stockton, CA 95205-6232
<br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orq/ehd
<br />FOOD PROGRAM OFFICIAL INSPECTION REPORT
<br />Name of •
<br />
<br />Facility ' (T444,-7 ....__. TZ,“ 4.47---- Date: .1/2 3 i 2, y
<br />Address: City: Zip Code: q d--)v1.6, wp/
<br />Alp try)
<br />'IC' 11 A/ (-74ii Owner/Operator: ' 67,24 Telephone:
<br />4, 14e--- ,,,7:71.,, czei th .1., Le_.__. Li e_
<br />Inspection Type: V.51,1_, Program Element: / b2..../3 / Program Record:fl P l'ytp,___
<br />SB180 Posted CI Yes 0 Permit Posted D es 0 I, 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 immediately
<br />on-site MAJ = Major Violation OUT = Not in Compliance
<br />correspond to each violation listed below.
<br />Non-compliance ma warrant closure of the food facility ,
<br />IN WO NA Demonstration of Knowledge N1AJ OUT cos , Supervision i OUT
<br />1 Demonstration of knowledge food safety certificate
<br />2(
<br />24 Person In Charge is present and performs duties
<br />Employee Hear .,,,..=iy"? Personal Cleanliness
<br />,2 Communicable disease reporting, restrictions & exclusions 25 Personal cleanliness and hair restraints
<br />3 No discharge from eyes, nose, or mouth; no open wounds General Food Safety Requirements
<br />Proper eating, tasting, drinking, or tobacco use Approved thawing methods used
<br />Preventing Contamination by Hands Food protected from contamination during storage
<br />Hands clean and properly washed; proper glove use Washing fruits and vegetables before use
<br />Handwashing facilities supplied and accessible
<br />re Relationship
<br />29 Toxic substances properly identified stored and used
<br />Food Storage/Display/Service
<br />. Proper hot and cold holding temperatures 30. Food storage food storage containers labeled
<br />. Proper use of time as a public health control 31. Customer self-service food protected; individual utensils provided
<br />. Proper cooling methods 32. Food properly labeled and honestly presented
<br />Proper cooking time and temperatures Equipment I Utensils! Linens
<br />Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean
<br />Protection From Contamination 34. Warewashing facilities maintained; test strips available
<br />12. No re-service of returned food 35. Equipment/utensils approved; installed; clean; good repair X
<br />13. Food free from contamination and adulteration 36. Equipment utensils and linens: storage and use
<br />14. Food contact surface cleaned and sanitizedfwarewashing procedures 37. Vending machines maintained
<br />I ' '
<br />
<br />Fra pproved Source 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; tags/display 40. Proper use and storage of wiping cloths . . „,
<br />17. Compliance with Gulf oyster regulations Physical Facilities
<br />Conformance'VVith'Approved Procedures 41. Plumbing maintained; proper back flow prevention
<br />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 />119 Advisory provided for raw or undercooked food I 44. Premises: personal/cleaning items: vermin-proofing
<br />Highly Susceptible Populations Permanent Food Facilities
<br />120 Prohibited foods not offered at high I lsk facilities 1 45. Floors, walls and ceiling are maintained and kept clean
<br />Water I Hot Water 46. No living or sleeping quarters inside facility . , . ...
<br />I 121. Hot and cold potable water available 0. Compliance and Enforcement
<br />Liquid Waste Disposal 47. Signs posted; last inspection report available
<br />1 ,22 Sewage/wastewater properly disposed toilet facility useable 48. Compliance with plan review requirements
<br />Vermin 49. Facility operating with a valid health permit
<br />123 No rodents, insects, birds or animals inside facility I 50. Impoundment
<br />51. Permit Suspension
<br />Received By/Title: or . i SP I n I la,- re del,t4A- • EH Specialist:Phone: 209 _ 4 ii, , 3D &--2 Page 1 of ,,,, Arco'. -- 17.....4.7.-e...44
<br />EHD 16-23 (1st pg) 4/9/12
<br /> FOOD PROGRAM OIR
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