HomeMy WebLinkAboutHealth Department Files_81077_pg0040 -------------
Establishment: Date of Inspection: Ir -4 Z. a
Address: rJ SOL
Owner or Operator:
ADDITIONAL FOUR POINT ITEMS '
KEY: DNC [DOES NOT COMPLY]
6 Foods not re-served.
-Unwrapped foods not re-served 4 31 Sewage disposal approved.
-Potentially hazardous foods not re-served rating as required
11 Toxic chemicals. ft cross connections,back siphonage,backflow
-Stored properly,labeled properly,used properly Proper t e/in tallati /backflo vic 'r a f r:
-Sanitizer concentration not to exceed maximum permitted -Food equipment - ose connectio Dish machines
-No unnecessary toxics on the premises -Soda system carbonator - everage dispensers �-Toilettanks
-Pesticides/rodenticides properly dispensed -Chemical dispensers -Ice machines
Proper drain for: S`s �1 g
29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines
-Well/well head protected from contamination 35-Water quality in compliance Toilet facilities. Adequate,convenient,accessible,
-Monitoring in compliance designed,properly installed
OTHER ITEMS KEY: DNC [DOES NOT COMPLY]
2 Sources of food: Original container,properly labeled 40 Garbage/rubbish storage area/rooms,enclosures-properly constructed,clean
5 Potentially hazardous food properly thawed 41 Garbage/rubbish disposed of in an approved manner,at approved frequency
0 od dispensing utensils properly stored 42 Armin Contr : No in odents se
Food worker:Clean outer clothes,effective hair restraints 2V3 Outer openings protected against entrance of insects/rodents
loors: Floor covering installed,constructed as required,good rep ir, an
16 Food-contact surfaces designed,constructed,maintained,installed, 5 Floors graded,drained as required
located
6 Floor,wall juncture covered
7 onfood-contact surfaces designed,constructed,maintained, 7 Mats removable,good repair,clean
installed,located
18 Single service articles,storage,dispensing
8 Exterior walking,driving surfaces,good repair,clean
19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good
repair,clean.Wall&ceiling surfaces as required
20 Dishwashing facilities approved design,adequately constructed,
maintained installed located 501 Dustless cleaning methods used,cleaning equipment properly stored
Equipment&Utensils• Cleanliness 51 Adequate lighting provided as required
21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors
22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required
2 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean
27 onfood-contact surfaces of utensils&equipment clean
55 Establishment and premises free of litter,noinsect/rodentharborage,
quipment/utensils,storage,handling no unnecessary articles
2 Proper disposal of wastewater 56 Complete separation from living/sleeping quarters and laundry
33 Plumbing location,installation,maintenance 57 Clean/soiled linens stored properly
58 No live birds,turtles,or other animals(except guide dogs)
36 Toilet rooms enclosed with self-closing door
59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at
37 Proper toilet fixturesprovided,good repair,clean entrance(s),smoking area indicated by sign(s)
39 Approved garbage/rubbish containers,adequate number,covered,
rodent proof,clean RRoutine Inspection ❑Reinspection ❑ Preoperational Inspection
N P TOR: PERSON I AR E: Ot er Inspection:
Demerit Score: *Include demerits from page 1
( � 4 3 2 1 Total Rating
signa ure s n ture �(
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print name print name
phone number title DATE CORRECTIONS DUE: t to
Page 2 of 2 plus---A continuation pages Focused Inspection 1/2002