HomeMy WebLinkAboutFood Service Establishment Inspection 45 (4) m Town of South Windsor
�J�DSOR•co HEALTH DEPARTMENT/WATER POLLUTION CONTROL
Inspection Checklist
Date: 57 \b
Inspector: G�
Establishment: U✓ �Wn o 1 YN 6r \A4 i�
Address: 1-� f 1('(AaA'r% {Z
Contact Name: TOf, N wyy a- C.LI An or Signature:
Phone: C.Bb0�
INTERCEPTOR NUMBER
General Information #1 #2 #3
1. Was grease interceptor inspected V�l ❑ N ❑ Y ❑ N ❑Y ❑ N
2. Grease interceptor accessible for maintenance E� ❑ N o Y ❑ N ❑Y ❑ N
❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Major Violations Outdoor Grease Interce for
1. Manhole cover brought to grade,and labeled. )V� ❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
2. Provided written contractor invoice for last cleaning o Y o N ❑ Y ❑ N ❑Y ❑ N
3. Date of last cleaning N\]k
❑ Y ❑ N oY ❑ N ❑Y oN
❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Major Violations Indoor Grease Interceptor
1. Unit maintained daily VA, ❑ N ❑ Y o N ❑Y ❑ N
2. Unit energized,and automatic timer set to ;vf ❑ N o Y ❑ N ❑Y o N
operate during business hours.
3. Screening basket in place p4 ❑ N ❑ Y ❑ N ❑Y o N
4. Skimmer in working order WY ❑ N ❑ Y o N ❑Y ❑ N
5. Heater in working order W� ❑ N ❑ Y ❑ N ❑Y o N
i
6. Grease collection container in place V!� ❑ N ❑ Y ❑ N o Y ❑ N
Minor Violations
4. Grease interceptor maintenance log available &17 ❑ N ❑ Y ❑ N o Y ❑ N
5. Signs posted at all sinks ❑ Y MN ❑ Y ❑ N ❑Y ❑ N
6. Pots,pans,dishes,and utensils scraped ❑ N ❑ Y ❑ N ❑Y ❑ N
7. Adequate renderable FOG container
)I storage O/Y ❑ N ❑ Y ❑ N ❑Y ❑ N
8. Exhaust hood properly cleaned N J ❑ Y ❑N o Y ❑ N ❑Y o N
9. Renderable FOG recycled q/ o N ❑ Y ❑ N o Y ❑ N
to. No chemical additives used gYl n N // ❑ Y o N ❑Y ❑ N
Non-Renderable FOG Disposal Location ❑ 'Trash �Ontractor ❑ Other
Grease InterceptItor Cleaner's Information Renderer's Information [�
Name: 11 ,'\� Name: W '1'c ,n A
Address: Address: , C f
Phone: Phone: \
Last Pump Date: