HomeMy WebLinkAboutFood Service Establishment Inspection 65 (12) C �
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Town of South Windsor
OR- 0 HEALTH DEPARTMENT/WATER POLLUTION CONTROL
Inspection Checklist
Date: W.
Inspector:
Establishment:
Address:
Contact Name: <'A ( o v\_i^o Signature:
Phone: ��„�� '2S S 6
INTERCEPTOR NUMBER
General Information #1 #2 #3
1. Was grease interceptor inspected ay ❑ N ❑ Y ❑ N ❑Y ❑ N
2. Grease interceptor accessible for maintenance W/y ❑ N ❑ Y ❑ N ❑Y ❑ N
❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Major Violations Outdoor Grease Interceptor
1. Manhole cover brought to grade,and labeled. N ❑ Y ❑ N ❑Y ❑ N
2. Provided written contractor invoice for last cleaning M/y ❑ N ❑ Y ❑ N ❑Y o N
3. Date of last cleaning
❑ Y ❑ N El ❑ N ❑Y ❑ N
oY oN ❑ Y ❑ N ❑Y ❑ N
Major Violations Indoor Grease Interceptor
1. Unit maintained daily @/y ❑ N ❑ Y ❑ N ❑Y ❑ N
2. Unit energized,and automatic timer set to Q/� ❑ N ❑ Y ❑ N ❑Y ❑ N
operate during business hours.
3. Screening basket in place U/� ❑N ❑ Y ❑ N ❑Y ❑ N
4. Skimmer in working order 4X ❑ N ❑ Y ❑ N ❑ Y o N
5. Heater in working order w'� ❑ N ❑ Y ❑ N ❑ Y ❑ N
6. Grease collection container in place 2/Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Minor Violations
4. Grease interceptor maintenance log available W/Y ❑ N ❑ Y ❑ N ❑Y ❑ N
5. Signs posted at all sinks ❑ Y n4 ❑ Y ❑ N ❑ Y ❑ N
6. Pots,pans,dishes,and utensils scraped ❑A' ❑ N ❑ Y ❑ N ❑ Y ❑N
7. Adequate renderable FOG container storage u/V' ❑ N ❑ Y ❑ N ❑Y ❑ N
8. Exhaust hood properly cleaned D,� ❑ N ❑ Y ❑ N ❑Y ❑ N
9. Renderable FOG recycled d Y ❑ N ❑ Y ❑ N o Y ❑ N
10. No chemical additives used c Y ❑ N � ❑ Y ❑ N ❑ Y ❑ N
Non-Renderable FOG Disposal Location ❑ Trash 1a'Contractor ❑ Other
Grease Interceptor Cleaner's Information Renderer's Information
Name: ^�L TCX/ S 66A% -ki, � Name:
Address: Address:
Phone: —1 C U1 $ Phone:
Last Pump Date: