HomeMy WebLinkAboutFood Service Establishment Inspection 67 (4) 'O
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Town of South Windsor
S0R•C0 HEALTH DEPARTMENTIWATER POLLUTION CONTROL
Inspection Checklist
Date: lee le/c
Inspector: isjg'
Establishment: S i
Address: �v
Contact Name: Signature:
Phone:2&D
INTERCEPTOR NUMBER
General Information #1 #2 #3
1. Was grease interceptor inspected y ❑ N ❑ Y ❑ N ❑Y ❑ N
2. Grease interceptor accessible for maintenance �k y ❑ N ❑ Y ❑ N o Y ❑ N
❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Major V/brought
r Grease Interceptor
1. Manhole e,and labeled. ❑ y ❑ N ❑ Y ❑ N o Y ❑ N
2. Provided ce olast cleaning o Y ❑N ❑ Y ❑ N ❑Y ❑ N
3. Date of la
❑ Y ❑N ❑ Y ❑ N ❑Y ❑ N
❑ Y ❑ N El ❑ N ❑Y ❑ N
Major Violations Indoor Grease nterceptor
1. Unit maintained daily fi(.7 qwy ❑ N ❑ Y ❑ N ❑ Y ❑ N
2. Unit energized,and automatic timer set to
.�._�_ �CY ❑ N ❑ Y ❑ N ❑Y o N
operate during business hours.
3. Screening basket in place y ❑ N ❑ Y ❑ N ❑Y ❑ N
4. Skimmer in working order )9 y ❑ N ❑ Y ❑ N ❑Y ❑ N
5. Heater in working order X y ❑ N ❑ Y ❑ N ❑Y- ❑ N
6. Grease collection container in place is y o N ❑ Y ❑ N ❑Y ❑ N
Minor Violations
4. Grease interceptor maintenance log available o Y A(N ❑ Y o N ❑ Y ❑ N
5. Signs posted at all sinks ❑ Y XN ❑ Y ❑ N ❑ Y ❑ N
6. Pots,pans,dishes,and utensils scraped KY ❑ N ❑ Y o N ❑Y ❑ N
7. Adequate renderable FOG container storage O('y ❑ N ❑ Y ❑ N ❑Y ❑ N
8. Exhaust hood properly cleaned W-y ❑ N ❑ Y ❑ N ❑Y ❑ N
9. Renderable FOG recycled,AJd 4" S V f-e— ❑ Y o N o Y ❑ N ❑Y ❑ N
10. No chemical additives used 114ugL , pay ❑ N ❑ Y ❑ N ❑Y ❑ N
Non-Renderable FOG Disposal Location ❑ Trash 'Contractor ❑ Other
Grease`Interceptor Cleaner's Information Renderer's Information
Name: _ r.,h r { Name:
Address: �j C (� O Address:
Phone: Phone:
Last Pump Date: