HomeMy WebLinkAbout577 John Fitch Boulevard (3) �OWN�E' �
w� Town of South Windsor
rN°SOR-CO HEALTH DEPARTMENTIWATER POLLUTION CONTROL
Inspection Checklist
Date: � /
Inspector: '—/_-;>/4r,Ui-Z7 L_
Establishment: 5
Address: - l 77i L ,
Contact Name: ,GAG- Signature: .=
Phone:
INTERCEPTOR NUMBER
General Information #I 'sec..) #2 #3
1. Was grease interceptor inspected R�Y ❑ N ❑ Y ❑ N ❑Y ❑ N
2. Grease interceptor accessible for maintenance EkY ❑ N ❑ Y ❑ N ❑ Y ❑ N
❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Major Violations Outdo rease Interceptor
1. Manhole cover brought grade,and labeled. ❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N
2. Provided writte ntractor invoice for last cleaning ❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
3. Date of las earring
❑ Y ❑ N El ❑ N ❑Y ❑ N
❑ Y ❑ N El ❑ N ❑Y ❑ N
Major Violations Indoor Grease Interceptor
1. Unit maintained daily QI Wgb*-q ❑ Y WN ❑ Y ❑ N ❑Y ❑N
2. Unit energized,and automatic timer set to cvT ❑ N ❑ Y ❑ N ❑Y ❑N
operate during business hours.
3. Screening basket in place E I ❑ N ❑ Y ❑ N ❑Y ❑ N
4. Skimmer in working order m/r' ❑ N ❑ Y ❑ N ❑Y ❑ N
5. Heater in working order Y ❑ N ❑ Y ❑ N ❑Y ❑ N
6. Grease collection container in place T/Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Minor Violations
4. `Grease interceptor maintenance IV av ilable, ❑ Y IN ❑ Y ❑ N ❑Y ❑ N
N� j
5. Signs posted at all sinks Y ❑N ❑ Y ❑ N ❑Y ❑ N
6. Pots,pans,dishes,and utensils scraped QV Y ❑ N ❑ Y ❑ N ❑Y ❑ N
7. Adequate renderable FOG container storage %Y ❑ N ❑ Y ❑ N ❑ Y ❑N
8. Exhaust hood properly cleaned p�y ❑ N ❑ Y ❑ N ❑ Y ❑N
9. Renderable FOG recycled KY ❑ N ❑ Y ❑ N ❑Y ❑ N
10. No chemical additives used 4-Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Non-Renderable FOG Disposal Location ❑ Trash f Contractor ❑ Other
Grease Interceptor Cleaner's Information Renderer's Information
Name: Name: /.,c 1��
Address: Address:
Phone: Phone:
Last Pump Date: