The URL can be used to link to this page

Home My WebLink AboutApplication 500 Evergreen Way Town of South Windsor — Health Department r 1540 Sullivan Ave., South Windsor, CT 06074— Mailing Address 1530 Sullivan Avenue, South Windsor, CT 06074—Office Address 5.1 i Phone Number: (860) 337-6173 Fax: (860) 644-1930 SOR•Co. Restaurant Establishment Information New Permit❑ Permit Renewal ] ***(Please Print Clearly)*** Name of Establishment: I I TeA '5 m ovLi'm a Manager's Name: J ph Street Address: tpc) eV Z�c Ve °� City, State, Zip Code: . b, _tv� Wk,;SDC- , L'f CJLe0]LA Phone#: Ow-(.04er ` I pb Cell Phone#: Fax#: E-Mail Address ()eat rIg Capacity: Please submit latest copy of the Qualified Food Operator/ServSafe certificates to the office. Qualified Food Operator: rrs No ❑ (Required for Certificate#: Class 3& 4) 9015(1303 Name: J phn R�JP j Cl Date: 4I2_2 JI?2 Testing Organization: �i1�U�cLf z Phone#: E-Mail Address: 1M&Oy&,JfEp5MQMT11Nft6AULLL.yTblternate Phone#: llc'�c� Designated Alternate 1: DeNoo m Designated Alternate2 : 3wft; som-J 1 Restaurant Owner Contact Information Owner's Name: T Of ?Sex) &nol ,d LLL Street Address: 133 j LtCkie 5,� j3lX) City, State, Zip Code: A-baa- q, 6A 3o3 o 3 Phone#: 404,2 Ap_ i39l4 Fax #: E-Mail Address: 55EVF Rp,,Z>'rg[Sn10pfj1 NA6QLU Cell Phone#: "VVI Renovations Were there any renovations made last year? YES❑ NO AWill there be any renovations? YES❑ NO ]c If Yes, please list all renovations that were done/to be done: Mailing Address to send Food License Renewal Permit to: RECEIVED Name of Restaurant/Company: I ed'S movito-n0. 61CM DEC 1 . Attention: b GVflce.S I O�r-(h.t'i7,S Address: 1 bJ > LUcAt' e ST Q(D SOUTH WINDKiij City, State, Zip Code: AV04 to I C " '50-2)o3 HEALTH DEPT Phone#: q0Q -Z(Ap - l3 yy Restaurant Menu/List of All Items Served/Sold Latest Menu Attached? YES' NO ❑ NOTE"(Must have latest copy on file) Please list all menu items in as much detail as possible or a copy of a menu attached is applicable. Additional Information Please check one only: State Licenses: ❑ Bakery I j Liquor Permit I I None Water Supply: Public Private Well Wastewater Disposal: Public On-Site _Other (please use space below to explain) Agreement and Signature By submitting this application,I affirm that the facts set forth in it are true and complete. I understand that any false statements or other misrepresentations made on this application may result in immediate shutdown or revocation of my Food Service License for the Town of South Windsor. Applicant Name (Print): /,,,, �w Applicant Signature: l�� Date: 2, 12,1 Office use Only Inspector Name (Print): Q Inspector Signatur Date: &Oaf Food Class: 1 ❑ 2 ❑ 3 [Z 4 ❑ Expiration Date: 13 It/ 'r Date Received: Date Approved: t 2.(Zcl 1(`) c ; Z Vb -# - 6 000 1 '1`1 01 q 2 ServSafe Student Name JOHN HALPIN Class Number 1238801 EXAM FORM NO. 4824 Exam Date 04/2212013 Expiration Date 04/Z2l2018 Instructor Name NOAH FREEDMAN ServSafe CERTIFICATE N O. 9956803 Sponsor Name Ted's Montana Grill Exam Location GA Exam Form Name 4824 J Overall Point Scoro 70 ServSafe Overall%Score 67 Passing%Score 75 Status PASSED CERTIFICATION PPoint Point Score Score so 70 Dom In Names Imple,� JOHN HALPIN Employee Food Safety and SOPS 12 16 Employee Hygiene end Health 12 10 Receipt Storage.Tra"port 13 8 Food Prep.Display and Service 28 26 Compliance with Regulatory 11 10 for successfully completing the standards- forth for the ServSafe'Food Protection Manager Codification Examination, which is accredited by the American ,I Standards Institute(ANSI)-Conference for Food Protection(CFP). To hrv..n.M km.mrintui—p1m.GARam Raqu.0 farm on our Mrsdn M a.nr.N.amr WW Woo Fwdd....sgaam c.d"coal DATE O pM.a'>rr""'°• 04/2 2/2 oNf:R..MII MMN Y l Aaednwn id c.Nwd foudMb.Atl d M n.wn. apNm .ma DATE OF EX Local laws apply.C or rocartlflca8an requirements i ServSafe r""""°"'s' ServSafe' CERTIFICATION To JOHN HALPIN 7H^_ Fd•.►�M.w�.aar�rtlrr/a�� DMA W Ev.r.rhudon:LWI2 0655 Dan of E.pml n 0412212018 r010i7 XMb..I ...raAM.df+b -., ,.N RAU,u.N W d rBa l by NMIwW O.nvad Anod m SoMh S LLG TfM 4p. +111d7.rrSar.--e—nir4W pi tlpV ddrin/�.rwr�rd��err. .Yl Y.yM•nwwL fI' �1 _— Yfrws is raO'aM1XsaM.Cvr1 1�L-...frMb.i.al ..p,ru..1 t•.1rr �. -� 4.raaw`Wrr llf: - - ""ram .. - _' .._ .._._ -� _�- h' _ r- �-•_ •..•--...w +� �!.i��Y'�+ .`Ilr l\I�.rP.w�I�1�1 ham.. AUTHENTI A M ER Wj A I. f r SCRATCH KITCHEN, NO SHORTCUTS MORTARA GRILL RANCH-RAISED BISON, AN AMERICAN SUPERFOOD BURGERS GROUND IN-HOUSE TWICE DAILY HAND-CUT PREMIUM STEAKS FRESH INGREDIENTS, LOCALLY SOURCED House 5 St. Phillip's Island Organic spring mix,iceberg,romaine,cucumber,vine-ripened tomato,croutons,red onion Crab Cake 14 Jumbo lump crab,guacamole,kale salad Caesar 5 Romaine,Parmesan,croutons,"eggless"Caesar dressing Homemade Chips 5 Fresh-cut,ranch onion dip Wedge 6 Bacon,vine-ripened tomato Bar None Sliderssm' BEEF 91 BISON 12 Kale 6 American cheese,onion ring Roasted corn,Anaheim pepper,vine-ripened tomato,fresh herbs,vinaigrette Salt&Pepper Onion Rings 7 Chopped 6 Hand-breaded,horseradish sauce Iceberg,roasted corn,garbanzo beans,vine-ripened tomato,green pepper,red onion, cucumber,smoked ham,basil vinaigrette Grilled Shrimp on Ciabatta Toast 13 Soup and Side Salad Ciabatta toast,arugula,lemon vinaigrette Entree Salads Karen's "Flying-D" Bison Chili CUP 5 1 BOWL 7 Balsamic Blue Steak 15 Certified Angus®beef sirloin,organic spring mix,iceberg,romaine,cucumber,blue cheese, Soup of the Day CUP 41 BOWL 6 bacon,vine-ripened tomato,balsamic reduction,onion straws Made fresh daily in-house Big Sky Grilled GRILLED CHICKEN 13 1 BEEF BURGER*141 CEDAR PLANK SALMON* 15 1 BISON BURGER* 16 Organic spring mix,iceberg,romaine,bacon,cheddar,egg,vine-ripened tomato, avocado,croutons Caesar GRILLED CHICKEN 131 CEDAR PLANK SALMON* 15 1 GRILLED SHRIMP 16 SANDWICHES Romaine,Parmesan,croutons,"eggless"Caesar dressing Farmhouse 14 Served with fresh-cut fries oryour choice ofside. Kale,romaine,roasted chicken,cucumber,vine-ripened tomato,Gruyere,bacon, roasted corn and pecans,basil,lemon vinaigrette Absolute Best Fish 13 Chicken Chopped 13 Lightly breaded cod,lettuce,chive caper Iceberg,grilled chicken,roasted corn,garbanzo beans,vine-ripened tomato, tartar sauce,cracked wheat bun,with green pepper,red onion,cucumber,smoked ham,basil vinaigrette kale salad Red Rock 13 All-natural grilled chicken breast,pepper jack,jalapeno,cilantro,fried onion straws, Z-Sauce,ciabatta Snowcrest 13 Fried or grilled all-natural chicken breast, Ages 12&under.Served with a fountain beverage,lemonade, mustard remoulade,lettuce,vine-ripened KIDS tomato,dill pickle chips,cracked wheat bun milk or iced tea. Choice of buttered carrots orfresh-cut fries. George's Cadillac 13 Chicken Tenders 6 Cedar Plank Salmon 10 All-natural grilled chicken breast,BBQ sauce,cheddar,bacon,chipotle ranch,fried onion straws,ciabatta Bar None Certified Angus Beef SlidersSM BEEF 61 BISON 9 Sirloin Steak 10 Meatloaf 12 Bison meatloaf,pepperjack, Mac-'n'-Cheese 5 Grilled Cheese 5 grilled onions,ciabatta Grilled Chicken 7 SIPSBottle Hand-Crafted Shakes, Malts &Floats Boylan°Cane Sugar Sodas Vanilla Coke° Hand-Dipped Shakes&Malts 6 Black Cherry,Creme,Orange Cherry Coke® Haagen-Dazsa ice cream: Coca-Cola®Classic,Diet Coke°, Fresh-Squeezed Lemonade Vanilla,Chocolate or Strawberry Sprite°,IBC®Root Beer,Sparkling Fresh-Squeezed Cherry Lemonade Coke®or IBC®Root Beer Float 5 WA for Cnrin M/a+c Arnold Palmer Choose freshly BURGERS* groundAll-Natural Bison, Certified Angus Beef`�orAll-Natural Grilled Chicken Breast with fresh-cut fries oryour choice ofside. We proudly offer Gluten Free buns for+1. Naked BEEF 131 BISON 15 Skinny Dip BEEF 141 BISON 16 Knife-and-Fork Chili Cheese Perfectly simple Bunless,avocado,with vine-ripened BEEF 16 1 BISON 18 tomatoes and kale salad Pepper jack,cheddar,bison chili,tomato, Cheese BEEF 14 1 BISON 16 jalapeno,red onion,sour cream,ciabatta American,cheddar,horseradish cheddar, George's Cadillac BEEF 15 1 BISON 17 pepper jack or Swiss BBQ sauce,cheddar,bacon,chipotle ranch, Kitchen Sink BEEF 171 BISON 19 onion straws American,grilled ham,bacon,grilled onion, Ted's Bacon Cheeseburger mushroom,fried egg* BEEF 15 1 BISON 17 Canyon Creek BEEF 161 BISON 18 Cheddar or Swiss,bacon,grilled onion Cheddar,bacon,jalapeno,blackberry jam, Delicious Duo 11 fried egg* Two 3 oz burgers(beef and bison), Blue Creek BEEF 161 BISON 18 American,lettuce,tomato,dill pickle, Blue cheese,bacon New Mexico BEEF 161 BISON 18 mustard remoulade,sesame bun Pepperjack,roasted Anaheim pepper, Swiss and Mushroom spicy tomatojam,guacamole House-Made BEEF 15 j BISON 17 Green and Hot BEEF 151 BISON 17 Veggie Burger 12 Swiss,mushroom,sour cream Lettuce,tomato,roasted garlic aioli, Pepperjack,grilled jalapeno,guacamole, cracked wheat bun Avalon BEEF 161 BISON 18 chipotle ranch Gruyere,blue cheese,bacon caramelized Montana Breakfast onions,roasted garlic aioli,baby arugula BEEF 16 1 BISON 18 Red Rock BEEF 161 BISON 18 American,grilled ham,spicy tomato jam, Pepperjack,jalapeno,cilantro,onion straws, fried egg* Z-Sauce,ciabatta CLASSICS Bison Meatloaf 18 Pecan-Crusted Trout 17 Gravy,garlic mashed potatoes,"Aunt Fannie's"squash casserole Fresh-cut fries,kale salad,remoulade St. Phillip's Island Crab Cakes 27 Salt-and-Pepper Trout 17 Southwestern-seasoned,guacamole,roasted asparagus,kale salad Roasted corn and tomato salsa,asparagus,vine-ripened tomato Bison Pot Roast 20 Bison Short Ribs 21 Slow-braised pot roast,gravy,garlic mashed potatoes,carrots Slow-braised,garlic mashed potatoes,carrots Roasted Chicken (Available all day,while it lasts) 16 Roast Turkey and Dressing(Sunday only) 16 All-natural half chicken,glazed with cranberries,Sam Adams®infused, Gravy,garlic mashed potatoes,carrots,cranberry sauce garlic,rosemary,garlic mashed potatoes,broccoli Vegetable Plate 15 Cedar Plank Salmon* 7 OZ 18 19 OZ 21 Choose 4 of our Sides,including the Chef's Featured Vegetable Garlic mashed potatoes,asparagus,horseradish sauce * PREMIUM CUTS Aged, hand-cut in our on premise butchershop,seasoned and finished with lemon butter. Choice ofsides. Ted's Filet New York Strip Delmonico Ribeye BEEF 27 1 BISON 34 BISON 30 BEEF 271 BISON 34 ' -- ' Montana Margarita to Kendall Jackson Vintner's Reserve California 2016 9 I 13 1 36 1800 Reposado tequila,Grand Marnier, Joel Gott Unoaked California 2016 10 I 14 1 38 freshly squeezed sour mix' Huckleberry Margarita 10 Sonoma-Cutrer Russian River Ranches 12 1 16 1 43 Jose Cuervo Especial tequila,Cointreau, Sonoma Coast 2015 huckleberry-infused sour mix' Rombauer Cameros 2015 - 1 - I 65 Grand Agave 11 Patr6n Silver,Grand Marnier,fresh lime juice, organic agave nectar Whites, Sparkling & Rose Jalapeno Huckleberry Margarita 10 Jalapeno infused Jose Cuervo Especial tequila,Cointreau, Mionetto Prosecco D.O.C.Treviso 11(187ML) 33 freshly squeezed sour mix*,huckleberry Seven Daughters Moscato Italy 2016 8 1 11 1 30 Martinis North by Northwest Rosh Columbia Valley 2016 8 1 11 1 30 Ultimate Dirty Martini 11 Grey Goose vodka,splash of olive juice, Clos du Bois Pinot Grigio California 2016 8 1 11 1 30 blue cheese-stuffed olives Santa Margherita Pinot Grigio Valdadige 2016 - 1 - 1 47 Lemon Drop Martini 9 Tito's handmade vodka,Cointreau,freshly Chateau Ste.Michelle Riesling 7 1 9 1 24 squeezed lemonade Columbia Valley 2015 Mountain Breeze 9 Starmont Sauvignon Blanc Napa Valley 2016 10 1 14 1 38 Finlandia Grapefruit vodka,freshly squeezed lime, orange juice,splash of cranberry Kim Crawford Sauvignon Blanc Marlborough 2017 - 1 - I 40 Classics Ted's Mojito 9 Cabernet Sauvignon Bacardi 8 rum,fresh mint,lime juice Bison Ridge California 2015 7 1 10 1 27 Big Sky Lemonade 9 Jim Beam bourbon,Cointreau,freshly squeezed J.Lohr Seven Oaks Paso Robles 2015 9 I 12 1 34 lemonade Wente Southern Hills Livermore Valley 2014 - 1 - 1 33 Buffalo 41 9 Buffalo Trace bourbon,Grand Marnier,freshly Louis M.Martini California 2015 - I _ 1 36 squeezed lemonade infused with wildberries Oberon Napa County 2015 12 1 16 1 43 Sun River Sangria 7 Red or white wine,Cointreau,pineapple,cranberry juice, Starmont Napa Valley 2015 - I - I 55 hint of mango Markham Napa Valley 2013 - I _ 1 62 Uptown Manhattan 12 Knob Creek Rye,chocolate bitters,organic agave nectar, Mount Veeder Napa Valley 2014 - 1 - 1 74 orange twist Newly Fashioned 12 Silver Oak Alexander Valley 2013 - 1 - I 100 Woodford Reserve,organic agave nectar,Angostura° bitters,black cherry More Reds Hendrick's Mule 10 Hendrick's gin,ginger beer,fresh squeezed lime juice,bitters MacMurray Ranch Pinot Noir Central Coast 2015 11 1 14 1 40 Wild Horse Pinot Noir Central Coast 2015 12 1 16 1 42 Meiomi Pinot Noir California 2016 13 1 17 1 46 BEER King Estate Pinot Noir Oregon 2015 - 1 - 1 49 Bison Ridge Merlot California 2014 7 1 10 1 27 Draft Rutherford Hill Merlot Napa Valley 2014 - 1 - 1 45 Local Craft&kserverfordetails Blue Moon CO 5.5 Gascon Malbec Mendoza 2016 9 1 12 1 33 Sam Adams MA 6 Ted's Red Ale CT 5.5 Stella Artois BEL 6 Trapiche Broquel Malbec Mendoza 2015 11 1 15 1 42 Bogle Petite Sirah California 2015 8 1 11 1 30 Bottled(1oo-180ca1) Federalist Zinfandel Lodi 2015 10 I 13 1 40 Bud Light Mo 5 Lagunitas IPA IL 5.5 Conn Creek"Herrick Red"Napa Valley 2013 13 1 17 1 45 Miller Lite WI 5 Corona Light MEX 5.5 Franciscan Magnificat Meritage Napa valley 2013 - 1 - 1 86 Michelob Ultra MO 5 Sam Adams MA 5.5 Coors Light Co 5 O'Doul's MO 5