HomeMy WebLinkAboutFood Service Establishment Inspection 10 (9) C � 7
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fN4SOR-co�� HEALTH DEPARTMENT/WATER POLLUTION CONTROL
Inspection Checklist
Date: 1 b
Inspector: 'S
Establishment: (Z, kpy� (�{►
Address: (}
Contact Name: w, 11C- 5ac�_� Signature-
Phone:
INTERCEPTOR NUMBER
General Information /#1 #2 #3
1. Was grease interceptor inspected dYY ❑ N ❑ Y ❑ N ❑Y ❑ N
2. Grease interceptor accessible for maintenance tlK ❑ 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. o,K ❑ N ❑ Y ❑ N ❑Y ❑ N
2. Provided written contractor invoice for last cleaning Wy ❑ N ❑ Y ❑ N ❑Y ❑ N
3. .Date of last cleaning
❑ Y ❑ N El ❑ N ❑Y ❑ N
1 ❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Major Violations Indoor Grease Interceptor
1. Unit maintained daily W> ❑ N ❑ Y ❑ N ❑Y ❑ N
2. Unit energized,and automatic timer set to Gyy ❑N ❑ Y ❑ N ❑Y ❑ N
operate during business hours.
3. Screening basket in place [ ❑ N ❑ Y ❑ N ❑Y ❑ N
4. Skimmer in working order o-f ❑ N ❑ Y ❑ N ❑Y ❑ N
5.. Heater in working order 2-V ❑ N ❑ Y ❑ N ❑Y ❑ N
6. Grease collection container in place p'y ❑ N ❑ Y ❑ N ❑ Y ❑ N
Minor Violations
4. Grease interceptor maintenance log available ❑ Y &-f ❑ Y ❑ N ❑Y ❑ N
5. Signs posted at all sinks ❑ Y " ❑ Y ❑ N ❑Y ❑ N
6. Pots,pans,dishes,and utensils scraped V�' ❑ N ❑ Y ❑ N ❑Y ❑ N
7. Adequate renderable FOG container storage r! Y ❑ N ❑ Y ❑ N ❑Y ❑ N
8. Exhaust hood properly cleaned 9'1 ❑ N ❑ Y ❑ N ❑Y ❑ N
9. Renderable FOG recycled &'Y ❑ N ❑ Y ❑ N ❑Y ❑ N
10. No chemical additives used T!r—Y ❑ N ❑ Y ❑ N ❑Y ❑N
Non-Renderable FOG Disposal Location ❑ Trash s,6ontractor ❑ Other
Grease Intercepttoor Cleaner's Information Renderer's Information
Name: _�0" Name: .Sor., Z,
Address: I Address:
Phone:_ ` �`I - Phone:
Last Pump Date: