HomeMy WebLinkAboutFood Service Establishment Inspection 85 (9) wG Town of South Windsor
R-Co HEALTH DEPARTMENTIWATER POLLUTION CONTROL
Inspection Checklist
Date: �� ` {� ' �.L
Inspector: (Q
Establishment: YN
Address: V1U ,P
Contact Name: Signature:
Phone: f M26 t,
TERCEP OR NUMBER
General Information #1 #2 #3
1. Was grease interceptor inspected c;X ❑ N ❑ Y ❑ N ❑Y ❑ N
2. Grease interceptor accessible for maintenance /Y ❑ N ❑ Y ❑ N ❑Y ❑ N
❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Li ❑ N ❑ Y ❑ N ❑Y ❑ N
Major Violations Outdoor Grease Interceptor
1. Manhole cover brought to grade,and labeled. 0� ❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
2. Provided written contractor invoice for last cleaning* Y ❑ N ❑ Y ❑ N ❑Y ❑ N
3. Date of last cleaning
❑ Y ❑ N El ❑ N ❑Y ❑N
(( ❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Major Violations Indoor Grease Interceptor
1. Unit maintained daily cl�❑ N n Y ❑ N ❑Y ❑ N
2. Unit energized,and automatic timer set to ff< ❑ N ❑ Y ❑ N ❑Y ❑ N
operate during business hours.
3. Screening basket in place olY ❑ N ❑ Y ❑ N ❑Y ❑ N
4. Skimmer in working order W-Ir ❑ N ❑ Y ❑ N ❑Y ❑ N
5. Heater in working order Wf ❑ N ❑ Y ❑ N ❑Y ❑ N
6. Grease collection container in place ❑ N ❑ Y ❑ N ❑Y ❑ N
Minor Violations
4. Grease interceptor maintenance log available ❑ Y PIK ❑ Y ❑ N ❑Y ❑ N
5. Signs posted at all sinks ❑ Y I"N ❑ Y ❑ N ❑Y ❑ N
6. Pots,pans,dishes,and utensils scraped �❑ N ❑ Y ❑ N ❑Y ❑ N
7. Adequate renderable FOG container storage Vy ❑ N ❑ Y ❑ N ❑Y ❑ N
8. Exhaust hood properly cleaned V'r ❑ N ❑ Y ❑ N ❑Y ❑ N
/
9. Renderable FOG recycled �Y ❑ N ❑ Y ❑ N ❑Y ❑ N
10. No chemical additives used ❑ Y R-K' ❑ Y ❑ N ❑Y ❑ N
Non-Renderable FOG Disposal Location ❑ Trash ❑ Contractor ❑ Other
Grease Interceptor Cleaner's Information Renderer'��s11Information
V Q
Name: Name: ! uu!U 01 �
Address: Address:
Phone: Phone: (YU�
Last Pump Date: