HomeMy WebLinkAboutFood Service Establishment Inspection 67 'O
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Town of South Windsor
�Ds0R,C0 HEALTH DEPARTMENTIWATER POLLUTION CONTROL
Inspection Checklist
Date: is
Inspector: isl✓ jg'
Establishment: S i
Address: ,v
Contact Name: 64 uaf /1 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 ❑ 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
.�._�_ �LY ElN ❑ Y Li o 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 R 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 )(N ❑ Y ❑ N ❑ Y ❑ N
6. Pots,pans,dishes,and utensils scraped ii y ❑ N ❑ Y o N ❑Y ❑ N
7. Adequate renderable FOG container storage O('y ❑ N ❑ Y ❑ N ❑Y ❑ N
8. Exhaust hood properly cleaned q-y ❑ N ❑ Y ❑ N ❑Y ❑ N
9. Renderable FOG recycled,AJd 4- S V f-e— ❑ Y o N ❑ 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 ��t�� Name:
Address: �j C (� O Address:
Phone: Phone:
Last Pump Date:
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