HomeMy WebLinkAboutFood Service Establishment Inspection 98 (4) � 4N Se4<
GO
e P
C U
w� Town of South Windsor
SOR•c HEALTH DEPARTMENT/WATER POLLUTION CONTROL
Inspection Checklist
Date: ,0 6
Inspector:
Establishment:
Address: c
Contact Name: Signature:
Phone: d s
INT RCEPTOR NUMBER
General Information 41 #2 40
1. Was grease interceptor inspected �y ❑ N ❑ Y ❑ N ❑ Y ❑ N
2. Grease interceptor accessible for maintenance dY ❑ 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. W/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 ❑ Y ❑ N ❑Y ❑ N
❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Major Violations Indoor Grease Interceptor
1. Unit maintained daily VY ❑ N ❑ Y ❑ N ❑Y ❑ N
2. Unit energized,and automatic timer set to /Y ❑ N ❑ Y ❑ N ❑Y ❑ N
operate during business hours.
3. Screening basket in place Y ❑ N ❑ Y ❑ N ❑Y ❑ N
4. Skimmer in working order Y ❑ N ❑ Y ❑ N ❑Y ❑ N
5. Heater in working order qg Y ❑ N ❑ Y ❑ N ❑Y ❑ N
6. Grease collection container in place Y ❑ N ❑ Y ❑ N ❑Y ❑ N
Minor Violations
4. Grease interceptor maintenance log available ❑ Y ❑ N ❑ Y ❑ N ❑Y ❑ N
5. Signs posted at all sinks ❑ Y R/ ❑ Y ❑ N ❑Y ❑ N
6. Pots,pans,dishes,and utensils scraped w"Y ❑ N ❑ Y ❑ N ❑Y ❑ N
7. Adequate renderable FOG container storage p/y ❑ N ❑ Y ❑ N ❑Y ❑ N
8. Exhaust hood properly cleaned M0*Y ❑ N ❑ Y ❑ N ❑Y ❑ N
9. Renderable FOG recycled [5 ❑ N ❑ Y ❑ N ❑Y ❑ N
10. No chemical additives used Vf ❑ N ❑ Y ❑ N ❑Y ❑N
Non-Renderable FOG Disposal Location ❑ Trash cgXontractor ❑ Other
Grease Interceptor Cleaner's Information Renderer's Information
Name: ` Name:
Address:j/ ��,. C7— Address:
Phone: r Phone:
3,1
Last Pump Date: Z3_1 _�e