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-~ DALLAS COUNTY HEALTH AND HUMAN SERVICES
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~ N ENVIRONMENTAL HEALTH DIVISION
2377 N. STEMMONS FRWY. ROOM 607
~~"re oF ~s~~~~ (214) 819-2115 Fax: (214) 819-2868
~ ~~~ ~g CITY/TOWN ~~~r/T ~4~, ~~~
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Establishment: ~L~y,Q. C/ ]'~ /~G?~',-~!.(,. " ner: ~L~.2 /'j L,,, /~''~/~
Physical Address: ~'~Q~ `c/~ Zip: S~~ Phone: (~}i~ 7 " 1 Da
/ 1. Proper Cooling for Cooked/Prepared Food
2. Cold Hold (41 degrees Fahrenheit/45 degrees Fahrenheit)
/ 3. Hot Hold (135 degrees Fahrenheit)
4. Proper Cooking Temperatures
5. Rapid Reheating (165 degrees Fahrenheit in 2 Hrs)
Item / Loc atio n/ Temperature
~ 6. Personnel with Infections Restricted/Excluded
7. Pro er/Ade uate Handwashin
~ 8. Good Hygienic Practices (Eating/Drinking/Smoking/Other)
/ ' / 9. Approved Source/Labeling
~' 10. Sound Condition
~ ll. Proper Handling of Ready-To-Eat Foods
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~ 12. Cross-contamination of Raw/Cooked Foods/Other
/ 13. Approved Systems (HACCP Plans/Time as Public Health Control)
14. Water Supply - Approved Sources/Sufficient Capacity/Hot and Cold Under Pressure
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~ P~ tN NA rto Cos ~ac~7ity and Equipm~nt Require~tents `
Vioiatioas Require Immediate Caz~-ec~ion, Not.To Exceed,' 10 Days Remarks
/ 15. E ui ment Ade uate to Maintain Product Temperature
/ 16. Handwash Facilities Ade uate and Accessible
(~ ° 17. Handwash Facilities with Soa and Towels
18. No Evidence of Insect Contamination
~/ 19. No Evidence of Rodents/Other Animals
/ 20. Toxic Items Pro erly Labeled/Stored/Used
21. Manual/Mechanical Warewashing and Sanitizing at (Z~A) m/temperature
/ 22. Mana er Demonstration of Knowled e/Certified Food Mana er
23. A roved Sewa e/Wastewater Dis osal S stem, Pro er Dis osal
24. Thermometers Provided/Accurate/Pro erl Calibrated (f2 de rees Fahrenheit)
25. Food Contact Surfaces of E uipment and Utensils Cleaned/Sanitized/Good Re air
~ 26. Postin of Consumer Advisories (Heimilich/Disclosure/Reminder/Buffer Plate)
""`° ~ ' 27. Food Establishment Permit
,r~~ Inspected by: Print: ( j ~
F/U Received by ~~ Print: n(.~ Titl~
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