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~. rroper ~:ooxing 1 emperatures
Item / Loc ati on / Temperature
Ci~e.~ ~~u.. 9 8~°~'
V~ ~b~ ~~{`~°~
pid Reheating (165 degre
C.MLCt l~f C~
~ ~ ?,5~~
~~~u~~~,~~uaur~gi~~rce xe,quirem+~ts , , -
Vic~~ati~n' ~~~q~.tlrev Tmrnediate Cc~rcect~v~* Actia~ii :'. , Remarks
6. Personnel with Infections Restricted/Excluded
i. Yroper/
8. Good F
9. Approv
10. Sound i
~ ~. rruper nanaimg ot Keady=l o-r;at Foods
12. Cross-contamination of Raw/Cooked Foods/Other
i~. tipprovea ~ystems (HAC:CY Ylans/Time as Public Health Control)
14. Water Supply - Approved Sources/Sufficient Canacitv/Hot and Cold Under P '
~ 15. E ui ment Ade uate to Maintain Product Tem erature
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 erl Labeled/Stored/Used
~
/' 21. Manual/Mechanical Warewashin and Sanitizing-at ( m/temperature
22. Mana er Demonstration of Knowled e/Certified Food Manager
23. A roved Sewage/Wastewater Dis osal S stein, Pro er Dis osal
' 24. Thermometers Provided/Accurate/Pro erly Calibrated (t2 degrees Fahrenheit)
25. Food Contact Surfaces of E ui ment and Utensils Cleaned/Sanitized/Good Re
~ 26. Postin of Consumer Advisories (Heimilich/Disclosure/Reminder/Buffer Plate
27. Food Establishment Perniit
)~er '~i+~lal~ns -~ Req'u~r~; ~~irx'~~e;'~~i~, ~~at t~, E~cce~d ~U °I~a~~ ~r~%~'~I~:~k ~ts~ecti~on W~ichever C~
~' ~`~- .~'~- N~f- (,•t~Z,/C' ~,I G:CQS(.~~ .
Other)
rahrenheit in 2
ressure ~
) Days Remarks ' ;
To al Inspected by: Print: u ~~L~
F/U `
Yes/No Received by~i Print: ~ ~D Title;~. ~ ~
~~A~RGt~L 1 A, ,~n.s