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DALLAS COUNTY HEALTH AND HUMAN SERVICES
~ l ~ `; ENVIRONMENTAL HEALT'H DIVISION
2377 N. STEMMONS FRWY. ROOM 607
+~,',yrf OF ~~-1-P~r ~ ~ - L / ~ ~ (~~) 819-2115 F~: (21Q) 819-2868
I,A,L c,~ e~ r
'~~~"~g CITY/TOWN ~ ~~~
Estabiishment: ~,/A cs ~ ~~l/(s Owner: ~~/r (~C~J7T
Physical Address: ~~ ~~._~L~ - ~ Z1P~ 7~2~~ Phone: (p~~ ~~p " ;
• 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
r/' S. Rapid Reheating (165 degrees Fahrenheit in 2 Hrs)
Item/Location/Temperature a5~~ ~ ~~5 ~~
~ p6~~ ~ P~ ~~-~
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
11. Proper Handling of Ready-To-Eat Foods
12. Cross-contamination of Raw/Cooked Foods/Other
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13. Approved SysYems (HACCP Plans/Time as
t and Cold Under Pressure
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14. Water Supply - Approved Sources/Sufficient Capac
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s t~ts NA NO
~~ CfJS j''acility ~tn(l.~+quipIIlerit RCqlliCexUeIIt5.' ,
viala~ai~s:Rec~uire Imnt~diate Cozrecti~znp Not:Tc~ EXoeed 10 Days Remarks
15. E ui ment Adequate 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 Sanitizin at ( ) m/tem erature
22. Mana er Demonstration of Knowled e/Certified Food Mana er
23. A roved Sewa e/Wastewater Disposal S stem, Proper Dis osal
24. Thermometers Provided/Accurate/Pro erl Calibrated (t2 de rees Fahrenheit)
25. Food Contact Surfaces of E ui ment and Utensils Cleaned/Sanitized/Good Re air
26. Postin of Consumer Advisories (Heimilich/Disclosure/Reminder/Buffer Plate)
. ~: ~~ 27. Food Establishment Permit
Tot~ Inspected by: f ~ Print: ~~ r'`~~W J
y~ / Title:
F/U Received by:~;Y/ Print: ~ ~r