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~~~~yTY pFQ 7 DALLAS COUNTY HEALTH AND HUMAN SERVICES ' ~ ~ ~ `N ENVIRONMENTAL HEALTH DIVISION ' 2377 N. STEMMONS FRWY. ROOM 607 ~~'re oF T~~'~~ ,+,~~ ~~ (214) 819-2115 Fax: (214) 819-2868 `~ -- ~~ s~a5 3 ~g "~ CITY/TOWN 1INtdF./~SJhi1~~~ Establishment: ~ / ~~ ~i Owner: ~~~=L /~~y~/,~'~ Physical Address: ~~~~ &Y,~ Zip:~75?j(~ Phone: (~ ) " f~~9 /" 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/ Location /Temperature ~i~'~crrµs 14g°P ~h~ -5rp~ 6~' t~'i`F ~` ~'~S I~~~' f~ ~` ~ ~+- ~u~s 15~ r ~~ ~~~'" p~~~ ~k8~ b~r 1~~~3~9~ , ~' / ____ 6. Personnel with Infections Restricted/Excluded / 7. Pro er/Ade uate Handwashin / 8. Good Hygienic Practices (Eating/Drinkin /Smokin /Other) /' 9. Approved Source/Labeling 10. Sound Condition 11. Proper Handling of Ready-To-Eat Foods 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 OUT 3 Pts iN NA NO COS F~Cility"~ntl ~qui~7tYent Rei~uiremeu~s Uiolati~ns.R~ uire Imrned~ate~Coz~ection, Not To'E~cceed-l0 Days Remark5~~~ 15. E ui ment Adequate to Maintain Product Tem erature / 16. Handwash Facilities Adequate 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 ( ) m/temperature / 22. Mana er Demonstration of Knowled e/Certified Food Mana er /~ 23. A roved Sewa e/Wastewater Disposal System, Pro er Dis osal / 24. Thermometers Provided/Accurate/Pro erl Calibrated (t2 degrees 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 Pernut ,~~ Inspected by: ~ Print: V S F/U T Received b/C ~ Print~~ Tj~i Y~ D~ _ _ ~P ,