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~OJriTY pFO -~ DALLAS COUNTY HEALTH AND HUMAN SERVICES F ~ ~ ~N ENVIRONMENTAL HEALTH DIVISION 2377 N. STEMMONS FRWY. ROOM 607 ~~~"re oF ~~~'~~ (214) 819-2115 Fax: (214) 819-2868 ~~~~~ CTTY/TOWN ~0`~ lrP~'1~S'~r ~~~ ''Z' e~`~ ~` " ~ e_ ~ , ~~, ~ ~ ~ ; ' ~ai~e ~~ ~ ~ , ~t~~~ ~ ~ ~ ~ ~' " ' ~° ~= t~b°'~shm+~~~~ ; R ~~~~ z , x ~t ~if~b~ez' .~ Risk~ G~te~+ory~. < _ , ~ ,. ,: ~: , ~_~. ,. t. „~~.. , e ..r~~e~ ~ ~ ~, , ~ `Pur~,r€~e:crf L~~c~~r 1 C~~l~~c~ ~~ '~3~a~i " 3 Fiel"cl Tn~~~~~~~ 4-'~isit' LL~C?ther ', , . ,:..,~a n r ., . ~ ,y~ ea,.~ ~ g Establishment: /~ /~~/~ ,~~ ~~ f j Owner: ~j~~ ~~.nC~ Physical Address: ,~ ~ ~9 ~~7~i /~'L. Zip: ~],~ ~ Phone: ~'~j~ % ''¢ ~~, ~: I r/ 1. Proper Cooling for Cooked/Prepared Food V 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 ation / Temperature i/ 6. Personnel with Infections Restricted/Excluded 7. Pro er/Ade uate Handwashin v'' ~ ~~ ~~ . ~°. : 8. Good H ienic Practices (Earin /Drinkin /Smoking/Other) if 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 ott7' tnt NA rrc~ Cos Facility ~id: Equipment :Requiremen~s ;., ~ Pts ~ip~aticins:`Re~uire'Trnrnediate CcarrectiQn, NQt To Ex~ee~i` 10 Days Rernarks ~ 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 Sanitizing at ( ) m e erature Y 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 (t2 de rees Fahrenheit) 25. Food Contact Surfaces of E ui ment and Utensils Cleaned/Sanitized/Good Re air ',1' 26. Postin of Consumer Advisories (Heimilich/Disclosure/Reminder/Buffer Plate) 27. Food Establishment Pernut S~i~,iatal ~#l~e~ r'~iol~ ti+~~is - R ` ~ e ,~~~~e ~.~ti~~; ~T~t to~E~rc~d `~Q":~, ~ ~v~:~e~t~`~ns cti~an, Whi~hever Gvmes First . 5t ~e ~ . ~ ' " l ~ 4 t 3 # ,~al i ~ ~ ;~G~ ~/"~ ' (!~ ~' 4~f 7~" ~ ~ r~l 'T~:y~~S' ~ '~ " ~ ~, ~e~ c,~ ~~ . ~~%-:~afi~:~ ~r~ aa~i ~ ~:s~a-- ~,~~ = ~ T~~ Inspected by: ~ ~ ~ Print: ~ ( )~ ~~.~" ~ ~ F/U Yec / Nn Received by: ~-~ !~ ~ Print: ~'~ ~ Title~~~). ~