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Pi Kappa Alpha
~OJp1TY pF,~ 7 DALLAS COUNTY HEALTH AND HUMAN SERVICES ~ ~ -~ 9 ENVIRONMENTAL HEALTH DIVISION 2377 N. STEMMONS FRWY. ROOM 607 •~T9T£ pp 'CE~P~« (214) 819-2115 FaY: (214) 819-2868 CITY/TOWN ~~~~~~, ~~ Establishment: ~~ ~~~ ;;~,q f~ ' - Owner: ~'~, ~,g'{ ~,~ ~, r ^ Physical Address: (~' ~.,~ ~ L~ Zip: ~~'~~~ Phone: (4(~~}'~ ~ ~ 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 ~ ~~~ l~'~`~' ~ !~`'F ~? Cr~~~ j5'~5' ~/ ~~`~ . "~: ~s • ~ 6. Personnel with Infections Restricted/Excluded V`: °` 7. Pro er/Ade uate Handwashin c.'' 8. Good Hy ienic Practices (Eatin /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 13. Approved Systems (HACCP Plans/Time as Public Health Control) 14. Water Supply - Approved Sources/Sufficient Capacity/Hot and Cold Under Pressure cxrx ~ ~~ ~ ~vA rro cos ~~~i~t~ ~anc~ ~q~me~t ~tequ~~e~ts ~ : _ ~ . ~ ~ 3 p"~~ '~aolatiaxas~~q~re Trnrne~i~t~ ~orr~t~v~,'~Tc~t Te~~'~c~d .f0 Days R~marks ~'' 15. E ui ment Ade uate to Maintain Product Tem erature 16. Handwash Facilities Ade uate and Accessible 17. Handwash Facilitie , Soa and Towels 18. No Evidence sect S'iontamination j~,j 19. No Evidence o ents/Other Animals 20. To ' ems Pro erl Labeled/Stored/Used 21. n Mechanical Warewashing and ''' at ( m/tem erature 22. ana er Demonstration of Knowled e/Certified Food Mana er 23. A roved Sewa e/Wastewater Dis osal System, Pro er Disposal 24. Thermometers Provided/Accurate/Pro erly 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 Permit ~, ,?~a f- ~..H ~~ ~'~'7~a-r ~~v~ ~s~ i o~ ~~,L~C,~Ylltit/~ ~i~?~~ `'~~/ Total ~ Inspected by: 1/ ~ Print ~~,/ ~`''~ F/U v~~ ~~1~ Received by: .~' ~ ~ ~ ~ ~ _ ~~~ ~ , Print:,~~~ Title~.