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DALLAS COUNTY HEALTH AND HUMAN SERVICES
�. > ENVIRONMENTAL HEALTH DIVISION
2377 N. STEMMONS FRWY. ROOM 607
sT ' DALLAS TEXAS 75207
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Of 214- 819 -2115 FAX 214 -819 -2868
CITY /TOWNS `Vr
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Code Date Time In Tinie Out Establishment Number ` Permit. Number Risk Category
Purpose of )inspections 1- Compliance Routine 3 -Field Investigation 4 -Visit 5 -Other
Establishment: L� wa �ti5 G 61.5 o Iflw Owner:
Physical Address: .. Lt„anr'j r Zip: . ? Phone:
OUT IN NA NO ' COS . Food Tei4erataire/Dm.e Requirements
5 Pts Violations Require Iznziediate Cortective.Acton Remarks.
1. Proper Cooling for Cooked/Prepared Food
2. Cold Hold (41 degrees Fahrenheit/45 de ees Fahrenheit
3. Hot Hold (135 degrees Fahrenheit
4. Proper Cookinc Temt)eratures
65 decrees Fahrenheit in 2
Item/Location/Temperature
OiJT IN NA NO COS I'e� °s�areanel/Ilandlin- /Source Requirements:,
4 Pts _ Violations Require Immediate Corrective Action Remarks
_ 6. Personnel with Infections Restricted/Excluded
7. Proper/Adequate Handwashina
& 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
13. Approved Systems (HACCP Plans /Time as Public Health Control)
14. Water Supply - Approved Sources /Sufficient Capacity/Hot and Cold Under Pressure
GUT W NA NO COS 'Faci*- nd Equipment Requirements
3 Pts ��olat�ors Re iiue inizoediate Correction, Not To Exeeed,l0. "!Da s, v' . Reztiarks .
. ...
15. Equipment Ade uate to Maintain Product Temperature
16. Handwash Facilities Adequate and Accessible
17. Handwash Facilities with Soap and Towels
18. No Evidence of Insect Contamination
19. No Evidence of Rodents /Other Animals
20. Toxic Items Pro erl y Labeled/Stored/Used
21. Manual/Mechanical Warewashing and Sanitizing at m/tem perature
22. Manager Demonstration of Knowledge/Certified Food Manager
23. Approved Sewage/Wastewater Disposal System, Proper Disposal
Thermometers Provided/Accurate/Properly Calibrated ( ±2 degrees Fahrenheit
25. Food Contact Surfaces of Equipment and Utensils Cleaned/Sanitized/Good Repair
26. Posting of Consumer Advisories ( Heimilich /Diselosure/ReminderBuffer Plate
27. Food Establishment Permit
Subtotal Other Viol
tions - Re uire Corrective Action,. Not to Exceed 90 Days or the Next Inspection, Whichever Comes First
5pt P,' t Nv
4 t
3t
Total Inspected by: �� ( Print:• t,
F/J Received b : ' Print: Title:
Yes/No y _I� ''�-- -- 1