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DALLAS COUNTY HEALTH AND HUMAN SERVICES
�y ENVIRONMENTAL HEALTH DIVISION
2377 N. STEMMONS FRWY. ROOM 607
OF � DALLAS, TEXAS 75207
214 -819 -2115 FAX 214 - 819 -2868
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CITY/TOWNt%%
San
Code,
Date
Time In
Time Out
Establishment Number
Permit Number ' _
Risk Category
Purpose of Inispection: 1'- CompliancE " :�---,,3 -Field Investigation.. 4 Visit S -Other
Establishment: / Oi,-),EC .`o Owner: /<A fr--11L 4-- 771J
Physical Address: �,�
Zip: '75205
Phone: ( )
OUT
5 Pta:
IN'
; -
NA
...:
NO
COS
F66d l'emperature/Time Requirements
Violations Require lnamedlate,Corrective Action Reri�arks
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 Cooking Temperatures
r/
5. Rapid Reheating (165 degrees Fahrenheit in 2 Hrs)
Item/Location/Temperature
OUT
4 Pts
1N
NA '
NO'
CC)s
, rersonnel/Iiandling/Source Requirements
Violations Require Immediate Corrective Action Remarks
6. Personnel with Infections Restricted/Excluded
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7. Proper/Adequate Handwashin
S. Good H enic Practices (Satin /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 Supp 1 y - Approved Sources /Sufficient Ca aci /Hot and Cold Under Pressure
OUT
3 Pts
: ` IN
NA
_
'�O
COS
� Facility' ared Equipment RequireiiaentS � h
Violations Re wire Immediate': Correction, loot Zq Exceed.lQ.T�a s' :' ' ,l enarks - „
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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 Properly Labeled/Stored/Used
21. Manual/Mechanical Warewashing and Sanitizing at 1 6)- m/tem erature
well
22. Manager Demonstration of Knowledge /Certified Food Manager
23. Approved Sewage/Wastewater Disposal _System, Proper Disposal
24. 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 /Disclosure/ReminderBuffer Plate
27. Food Establishment Permit
Subtotal
Other 'violations - Require Corrective Action, Not to Exceed 90 Days or the Next Inspection, Whichever Comes First
5pt
4t
3t
Total
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Inspected by:
Print:
F/U
Yes/No
Received by"
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Print:
Title:
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