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DALLAS COUNTY HEALTH AND HUMAN SERVICES
y ENVIRONMENTAL HEALTH DIVISION
2377 N. STEMMONS FRWY. ROOM 607
.�T9Tf pF �� DALLAS, TEXAS 75207
214- 819 -2115 FAX 214 - 819 -2868
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CITY/TOWN�
San
Code
Date
Time In .
Time ®ut
Establishment .Number .
B6rnlitl Number
Risk Category
Purpose 0i Inspection:
1- Compliance Routine - 3 -Field Investigation' . 4-Visit 5 -0ther
Establishment: d p °
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Owner: 14AI�d®
Physical Address: `lJi
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Zip:
Phone: )
'OUT
IN'
NA
; NO,
;COS
Food Temperature/Tinne equirements
5 Pts
1. 1.
Violations Require Immediate'Correcti Action Rexrarks
1. Proper Cooling for Cooked/Prepared Food
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2. Cold Hold (41 degrees Fahrenheit /45 degrees Fahrenheit)
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3. Hot Hold (135 degrees Fahrenheit)
4. Proper Cooking Temperatures
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5. Rapid Reheating (165 degrees Fahrenheit in 2 Hrs
Item/Location/Temperature
OUT
IN°
NA'
: NO;
COS
, Personnel/Handlitig/S ®urce Requirements
4 Pts,
Violations Require Imxnediate'Correctve,Acton . Remarks ":
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6. Personnel with Infections Restricted/Excluded
7. Pro er /Ade uate Handwashing
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8. Good Hygienic Practices (Eating/Drinking/Smoking/Other) .
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9. Approved Source/Labeling
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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
IN _
NA:
'' NO "
COS
Facility and Equipni6i Requirexrients '
3 Pts . `
-
..TiolationsRe
wire Imriediate;Correction,, Not To Exceed lO pays-:, t2ernarks '
15. Equipment Ade uate to Maintain Product Temperature
16. Handwash Facilities Adequate and Accessible
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17. Handwash Facilities with Soap and Towels
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18. No Evidence of Insect Contamination
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19. No Evidence of Rodents /Other Animals
20. Toxic Items Properly Labeled/Stored/Used
21. Manual/Mechanical Warewashing and Sanitizing, at ) m/tem erature
22. Manager Demonstration of Knowled eL.Ce ti 'Fo"od Ma g^
23. Approved Sewage/Wastewater Dis osal s em, ro ` ei'Dis osal
24. Thermometers Provided/Accurate/Properly Calibrated ( ±2 degrees Fahrenheit)
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25. Food Contact Surfaces of Equipment and Utensils Cleaned/Sanitized /Good Repair
26. Posting of Consumer Advisories ( Heimilich /Disclosure/Reminder/Buffer Plate)
27. Food Establishment Permit
Subtotal
Other Violations - Require Corrective Action, Not to Exceed 90 Days or the Next Inspection, Whichever Comes First
5pt
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To al
Inspected by:
Print:
F/U
F/U
Received b
Print:
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Ti e: '��%�
Yes/No
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