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DALLAS COUNTY HEALTH AND HUMAN SERVICES
i ENVIRONMENTAL HEALTH DIVISION
y 2377 N. STEMMONS FRWY. ROOM 607
�� DALLAS, TEXAS 75207
OF
d �,s 214- 819 -2115 FAX 214 - 819 -2868
CTTY /TOWN��1125�` --
San Date Time In Time Out blishfli�ent Nianaber.' Permit Number Risk Category
Code
Purpose of Inspectioih 1- Compliance 2- Routine 3 -Field Investigation 4 -Visit 5 -Other
Establishment: � Owner: � 'e S 0 /I
Physical Address: l 40 Zip: 5 "ZD65' Phone: (1;ZM 7
1. Proper Cooling for Cooked/Prepared Food
2. Cold Hold (41 degrees Fahrenheit/45 decrees Fahrenheit)
3. Hot Hold (135 degrees Fahrenheit)
4. Prover Cookiniz Temperatures
65 decrees Fahrenheit in 2
Item/Location/Temperature
OUT
4 Pts
G IN `
NA
NO
COS
t'ersoniiel/Handling/Source Requirements,
i Violations Require ImmedlateCorrective Action. Remarks
6. Personnel with Infections Restricted/Excluded
7. Pro er /Ade uate Handwashin
e!
-
8. Good Hygienic Practices (Eating/Drinking/Smoking/Other)
9. Approved Source/Labeling
%
10. Sound Condition
`
11. Pro er 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 =
3 Pts
� IN
NA'
NO ,
COS
.,Facility! and Eg11 meht Requirements
Violations Require h=ediate Correction, Not To Exceed 10 Days Remarks
15. Equipment Ade uate to Maintain Product Temperature
�^ 16. Handwash Facilities Adequate and Accessible
.s 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 ) m/tem erature
22. Manager Demonstration of Knowled e /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 I Other Violations Reauire. Corrective Action, Not to Exceed 90 Days or the. Next .Inspection, Whichever Comes First
Tot 1 Inspected by: u Print:
F� T- Received b . t ,� — Print: Title: