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DALLAS COUNTY HEALTH AND HUMAN SERVICES
F `y ENVIRONMENTAL HEALTH DIVISION
2377 N. STEMMONS FRWY. ROOM 607
sT - Py DALLAS, TEXAS 75207
'rf OF. i` °' l t'1Tizt "� 214 - 819 -2115 FAX 214 - 819 -2868 apr, Z J/Z
CITY/TOWN ZA I Yp z's'
San
Code
Date
Time In
Time Out °
Establishment Number.
Permit Number
Risk Category
Purpose of Inspection:: 1- Compliance 2 -R ie 3- Field Investigation 4 -Visit V 5- 0ther'
Establishment: ! AaA V,EF
Owner: '4
Physical Address: �(% %
Zip: '76 `Zt
Phone:
OUT
5 Pts ::.
IN
NA
NO :
COS
liood TernperatureMne: R6quirem nts
Violations. Require Immediate Corrective Action Remarks
L. –
1. Proper Cooling for Cooked/Prepared Food
tr
2. Cold Hold (41 degrees Fahrenheit/45 degrees Fahrenheit)
i--
3. Hot Hold (135 degrees Fahrenheit
4. Pro per Cooking Temperatures
5. Rapid Reheating (165 degrees Fahrenheit in 2 Hrs)
Item/Location/Temperature
O TT
4 its
IN
NA
NO {
COS
Personnel/Handling/Source Requirei -nents
Violations Require Immediate- Corrective Action Remarks
--
6. Personnel with Infections Restricted/Excluded
7. Proper/Adequate Handwashin
�-
8. 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 Capacit ot and Cold Under Pressure
OUT
7 Pts
IN ''
NA
N(5—;
COS
facility and Equipment Requirements
violations Re uiie.Inlinediate' Correction, Not To Exceed 1.0 Trays Remarks
a
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/1Jsed
v'
21. Manual/Mechanical Warewashing and Sanitizing at ) m/tem erature
22. Manager Demonstration of Knowledge/Certified Food Manager
V^
23. Approved Sewage/Wastewater Disposal System, Proper Disposal
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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 Da s or the Next Inspection, Whichever Comes First
5ptLi�
,
4 tom,
3 t
7
Total
F/U
Yes/No
%
Inspected by: ,, A
Received by: "y ,
9
Print:
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