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DALLAS COUNTY HEALTH AND HUMAN SERVICES
ENVIRONMENTAL HEALTH DIVISION
2377 N. STEMMONS FRWY. ROOM 607
DALLAS, TEXAS 75207
214 -819 -2115 FAX 214 -819 -2868
CITY /TOWN�iy�r
Item/Location/Temperature
Total- Inspected by: / int: 11 "�j 0' rt j I L -4•' j
F/U �
FIU Received by: / t � �� Print: Title:
Yes/No (
6. Personnel with Infections Restricted/Excluded
u
7. Proper/Adequate Handwashin
/U
8. Good Hygienic Practices (Eating/Drinking/Smoking/Other)
9. Approved Source/Labeling
10. Sound Condition
11. Proper Handling of Read To -Eat Foods
12. Cross - contamination of Raw /Cooked Foods /Other
13. Approved Systems (HACCP Plans /Time as Public Health Control)
14. Water Su 1 - Approved Sources /Sufficient Ca aci /Hot and Cold Under Pressure
3 Pts :;
:COS
,; acihty: and Equipment kequiremen�s
Violations R" dire Trnmechate C orreMon, Not To Exceed 10 Days" " Remarks "
15. Equipment Ade uate to Maintain Product Tem erattire
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 ( m/tem erature
22. Manager Demonstration of Knowledge/Certified Food Manager
23. Approved Sewage/Wastewater Disposal System, Proper Disposal
f
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 Correeccfiive Action, Not to Exceed 90 Days or the Next Inspection, Whichever Cones First .
Total- Inspected by: / int: 11 "�j 0' rt j I L -4•' j
F/U �
FIU Received by: / t � �� Print: Title:
Yes/No (