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40* �� ,� DALLAS COUNTY HEALTH AND HUMAN SERVICES
i :q° lil > ENVIRONMENTAL HEALTH DIVISION
• k��t!�1 2377 N. STEMMONS FRWY. ROOM 607
`P), OF E+"� DALLAS, TEXAS 75207
214-819-2115 FAX 214-819-2868
5-2S- 13 CITY/TOWN L/piv ivexs
San Date Time In Time Out Establishment Number Permit Number Risk Category
Code
Purpose of Inspection: 1-Compliance outine ield Investigation 4-Visit 5-Other
Establishment: L\t t-J>1■,. Owner: / ''r`° (
Physical Address: `' '50(p . Zip:5 Z25 Phone: 4L)363.-415O0
OUT IN NA NO COS Food Temperature/Time Requirements
5 Pts Violations Require Immediate Corrective Action Remarks
1. Proper Cooling for Cooked/Prepared Food
2. Cold Hold (41 degrees Fahrenheit/45 degrees Fahrenheit)
3. Hot Hold (135 degrees Fahrenheit)
✓ " 4. Proper Cooking Temperatures
5. Rapid Reheating (165 degrees Fahrenheit in 2 Hrs)
Item/Location/Temperature
OUT IN NA NO COS Personnel/Handling/Source Requirements
4 Pts Violations Require Immediate Corrective Action Remarks
6. Personnel with Infections Restricted/Excluded
✓ 7. Proper/Adequate Handwashing
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 Capacity/Hot and Cold Under Pressure
OUT IN NA NO COS Facility and Equipment Requirements
3 Pts Violations Require Immediate Correction, Not To Exceed 10 Days Remarks
15. Equipment Adequate to Maintain Product Temperature
•� 16. Handwash Facilities Adequate and Accessible
17. Handwash Facilities with Soap and Towels
t," 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 ( )ppm/temperature
22. Manager Demonstration of Knowledge/Certified Food Manager
f 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 iolations - Require Corrective Action, Not to Exceed 90 Days or the Next Inspection, Whichever Comes First
Spt
4pt
apt
AO a
Total Inspected by: r ��� t ♦ ' J Print: / �1� S
F/U '
Yes/No Received b 1 111 'I / Print: Title: