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004" DALLAS COUNTY HEALTH AND HUMAN SERVICES
ENVIRONMENTAL HEALTH DIVISION
• 41) w • 2377 N. STEMMONS FRWY. ROOM 607
+` DALLAS, TEXAS 75207
rf°F � 214-819-2115 FAX 214-819-2868
(cc5L CITY/TOWN 'LI i visit]
San ,Date Time In Time Out Establishment Number Permit Number Risk Category
Code
Purpose of Inspection: 1-Compliance Routine 3-Field Investi ation 4-Visit 5-Other
Establishment: / Y 3 w \ QR J U F1�
6 j Owner: 1 A-/ ic.s.s
/ Zip: ; a5 Phone: !02 /
Physical Address: JO/ �� U � P ��� (���
OUT IN NA NO COS Food T perature/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
I
OUT IN NA NO COS Personnel/Handling/Source Requirements
4 Pts Violations Require Immediate Corrective Action Remarks
t1 6. Personnel with Infections Restricted/Excluded
7. Proper/Adequate Handwashing
V/ 8. Good Hygienic Practices (Eating/Drinking/Smoking/Other)
i/l 9. Approved Source/Labeling
✓ 10. Sound Condition
11. Proper Handling of Ready-To-Eat Foods
12. Cross-contamination of Raw/Cooked Foods/Other
t/ 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
1/ 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( )ppm/temperature
✓ 22. Manager Demonstration of Knowledge/Certified Food Manager
1J 23. Approved Sewage/Wastewater Disposal System, Proper Disposal
t/A 24. Thermometers Provided/Accurate/Properly Calibrated(±2 degrees Fahrenheit)
f 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 Days or the Next Inspection,Whichever Comes First
5pt
4pt
apt
r t
Total Inspected by: s I 4i 5int: ()id PH7L14pS
vy
rr
F� Received by:'a� -:'I� Print 1�_ CN Titl /C EO
Yes/No I► 11,' 1 �i'-�J