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(.° *6 DALLAS COUNTY HEALTH AND HUMAN SERVICES
11 ENVIRONMENTAL HEALTH DIVISION
1- 4• of 2377 N. STEMMONS FRWY. ROOM 607
�aT f o' �+° DALLAS, TEXAS 75207
214-819-2115 FAX 214-819-2868
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San Date Time In Time Out Establishment Number / Permit Number Risk Category
Code
Purpose of Inspection: 1-Compliance -Routii- 3-Field Investigation 4-Visit 5-Other
Establishment: /*L• R,ay,>j_j Owner: sc or-- 4 Le/ZiteC.t/
Physical Address: +ff !h! fd' 4„a/Eyz5 l Zip: 76205 Phone: {2/9) c,i96.39? ,
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)
• t 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 Practic (Eating/Drinking/Smoking/Other)
9. Approved Source elin
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 P •mperature
✓ 16. Handwash Facilities Adequate . d • cessible
✓ 17. Handwash Facilities with Soap an• "'...-
✓' 18. No Evidence of Insect Contamination
//7 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
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/Reminder/Buffer Plate)
27. Food Establishment Permit
Subtotal Other Violations - Require Corrective Action, Not to Exceed 90 Days or the Next Inspection, Whichever Comes First
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Total Inspected by: L ,, r 1 4, OIC Print: 1100.7, P117424)-S
No Received by: C ` . 3 Print: Title:
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