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• �o •∎ o DALLAS COUNTY HEALTH AND HUMAN SERVICES
°ii �\ f) ENVIRONMENTAL HEALTH DIVISION
' �• 2377 N. STEMMONS FRWY. ROOM 607
J'/NI a +" DALLAS, TEXAS 75207
4 'Pr p 69 F14 41 214-819-2115 FAX 214-819-2868
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10413 CITY/TOWN "/f Etz50 ]
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San Date Time In Time Out stablishment Number Permit Number Risk Category
Code
Purpose of Inspection: 1-Compliance 2 Routine 3-Field Investigation 4-Visit 5-Other
Establishment: ti ) Owner: 1.<',4,izo,si kfkac,Physical Address:,S '9C._)0 UCH NI , i....../ b Zip: 5 203 Phone: (C /1,./).- 3
OUT IN NA NO COS Food Temperature/Time Requirements
5 Pts Violations Require Immediate Corrective Action Remarks
�- 1. Proper Cooling for Cooked/Prepared Food
yy 2. Cold Hold (41 degrees Fahrenheit/45 degrees Fahrenheit)
✓' 3. Hot Hold (135 degrees Fahrenheit)
, " 4. Proper Cooking Temperatures
47- 5. Rapid Reheating (165 degrees Fahrenheit in 2 Hrs)
Item/Location/Temperature/-r. /' , P 0 (Tritieir
OUT IN NA NO COS Personnel/Handling/Source Requirements
4 Pts Violations Require Immediate Corrective Action Remarks
_6. Personnel with Infections Restricted/Excluded
t/ 7. Proper/Adequate Handwashing
i/ 8. Good Hygienic Practices (Eating/Drinking/Smoking/Other)
t/ 9. Approved Source/Labeling
V 10. Sound Condition _
11. Proper Handling of Ready-To-Eat Foods
`� 12. Cross-contamination of Raw/Cooked Foods/Other
'J 13. Approved Systems (HACCP Plans/Time as Public Health Control)
14. Water Supply - A.',roved Sources/Sufficient Ca•acit /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
L.'" 16. Handwash Facilities Adequate and Accessible
t/" 17. Handwash Facilities with Soap and Towels
4/ 18. No Evidence of Insect Contamination
_ sue'' 19. No Evidence of Rodents/Other Animals
✓ 20. Toxic Items Properly Labeled/Stored/Used
1/-( 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
i ' 24. Thermometers Provided/Accurate/Properly Calibrated (±2 degrees Fahrenheit)
t/'s 25. Food Contact Surfaces of Equipment and Utensils Cleaned/Sanitized/Good Repair
vr-' 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
( � t S S A ; 1 '1/rh i V••1 - /M-0 5M-L 5
3pt t
Inspected by: / 1 �. Print: t + 9` }�C
Total ...A...4 Y, V Li.-I
F/U
Title: v
Yes/No Received by: 4.,, Print: P ,,,,