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�° � o DALLAS COUNTY HEALTH AND HUMAN SERVICES
o ENVIRONMENTAL HEALTH DIVISION
c�J' 4-4 • 2377 N. STEMMONS FRWY. ROOM 607
,,f OF DALLAS, TEXAS 75207
214-819-2115 FAX 214-819-2868
t'1j CITY/TOWN �±'VI�/ ./2 e /1 r '�1 San Date 1: -
Code Date Time In Tune Out Establishment Number Permit Number Risk Category
Purpose of Inspection: 1-Compliance out 3-Field Investigation 4-Visit 5-Other
Establishment: /117 k/°r i—CCO5 Owner: 3 Y i
Physical Address: %C b f/)L 1_:#3 5r Ave- Zip:752 J Phone: (23if S ..6 e 7
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 Firs)
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
a✓ 11. Proper Handling of Ready-To-Eat Foods
12. Cross-contamination of Raw/Cooked Foods/Other _
v' 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
z/• 18. No Evidence of Insect Contamination
4/' 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/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
4114
Inspected by: - Pak /21 / /lL_if?
Total y
1
Yes/No Received byiel ) # Print\\ N.W\t V-'(1/y Title:c