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° DALLAS COUNTY HEALTH AND HUMAN SERVICES
Z ,Oq,l� �n?J > ENVIRONMENTAL HEALTH DIVISION
',e ,;,±% y 2377 N. STEMMONS FRWY. ROOM 607
':/)..,T f a,F �� +" DALLAS , TEXAS 75207
214-819-2115 FAX 214-819-2868
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CITY/TOWN Ivo?-St 1) ..-
San Date Time In Time Out Establishment Number Permit Number Risk Category
Code
Purpose of Inspection: 1-Compliance -Routine 3-Field Investigation 4-Visit 5-Other
Establishment: /1-1/1u/a�. f 6:14 Owner: TII- y, /3RorJ
Physical Address: � �33 1.-0\11..-. S IS 414 Zip: 7521_15 Phone: ( / 6--q 75
OUT IN NA NO COS Food Temperature/Time Requirements
5 Pts Violations Require Immediate Corrective Action Remarks
1. Proper Cooling for Cooked/Prepared Food
v' 2. Cold Hold 41 de rees Fahrenheit/45 de rees Fahrenheit)
f✓ 3. Hot • degrees
'`' 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
t., .. 6. Personnel with Infections Restricted/Excluded
c,o" 7. Proper/Adequate Handwashing
.✓ 8. Good Hygienic Practices (Eating/Drinking/Smoking/Other)
9. Approved Source/Labeling
A--' 10. Sound Condition
,1--- 11. Proper Handling of Ready-To-Eat Foods
v _12. Cross-contamination of Raw/Cooked Foods/Other
__ 13. Approved Systems (HACCP Plans/Time as Public Health Control)
s..-- 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
�- _ T~ 16. Handwash Facilities Adequate and Accessible
4.-" 17. Handwash Facilities with Soap and Towels
i..---- 18. No Evidence of Insect Contamination
✓ 19. No Evidence of Rodents/Other Animals
20. Toxic Items Properly Labeled/Stored/Used
21. Manual/Mechanical Warewashin: and Sanitizin• at .F4 to:rn/t-.m.erature
22. Manager Demonstration of Knowledge/Certified Food Ma ager
23. Approved Sewage/Wastewater Disposal System, Proper Disposal
L/' 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)
V 27. Food Establishment Permit
Subtotal Other Violations-Require Corrective Action,Not to Exceed 90 Days or the Next Inspection,Whichever Comes First
5pt
4pt
3pt
1( it__ ------„1--- --: f 4 Pi'J 1/' itl;ip +.'i_ ,y: !'r'�. rii a ') sc? ) Prillt: i \2{- �y ,.F> _�_
Total .l ti� �' - I
F/U Received by: v,:!' \N., Print: Title:
'ves/No _