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Home My WebLink AboutLENNIE'S BLUES N BBQ 2018.05.20F-iJ ~uJ ()(_10 Dallas County Health and Human Services -Environmental Health DiViS~'en(~.\t Retail Food Establishment Inspection Report 2377 N.STHI:\-IONS FRWY.,R.\1 607,DALLAS,TX 75207 214-819-2115 FAX:214-819-2868 License/Permit # Page_of_ 5-0ther TOTAUSCORI ()Follow-up:Yes No (circle one) R;repeat violation asterisk'*'ina ro riale box for Jl Time and Temperature for Food Safety (F ;degrees Fahrenheit) R REmployeeHealthI.Proper cooling time and temperature 12.Management,food employees and conditional employees; knowled e.res onsibilities,and re orlin2.Proper Cold Holding temperature(41 0F/450F) o discharge from Time as a Public Health Control:roccdures &records Approved Source 7.Food and ice obtained Irom approved source:Food in good condition,safe.and unadulterated;parasitedestruction Pasteurized egus lIsed when re uired Chemicals 8.Food Received at proper temperature Food additives;approved and properly stored;Washing Fruits &VegetablesProtectionfromContamination 18.Toxic substancesFoodSeparated&protected.prevented during food re aration.storage,dis la •and tastina 10.Food contact surfaces and Retumables ;Cleaned and Sanitized at m/tem erature 19.Water from approved source;Plumbing installed;properbacktlowdeviceII.Proper disposition of retumed.previously served or reconditioned 20.Approved Sewage/Wastewater Disposal System,properdisposalPriorityFoundationItems2Pointso U T "ire Corrective Actioll withill 10 da '5RDemonstrationofKnowledgelPersonnelc o Food Temperature Con troll Identifications R Person in charge present.demonstration of knowledge, and erform dutiesl Certified Food Manager (CFM)Equipment Adequate to Safe Water,Recordkceping and Food Package Labelin osition 29.Thermometers provided,accurate.and calibrated;Chemical!Thermal test stri sHotandColdWateravailable;adequate pressure.safe Permit Requir'ement,PrereqUisite for OperationRequiredrecordsavailable(shellstock tags;parasite destruction);Packaged Food labeled 30.Food Establishment Permit (Current &Valid)Conformance with Approved Procedures 25.Compliance with Variance.Specialized Process,and HACCP pian;Variance obtained for specialized rocessinrr methods:manufacturer instructions Utensils,Equipment,and Vending 31.Adequate handwashing facilities:Accessible and properlysupplied,usedConsumerAdvisory 32.Food and on-food Contact surfaces cleanable.properly designed.constructed.and usedPostingofConsllmerAdvisories;raw or under cooked o U T R Title:Person In Chargel Owner ""n..!~ ..•.,(fuas Department ofMotor~hicles TITLE APPLICATION RECEIPT COUNTY:TARRANT PLATE NO:964038J DOCUMENT NO:22040043184104804 TAC NAME:RON WRIGHT DATE:03/27/2018 TII1E:10:48AM EMPLOYEE 10:4870JB5 OWNER NAME AND ADDRESS LYNDELL JAMES COLLINS 8200 SNOW EGRET WAY FORT WORTH,TX 76118 EFFECTIVE DATE:03/27/2018 EXPIRATION DATE:2/2019 TRANSACTION 10:22040043184104804 REGISTRATION CLASS:TRAILER PLATE TYPE:TRLR PLT ORGANIZATION: STICKER TYPE:US VEHICLE IDENTIFICATION NO:4S9S1EH25JN364914 VEHICLE CLASSIFICATION:TRLRYR/MAKE:2018/SDGT MODEL:BODY STYLE:UT UNIT NO: EMPTY WT:3400 CARRYING CAPACITY:4100 GROSS NT:7500 TRAILER TYPE:S BODY VEHICLE IDENTIFICATION NO:TVL TRLR L/W/SQfT:0'0. PREV OWNER NAME:SOUTHERN DIMENSIONS GROU PREV CITY/STATE:WAYCROSS,GA INVENTORY ITEM(SITRLRPLT PLATE STICKER VEHICLE RECORD NOTATIONSPAPERTITLE MAJOR COLOR:RED YR 2019 FEES ASSESSED TITLE APPLICATION FEE TEXAS MOBILITY FUND FEE SALES TAX FEE PLATE STICKER CNTY ROAD BRIDGE ADD-ON FEE MOBILITY I CLEAN AIR FEE PROCESSING AND HANDLING FEE TOTAL ODOMETER READING:BRAND: OWNERSHIP EVIDENCE:MANUFACTURER'S CERT.OF ORIGIN1STLIEN $$$S$ $ $ $ 13.00 20.00 1,250.00 54.00 10.00 7.50 4.75 1,359.25 METHOD OF PAYMENT AND PAYMENT AMOUNT: CHARGE $1,359.25 TOTAL AMOUNT PAID $1,359.25 SALES TAX CATEGORY:SALES/USE Date of Assignment/Sales Tax Date:03/27/2018SalesPrice$20,000.002NDLIENLessTradeInAllowanceS0.00TaxableAmount$20,000.00SalesTaxPaid$1,250.003RDLIENLessOtherStateTaxPaid$0.00 TOTnxT~~n~ab S 0.00$1,250.00BatchNo:4004318401 Batch Count:5 THIS RECEIPT TO BE CARRIED IN ALL COMMERCIAL VEHICLE~. TillS RECEIPT IS YOUR PROOF OF APPLICATION FOR CERTIFICATE Of TITLE AND REGISTRATION. PEEL FROM BACK ONLY I DESPEGUE POR DETRAs 24907381 'litP NO USE WINDSHIELD STICKER I CALCOMANiA DE PARABRISAS OR Peel sticker from any corner. Oespegue la calcomanfa de cualquier esquln ~~ v v >< < A PLATE STICKER I CALCOMANiA DE PLACA PIt.No,l,1M.t7!l I ~S1IOKER ~~ ~ ~ ~~~~ "" ::r.-:.0 .,. 101·~~..•I"%j ~ :::-'H._,tj g-O (1 ~t:"'..•.t-'0 ~ H ••~,""'\ ~ ;-.~=.f-H 8.•.••.•••.•tJ ~~ ~~~~~ I~10-1 "0 ••••r.;~~~~<:o H 1-3 ~~I!r:I C".l I-i J ,;,-:;...... ..•..1;1 g Establishment I.D.Number ».- CODE COMPLIANCE CONSUMER HEALTH DIVISION Permit Number 16F-10164 INVENTORY# 1 This is to certify that the Establishment shown below has complied with the rules and regulations of this department,and is hereby granted permission to operate the type of establishment shown below: SITE PERMITTED OWNER OF RECORD 1675102 DONA CARMEN PUPUSERIA #2 JOSE FLORES 1712 N SYLVANIA AVE FORT WORTH TX 76111-2737 Restaurant 3 Employee(s)@5.00 JOSE FLORES DONA CARMEN PUPUSERIA #2 1014 N RIVERSIDE DR FORT WORTH TX 76111-4332 285.00 15.00 COMMISSARY INSPECTION DOCUMENT SITE#11534 THIS PERMIT IS VALID FOR THE PERIOD SHOWN BELOW,UNLESS SOONER REVOKED OR SUSPENDED FOR CAUSE. VALID FROM:11/11/17 THRU 11/10/18 WYNDIE TURPEN,RS BRANDON S.BENNEIT Code Compliance Supenntendent Code Compliance Director IN THE EVENT AN ESTABLISHMENT IS EXTENSIVELY REMODELED,A CHANGE OF OWNERSHIP OCCURS,OR THE NATURE OF THE OPERATION CHANGES,CONTACT THE CITY OF FORT WORTH CODE COMPLIANCE DEPARTMENT AT 817.392.7255. DISPLAY PROMINENTLY AT THE PLACE OF BUSINESS. SEHABLA ESPANOL Juan Reyes REYES, BILE KITCHEN DESIGN'S.IMOB·Id _Repair's .Commlssary_Custom UI Page 1 of 1 r----- I Texas Gerfified Fooa Manager This certifies that Lynde11 Collins has successfully completed the Food Manager Classes certification examination ' approved by the Texas Department of State Health Services. TXDSHS License 110023 License No:TX-105199 Completed:1/1512018 Expires:1/1512023 Thisce ifica ion is valid in all Texas cities and counties and must be accepted 5 atewide by regulatory authori ies according to Texasstate law.hiscard shall be available to the regulatory authority at all times at the tood as ablishmen .Check with your local health deportment for any requirements regarding the transferral of this certificate per city/county ordinances. GCHD Director GCHD 205 North Houston Denison,TX75021 www.FoodManagerClasses.com ~c:::u 01·300~'::=(Rev.9-16/20) This permit is not transferable,and this side must be prominently displayed in your place of business. TEXAS SALES AND USE TAX PERMIT IIrItIIltn:..ar..,•iIOWOfiNs perrnI inlieu at a properly completed eJlfHfl/Kion 01' ftI6BIe CBftiflClllli_A09f!ificste is necessary to document why tax is not collected on a sale. ••••-----TAXPAYER NAME.BUSINESS LOCATION NAME,and PHYSICAL LOCATION LYNDELL J COLLINS Youmust obtain a new permI,"_is •changs awnership,location,or business location name . Type of permit SALES AND USE TAX TX 76118-7624 Taxpayer number 3':"20663-6490-5 00001 LENNIE BLUES N BBQ 8200 SNOW EGRET WAY FORT WORTH TARRANT COUNTY NAICS CODE:722330 Location number DESCRIPTION ON NEXT LINE: Mobile Food Services WE SHOW THIS BUSINESS IN THE FORT WORTH FORT WORTH MTA You may need to collect sales and/or use tax for other local taxing authorities depending on your type of business. For additional information,see "Collecting Local Sales and Use Tax"section on the back of this documerrt. If you have any questions regarding sales tax,visit our website al www.comptroller.lexas.gov or call us at 1·800-252-5555. Texas liability Insurance Card Progressive County Mutudllns Co 1-800-444 -448 7 (se habla espana/) Policy period: Policy number: Agent: PROOREIIIVE Mar 26,2018 to Mar 26,201 9 06648639-0 ..:#'tNameofInsuredf'<"I ., LYNDELL COLLINS -1i.-;£;;'·i ,.-.:-~.,! -'!l!-~,~;~8200 SNOW EGRETWAf.;i!._it"~"f >;[•It- ',~-[if ~'f''FORTWORTH,TX 76118~;!>o _•.,~•~.... ," P~~er<4V~!frSurance ~~t.1$j.ai776~37 ~:.~.~t 1,._~.~. Vehicle Year 2017 Make FORD Model F2S0 Vehicle Identification No. 1 FTlX2136XHEES5430 rhls puli':y plOvldes d!led>t rhl!Illlllllllurn "IPoun!;uf itdbtll!V IIllUldnte reljUlled hI'Ihe 1e'J,Moror '/phlcip I,ltery HesponSlbtli:y Al1I01 the sp0f1tird vehicle,Jnd named :nsu/cus alld I11d\'movlde coveldrjP for u:I'er pel>Urll anu ollie/vehidt',d,plOVI[lp(1hy lite IIlSUlance policy. Texas Liability Insurance Card Keep this card. IMPORTANT:This card 01 a copy of your insurance policy must be 'shown when you apply for or renew your: •motor vehicle registration Tarjeta de Segura de Respansabilidad de Texas Guard!!esta tarjeta. IMPORTANTE:Esta tarjeta a una copla de su paliza de segura dt'll1' ser Illostrada cuando usted solicite 0 renu€w 511: •driver'S license •motor vehicle safety inspedion stickel •reglstro de vehiculo de;mo{or •lictencla~ilfaco~~qi .';~[ '.f>.::,..!~qiJetJ ~qe)~pe(~ion,de S"~guridac/para su vehi(ulo You may also be asked to show thiS card or ygur /??Iky,if;you !':."P9eJie...que usted fenqa tilillbien que mostrar esla Iilljeta 0 su POllZiI cle have an accident or a peace oHI,o~ra$fa se~~..,';;~:segura ~:tiene un accidente a si un aliCIaI de la paIsI'la plde. All drivers in Texas must carry 1i~~ilityj1suraOCe'o~th-eirvehicles Todos los condudores en Texas deben de tener segura de or otherwise meet legal requlrem~ts far:ijria~(lal ~esponslbtlity lesponsabilidad para sus vehiculos,0 de Olra manela lienal los Failure to do so could re,ult In fines up to $1,000.suspension of requisltoslegale,de responsabilidad Civil.Falla ell lIeliar este rcqUISi[O your driver's license and motor vehicle registration,and pudlera resultar en multas de hasta $1,000,suspension de su licencia impoundment of your vehicle for up 10 180 days (ilt a cost of $15 para COlldUCiry su registro de vehiculo de Illolor,y la retencicin de su per day).vehfculo por un periodo de hasta 180dias (a un costa de $15 par dia). Our clilims service number is 1·800·274·4499 We ale available 24 hours a day,7 days a week to begin working to resolve your claim.