The URL can be used to link to this page

Home My WebLink AboutSt. Paul UMC 220007 07 27 16.LS.PDFYes No Name Change Verification of Closure Status Change Maximum Attendance 1. SITE: Satisfactory for facilities and activities; hazard-free 20* (.1010) .......................................... 2. WATER SUPPLY: Supply meets requirements of 15A NCAC 18A .1700, no cross-connections, adequate for all requirements 40*; adequate hot water heating facilities 20* (.1011) 3. RECREATIONAL WATERS: Pool meets requirements of 15A NCAC 18A .2500; Natural bathing place acceptable 50* (.1012) ................ 4. LIQUID WASTES: Sewage and other liquid wastes disposed of by approved method 50*; on-site disposal system properly operated 20# (.1013) 5. TOILET, HANDWASHING, LAUNDRY, AND BATHING FACILITIES: Toilet, handwashing, and bathing facilities provided, adequate, convenient, accessible; water closets or privies approved, sufficient number 30#; lavatories with running water convenient to toilets 10*; lavatory (ies), hot, cold water, mixing faucet, soap, towels in food preparation areas 30#; laundry facilities clean, in good repair 10# (.1014) ... 6. DRINKING WATER FACILITIES: Sanitary drinking water facilities, fountain approved, regulated, clean 20# (.1015) ................................ 7. LODGING FACILITIES: Cross ventilation, 30 inches between beds, 6 feet between heads, at least one bed per camper, only single or double level beds 20#; lodging clean, in good repair 10#; linen stored, handled in sanitary manner 10# (.1016) ................................................. 8. (a) FOOD SERVICE FACILITIES: Kitchen adequate size, completely enclosed, permanent construction, dining hall protected from elements 30# (.1017) .......................................................... (b) EQUIPMENT AND UTENSILS: Smooth, easily cleanable, in good repair, clean 10#; food contact surfaces accessible, nontoxic, corrosion resistant, smooth 10*; multi-use eating and drinking utensils cleaned and sanitized after each usage 60-/; cooking utensils and food contact surfaces of equipment and storage utensils cleaned after each use 10#; cooking surfaces cleaned each day 10*; utensils, etc. used for hazardous foods cleaned and sanitized before each use 20*; non-food contact surfaces of equipment and shelves, tables, sinks, cabinets, refrigerators, ranges, hoods, etc. kept clean 10*; necessary facilities provided for cleaning and sanitizing (comply with 15A NCAC 18A .2600) 20#; clean utensils and equipment properly stored and protected 10*; single-service articles properly stored and handled and clean cloths, equipment accepted 10* (.1018) ................................................ (c) FOOD SUPPLIES AND PROTECTION; ICE HANDLING; FOOD SUPPLIES: All food clean, wholesome, from approved sources, properly identified 20#; SHELLFISH; Shellfish from approved sources, properly stored and handled (record permit numbers); singleservice shipping containers not re-used, shucked shellfish properly stored 10#; MILK SUPPLY: Grade A pasteurized milk for drinking, individual containers or approved dispensing, reconstituted milk for cooking only 20#; FOOD PROTECTION: Protected during storage, preparation, display and service, potentially hazardous food below 45°F, or above 140°F, storage facilities adequate, all refrigerators with thermometers; pork, stuffings, ground beef, etc. thoroughly cooked; meat and poultry salad, potato salad, etc. handled as required, no re-serving, adequate facilities for cold and hot food storage display, food containers stored above floor and protected from splash and other contamination 60-/; ICE HANDLING: Ice stored and handled in sanitary manner; ice clean, storage chests, houses, icemakers, scoops, containers, etc. properly stored, handled, located, in good repair and clean 20# (.1019, .1020, .1021, .1022, .1023) .................. 9. CONSTRUCTION AND MAINTENANCE REQUIREMENTS: FLOORS: Easily cleanable construction, in good repair 10*; space for all operations, no obstacles to cleaning, kept clean 10*; non-absorbent and graded to drain where required 10*; WALLS AND CEILINGS: Clean and in good repair 20#; easily cleanable, light color where required, washable to level of splash, where required 10*; LIGHTING AND VENTILATION: Adequate in all rooms as required 10*; fixtures, equipment in good repair and clean 10#; vents for kitchens, toilets, etc. clean 10* (.1024) ............................... 10. SOLID WASTES: Garbage in standard containers, properly covered and stored; container cleaning facilities, containers, storage room or area clean; dry rubbish in suitable receptacles; approved disposal of all wastes 60-/ (.1025) .............................................................................. 11. VERMIN CONTROL, PREMISES, STABLES: Outside openings effectively screened or otherwise protected against entrance of flies, etc. or flies absent 10*; effective control of rodents and other vermin 40*; pesticides registered and properly used and stored 10*; premises clean and free of vermin harborages and breeding areas 30*; no birds or animals in kitchen or dining areas 10*; STABLES: Stables properly located, manure removed and disposed of so as to minimize fly breeding 10* (.1026) ........................................................................ 12. FOOD SERVICE EMPLOYEES: Clean outer clothing, no tobacco use 20#; hands washed 20#; hairnets, caps, etc. worn 20# (.1027) .......... 13. MISCELLANEOUS: Potentially hazardous materials, equipment and apparatuses, properly handled and stored, protective railing and fences, etc. provided and in good repair 10* (.1028) ..... Comment Sheet Attached? Season Closes Inspection of Summer Camp City:Zip: Boys City: N.C. Department of Environment and Natural Resources Division of Environmental Health Present AttendanceEmployeesGirls Old Facility ID Health Department Current Facility ID Score: Date: Name of Summer Camp: State:Zip: Location Address: Purpose: General Statute 130A-248 requires the Commission for Health Services to adopt rules governing the sanitation of facilities where food or drink is prepared or served for pay or where lodging is provided for pay. 15A NCAC 18A .1007 specifies the contents of an inspection form to record the results of inspections made of such facilities. This form is developed to be used in making inspections of summer camps. Preparation: Local environmental health specialists shall complete the form every time they conduct an inspection. Prepare an original and two copies for: 1. Original to be left with the camp director or manager. 2. Copy for the local health department. 3. Copy for the Environmental Health Services Section, Division of Environmental Health. Disposition: This form may be destroyed in accordance with Standard-8.B.6., Inspection Records, of the Records Retention and Disposition Schedule for County/District Health Departments which is published by the North Carolina Division of Archives and History. Additional forms may be ordered from: Division of Environmental Health, 1632 Mail Service Center, Raleigh, NC EHS 1050 (Revised 07/05)Environmental Health Services Section (Review 07/08) Permittee Permit: State: NC TOTAL:1000Signed DIVISION OF ENVIRONMENTAL HEALTH Water sample taken today? Wastewater:Seating Capacity: 1 2 V Mailing Address: EHS I.D. 1. 2. 3. 4. 5. 6. 7. 8a. 9. 10. 11. 12. 13. 8b. 8c. Season Opens Yes No // //// Inspection Re-inspection VisitMunicipal/Community On-Site System Municipal/Community On-Site SupplyWater Supply: 0 7 2 7 2 0 1 6 100 18 2018220007 A 5 0 ST. PAUL UMCST. PAUL UMC 103 S ERVIN AVE NEWTON 28658 107 WESTBROOK DR NEWTON NC 28658 0 1896 - Sears, Luke Total Time: N.C. Department of Environment and Natural Resources Division of Environmental Health COMMENT ADDENDUM Time In: Time Out: City: Street: ID: Name:am pm am pm : : ST. PAUL UMC 2018220007 103 S ERVIN AVE NEWTON 0 9 4 6 1 0 1 5 29 minutes N.C. Department of Environment and Natural Resourses Division of Environmental Health COMMENT ADDENDUM City: Street: ID: Name:ST. PAUL UMC 2018220007 103 S ERVIN AVE NEWTON N.C. Department of Environment and Natural Resourses Division of Environmental Health COMMENT ADDENDUM City: Street: ID: Name: General Comments: ST. PAUL UMC 2018220007 103 S ERVIN AVE NEWTON