HomeMy WebLinkAboutBalls Creek Campground 010093 08 25 11.JH.pdf
NA NO Employee Health .2616 Good Hygiene Practices .2616 Preventing Contamination by Hands .2609,.2616,.2625 Approved Source .2608,.2610,.2612,.2615,.2622 Food Service Establishment
Inspection Food contact surfaces cleaned & sanitized; approved methods and sanitizers Protection from Contamination .2608,.2610,.2611,.2612,.2614,.2615,.2617,.2618,.2619,.2622 13 Potentially
Hazardous Food .2609,.2612 16 # 11 1 Proper hot holding temperatures 2345 Item 67 Temp 89 10 Location Temp City: Establishment Name: Item Email Address: Location Score: Lat. Long. Location
Address: NA = Not Applicable + NO = Not Observed NC Department of Environment & Natural Resources Division of Environmental Health Mailing Address: [.2606(b)] = City: State: Zip: State:
Permittee: Zip: Date: Status Code: County: Current Establishment ID: Previous Establishment ID: Name Change Seating: Wastewater Systems: Status Change Water sample taken today? Water
Supply: CRITICAL VIOLATION RISK FACTORS Critical Violation Risk Factors = Contributing factors that increase the chance of developing foodborne illness GC = General Comment CDI = Corrected
During Inspection R = Repeat Violation GC CDI R TEMPERATURE OBSERVATIONS Pts Personnel with infectious or communicable diseases restricted Proper employee beverage or tobacco use Hands
clean and properly washed Minimal bare hand contact with foods Handwashing facilities provided Food protected during storage, handling, display, service & transportation; written notice
for clean plates Proper handling of returned, previously served, and adulterated food Proper cooking time and temperature Proper cooling Proper reheating procedures Proper cold holding
temperatures Time as a public health control, procedures & records Food obtained from an approved source Food received at proper temperature Food in good condition, safe and unadulterated
Shellstock tags retained Temp Item COMMENTS: DENR 4007 (revised 01/08) Page 1 of 2 Location 12 14 15 17 18 Time: Municipal/Community On-Site System Municipal/Community On-Site System
Inspection Re-inspection Visit CV Visit CV Follow-up //Risk: I II III IV : 3 1.5 3 1.5 4 2 3 1.5 3 1.5 4 2 3 1.5 3 1.5 2 1 3 1.5 3 1.5 2 1 4 2 4 2 3 1.5 4 2 4 2 3 1.5 BALLS CREEK CAMPGROUND
2039 BUFFALO SHOALS RD CATAWBA NC 28609 BALLS CREEK CAMPGROUND C/O DAVID JONES CATAWBA 93 93 0 8 2 5 2 0 1 1 0 3 3 9 A 18 2018010093 4 8 CHEESE• REACH IN 42 HAMBURGER REACH IN 43 LEFTOVER
SLIDING DOOR 44 HOT WATER 2 COMPARTMENT 130
48 36 37 20 38 # 39 Establishment Name: 40 19 Purpose: General Statute 130A-248 requires the Commission for Health Services to adopt rules governing the sanitation of facilities where
food or drink is provided or served for pay. 15A NCAC 18A .2604 specified 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 restaurants, food stands, drink stands, delicatessens, school lunchrooms, educational food services, commissaries, meat markets, and other
similar establishments. Preparation: Local environmental health specialists shall complete the form every time an inspection is conducted. Prepare an original and two copies for: 1.
Original to be left with the responsible person. 2. Copy for the local health department. 3. Copy for the Environmental Health Services Section. Disposition: This form may be destroyed
in accordance with Standard-8.B.6., Inspection Records, of the Records Disposition Schedule, published published by the N.C. Division of Archives and History. Additional forms may be
ordered from: Division of Environmental Health, 1632 Mail Service Center, Raleigh, NC 27699-1632 (Courier 52-01-00) 21 22 23 24 25 26 27 28 .2612 29 30 Consumer Advisory 31 32 33 34
2 35 41 R 42 43 44 45 46 47 49 NA Original container for storage of milk & shellfish Food & non-food contact surfaces easily cleanable & in good repair Consumer advisory provided Food
Service Establishment Inspection NC Department of Environment & Natural Resources Division of Environmental Health Approved warewashing facilities of sufficient size Current Establishment
ID: Warewashing facilities maintained; test strips usedDate: GOOD RETAIL PRACTICES Preventitive measures to control the introduction of pathogens, chemicals, and physical objects into
foods COMMENTS: Food service equipment and utensils approved NO Non-food contact surfaces clean Pts GC Toxic substances properly identified, stored, used Source in accordance with 15A
NCAC 18A .1700; hot & cold water available, under pressure Refrigeration and freezer capacity sufficient Proper cooling methods used Proper thawing methods used Thermometers provided
and accurate Dry food stored properly & labeled accordingly Insects, rodents, and animals not present Clean clothes, hair restraints Linens, cloths, & aprons properly used & stored Washing
fruits & vegetables Not used for domestic purposes In-use utensils properly stored Utensils & equipment properly stored, air-dried, handled Single-use/single-service articles properly
stored, handled, used Wastewater discharged into approved, properly operating wastewater treatment & disposal system; other No cross-connections Toilet and lavatory facilities; supplied,
properly constructed, clean, good repair, signs provided Garbage properly handled & disposed; containers properly maintained Floors, walls, ceilings properly constructed, clean, in good
repair Meets illumination requirements; shielded; lighting & ventilation clean & in good repair Storage spaces clean, storage above floor; approved storage for mops, brooms, hoses, &
other items Doors self-closing where required; all windows screened Successfully completed approved food safety training Total Deductions by-products disposed of properly Page 2 of 2
Food Safety Knowledge .2606 Utensils and Equipment .2612,.2613,.2617,.2618,.2619,.2620,.2621 Physical Facilities .2623,.2624,.2625,.2626,.2627,.2628,.2630,.2631,.2632,.2633 Prevention
of Food Contamination .2609,.2616,.2617,.2626,.2633 Proper Use of Utensils .2612,.2618,.2620,.2622 Food Temperature Control .2609 Food Storage .2610,.2612,.2615 Water Supply .2618,.2622,..2623
Chemical .2618,.2633 ATTACHMENTS: Inspection by: Report Received by: EHS I.D. #: 3 1.5 2 1 3 1.5 1 .5 2 1 1 .5 1 .5 1 .5 1 .5 2 1 1 .5 1 .5 1 .5 1 .5 1 .5 1 .5 1 .5 1 .5 1 .5 1 .5 1
.5 1 .5 3 1.5 3 1.5 2 1 1 .5 1 .5 1 .5 1 .5 1 .5 BALLS CREEK CAMPGROUND 08/25/2011 2018010093 71654-Huffman, Jason
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 BALLS CREEK
CAMPGROUND 2018010093 2039 BUFFALO SHOALS RD CATAWBA 0 3 3 9 0 3 4 0 1 minute 10 23 29 36 39 40 PROTECT FOODS DURING STORAGE/PREP: COVER FOODS DURING STORAGE--CHEESE UNCOVERED OVERNIGHT
IN REFRIGERATOR--COVERED AS NEEDED COOL FOODS PROPERLY: USE ICE BATHS, SHALLOW PANS, AND PARTIALLY UNCOVERED CONTAINERS--CHILI (DEEP IN PLASTIC CONTAINER) WITH MUCH CONDENSATION ON CONTAINER
LID. EMPLOYEES TO WEAR HAIR RESTRAINTS COOLERS IN POOR REPAIR FOODSERVICE EQUIPMENT TO BE NSF OR EQUAL CLEAN SHELVES, INSIDE COOLERS, DOOR HANDLES, DOOR GASKETS, ETC
N.C. Department of Environment and Natural Resources Division of Environmental Health COMMENT ADDENDUM City: Street: ID: Name: BALLS CREEK CAMPGROUND 2018010093 2039 BUFFALO SHOALS RD
CATAWBA 45 46 CLEAN/REPAIR FLOORS, WALLS, CEILINGS AS NEEDED CLEAN HOOD SYSTEM
N.C. Department of Environment and Natural Resources Division of Environmental Health COMMENT ADDENDUM City: Street: ID: Name: BALLS CREEK CAMPGROUND 2018010093 2039 BUFFALO SHOALS RD
CATAWBA
N.C. Department of Environment and Natural Resources Division of Environmental Health COMMENT ADDENDUM City: Street: ID: Name: GCItem Location Temp Item Location Temp TEMPERATURE OBSERVATIONSTemp
Item Location BALLS CREEK CAMPGROUND 2018010093 2039 BUFFALO SHOALS RD CATAWBA