HomeMy WebLinkAboutAmerican Legion Baseball Concession 140169 08 31 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 AMERICAN LEGION
BASEBALL CONCESS PO BOX 1844 HICKORY NC 28603 AMERICAN LEGION PO BOX 1844 HICKORY 94.5 94.5 0 8 3 1 2 0 1 1 1 2 3 8 A 18 2018140169
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 AMERICAN LEGION BASEBALL CONCESS 08/31/2011 2018140169 5.5 1654-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 AMERICAN
LEGION BASEBALL CONCESS 2018140169 PO BOX 1844 HICKORY 1 2 3 8 1 2 3 9 1 minute 16 17 36 40 45 HOT HOLD ALL HEATED FOODS ABOVE 135 DEG F: BOLOGNA, LIVERMUSH DISCARDED COLD HOLD ALL REFRIGERATED
FOODS BELOW 45 DEG F--CHEESE, TOMATOES DISCARDED--DISCONTINUE USE OF REACH IN COOLERS UNTIL ABLE TO HOLD FOODS BELOW 45 DEG F--REPAIR/REPLACE WORN CUTTING BOARDS, SHELVES, ETC CLEAN
DOOR HANDLES, DOOR GASKETS, INSIDE COOLERS, ETC CLEAN/REPAIR. FLOORS, WALLS, CEILINGS AS NEEDED
N.C. Department of Environment and Natural Resources Division of Environmental Health COMMENT ADDENDUM City: Street: ID: Name: AMERICAN LEGION BASEBALL CONCESS 2018140169 PO BOX 1844
HICKORY
N.C. Department of Environment and Natural Resources Division of Environmental Health COMMENT ADDENDUM City: Street: ID: Name: AMERICAN LEGION BASEBALL CONCESS 2018140169 PO BOX 1844
HICKORY
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 AMERICAN LEGION BASEBALL CONCESS 2018140169 PO BOX 1844 HICKORY