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BURGER KING - ESTABLISHMENTS ri BURGER KING - 0 259 HIGHLAND AVENUE 'fit , d s, u . aF I rq i d d r� V V n __ n n 4D s 4 u � , r a t I t f i i� `4 ��' j � ° 6 n 0 e � a � ,3 =�a�, - _. -z:-i�4e t'<�x _ tee- �'ec �k�arw - 3La. x - C� _ _ � -_ .� _ wry.z ._ _ 'n!1e"'"er,-a "'+�ew'�. '�*' JOSEPH M.BRANCALEONE DISTRICT MANAGER R�R BOSTON-WYMAN,INC. V/r 110 Breeds Hill Road#a Hyannis,MA 02601 (508)778-5044 CELLUTAPo(508)364.0232 A Franchisee N Burger King Corporation �I J I JOSEPH M.BNANCALEONE DISTRICT MANAGER I pPrG BBSTON•YIYMAN,INC. HY nis,M 02601 nB Hyannis,MA 02601 OM ^" CELLULAR: 8-5004 CELLULAR:(508)364-9232 A Franchisee of Burger King Corporation 1 MObn E LI ASSSOC/E rE3 John E Morcels,PhA.,R.S.,C.H.O. I President i 1 Public Health Consultants ! Food Safety Specialists Food&Water Analysis 1 Integrated Pest Mgt. I, P.O.Box 288 1881 Ocean Street Marshfield,Massachusetts 02050 (781)837-1395— - -J I Massachusetts Department of Public Health Salem Board of Health Division of Food and Drugs rr ems. -<.,' 120 Washington Street,0 Floor Salem, MA 01970-3523 Tel. (978)741-1800 Fax (978) 745-0343 City/Town of w Address: " FOOD ESTABLISHMENT INSPECTION REPORT Tel. Name ' / Date Type of Operation(s) Type of Inspection I(GPn K A- I� '3 )l l Food Service ❑ Routine Address -� ( Risk Retail Re-inspection -�S �J�l y�lllero�iY V]Level ❑ Residential Kitchen Previous Inspection Telephone v -7</4 qji/6-7- ❑ Mobile Date:c7/Z4,I,,Z Owner HACCP YIN ❑ Temporary ❑Pre-operation ❑ Caterer ❑Suspect Illness Person-in-Charge(PIC) Time ❑ Bed 8 Breakfast ❑General Complaint In, } 7 ❑ HACCP Inspector - I�,<o nh Permit No. ❑ Other Each violation checked requires an explanation on the narrative jpage(sf and a citation of specific provision(s)violated- II Non-compliance with: Violationselated to Foodborne Illness Interventions and Risk Factors_(Red Items) Anti-Choking 590.009(E) El Violations arked may pose an imminent health hazard and require immediate Tobacco 590.009(F) El Allergen Awareness 590.009(G) ❑ corrective action as determined by the Board of Health. _FOOD PROTECTION MANAGEMENT _ ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS' _ ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14 Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE .. ' - I ❑ 15. Toxic Chemicals F14. Food and Water from Approved Source TIMENEMPERATURE CONTROLS(P.otehilallq Hazardous Foods)_ ❑ 5. Receiving/Condition [116. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements [117. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans [118.Cooling PROTE_vn0N FROM CONTAMINATION [119. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time as a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIOHLYSUSCEPTnBLEEPOPULATIONS(HSP) ❑21. Food and Food Preparation for HSP El 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices ,CONSUMERADVISORY ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices_(Blue Number of Violated Provisions Related r Items) Critical(C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1-22): of Health. Non-critical(N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code.This report,when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2x590 003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (Fc-0x550.004) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4x590.005) the food establishment permit and cessation of food 26.Water, Plumbing and Waste (FC-5X590.006) establishment operations. If aggrieved by this order,you 27. Physical Facility (Fc-6x590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7X590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: .. o-eaam N QX��C/1/IE Inspector's Signature: ) / Print: - `I PIC&Signature: ;r Print �"�SU �l v'•r / -t_(�{_ I Page ( of'7 fPages I K 1 111 Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) PROTECTION FROM CONTAMINATION 1 I FOOD PROTECTION MANAGEMENT 8 Cross-contamination I 3-302.t1(A)(1) I Raw AmmalFotxlsSeparated from 1 1590.003(A) Assignment of Responsibility* I Cooked and RTE Foods* 590.003(B) Demonstration of Knowledge" Contamination from Raw Ingredients 2-103.11 Person in charge-duties I 3-302.1 I(A)(2) I Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other* Contamination from the Environment I 2 590.003(C) Responsibility of the person in charge to 13-302,11(A) Food Protection* require reporting by food employees and 3-302 15 I Washing Fruits and Vegetables applicants* 3-30.4,11 Food Contact with Equipment and 590.003(F) Responsibility Of A`raid Employee Or An Utensils* Applicant To Report To The Person In I Contamination from the Consumer I Charge* 590.003(G) Reporting by Person in C har;_e* 13-306.14(A)(B) Retuned Food and Reservice of Food* I Disposition of Adulterated or Contaminated 13 1590.003(D) Exclusions and Restrictions* I Food 1590.003(E) I Removal of Exclusions and Restrictions I 3-701.1 1 Discarding or Reconditioning Unsafe I FOOD FROM APPROVED SOURCE I I Food* J 4Food and Water From,Ragulated Seurr-es I 19 Food Contact Surfaces 59U.U041A-B) Compliencewnb Food Law" 4-501.111 Manual Warewashing-Hot Water 13-201.12 I Food ma Hermetically Seated Container* I Sanitization Temperatures* I3-201.13 I Fluid Milk and Milk Products* I 4-501.112 MechanicalWarewashing-Hot Water 13-202.13 Shell Eggs* I I Sanitization Temperatures* 13-202.14 I Eggs and Milk Products, Pasteurized* _- I I !-501.114 I Chemical Sanitization-temp.,pH, 13-202.16 i ice Made From Potable Drinking Water' I concentration and hardness.' 5-101.11 DrZrig Water from an Approved System" I 14-601.11(A) I Equipment Food Contact Surfaces and 590.+106(A) Bottled Drinking 1A'aleff I Utensils Clean* 590.006(B) Water Meets Standards in 310 CMR 22.0* I ( 4-602,11 Cleaning Frequency of Equipment Foci- I Shethish and Fish Fron an Approved Source Contact Surfaces and Utensils'k r 14-702.1 1 Frequency of Sanitization of Utensils and 3-201.14 Fish and Recrean.:o'I , Shellfish` Cvapht sloliusc:+° Foal Contact Surfaces of Equipment*_ 14-703.11 Methods of Sanitization-Hot Water and 201.15 llpl usean Shcllfisb frons:JSSF L>ttld Chemical* Sources* Game and Wild Mushrooms Approved by 110 i Proper,Adequate Handwashing Regulatory Authority I 12 301.11 I Clean Condition-Hands and Arms* 13-202.13 I Shelkt k ldeniifi(ation P resenv" I 2-301 12 Cleaning Procedure* 590.004(C) I Wild Mushrooms* I I 2-301.14 When to Wash* I 13-201.11 Game Animals* I I Il I Good Hygienic Practices 5 I ReceivingiCondition 12401.11 Eating,Drinking or Using Tobacco* f 3-202.11 PRFs Received at Proper Temperarurea* I ( 2401.12 Discharges From the Eyes,Nose and 13-202.15 Package integrity' ( Mouth* 3-k,L.i i ftood Safe and Unadulterated* I 13-301.12 Preventing Contamination When Tasting* 16 TagafRccords:Shellstock I 112 ( Prevention of Contamination from Hands I 3-202.18 Shellstock Identification* I 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* I Employees* TagslRecords:Fish Prcducts 1 113 I Handwash Facilities 3-402.11 Parasite Destruction* I + I Conveniently Located and Accessible 3-40112 Record",Creanon and Retention* I 15-203.11 Numbers and Capacities* 590.004(1) Labeling of Ingredients* --+ 15-204.11 Location and Placement* 1 71 15-205.11 Accessibility.Operation and Maintenance Conformance with Approved Procedures Y I IHACCP Plans I ( I Supplied with Soap and Hand Drying 13-502.11 Specialized Processing Methods* I Devices I 13-502.12 Reduced oxygen packaging,criteria* I 16-301.11 I Handwashing Cleanser,Availability I 8-103.!2 Conformance with Apmoved Procedures* I 16-301.12 Hand Drying Provision *Denotes critical(ten+in the&feral 1999 r�,d Code of Pin CMR 590.000. x I CITY OF-SALEM /BOARD OF HEALTH / Establishment Name: 1'�I(c a� �; nc l S 4 /�� i,� l __j,�- Date: 0131'9- Page: of c? Item Code C-Critical tteW d DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R=Red Item (� Verified PLEASE PRINT CLEARLY C(a _. n. `. I ti i I S I I I Discussion With Person in Charge: Corrective Action Required: ❑ No I have read this report, have had the opportunity to ask questions and agree to correct all 111�\ voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Emersion P ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that non ompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. �� ❑ Voluntary Disposal 0 Other: + 3-501.14(C) PHF>Received at Tempermune,g- Violations Related to Foodborne fitness interventions and Risk Acccx'din;:to law Cowled to ..� Fasters(items 1-22) (Cont) 41'F145`F Within 4 Hunts. PROTECTION FROM CHEMICALS 3-501.15 Coolies Met for PHFs 1 j 14 Food or Color Additives ( 19 PHF Hot and Col Cooling Holding j 3-202.12 Additives* j 3-501.16(B) Cold Pl3Fs Maintained at or below 3-302.14 Protection from Unapproved Additives" 590.004(F) 410145'F* ( 15 ( Poisonous or Toxic Substances + 3-50 L 16(A) Hot PHFs Maintained at or above 140°F. * 17-101.11 ldentifyingInformation-Original i ( 3-501.16(A) Roasts Held at or above 1300F. Containers' � Time as a Public Health Control 7-102.11 Cor mon Name-Working Containers" j ( 7-101.11 Separation-Storage' j 3-501.19 ( Time as a Public Health Control* j 7-202.11 Restriction-Presence and Use* ( 590.004(H) j Variant Requirement j 7-02.12 Conditions of Use* ( REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 1 7-203.11 1 Toxic Containers-Prohibitions* ( POPULATIONS(HSP) 7-204.11 1 Samtizers.Criteria-Chemicals* j 21 3-801.11{,4} Unpasteurized Pre-packaged Iutces and 7-204.12 Chemicals far Washing Produce,Criteria* 1 Beverages with Warning Labels'" ( 7-204.14 Diving Agents.Criteria* j Use of Pasteurized Eggs* 7-205.11 Incidental Food Contact Lubricants* ( 3-841.11(6} 7-206.11 Restricted Use Pesticides,Criteria* ) 3-801.11(D) Raw or d Sprouts Cooked rved- Foal and R<an Seed Sprouts Nnt Served- ,-206.12 Rodent Bait Statitms* 3-801.1I(C) Unopened Faxi Package Not Re-served. 7-206.13 Tracking Powders, Pest Control and Monitoring* CONSUMER ADVISORY TIME(iEMPERATURE CONTROLS 22 3-603.11 Cousmner Advisory Posted fur Consumption of { Animal Foods That are Raw.Undercooked or 16 Proper Cooking Temperatures for i PHFe Not Otherwise Prtxessed to Eliminate 3-401.11A(I)(2) Eggs- 155`F 15 Sec. 1 Pathogens.'F"bw"'n`r"f Eggs-immediate Service 145`Fl5sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell 3-401.11(A)(2) Comminuted Fish.Meats&Game Etss' Animals-1550F 15 sec. * SPECIAL REQUIREMENTS 3401.11(B)(1)(2) j Pori,and Beef Roast- 130'F 121 mm' 3-401.I1(A)(2) Ratites,Injected Meats-155`F 15 ) 590.004(A)-(D) Violations of Section 59(}.{)[39{A)-(T))in sec.* i catering, mobile food,temporary and 3-401.1 I(A)(3) Poultry,Wild Game,Staffed PHFs, i residential kitchen operations should be Stuffing Containing Ftsh,bleat, i debited under the appropriate sections Poultry or Ratites-165'F i 5 sec. * 4 above if related to foodborne i dness 3-401.11(C)(3) Whole-muscle,bract Beef Steaks interventions and Tisk factors. Other 145°F* 590.009 violations relating to good retail 3-401.12 Raw Aminal Faxls Cooked in a practices should be debited under#29- Mictowave 165'F* Special Requirements. 3-40i.11(A)(1)(b) All Other PHFs- 145'F 15 sec, * j ( 17 Reheating for Hot Holding ( VIOLATIONS R.ILATED TO GOOD RETAIL PRACTICES 3-W3.i1(A)&(D) PHFs 1651117 15 see.* j (Items 23-301 3-403.11(B) Microwave- 165`F 2 Minute Standing Critical and non-critical violations, which do not relate to the Time* foodborne illness interventions and risk facrnra listed above, can be 3-103.11(C) Conmtercially Processed RTE Food- foundin the following sections of the Food Code and 105 CMR140°F* 59O•0�• 3403.11(£) Remaining Unsliced Portions of Beef I item Goad Retail Practices 1 FC 1 590.000 Roasts* j 23. Maregament and Personnel ; FO-2 1 .003 i j 1fS Proper Cooling of PHFs j 1 24. Food and Foci Protection i FC -3 .004 !, 1 25. j Equipment and Utensils FG-4 005 3-501.14(A) Coaling Cooked PHFs from 140°F to 26. Water.Plumbing and Waste FC-5 j .006 700F Within 2 Hours and Front 70'F 1 27. i Phvaical Facibiv FC--6 I .007 i to 4I'F145'F Within 4 Hours. * 128. Poisonous or Tosc Materials FC-7 j .008 3-501.14(6) Cooling PRFs Made From Ambient 29. Special Reauirements 009 r Temperature Ingredients to 410FAFF 30' i Otter i Within 4 Hours° &c 'Dmorac mural item in the federsl i`N)9 Fucd Cate or 105 C.MR 390.070. 7 Massachusetts Department of Public Health Salem Board of Health :�-1'_20,Washington Street,4r'Floor Division of. and Drugs Salem, MA 01970-3523 Tel. (978) 741-1800 Fax(978) 745-0343 City/Town of Address: FOOD ESTABLISHMENT INSPECTION REPORT Tel. Name �I ') I/ D tQ ( Type of Opeeation(s) Type of Inspection K )ry/L1 Y�,i ✓\U �lobok.L I0-Food Service k❑ Routine Address r�11 I f j d Risk ❑ Retail Re-inspection I 1' r `��^� '` V L- Level I ❑ Residential Kitchen Previous Inspection Telephone [II Mobile Date: Owner HACCP YIN ❑ Temporary [IPre-operation �O K L L G I ❑ Caterer ❑Suspect Illness Person-in-Charge(PIC) Time El Bed 8 Breakfast ❑ General Complaint In: W [-] HACCP Inspector JJI I 1 I Permit No. E] Other Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors_(Red Ant Choking 590.009(E) ❑ Items) Tobacco 590.009 IF) ❑ Violations marked may pose an imminent health hazard and require immediate Allergen Awareness 590.009(G) ❑ corrective action as determined by the Board of Health. ' FOOgPROTECTION MANAGEMENT ❑ 12 Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties EMPLOYEE HEALTH - ❑ 13. Handwash Facilities - -" - ,0k0TkcTI6N FROM CHEMICALS F12. Reporting of Diseases by Food Employee and PIC ' [114.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals FOOD FROM and APPROVEfromAppD SOURCE _ _. + TIMEITEMPERATURECONTROLS(PotenttallyHazaMousFoods), ❑ 4. Food and Water from Approved Scarce _ - , ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17.Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION _ _ _'" _ ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection P ❑20.Time as a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ,REQUIREMENTS FOR HIGHLY-S CEPTIBLE=POPULAT(ONS.(H$P)' 10. Proper Adequate Handwashing El 10. Food and Food Preparation for HSP ❑ _ _ »- El 11. Good Hygienic Practices CO NSUMERADYISORY El22. Posting of Consumer Advisories Violations Related to Good Retail Practices-(Blue Number of Violated Provisions Related items) Critical(C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1-22): of Health. Non-critical(N)violations must be corrected Official Order for Correction:Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code.This report,when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (Fc-2X590.0 order of the Board of Health. Failure to correct violations -24. Food and Food Protection (Fc-3)(sso.004)) cited in this report may result in suspension or revocation of -25. Equipment and Utensils (FC-4X590.005) the food establishment permit and cessation of food 26.Water, Plumbing and Waste (FC5X590.006) establishment operations. If aggrieved by this order,you 27. Physical Facility (FC-6X590.007) have a tight to a hearing.Your request must be in writing 28. Poisonous or Toxic Materials (Fe-7X590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OFREINSPECTION: C3Ct 1 3 bra Inspector's Signature: Princ-1 1i,�I/� PICS Signature Print-: I Page of Pages Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION 8 Cross-contamination FOOD PROTECTION MANAGEMENT 1 I I 1 590.003(A) Assignment of Responsibility* I 13-302.11(A)(!) I Raw Animal Foals Separated from I I Cooked and RTE Fads* ) 590.003(B) Demonstration of Knowledge* Contamination from Raw ingredients 12-103.11 Person in charge-duties I 3-302.1 I(A)(2) ( Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other` I I Contamination from the Environment 2 590.003(C) Responsibility of the person in charge to 3_; I I . 02.11(A) I Fiord Protection* require reporting by taxi employees and 3-302.15 applicantsWashing Fruits:rod Vegetables 590003(F) Responsibility Of A 13-304.11 Food Contact with Equipment and Food An Utensils* Charge* Applicant To ReportTo The Person In I I Contamination from the Consumer I 13-306.14(A)(B) I Returned Food and Reservice of Foal* 590 003(G) Reporting by Person in Charge' I 1 Disposdion of Adulterated or Contaminated 3 590.003(D) I Exclusions and Restrictions* I Food 590.003(E) I Removal of Exclusions and Restrictions I 3-701.1! Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE I Food* q 1 Food and Wafer From,Regulated Sources 19 Food Contact Surfaces 590.004(A-B) Compliance with Ford law* I 4-501.I I II Manual Warewashing-Hot Water I 3-201.12 I Food in a Hermetically Scaled Container* I Sanitization Temperatures* _ 13-201.13 I Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashin -Hot Water 13-202.13 Shell Eggs* I ( I Sanitization Temperatures* 13-202.14 I Egg,>s and Milk Products. Pasteurized* 4-501.114 I Chemical Sanitization-temp.,pH, 13-202.16 I lee Made From Potable Drinking Water' I concentration and hardness.* 15-iUl.]1 ( Drinking Water from an Approved System* I 4-601.i 1(A) Equipment Food Contact Surfaces and 590.006(A) I Bottled Drinking Water" I Utensils Clean* 590,000(.13 (' l ( Water Meets Standards in 3 i U ,b1R.22.l:* 4-602'.1 l Cleaning Frequency of Equipment Food- , and Fish From an Approved Source I ( Contact Surfaces and Utensils`" 3-201.14 Fish and RecreationxAy Caught Molinscta 4-702.11 Frequency of Sanitization of Utensils and I Shellfish" ( Food Contact Surfaces of Equipment* 4-703.11 Methods of Sanitization-Hot Water and 3-201.15 I Molluscan Shellfish fmin NSSP Listed I Chemical* l Sources* - -----Game and Wi130 I Proper,Adequate Handwashing .d,y;cshrooms Approved by _ JRegulatory Authonty , 12-301.11 I Clean Condition-Hands and Arms* f 3-202.18 i Shellstock identification Pre�cnt' I 12"301.12 Cleaning Procedure* 590.004(C) Wild Mushrooms* ----I ( 2-301.14 I When to Wash+' 7 13-201.17 I Game Animals'' J 111 I I Good Hygienic Practices ISI Receiving7Condition. 12401.11 Eating,Drinking or Using Tobacco* 13-202.11 I PHF%Received at Proper Temperatures* , 12"401.12 I Discharges From the Eyes,Nose and I 13-202.15 Package integrity' Mouth J 13-i0i.)I Pral Safe and Unadulterated* I 13-30[.12 I Preventing Contamination When Tasting* I 16 I Tags/Records:^ahelistock ( 112 I + Prevention of Contamination from Hands 13-202.18 I Shellstock Identification* I 590.004(F) ( Preventing Contamination from 13-203.12 Shellsleck Identification Maintained" Employees* Tags/Records:Fish Products 113 I Handwash Facilities I 13-402.11 ParasiteDestrucdott` I I Conveniently Located and Accessible I 13-402.12 I Records. Crcafion and Retention* I 15-203.11 I Numbers and Capacities* 590.004(J) I Labeling of Ingredients' 15-204.11 I Location and Placement* 71 Conformance with Approved Procedures 15-205.11 I Accessibility.Operation and Maintenance 1HACCP Plans J I I Supplied with Soap and Nand Drying 13-502.11 Specialized Processing Methods* I Devices 13-502.12 Reduced oxygen packaging,criteria* I 16-301.11 I Handwashing Cleanser, Availability J 8-103A2 2 Conformance with Approved Procedures'` I 16-301.12 I Hand Drying Provision *Denotes critical item 4t the fsderal 1999 Foil Cate or 105 CMR 590.000. I. �t ti CITY OF SALEM _ BOARD OF HEALTH Establishment Name: ,r r�, tZ I^ r9)14; f�, (c. - Date: Page: %x of ? Item Code C-Crluoal Item DESCRIPTION OF VIOLATION!PLAN OF CORRECTION Data No. Reference R-Red Item _i7„ PLEASE PRINT gFARLY verified f t Imo•. Y�3t II Y F-lr riffA n!! ck� // .m�n f �GtK -wJ eZC)iCrtt _, (tess-,wc, rovCe- IfJ�rsJ rJ(TD c+n rtn�.n,sii - Zpc” fjord r [42c-n { yr AA . rcTs. cam: -,_,/f /7l?c�rJ .,)AJ tJor'1/ 06Aj-0GuYI-� Ari OF rIf 1-J(2PeL I H?\- I I 1M,).t,ty 0 j ILI1 t'Lar/rte S�z n ten, J - ,I/ f b� 1 �/ l ! i �f� (,N� ?710./1 /•'1_/173n�� \�PnIT rn} a�on,cJ r)�' if i�nC,n �, l"l�'G/1. � l�:r",I- /"1.>k'r•� ji c i�✓ f 1 I I f 1 IPS Discussion With Person In Charge: Corrective ective Action Required: O No I have read this report, have had the opportunity to ask questions and agree to correct all o voluntary Compliance o Employee Restriction t violations before the next inspection, to observe all conditions as described, and to ( Emersion comply with all mandates of the Mass/Federal Food Code; I understand that .Re-inspection scheduled to Emergency Suspension noncompliance may result in daily lines of twenty-(iyeollars or sus pensio Jxevocation of 011 Embargo U Emergency Closure your food permit._ �;� � y44 ' ❑ Voluntary Disposal 0 other: �9. 3-501.14(C) PHFs Received at Temperatures Wolatlans Related to Foodborne Illness interventions and Risk According to Law Cooled to Factors{(terns 1-22) (Cont.) 41'F145°F Within 4 Hours. PROTECTION FROM CHEMICALS 3-54l.i5 Cooling Methods for PHFs I j 14 Food or Calor Additives ( 19 PHF Hot and Cold Holding j 501.16(B) Cold PITFs Maintained at or below 3-202.12 Additives* j 1 590,004(F) 410145"F* 3-302.14 Protection from Unaeoroved Addinvesil E 3-501.16(A) Hot PHFs Maintained at or above 15 Poisonous or Toxic Substances {j{ 140°F. * 7-101.11 Identifying Information-Original 4 3-501.16(A) Roasts Held at or above 1300F.* j Containers" 1 j 2Q Time as s Public Health Control j 7-102.11 Common Name-Working Containers* j 201.11 Separation-Storage* j 3-501.19 Time as a Public Healtb Control' j C 7 i $ 7-202.11 .Restriction-Presence and Use° 590.004(H) Variance Requirement 7-202.12 Conditions of Use* j REQUIREMENTS FOR HIGHLY SUSCEPTIBLE j 7-203.11 Toxic Containers-Prohibition-,* j POPULATIONS(HSP) j 7-204.11 Sanitizers.Criteria-Chemicals" g 21 3-801.11{A) Unpasteurized Pte-packaged Juices and i j 7-2(}4,12 Chemicals for Washing Produce,Criteria* j ,Beverages with Warning Labelsi j 7-20.4.14 Diving Agents.Criteria' j 3-801A I(B) Use of Pasteurized Eggs* j 7-205.11 Incidental Food Contact.Lubricants* j ( 3-801.I I(D) Raw or Partially Cooked Animal Food and { 7-206.11 Restricted Use Pesucides,Criteria' j Raw Seed Sprouts Not Served. ' { j 7-206.12 Rodent Bait Stations* j j 3-801.11(C) Unopened Food Package Not Re-servLd. 7-206.13 Tracking Powders, Pest Control and Monitoring` CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of f 16 Proper Cooking Temperatures tar Animal Foods That are Raw,Undercooked or PHFs Not Otherwise Processed to Eliminate 340i.lIA(1)(2) Eggs- 155`F 15 Sec. Pathogens.*tram rnr<¢v!r Eggs-Immediate Service 145"Fl5sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell i 3401.11(A)(2) Comminuted Fish.Meats S Cram-, j E�rt Animals-155'F 15 sec. * { SPECIAL REQUIREMENTS 3.40111(B)(1)(2) Poria and Beef Roast-130'F 121 mm* 3-401.11(A)(2) Ratites,Injected Meats- 155'F 15 590.009(A)-(D) Violations of Section .590.009(A)-(D) in sec.' catering, mobile food,tcmporarr and 3-401.11(A)(3) Poultry,Wild Game.Stuffed PHF's, residential kitchen operations should be Staffing Containing Fish,Meat. debited under the appropriate sections Poultry or Ratites-165'F 15 sec. * above if related to foodborne illness 3401.11((2)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 145°F* 590,009 violations relating to good retail 3-401.12 Raw Animal Fanls Cooked in a { practices should be debited under#29- Microwave 165`F* i Special Requirements. 3-A0LII(A)(1)(b) All Other PRFs- 145'F 15 sec.# j j 17 Reheating for Hot Holding VIOLA770AIS R FLATEIO TO GOOD RETAPL PRACTICES 3-403.1 I(A)&(D) PHFs 165"F 15 sec. * j (Items 23-30) 34W.I I(B) Microwave-165"F 2 Minute Standing � Critical and non-critical violations, which do not relate to the Time* foodborne illness interventions and risk factors listed above, can be 3-403.11(C") Commercially Processed RTE Food- found in the following sections of the Fuod Cade and 105 Cb1R 1400F'* 590.000. 3403.1I(E) Remaining Unstieed Portions of Beef i Item Good Retail Practices I FC 590.000 ; Roasts" j 23. i Management and Personnel FC--2 .803 _ 18 Proper Cooling of PHFs ( f 24. ; Food and Food Protection ' FC-3 .004 1 25. i Equipment and Utensiis I FC-4 .085 3-501.)4(A) Cooling Cooked PRFs from 140'F to 2g, 1 Water.Plumbino and Waste FC-5 om 70"F Within 2 Hours and From 70°F 27. Phvsical Facility FC--6 .007 to 41'Fl45°F Within 4 Hours. * i 28. Poisonous or Toxic Materials j FC-7 .888 3-501.14(B) Cooling PHFs Made From Ambient � 28. ( Special Requirements nos Temperature Ingredients to 41017/45°F 30. 1 other ! Within 4 Hours* n Drw n,rnticw u.n in the G-d.;.at 1 H99 FtuwJ Cale zea 105 CMk 590.000. Iv I _- .... . ....a, -. ...-, ..-ten _ .... rtY.MSFTA.....++.mow.--♦ .mow,..��+: CITY OF SALEM B/OARD OF HEALTH Establishment Name: ��i Ste. x. N c �/ �/c h 1G-7 cf yG Date: Cir/ Imo- Page: 0'P Item Code C-Critical Item V DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date, " No. Reference R-Red Item / Verlfled f 11� PLEASE PRINT CLEARLY �-�;,r\4 a2 , I I i� S�G l� S�kiYll.yl C U n I r 4– l �vi= 40 A n.c Ir/'-f i� � �/ ( \ � C. AA(�)l/7�pi!' r. hG-�VC(✓ l )�.w /;J� -�Y /�/�JS"�J`� 2"t i--'/i!� /_ '�Y� i-�. S/Xllr1w .� I 7 e- Scz):Y) ( 7,nJ I (_-a uo.. n'- ro. C . CIL/r 6 y i4_4_PlIlk r r. AA rlt? 4U -f- ��,7. _�2c . r)IC1I0 -7S, nis C/n. r 12tAr—i7i✓v n c�, 33r, IN ho'l<.t' 14/0 Kp-(-z7 _7, .L, I ,G ��1 r �,l �Zrnr ��n, �al_i �Sn.oR.�r . ,all AJex,J, 41 � c �Q �Jln��✓�n r � T Sn r ini �ccv,.�rin r� (.y. ;r✓n I � r _ cr.9.i2(t — Discussion With Person in Charge: Corrective Action Required: I ❑ No I I �Fes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion P _0 s-inspection Scheduled ❑ Emergency Suspension _ comply with all mandates of the Mass/Federal Food C�. I understand that_—_. noncompliance may result in daily fines of twenty-.ive chars or suspension/-revocati0 of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: ic--Ji t 3-501,14(C) PHFs RecrivedatTemperaturos Violations Related to Foodborne Illness.Interventions and Risk According to Law Cooled to 1 Factors(ffems 1-22) (Cont.) 41'F145`F Within 4 Homs..* 1 ( 3-501.15 Cooling Methods far PHFs PROTECTION FROM CHEMICALS I 19 PHF Hot and Gold Holding 14 f Food or Color Additives E ! 3-50L16(B) Cold PIIFs Maintained at or below 3-202.12 ! Additives*' I 590.004(F) 41'/45°F* 3-302.14 Protection from Unapproved Additives' 3-501-16(A) Hot PRFs Maintained at or above 15 Poisonous or Toxic Substances 7-101.11 Identifying Information-Original 6 3-SOI140`F. Containers* 1 .I6tA) Roasts Held at or abuse 130'F, I 20 Time as a Public Health Control 7-102.11 Common Name-Working Containers* 3-501.19 Time as a Public Health Control* 1 1-201.11 Separation-Storage* I 7-202.11 Restriction-Presence and Use* 1590.004(H) Variance Requirement I 7-202.12 Conditions of Use* I REQUIREMENTS FOR EIIt'aIiLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions* t REQIREMEPOPULATIONS(HSP) 7-204.11 Sanitizes.Criteria- g Produce. ! 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals far Washing Prcxhitx.Criteria• I .Beverages with Warning Labels* d 7-204.14 Drying Agents.Criteria' 7-205.11 Incidental Food Contact.Lubricants* 3-801.11(B) Use o Pasteurized C Eggs* 17-206.11 Restricted Use Pesticides,Criteria' j 3-801.11(D) Raw or Partially Cooked tlninnil Food and Raw Seed Sprains Not Served 7-206.12 Rodent Bait Stadons" i 3-501AI(C) Unopened Food Package Not Re-served. 7-206.13 Tracking Powders, Pest Control and Monitoring" CONSUMER ADVISORY TIMEREMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Pasted for Consumption of 16 Proper Cooking Temperatures for Aminal Foods That are Raw,Undercooked or PHFs Not Otherwise Processed to Eliminate 3 40t.21A(1)(2) Eggs- 155 F 15 Sec. I Pathogtms.* "`°�''•' "' Eggs-Immediate Service 145`Fl5see* 3-302.13 Pasteurized Eggs Sub:titute for Raw Shell 3-401.11(A)(2) Comminuted Fish.Meats&Game Egrt Animals-155*F 15 sec.* SPECIAL REQUIREMENTS 13.40131(B)(1)f2) Pork and Beef Roast-130'F 121 rn mw � 3-401.11(A)(2) Ratites,Injected Meats- 155`F 15 590.009(A)-(D) Violations of Section 590.009(A)-(D)in sec * catering, mobile food,temporary and } 3401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, i residential kitchen operations should be 1}I Stuffing Containing Fish,Meat, ( debited under the appropriate sections Poultry or Ratites-165°F 15 sec. * above if related to foodborne illness -401.11(00) Whole-muscle,intact Beef Steaks interventions and risk factors. Other 145°F* 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Cooked in a practices should bo debited under#29- Micivwave 165`F* Special Requirements. 3-40LI1(A)(1)(b) All Other PIs-145'F 15 sec.* I 117 Reheating for Hot Holding WOLA77ONS R RATED TO GOOD RETAIL PRACTICES 3.403AI(A)&(D) PHFs 165"F 15 sec. * (Items 23-30) 3-103.11(B) Microwave- 165`F 2 Minute Standing Critical and non-critical violations,which do not relate to the Time* S foodborne illness inten>entions and risk,factors listed abate, can be 3-403.11(C) Comm erciady Processed RTE Food- fnind in the following sections of the Food Cole and 105 OViR 140°F* 590.000. 3-103.11(E) Remaining UnsiicedPortions ofBeef i Item Good Retail Practices j FC 590.Up0 Roasts* 1 23. : Managsmentand Personnel FC-2 .003 1ffi Proper Cooling of PHFs i 24. pond and Food Protection I FC-3 .004 i 1 25. Equipment and Utensils FC-4 .0055 3S01.14(A) Cooling Cooked PHFsfrom 140`Fto I ; 28. Water.Plumbino and Waste FC-5 006 70'F Witbin 2 Hours and Front 70'F 127. i Phvsical Facility IFC-6 .W7 i to 41"F/45'F Within 4 Hours. * 1 28. i Poisonous or Tome Materials + FC-7 .008 3-501.14(B) Cooling PHFs Made From Ambient 29. Special Requirements k 009 Temperature Ingredients to4l°F/45`17 3a i Other } Within 4 Hous* Denote..ryiti.;ni=ni in the federal 1:'99 Food Cale w 105 CNIR X90.000. 0416-1 Commonwealth of Massachusetts 7.1 City of Salem Board of Health Kimberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 01/24/2011 ESTABLISHMENT NAME: Burger King File Number:BHF-2004-000088 259 Highland Avenue Salem MA 01970 LOCATED AT: 0259 HIGHLAND AVENUE SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes FOOD SERVICE BHP-2011-0340 Jan 1,2011 Dec 31,2011 $280.00 ESTABLISHMENT Total Fees: $280.00 PERMIT EXPIRES IDecember3l, 2011 Board of Health This Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code,beofre any revonations,improvements,or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Page 1 J . CITY OF SALEM, MASSACHUSET"T"S BOARD OF HEALTH 120 WASHINGTON STREET,4� FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR nc,RF.F.NRAunt r At.r:%1.COM DAVID GREENBAUM,RS ACTING HEALTH AGENT 2011 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT J UMvr Ai'175 TEL# 978-7W- 94167 ADDRESS OF ESTABLISHMENT daS9 iohIeLJ p��Z _ FAX# 7b1 - 899- W7 ONO ,.r" MAILING ADDRESS (if different) g ad LQxrno-lnn Sl . FL-W&H4UM M4. oaySa EMAIL-Business': Website: OWNER'S NAME .488 1-1-C TEL# 781-893-d990 ADDRESS Wolaal UringLn 5�. c;N!a. "IM 4!qn . Oa III STREET V CITY STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S' CERTIFICATE#(S) (Required in an establishment where potentially nazardous food is prepared) - EMERGENCY RESPONSEPERSON �nn amicx HOME TEL#_603. 770 a5_3/o I DAYS OF OPERATIONMonday Tuesday Wednesday !' Thursday' Friday Saturday Sunday" HOURS OF OPERATION 44M- barn - ;64M - 6aM , bam- GAM - �aM Please write in time of day. (Forexample Ilam-ttpm) 1w AM laam Omn 1a7awi aaM 01a41 /aaI►7 TYPE OF ESTABLISHMENT FEE (check onlv) RETAIL STORE YES NO less than 1000sq.ft. _ 1000-1 O,000sq.ft. more than 1 0,000sq.ft. .......................... ESO..-.N-d.................................-----.......ess.......than.......2.5....se..at................_.......... RESTAURANT s 140 (Outdoor Stationary Food Cart$210) 25-99 seats $280 - more than 99 seats 0 - ------------------------------------------------------------------------------------------- BED/BREAKFASTI YESU $100 CHILDCARE SERVICES/NURSING HOME-------------------------------------- ADDITIONAL PERMITS MAKE (notjust serve) ICE CREAM, YOGURT/SOFT SERVE YE NO TOBACCO VENDOR YES $1 ALL NON-PROFIT(such as church kitchens) YES $25 *Plea e a s pay total with one check payable to the City of Salem. This Permit is not transferable and must be reissued upon change of ownership. The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements,or equipment changes are made,all plans for su must be submitted and approved by the Salem Board of Health. - Pla rsu t to MGL C ter 2 Se io 49A, I certify under the pat s and penalties of perjury that I,to my best knowledge and belief, have fled all state tax `rt�n ria at allst taxes uire under the law. i 7 "- Signature Daft I ( S ial Security or Federal Identification Number ----------- ----------------------------------- -- -=--------- jj--------- ------------------------------------------- Revised 10/7/11 FOODAP20l Ladm Check4&Date G/ / ® MORRELL ASSOCIATES Current Date: 10/18/2011 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 10/3/2011 (781)837-1395 www.morrell-associates.com Customer#: FB13-10 uo♦a[u •saoc �rea C LBK LLC L Burger King#3564 L 10/17 OC Hawthrone Square Mall/Rte 107 A 259 Highland Ave N I Salem, MA T N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Ice Cream <250 EPAC < 1 EPCC fV Cl Nov 32011 Zo bOq OF� l H MASSACHUSETTS STANDARDS Machine: SPC:r 50,000/g;Coliform s 50/g Other: SPC!g 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products, 17th Edition,American Public Health Association, 2004 �f Baerf health /R MORRELL ASSOCIATES Current Date: 11/29/2011 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 11/18/2011 (781) 837-1395 www.morrell-associates.com Customer#: FB13-10 vO R�[L •560C/I fb C LBK LLC L Burger King#3564 L 10/17 OC Hawthrone Square Mall/Rte 107 A 259 Highland Ave N I Salem, MA T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Ice Cream <250 EPAC < 1 EPCC DEC 'I °L 2011 Ci I Y OF SALEM 30ARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliform s 50/9 Other: SPC s 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST C ( Products, 17th Edition,American Public Health Association, 2004 Soarr� of lieal:h i J ® I MORRELL ASSOCIATES Current Date: 9/26/2011 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 9/6/2011 (781)837-1395 www.morrell-associates.com Customer# FB13-10 �Oss 4ti ♦58OC/A edd C LBK LLC L Burger King#3564 L 10/17 OC Hawthrone Square Mall/Rte 107 A 259 Highland Ave N I Salem, MA T O N BACTERIA COUNT Sample �� ^ Standard Plate Count/g Coliform/g Vanilla Ice Cream j,J <250 EPAC < 1 EPCC OCT 0 6 2011 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliforms 50/g Other: SPC:s 50,000/g;Coliform s 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST G Products, 17th Edition, American Public Health Association, 2004 board of Hen!th MORRELL ASSOCIATES Current Date: 1/10/2012 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 1/3/2012 (781) 837-1395 www.morrell-associates.com Customer#: FB13-10 YOII 1,LLl IE80Cld LFd C LBK LLC L Burger King#3564 L 10/18 OC Hawthrone Square Mall/Rte 107 I A 259 Highland Ave N Salem, MA T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Ice Cream <250 EPAC < 1 EPCC REC ajVE ® FEB U 2 2012 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliforms 50/g Other: SPC!g 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products, 17th Edition, American Public Health Association, 2004 i Massachusetts Department of Public Health Salem Board of Health 120 Washington Street,4t"Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 NamepII JJ � Date T e of O eration s Type of Insoection M A �ZN (A/), C,}-ri.�-� Food Service ®Routine Address 1 O Risk Retail N Re-inspection 1� Level ❑ Residential Kitchen Previous Inspection Telephone n n�/ (�(, /7 [IMobile Date: Owner �I r HACCP YMElTemporary [:3 Pre-operation (� I ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) Jr S Time ElBed&Breakfast [IGeneral Complaint t . 1 D l 10a, Ua, In�Iq�yy [IHACCP Inspector � �)el^ri r Out: Permit No. El Other Each violation checked requirexplanation on the narrative page(s)and a citation of specific provision(s)violated. �J Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) �(] 590.009(F) action as determined by the Board of Health. n ,, /) _ C �, / LFOOD PROTECTION MANAGEMENT i [112. Prevention of Contamination from Hands ,U G(� ❑ 1. PIC Assigned/Knowledgeable/Duties El_ 13. Handwash Facilities CEMPLOYEE HEALTH """' ---- --- - - - - I PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC El 14.Approved Food or Color Additives El3. Personnel with Infections Restricted/Excluded _ ❑ 15.Toxic Chemicals L FOOD FROM APPROVED SOURCE TIMElTEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4. Food and Water from Approved Source N _ J ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling [ PROTECTION FROM CONTAMINATION [ ❑ 19. Hot and Cold Holding ❑ 8.Separation/Segregation/Protection I ❑20.Time As a Public Health Control 50 9. Food Contact Surfaces Cleaning and Sanitizing C C(�(REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) r_121. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing fid ❑ 11. Good Hygienic Practices LCONSUMER ADVISORY - 1 ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code. This report,when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2)(590.009) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of 25.,Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION �!.t��6 iJ � S, V4,wCOCA - nat C IInspector's Signature: (�J Print: ��,1n� /i_ � I PIC'sSignature: v Print: f"_ `.crt_q I Page`of-2-Pages F_ t Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION I S Cross-contamination FOOD PROTECTION MANAGEMENT 3-302.11(A)(1) Row Animal oodsI I Separated from I 1 590.003(A) Assignment of Responsibility* Cooked and RTE Foods* 590.003(B) I Demonstration of Knowledge* I Contamination from Raw Ingredients 2-103.1 I Person in charge-duties 3-302 11(A)(2) Raw Animal Foals Separated from Each Other* EMPLOYEE HEALTH ( I I Contamination from the Environment 2 590.003(C) Responsibility of the person in charge to 13-302.11(A) Food Protection* require reporting by food employees and 13-302.15 Washing Fruits and Vegetables applicants* 590.003(F) Responsibility Of A Food Employee Or An 3-304.11 Foci Contact with Ey ripment and Applicant To Report To The Person in I Utensils I � Contamination from the Consumer Charge* 590.003(6) Reporting by Person in Charge" 13-306.14(A)(B) Returned Food and Reservatedor C of Fend* Disposition of Adulterated or Contaminated 13 590.003(D) I Exclusions and Restrictions* Food 590.003(F) I Removal of Exclusions,and Restrictions 3-70111 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Foal* 4 Food and Water From Regulated Sources ( 19 ( Food Contact Surfaces 590.004(A-B) Compliance with Food law* I 4-501.111 I Manual Warewashing-Ha Water 13-201.12 Food in it Hermetically Sealed Container* I Sanitization Temperatures 3-201.13 Fluid Milk and Milk Products* I 4-501.112 Mechanical Warewashing-Hot Water 3-202.13 Shell Eggs* I Sanitization Temperatures* 3-202.14 Fg�s and Milk Products.Pasteurized* I 4-501.114 I Chemical Sanitization-temp.,pH,. 13-20216 lee Made From Potable Drinking Wate,* I concentration and hardness.* I'S=IU1.71 Drinking Water from an Approved System" f 14-601.11(A) Equipment Food Contact Surfaces and 590.006(A) Bottled Drinking Water* I Utensils Clean* 1590.0(6(B) Water Meets Standards in 310 CMR 22.0* I 14 602.11 Cleaning Frequency df Equipment F xd- ShelGish and Fish From an Approved Source ( Contact Surfaces and Utensils* 3-201.14 Fish and Recreationally Caught Molluscan 4-702.11 Frequency of Sanitization of UtensilFood Contact Surfaces of Equipments"and Shellfish` . I 4-703.11 Methods ofSamtization-HotWaterand .ff 3-201.15 Molluscan Shellfish from NSSP Listed I I Chemical* I Sources* I to I Proper,Adequate Handwashing _ Game and Wild Mushrooms Approved by RegulatoryAuthonty ( 12-301.11 Clean Condition-Hands and Arms*; .J 3-202.18 I Shellstrxk Identification Present'" I 12-301.12 Cleaning Procedure* �. r 590.004(0)_ Wild Mushrooms* --( ( 2-301.14 When to Wash* 3-201.17 I Game Animals* ( I It I Good Hygienic Practices- 5 ( Receiving/Condition I ( 2401.11 I Eating,Drinking or Using Tobacco* 3-202.11 ( PHFs Received at Proper Temperatures* I 2401,12 Discharges From the Eyes,Nose and 3-202.15 I Package Integrity* I Mouth* .. - 3-101.11 Food Safe and Unadulterated * 13-301.12 I Preventing'Contamination When Tasting* 16 Togs/Records:Shellstock 112 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.12 I Shellstock Identification Maintained* Employees* Tags/Records:Fish Products I I 13 I Handwash Facilities 3-402.11 I Parasite Destruction* I I Conveniently Located and Accessible 3-402.12 Records.Creation and Retention* I 15-203.11 I Numbers and Capacities* 590.004(7) Labeling of Ingredients' 15-204.11 I Location and Placement* 9 Conformance with Approved Procedures 15-205.11 I Accessibility,Operation and Maintenance IHACCP Plans I ` Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 13-502.12 ( Reduced oxygen packaging,criteria* 16-301.11 Handwashing Cleanser,Availability I 18-103.12 I Conformance with Approved Procedures* 16-301.12 Hand Drying Provision "Denotes critical item in the Federal 1099 Fond Caie of 105 CMR 590.000 CITY OF SALEM BOARD OF HEALTH Establishment Name:'222a tiVl G il)&t � Date: - 2.�- Page: n� of 31_. Item Cafe C-CNtlbaf Item DESCRI ION VIOLAT N/PLAN OF CORRECTION Dale AS PRINT No. Reference R-R m n 'J �� _T CLEARLY �,��J��(��X7�� Verlfled '\ IF JFPO/JQ AG ao l �t t�Q, all P v fin, (1 II I eTc I 4 D oD 0 kMn v ✓� �o nD k(10 a,rp q,' 1Zv .xt 1�iJo n 4Q .�CM C Ari � o,,�. I �/n,/� IFI) �n(�nom, "�'�¢-$;` I'AA ,DJ., A, � a a1PAA1JA' 1 A- �l USM/ ..� /�� ~ 0-0 irrq. ( /LL d� ( 'X V l_1/lAn. ^ ' /,On, .QED t tJ t. d Q— . ct, �d— rlri p {SYN _ _ �' 6lils.ct.0 moo. Discussion With Person in Charge: f Corrective Action Required: I ❑ No yes I have read this report, have had the opportunity to ask questions and agree to correct all I 1j,' Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to `Vl Exclusion cgmply with all mandates of the Mass/Federal Food Code. I understand that Re-in ectic 6u ed� ❑ Emergency suspension noncompliance may result in daily fines of twenty-five dollars suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ' n y/ ///q/� ❑ Voluntary Disposal ❑ Other: � N - // ry P J �5.'7'i'^.r"'�J..a'+.�.�: a i'-`^^ .,.�.. .. -_ � .,..n...*r. �m a�'c"a'4+s'*'..r.M.`„+'i+} yw.p'.C+-w.rrtr``�v.�-'vrr��( 'Yi .a"....viw..>•'�v._ ...- ,�y, A _ 3-501.14(C) PHFs Received at Temperatures Violations Related to Foodborne illness Interventions and Risk According to Law Cooled to - Ii Factors{!tams 1-22) (Cont.) 41°F/45°F Within 4 Hours. 3-501.15 Cooling Methods for PHFs PROTECTION FROM CHEMICALS 19 PHF Hot and Cold Holding 14 Food or Color Additives 1 3-501,16(B) Cold PRFs Maintained at or below 3-202.12 Additives* I 590,004(F) 4101450 F* 3-302.14 Protection from Unaeoroved Additives" ( ces 3-50t.16(A) Hot PHFs Maintained at or above 15 Poisonous or Toxic Substan 7-101.11 Identifying Information-Original J 1400F I 13501.16(A) Roasts Held at or above Containers* 130°F. 17-102.11 Common Name-Working Containers* I I Time as a Public Health Control 1 7-201.11 Separation-Storage* I 3-501.19' ( Time as a Public Health Control* 7-202.11 Restriction-Presence and Use* I 1590.004(H) I Variance Requirement 17-202.12 Conditions of Use* I 17-203.11 Toxic Containers-Prohibitions* i REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 17-204.11 Sanitizers.Criteria-Chemicals* POPULATIONS(MSP) 17-2(4.12 Chemicals for Washing Produce,Criteria* I ( 21 3-801.1)(A) Unpasteurized Pre-packaged Iaices and 17-204.14 Drying Agents.Criteria* ( Beverages with Warning Labels* 17-205.11 Incidental Food Contact,lubricants* I 3-801.11(13) I Use of Pasteurized Eggs" 7-206.11 Restricted Use Pesticides,Criteria* 13-801.11(D) I Raw or Partially Cooked Animal Food and 17-206.12 Rodent Bait Stations" Raw Seed Sprouts Not Served. I 13-801.L i(C) Unopened Food Package Not Re-served. 7-206.13 Tracking Powders,Pest Control and " Monitoring* CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods That are Raw.Underc coked or PHFs Not Otherwise Processed to Eliminate 3401.11A(1)(2) Eggs- 155°F IS Sec. Pathogens.*Erisc>ve vvxnr .. Eggs-Immediate Service 145°Fl5sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell 3401.17(A)(2) Comminuted Fish.Meats&Game Ems* Animals-155°F 15 SPECIAL REQUIREMENTS 3401.11(B)(1)(2) Pork and Beef Roast-130°5121 min* I 3-401.11(R)(2) Ratites,injected Meats-155°F 15 590.009(A)-(D) Violations of Section 590,009(A)-(D)in see. * I catering,mobile food, temporary and 3401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, I debited under the appropriate sections Poultry or Ratites-165°F 15 sec. * above if related to foodborne illness 3.401.11(C)(3) Whole-muscle,Intact Beef Steaks ( interventions and risk factors. Other 145°F* I 590.009 violations relating to good retail 3401.12 Raw Animal Foods Cooked in a practices should be debited under#29- Microwave 165°F* Special Requirements. 3401.11(A)(1)(b) All Other PHFs-145°F 15 sec. 17 Reheating for Hot Holding I VIOLATIONS RaLATED TO GOOD RETAIL PRACTICES 3-403.11(A)&(D) PHFs 165°F 15 sec. * (Items 23-30) 3403.11(B) Microwave- 165°F 2 Minute Standing Critical and non-critical violations,which do not relate to the Time* foodborne illness interventions and risk factors listed above, can be 3-403.11(C) Commercially Processed RTE Food- found in the following sections of the Food Cade mid 105 CMR 140°F* 590.000. 3403.11(E) Remaining Unsliced Portions of Beef I Item Good Retail Practices 1 .FC 1 590.000 1 Roasts" 1 23. Managegtent and Personnel FC-2 .003 .I 18 Proper Cooling of PHFs 1 24. Food and Food Protection . FC-3 I .004 1 25. 1 Equipment and Utensils 1 FC-4 1 .005 I 3-501.14(A) Cooling Cooked PHFs from 140°F to �, Water,Plumbinq and Waste i FC-5 .W6 70°F Within 2 Hours and From 70 P 127, Physical Facility FC- to C-to 41017/4FF Within 4 Hours.* ( 28. Poisonous or Toric Materials FC-7 .008 j 3-501.14(B) Cooling PHFs Made From Ambient 29. Special Requirements .009 I Temperature Ingredients to 41°F/45°F ( 1 30, 1 Other ! 1 I Within 4 Hours* s" 'onnbv4'z d" *lhnotes critical item in the federal 1999 Foal Code or 105 CMR 590.000. Massachusetts Department of Public HealthSalem Board of Health 120 Washington Street,4tb Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax(978) 745-0343 Name ' I Date T e of Operations) Type of Insoectlon ��i ,A a(�� .1J 11VLA - S-( � I t YPFood Service 1R Routine Address �� I n / °)�O I Risk LJ Retail ` [Ne-inspection �P . Y�° ` x Level ❑ Residential Kitchen Previous Inspection Telephone ❑ Mobile Date: Owner HACCP YM El Temporary ❑ Pre-operation I y ' L� 1-„ " � ❑ Caterer Time ❑Suspect Illness Person in Charge(PIC) General Complaint f_I- In ,4h Permit No. Bed&Breakfast ElEl Inspector � rc7V)I �� 1. Out: ❑Other Each violation checked requires/an explanation on the narrative page(s) and a citation of specific provision(s)violated. UNoncompliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking__/Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) p' 590.009(F) d action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT I P❑ROTEHandwFROM CHEMICALS S .. Hands El 12. Prevention of Contamination from 13. ash CTION Q 1. PIC Assigned/Knowledgeable/Duties EMPLOYEE HEALTH . ❑ 2. Reporting of Diseases by Food Employee and PIC -- ❑ 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals LFROM APPROVED SOURCE (]El 4. ) TIMEMEMPERATURE CONTROLS(Potentially Haiardous Foods) 4. Food and Water from Approved Source I _f ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling I PROTECTION FROM CONTAMINATION " ' ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing [REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) El21. Food and Food Preparation for HSP El 10. Proper Adequate Handwashing ' ❑ 11.Good Hygienic Practices (_CONSUMER ADVISORY I Dr-P,22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated'Provisions Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code. This report, when signed below C x by a Board of Health member or its agent constitutes an 23. Management and Personnel (Fc-2) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (Fc-3)(590.0so.004) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (Fc-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: ` UV+ rR C � S sw,nvpe Fm 1 '.4.a � n' `-i'� Inspector's Signature: - ,P= �Print: PIC's Signature: � Page ofZPages` Af �1 �.-ti L"_Ii:L- L) �1 r � Violations Related to Foodborne Illness interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 18 Cross-contamination 3-302.11(A)(J) Raw Animal Foods Separated from 1 590.003(A) Assignment of Responsibility* I Cooked and RTE Foods* 590.003(B) Demonstration of Knowledge* I I j Contamination from Raw Ingredients 2-103.11 Person in charge -duties I 3-302.11(A)(2) Raw Animal Foods Separated from Each Other' EMPLOYEE HEALTH I I Contamination from the Environment I 2 590.003(C) Responsibility of the person in charge to j 3-302.11(A) Food Protection• - -- -- -- --I require reporting by food employees and 13-302.15 Washing Fruits and Vegetables I applicants* 13-304.11 Food Contact with Equipment and 590.003(F) Responsibility Of A Food Employee Or An I Utensils* Applicant To Report To The Person in i Contamination from the Consumer Charge* 590.003(G) I Reporting by Person in Cb<rge* ( 3'306.1+1 A)(B) Returned Food and RFood* -- Disposition of Adulteratedted or or Contaminated aminated 13 590.003(D) Exclusions and Rcsuictions* Food 1590.003(E) Removal of Exclusions and Restrictions I 3.781,11 Discarding or Reconditioning unsafe FOOD FROM APPROVED SOURCE Food* 4Food and Water From Regulated Sources ( ( 9 I Food Contact Surfaces 590.0()4 (A-B) Compliance with Food Law* I ( 4-501.i i I Manual Wazewashing-Hot Water 3-201.12 Foots in a Hermetically Sealed Container* I Sanitization Temperatures* 3-201.13 Fluid Milk and Milk Products* j 4-501.112 Mechanical Warewashing-Hot Water 3-202.13 Shell Eggs* I Sanitization Temperatures* 3-202 14 Eggs and Milk Products.Pasteurized* j 4-501.114 Chemical Sanitization-temp.,pH, 13-202.16 Ice Made From Potable Drinking Water" I concentration and hardness. " 5-101.11 Dunking Water from an Approved System" I 4-60I A I(A) Equipment Food Contact Surfaces and 590.0060) Bottled Drinking Water+ ( Utensils Clean" J i 590.006tB) Water Meets Standards in 310 CMR 22.0" j 4-602'11 Cleating Frequency of Equipment Fo xl- Shellfish and Fish From an Approved Source I 4-702.11 Frequenccy of Contact of Surfaces and Utensils`" Sanitization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan I Food Contact Surfaces of Equipment* i Shellfish* 4.703.11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Usted I I Chemical* Sources* Game and Wi.'d Mushrooms Approved by I 110 I I Proper,Adequate Handwashing Regulatory Authority 2-301.11 Clean Condition-Hands and Ams* 3-202.19 Shellstock Identification Present* { 2-301.12 Cleaning Procedure* 590.004(C) I Wild Mushrooms* - - - 2-301.14 When to Wash* j 3-201.17 Game Animals* I Il I Good Hygienic Practices g Receiving/Condition _{ 11--401 11 Eating.Drinking or Using Tobacco* I 3-202.11 I PHFs Received at Proper Temperatures* I 2401 12 Discharges From the Eyes, Nose and j 3-202.15 Package Integrity* j Mouth* 3.101.11 Food Safe and Unadulterated* ( ( 3-30L12 Preventing;Contamination When Tasting* I 6 TagslRecords:Shellstock 112 I Prevention of Contamination from Hands 3-202.19 Shellstock Identification ' I 590D04I,E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained'- Employees* I Tags/Records:Fish Products I 113 Handwash Facilities 3-402.11 I Parasite Destruction' Conveniently Located and Accessible - 3-402.12 j Records,Creation and Retention* I 15-203.11 I Numbers and Capacities* j 590.004(J) I Labeling of Ingredients' 15-204.11 ( Location and Placement* 2 Conformance with Approved Procedures 15-205.11 j Accessibility,Operation and Maintenance I /HACCP Plans I ( Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 13-502.12 Reduced oxygen packaging,criteria* I 1 6-301.1 L Handwashing Cleanser,Availability I 9-103.12 Conformance with Approved Procedures' I 16-301.12 Hand Drying Provision *Denofec c ritical nem in the tederal 1199 Food Calc or 105 0,110 90000, CITY�-OF- SA_LE+M BOARD OF HEALTH Establishment Name>P"_ JLC Date: a.- t�(� Page: of 7 Item Code C-Critical Item U DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date ' No. Reference R-Red Nem 'l n/ ( �f/,�n�lV'e/LEASE PRIlN�T C�LE�Ay/RL(Y � L ��'\,�� Verified/ p ✓✓ - I p 'L Mno nXlnni, _ � I � l / I -ly'Io /I ) ;,tt -P) �Jtac�Jta, U ' i-H �}-(�}(, �e 9fn1 h)(V P„Q' IrrV\\ y� ,t� � 1 r �n'Usno.O, i - �,5-(1 �� `r��. NV\' VAa--,-0) b� Yt6k$V_4_j - JD�Q CJi�� tt iy1 c c ` 1' ti, d= t` _ t � �V be ( -KY j C°�r n�& l a_exel ya9 7z 2j U U V (IPP '464_ . i/',Jqno 01/L0 (00FJ&Lv-r0 J_ (11)rl4e U �>{/�t_( 11-r�iwvz ^ �P,�-,� (�v_n,�.Ptir.-u-r,/J, ��P a_n.� G:•w�— - �i,,��t,��.e,Q `1-4' P_ �u� n �i' v�r��-�'✓_�� ,,.� „�Q �,k.rte-� �,S� � C�L'� ,IP J ' ��d= ✓ �1-�y ce�2_i_t�e.�Q La J Discussion With Person in Charge: U / \ Correcth e Action Required: ❑ .No t7' Yes { 1 have read this report, have had the opportunity to ask questions and agree to correct all cK voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that Yp,�(T Q-�(A ,yt .e noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of o Embargo o Emergency Closure •°� your food permit. y S�(ppp lb �wo_ .�.�h CSM �� I ❑ Voluntary Disposal ❑ Other: 3-501.14(C) PRFs Received at Temperatures Violations Related to Foodboma t//ness,Interventions and Risk According to Taw Cooled to Factors(Items 1-22) {Cont.) 41'F/45°F Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14 Food or Color Additives 19 PHF Hot and Cold Holding 3-202.12 Additives* 3-50116(B) Cold PH�Fs Maintained at or below 590.004(M 4)°/45°I±y 3-302.14 Protection from Unapproved Additives* 13-501.16(A) Hot PHFs Maintained at or above 15 Poisonous or Toxic Substances 7-101.11 Identifying Information-Original I i ISO°F. y f � 3-501.)6(A) Roasts Held at or above L30°F. Containers* 20 * i Time as a Public Health Control 7-102.11 Common Name-Working Containers* i 3-501.19 Tante as a Public Health Control* 7-201.11 Separation-Storage* 7-202.11 ,Restriction-Presence and Use* � 590.004(11) Variance Requirement � 7-202.12 Conditions of Use* 7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 17-204.11 Sat»tizers.Criteria-Chemicals* POPULATIONS(HSP) 7-204.12 Chemicals for Washing Produce,Criteria* 121 3-801AI(A) Unpasteurized Pte-packaged Juices and Beverages with Wasting labels* 7-204.14 Drying Agents.Criteria"' 3-801.11(B) Use of Pasteurized Eg,°s* 7-205.11 Incidental Food Contact,lubricants* 13-80L.11(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria* Raw Seed Sprouts Na Served.* 7-206.12 Rodent Bait Stations* 3-801.11(C) Unopened Food Package Not Re-served. 7-206.13 Tracking Powders,Pest Control and Monitoring* l CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods That are Raw,Undercooked or PHFs Not Otherwise Processed to Eliminate 3-401.11A{I}(2) Eggs- 155°F IS Sec. Pathogens!Er`°`°"",nnmi Eggs-Immediate Service 145°F15sec* 3-3011 3 1 Pasteurized Eggs Substitute for Raw Shell 3401.11(A)(2) Comminuted Fish.Meats&Game Eggs* Animals-155°F 15 sec. * SPECIAL REQUIREMENTS 3401.11(B)(1)(2) Pork and Beef Roast-130'F 121 min* ( 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 590.009(A)-(D)9(A)-(D) Violations of Section 590.009(A)-(D)in sec. * catering, mobile food, temporary and 3-401.1 t(A)(3) Poultry,Wild Game,Stuffed PHFs, residential kitchen operations should be Stuffmg Containing Fish,Meat, debited under the appropriate sections Poultry or Ratites-165'F 15 we. * above if related to foodborne illness 3401.11(C)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 145°F* 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Cooked in a ( practices should be debited under#29- Microwave 165°F* Special Requirements. 3-401.11(A)(1)(b) All Other PHFs-145°F 15 see. 17 Reheating for Hot Holding V70LA77ONS RELATED TO GOOD RETAIL PRACTICES 3403AI(A)&(D) PHFs 165"F 15 sec.* (Items 23-30) 3-403.11(B) Microwave- 165'F 2 Minute Standing I Critical and non-critical violations,which do not relate to the Three* foodborne illness interventions and risk factors listed above,can be 3403.11(C) Commercially Processed RTE Food- ' found in the following sections of the Food Code mid 105 CMR 1400F* 590.000. 3403.11(E) Remaining Unsticed Portions of Beef ( I Nem i Good Retail Practices I FC 1590.00 I Roasts* 123. i Manauement and Personnel j FC-2 1 .003 1 18 Proper Cooling of PHFs 124. I Food and Food Protection I FC-3 I .004 f 3-501.14(A) Cooling Cooked PHFs from 140°F to I 125. Equipment and Utensils I FC-4 .005 I 26. Water,Plumbing and Waste IPC-5 f .008 f 70°F Within 2 Hours and From 707 27. 1 Physical FacitiN FG-6 i .007 to 41'F/45'F Within 4 Hours. * 128. Poisonous or Toxic Materials FC-7 I .008 3-501,14(B) Cooling PHFs Made From Ambient 29- I Special Requirements i ( .009 I Temperature Ingredients to 41°F/45'F I + 30. 1 Other ! I I Within 4 Hours* *Denotes critical item in the federal 1999 FcoJ Code or 105 CMR 590.000. h'4 i ! ♦<t '"�� i aiP ,l lkn r}IW '�n 4T `t rl�k F l'__ III 1111111 III 111111 II III III III II II I j'tillj - ri - .,.ir�Walllia�aa S ,� .r i -v oxi len ' I (/ G Quint#y Checks &`Food+rfety Saturday, Febiiicriy 5;.'2011 r z xr,z yt ,'.Y a.n.'lidlw�aryty4,tyN�U `p� I t=Opening 2=61:ndt. '$=01+x•,!:!#s� 32aagei ratwaControltZuality Cheeks I Recon iemcerature 11.Handwaehing/Hand Stales, : 'a;` ;i-:i 'r ;'„; (: (,'2maiate batare caoktrt oidine droducb AM I4PMLN1122Stocked with paper towels.antibacterial soap,sanitizes -' _ �, d lnitials •-pyoand approved nallbrushinasanitizersolution container i C Calibrate/Senilize Functional Thermometer 3Hands correctly washed and sanitized at teas!once iFftONT COUNTER 7iD2 per hour(or more frequently if needed) tj f .^_ 1 i~ Heat Chute Free from obstruction(including basin) •t ? 7 G ../"� Health violations `;;,r."r'l i- ;`' @ (C Fry Station Grate ( ( `” ` 2 't IC Refrigerator Unit ?-7 Most current health inspection report available ! ' I Follow up action(s)documented IE' Display Merchandiser(heat/cool) �,i'f All critical&non-critical violations corrected&maintained IC= Coffee/E-' Soft Drink )9 3.Hot Water, r,1a (Shake Mix/Soft Serve In Hopper I All sinks meet hot water requirements and in good repair v'1 y" ¢•rsL%� :` (Poured Shake/Soft Serve Temperature STORAGE I PM LN/24 Approved,property labeled containers/spray % ,+ Cott+es used for saniazer solution t `•' iu' Walk-In Cooler �,2-7 t^' �l :i:' Potentially Hazardous Product 7 5 4.,, '� �{4 ISanifi er test strips readily available Shift responsible individual can demonstrate proper use of Potentlally Hazardous Product 2 1-aL,r,-", - {'��C'� I `8 ISaltitV.Er test Strips Walk-In Freezer _ Q1 Nt oponstations have accessible saniuzer solutions at proper PPM U Specialty Freezer lei ( i (50-206)with correct color wipe cloth(s)immersed in solution :e`'. Meat Well j r} i 6.Shake Machtde/Sofr Some _ _ '•_Eat' ti'd.; �' '" '+ 2' Product Dispensing Unit `7t9 I No buildup evident In carburetor tube KITCHEN AM PM 10/241 All required brushes preset,clean,stomd properly aid in good repay Onions(after 2-3 hrs.at room temp.) —7 Blender/spindle area free of dried shake mix buildup .: Tomatoes(after 2-3 hr&at room temp.) 17.Approved Product Steamer I All food,packaging and chemicals in use listed in the ',;_g L Toasted Bun Temp/Dial Setting HD Approved Brands List(ABL) .F,s_ji,�. ( &Time Control ?l.j C; ti Upper I Lower Middle Potentially hazardous foods held at room temperature •�_" as Levet{Level Levet `�• ''!! marked with proper hold lime and discarded when " PHU 1:circle. PC or Duke 76a atom ✓ expired{ham.cheese,sliced tomatoes,lettuce and PHU 2:circle: PC or Duke 80 Chicken Ries) jp')kR PHU 3:circle: PC or Duke E da m e.Crone Contamination 1" 2,,i tn3h3 PHU 4: aisle: PC Or Duke roa All required tongs available (PHU:Duke 3 X 4-ONLYCooked and raw product tongs kept separate and stored so onnm that handles do not touch cooked or raw product —v IDischarge Heater(NIECO3 9006 SERIES) / I}AII tongs,knives,PHU pans,shake spindle,iced coffee >`'= I1w CRESCDR0 l�(j (stainless mixing cup,other utensils and specified broiler parts (Fry Vat 1 Shortening Tested VII every 4 hours when in use ;.- fFr Vat 2 Shortenin Tested �--� Shift responsible individual can explain system of IC' )' g 4-hour change out of tongs,pans,utensils and specified equipment -;.e- 0' Multi Vat 7 Shortening Tested Only blue(in clean,sanitized smallware)and Lift-n-Grip (Multi Vat 2 Shortening Tested_ (stored on top of bag)tongs stored in meat well w ^ 13-Comp, Sink(Hot Water)Temperature ) 1p New or replacement product not mixed with old product )Hand Wash Sink(Hot Water)Temperature l - 1!0.Peat Activity {,- . 2,` ;T;3'„3 y)!m , .;�._' ICOOS-OUTS,- "_ AM PM LN/24 Restaurant free of Insects,live or dead rodents,visible ITemperature must not fall in the danger zone and must meat mirdmum required internal Crook-out rodent droppings and nesting birds temperatuleslRefer to OPS Manual for specifics! I�Most recent past control operator report on file in restaurant It= Baked Egg Portions 141_ ' 11.Cook-oouts I Sausage PattylChicken Fritter It- Scrambled Eggs / _ �Shih responsible individual able to correctly demonstrate beef ' cook-out IE: Potato Mix ) 7 Beef cook-out performed& recorded at least 3 times per - 4 Imfor iTENDERGRiLt Fillet y, day esida( Y Late Night or 24 Hour restaurants) ISpicy CHICK'N CRISPa Patty ly No more than 3 cook-outs missed or corrective action 10riginal Chicken Patty � not taken in a 30 day window/any missed Cook-out _ - `t 7 highlighted and initialed by supervisor running next shift ITENDERCRISM Fillet t .p; (CHICKEN TENDERS® j� _ 1Z.OtherCdticalviolatiina . 1 1-1x ,.:,''jr_y3:: !tAq `, IDK Chicken Fries(atter 2 min.cook) )—� No evidence of communicable diseases in Team / r f Members e. cold,flu,stomach disorders ,.,iw iBK®Chicken Fries(after 25 sec.finish) t��' - ( g"' ) � " ' e IFish Patty ._ = I No chemicals improperly labeled or stored by food 1 f •;`g,"t„; (Country Pork R = (Yellow wipe cloths used ONLY in rest rooms A/ J LA11L (Macaroni&Cheesa Kraft n;nnu,toulh l ".i,. - .. v, .e r a•„��ati.�..s r ..d..;,). •N+. , is1K .'Y.•f . `',hnr+,. , , .. .m.� 1 4' ..r'.`Jr T•n•'�'."i'rht�N...J !y'"^m�tY fly* .rrr (iJ /&ftdA��• r 4" Department of Public Health Salem Board of Health Massachusetts h 1Divieion of Food and Drugs ~ Sal Washington Street,4 Floor 9 � Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name Dat¢ / TYoe of Operation(s). Type of Insoection qOil ! IK f ��JJ l a Tamil-Food Service ❑ Routine Address V Ri$k LJ Retail ® Re-inspection �7i pit 1",1 drvC. Level ❑ Residential Kitchen Previous I s ection Telephone /'� ❑ Mobile Date: r✓ �/ Q - Ce 46 d ❑ Temporary ❑ Pre-operation� Owner `J; (- t ( r HACCP YM [:] ❑ p Caterer Suspect Illness Person in Charge�PI6) , Time ❑ Bed&Breakfast ❑❑ General HACCP Complaint In:, Inspector, x [ ) A1h �� Out: $ - Permit No. El Other Each violate n the ed requires an explanation on the narrative page(s) and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT „ " ,., _. ! ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties El 13. Handwash Facilities EMPLOYEE HEALTH .. . . ...... .. . PROTECTION FROM CHEMICALS El 2. Reporting of Diseases by Food Employee and PIC ❑ 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals FOOD FROM APPROVED SOURCE , w _ ❑ 4. Food and Water from Approved Source TIMElrEMPERATURE CONTROLS(Potentially Hazardous Foods)-' " ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ' REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑21. Food and Food Preparation for HSP [110. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices CONSUMER ADVISORY ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code. This report, when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (Fc-2)(590.0 order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.0044)) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(59o.00s) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. _ 30. Other DATE OF RE-INSPECTION: S 501ns fFor 14 dw 1//////�� Q'.ry�G•'�./ 'I i V /(J Inspector's Signature: Print: PIC's Signature: Print: t'/ /�O Page of 2Pages T Violations Related to Foodborne illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT S Cross-contamination 1 590.003(A) Assignment of Responsibility' 3-30111(A)0) Raw Animal Foods Separated from 590.003(6) Demonstration of Knowledge` Cookedand RTE Foods* � 2-103.11 Person in charge-duties Contamination from Raw Ingredients -302 11(.A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH .3 I Other' 2 590.003(C) Responsibility or the person in charge to ( Contamination from the Environment require repcn ting by foo,!employees and 3.302.11(.A) Food Protection'" applicants* 3-302,15 _ Washing Fruits and Vegetables J 590.003(F) Responsibility Of A Food Employee Or An 3-304.!1 Food Contact with Fgnipment and Applicant To Report To The Person In I I Utensils* ChargeT ! Contamination from the Consumer 590.003(0) Reporting by Person in Charpe' j 3-306.14(A)(I3) Returned Food and Reservice of Food' 3 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003(E) Removal of Exclusions and Restrictions I Food 3-701.1 1 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 41 Foodand Water From Regulated Sources 9 Food Contact Surfaces J 590.004(0-6) Compliance with Food taw" 4-501.1 t I Manual Warewashing-Hot Water 3-201.12 Food in a Hermetically Scalcd Container` Sanitization Temperatures* 3-201 13 Fiu:u Milk and Milk Products* 4-501.112 Mechimical Warewashino Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Milk Products.Pasteurized* ( 4-501.114 ( Chemical Sanitization-temp.,pH, 3-202.16 Ice Made From Potable Drinking Water* ( concentration and hardness. '9 5-101.{t Drinking Water from an Approved System- 4-60L1](A) Equipment Food Contact Surfaces and 590.006(.A) Bottled Drinking Water* � Cleaning Clean" - 590.006(f3) Water Meets Standards in.310 CMR 22.0'She4-fi02.;1 Cleaning Frequency of Equipment Food- ' Contact Surfaces and Utensils* Fish fish and Fish Froman Approved Source 4-702 1 i Frequency of Sanitization of Utensils and 3-201.14 Fish and Recre.mionai ly Caught Molluscan Foul Contact Surfaces of Equipment* Shellfish" ( 14-703.11 ,Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Iisted Chemical4' Sources* Game and Wild Mushrooms Approved by 110 �, Proper,Adequate Handwashing - Repulatory Authority ( 2-301.11 Clean Condition-Hands and Anus* 3-202.15 Shellstock Identification Prcaeml' 2-301.12 Cleaning Procedure* _ --- 590.004(C) Wild Mushrooms* 2-301.14 When to Wash` 3-201.17 Game Animals* i if Good Hygienic Practices - 5 Receiving/Condition I ( 2-401.11 Eating,Drinking or Using Tobacco* 3-202.11 PHFs Received at Proper Temperatures* ' 2401.12 ( Discharges From the Eyes,Nose and 3-202.15 Package Integrity* ( f Mouth* 3-101.11 Ford Safe and Unadulterated* j 3-301.12 Preventing Contamination When Tasting* b Tags/Records:Shellstock 12 ( Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203,12 Shellstock Identification Maintained" ( Employees* Tags/Records:Fish Products J 13 Handwash Facilities 3402.11 ParasiteDcstniction" Conveniently Located and Accessible 3-402.12 Records.Creation and Reteni:un* 5-203.11 Numbers and Capachies* 5-204.11 Location and Placement* J 590.004(1) Labeling of Ingredients' 5-205 11 ( Accessibility. Operation and Maintenance Conformance with Approved Procedures 4 Suppled with Soap and Nand Drying /HACCP Plans ( P n'� 9 Devices 3-502.11 Specialized Processing Methods* 6-301.1 I Handwashing Cleanser,Availability 3-502.12 Reduced oxygen packaging.criteria* 8-103.12 Conformance with Approved Procedures° 6-301.12 Hand Dry ng Provision Denotes ctitiul nem in the federal 1999 Focus Code of 105 CMR 590.000. 0 CITY OF SALEM BOARD OF HEALTH � Establishment Name: _�,rc"e4 )1>✓I/r 4 > S W, Date: //GAJ o Page: Z of 2- Item Item Code C-Critical Item/ / DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified PLEASE PRINT CLEARLY 7 A A �^ l C �o 67ie,. /-I OF — Ica /�l f=�,i.? V < oil 1— v lA/ /J I_)n ,n)O nC4 i I� Z C�'� . , � t� �r-�A v1 :�-�— 1-�,,_,r r. ( _�� . {1•�nnLl,�-� _� (^Y/S�) D w)fJOn /.l✓,of ? e-wL? I r)r.. n -1I to '1 1/, n„n r 12 'IJn��• �\1 -AAAr';"O' � nN—' I i I I I I Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ esu I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to b -e-inspection Scheduled ❑ Exclusion Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure yo>jrfood permit. � ❑ Voluntary Disposal ❑ Other: t � ?-:SUI 14(C,1 PHFs Reuived at Temperatures r, " Violations Related to Foodborne Illness interventions and Risk Aax)f-ding to U" Cooled to Factors(Items1-22) (Cont) 41'FAY FWithin-1Hmns. ' t-501 15 Cxilino Method.for PHFs PROTECTION FROM CHEMICALS 14 j Food or Color Additives ' 19 1 PHF Hot and fold Holding 3-501 1t,B) Cold PHFs Mamt'.uned at -w below 3-2(72.12 f Ad Ltn'es'1 59t}Dila{}-) 1 3-302.14 I Protection from Iinappro':ed Additoee' � 41`'/45°F` 15 i2-j01 it)iAJ i Poisonous or Toxic Substances ! H,rt PHtc ltainEained at or at*.n'e 1 ' 101.11 i ldenUfYinb lnfonnalion - lhtr)nal t40'}= !t: i - -E:i,a 16t,41- kt,m+Held at or aho%e 13011 e - untsner. ` - — -' --- 2o ! - _-1111_-dime asit Public Health Control i 7 !02.11 .�'a> .i Public ontrr)1 1waith C - � ',-201.11 _..._ _-� r 111'1_ .1Lt, '!}:+t1i \:.•^,rii`��:'Ziitw i'*'Pi ?_)(J2.12 i (',+adlilsNt:of Usc" 7-?03 !1 loci. Co„taincr:.-f'rrh;tn:'ut,. REQUIREMENTS FOR HIGHLY SUSCEPTIBLE ' 204.11 Saqiiirjs.Criterit, -Che:nicaiiv --� POPULATIONS (HSPS 7-'04.13 Cho mica!>^oi Wivhttye Yn>ui..c_C'rit�:;;' i I"1 '-S t' !it L'np:.,teu:l:ad Pw-ialc;a}:ed Juices a)d I With l'+etutnx;I,a!'.is- i 7-204 14 Orrin;i Amt ms,Craermt r--_-_ );)` 71 __ Lr id•nt.ai is>!E.unta�t ,n:natusJ - � --- - --------- --- , £'.vr t:71, t. i Ar-nrv)I F+ .+nd :-106A1 i?; 4'irl c,i t yr Pc":u.tdt, :itteca'v ;— 7-:.45.12 iRcx6'nl ti i i;,•"+r:.c'r! itx+/t Pai i..trt h,e R,--;;rt t:l j ;rr,;tEr.:C nil,l F'+':u1C:: i'`.:! OtiiRt•gK( _.-....1..__1.- `,i,'wt,.;fr.'• t,r.NSUMEA ADVISORY 22 ' 11 ..a:<J t'i: ] t :SO:s 1.n',..' ,.+Z l 71"1131 {h a3A. TIMFJTEMPERATURE COW.,fOLS 14 I i Proper Cookm^T?:itpelanups tar i I i 17, _------ 5 --- - - -' Pc £AL P.20ORrIMENTS ±--•o• 3 , £3+,( :), i p,i;. ;,r'J tE„ +„r ai , ! i[ _ _ _. . 1111_-..-.__ __ ___... __ ._ _.._._._ _ .-._ I ' JCi.. :1',.� F;:..:. .•',:: ... \ ....-i :; ri, i .. . 1'IC:+1nt 4i':" ;i:iifi�f,:- 1 .:--'-.t 1. '^ {, .0 . ., ti., i,-'aCi ,��L i,! 1 it , i�G:, iiCb Ol'.'ltiY . .�. i!ti :{�- .. '•L:,le. .. .. :-. tz , .. - , i 5`h.af' S iC: i:Ji i!F C,i- .e% i..; z ,n...' i]. '< __ ' i 1Lt„ i i ci!l" t' f. .._l :1S C:fR 2".301 t% ir,',� �s'Lnu+ 5i . r::.c± : ,. . . :Cor-i:u, 1 1'In; `,t•: ''L. . n r-, , .m . ., r? ltu n,., ! " 'r„n. if I- Sit F` tS; 1101 Rcmaoti uwi'CCd yn'iics nl tier 40011 Good Retail Prac..C.-'s FC 59170tio _. jh ! Proper Cooflng of PHFst : 2C t-o)a.,ad:=ir:,it P'J'2.:fin _ -__ FC 011 tJi r 411111❑ : £'iii. :,}}Friry-i'}•.i, i r - - 71F t15P 1'athxt- H,v, •;:;,:�iv,. i - - pa,a..,i-. �J!il L�v ,I__ __ _ -.__ __ It -4 91 z n°d¢A c Ii U --- ------ -- -- - - -- -- _ T / MORRELL ASSOCIATES Current Date: 6/17/2011 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken. 6/1/2011 (781) 837-1395 www.morrell-associates.com Customer#: FB13-10 YO RRStt ISSOC/S IES C LBK LLC L Burger King#3564 L 9/16 OC Hawthrone Square Mall/Rte 107 I A 259 Highland Ave N � Salem, MA T O N BACTERIA COUNT Sample Standard Plate Count1g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC MASSACHUSETTS STANDARDS Machine: SPC!g 50,000/g;Coliform s 50/g Other: SPC!-.50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products, 17th Edition, American Public Health Association, 2004 „:e;or or Health 1 s MORRELL ASSOCIATES Current Date: 5/24/2011 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 5/2/2011 ea (781)837-1395 www.morrell-associates.com Customer#: FB13-10 Y OYndLL ♦590CId Ild , C LBK LLC L Burger King#3564 L 9/16 C Hawthrone Square Mall/Rte 107 A 259 Highland Ave N I Salem, MA T O N a BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC s MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g; Coliform s 50/g Other: SPC s 50,000/g;Coliform s 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products, 17th Edition, American Public Health Association, 2004 / MORRELL ASSOCIATES Current Date: 4/21/2011 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 4/4/2011 m4il (781) 837-1395 www.morrell-associates.com Customer#: FB13-10 vO Rn[lt •bb OC4 ifb C LBK LLC L Burger King#3564 L 9/16 00 Hawthrone Square Mall/Rte 107 I A 259 Highland Ave N Salem, MA T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC ��DEIVED ti� 02 2011 CI iY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPCs 50,000/g;Coliform s 50/g Other: SPC!-.50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST �� Products, 17th Edition,American Public Health Association, 2004 ® MORRELL ASSOCIATES Current Date: 3/18/2011 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 3/1/2011 (781)837-1395 www.morrell-associates.com Customer#. F613-10 u ONA[ta •bb OCTA ffb C LBK LLC L Burger King#3564 L 9/16 0 Hawthrone Square Mall/Rte 107 I A 259 Highland Ave N Salem, MA T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC C�`jf"® ppR �12�1 0oP D OF H MASSACHUSETTS STANDARDS Machine: SPC!;50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products, 17th Edition, American Public Health Association, 2004 J� / ® MORRELL ASSOCIATES Current Date: 1/16/2011 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 1/4/2011 (781) 837-1395 www.morrell-associates.com Customer#: FB13-10 u oxx¢¢a •xxo< uxx C LBK LLC L Burger King#3564 L 9/16 0 Hawthrone Square Mall/Rte 107 A 259 Highland Ave N I Salem, MA T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC MASSACHUSETTS STANDARDS Machine: SPCs 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliform s 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST ( Products, 17th Edition, American Public Health Association, 2004 �17e Board in He:a;wg MORRELL ASSOCIATES Current Date: 12/21/2010 ` P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 12/6/2010 (781)837-1395 www.morrell-associates.com Customer#: FB13-10 YO AEE'lL X380 CSA t[E C LBK LLC L Burger King#3564 L 9/16 C Hawthrone Square Mall/Rte 107 I A 259 Highland Ave N Salem, MA T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC y Tj ,J�i�OF NTN MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliform s 50/g Other: SPC s 50,000/g;Coliforms 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products, 17th Edition, American Public Health Association, 2004 Board of Health MORRELL ASSOCIATES Current Date: 2/10/2011 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 2/3/2011 (781)837-1395 www.morrell-associates.com Customer#: FB13-10 uoaan♦ .saoc,•ras C LBK LLC L Burger King#3564 L 9/16 C Hawthrone Square Mall/Rte 107 I A 259 Highland Ave N Salem, MA T 0 N BACTERIA COUNT Sample Standard Plate Ccunt/g Coliform/g Vanilla Milk Shake !� 720 < 1 EPCC oa MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products, 17th Edition, American Public Health Association, 2004 / MORRELL ASSOCIATES Current Date: 11/16/2010 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 11/2/2010 (781)837-1395 www.morrell-associates.com Customer#: FB13-10 YO R11lll RSfOCil tf! C LBK LLC L Burger King#3564 L 10/17 00 Hawthrone Square Mall/Rte 107 A 259 Highland Ave N I Salem, MA T 0 N BACTERIA COUNT Sample Standard Plate CounUg Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC - �.aVE® DEC 0 6 2010 OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliforms 50/g Other: SPC:r 50,000/g;Coliforms 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST C//( Products, 17th Edition, American Public Health Association, 2004 f�� MASTORAN CORPORATION CO NSTRUCTION DIVISION Marc Q Rochon Projects Manager t 822 Lexington Street,2nd Floor,Waltham,MA 02452-4848 Office:(781)893.0990 Office Fax:(781)899-6977 Home Office:(978)388-4554 Cell:(617)645-1596 ■ CITE' CIF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,40'FLOOR TEL. (978) 741-1800 KIIvIBERLEY DRISCOLL FAX(978)745-0343 MAYOR DGRlTNRAUM((&\LILM.COM DAVID GREENBAUM, ACTING HEALTH AGENT 2009 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT TEL#,-521P 7,4 / 1/6/ ADDRESS OF ESTABLISHMENT,�?Sy A7C//, d i/A , FAX# &/qq -�D !� 70 MAILING ADDRESS(if differentX t l//iu .<t t fl h-14 /&I IA- 4/�GL O� 44 EMAIL-Business':OC C f✓AQ 4l Ctl,-?-Website: IY0,,y'e-- J OWNER'S NAME TEL# 7'.Fl &4� 2WO iI �f.�LG ?Y�rvQ17��L-T �� Clh'l- IIZ ADDRESS STREET ;/ CITY STATE zip ' CERTIFIED FOOD MANAGER'S NAMESCERTIFICATE#(S)4 (Required in an establishment where potentially hazardousfoodis preparedii, /), EMERGENCY RESPONSE PERSON P ry-) J)IOC►Yl W) _ HOME TEL# fOD')— r110-a5O DAYS OF OPERATION I MondayTuesday Wednesday 1 Thursday I Friday Saturday Sunday HOURS OF OPERATION 1 (o �� - 1!'�!� �OQirt - — , _ //� _ y Please write in time of day. Kim _/a Q�'1 1 I 6 4m /et (For example 1 lam-1 1 pm) !./,� 0-in' ! 1,7al —1 aa.m. I TYPE OF ESTABLISHMENT FEE (check onlvl RETAIL STORE YES NO less than 1000sq.ft. =$70 1000-10,000sq.ft. =$280 more than 10,000sq.ft. =$420 ..................................................._....---.. RESTAURANT YES N -O less than 25 seats $140 (Outdoor Stationary Food Cart$2 0 25-99 seats =$280 more than 99 seats =$420 BED/BREAKFAST/....................YE.S......NO.......................................................---------------------------$-100------ CHILDCARE ----- CHILDCARE-SERVICES/NURSING HOME.---------------------------------------------------------------------------------...---------------------------------------- ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGURT/SOFT SERVE YES NO $25 TOBACCO VENDOR YES rrOJ $135 ALL NON-PROFIT(such as church kitchens) YES o $25 'Please pay total with one check payable to the City of Salem. This Permit is not transferable and must be reissued upon change of ownership. The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements,or equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 62C,Section 49A,I certify under the pains and penalties of perjury that I,to my best knowledge and belief,have filed all state tax returns and all tate ax re u' ed under the law. r 7-/2.5� 17(,7 Signature ate Social Security or Federal Identification Number CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH G, g 120 WASHINGTON STREET,4 FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR ocaatr•.NBAunda SAi.FM.COM DAVID GREENBAUM, ACTING HEALTH AGENT Revised 4/24/07 FOODAP2008.adm Check#&Date $ ry fe EXAMINATION FORM NO : 4006 ' CERTIFICATION NO : 4692854 ti Seiv Safi'® Cert-iffrot"wcation OBERT MS for successfully completing the standards set forth by the National Restaurant Association Educational Foundation for the ServSafe®Food Protection Manager Certification Examination, which is accredited by the American National Standards Institute (ANSI)-Conference for Food Protection (CFP). Presented by the National Restaurant Association Educational Foundation 1/13/2006 DATE OF EXAMINATION 1/13/2011 DATE, OF EXPIRATION L ocal laws apply. Check with your local regulatory agency for recertification requirements. 1 � Mary M Adolf President antl Chief Operating Officer National Restaurant Assocatioe Ed,,cavoral Fou�dabon National Restaurant Association EDUCATIONAL,FOUN DATION ®2004 National Restaurant Association Educational Foundaiien WWW n raet Org 03702307 v0572 �R November 23, 2009 City of Salem Board of Health 120 Washington Street, 4`h Floor Salem, MA 01970 RE: Burger King #3564 To Whom It May Concern: LBK, LLC will be acquiring the above referenced Burger King on or around December 1, 2009. Please find enclosed the license/permit application and fee included. Please mail the original license once complete, to LBK, LLC, 822 Lexington Street, Second Floor, Waltham, MA 02452. We will keep a copy for our office files and forward the original to the restaurant. If you prefer to mail the original to the restaurant, please either mail or fax a copy to us. If you have any questions or need any additional information, please give us a call at (781) 893-0990. Thank you in advance for your prompt attention to this matter. Sincerely, Melissa Goldberg Accounts Payable Manager Enclosures LBK, LLC 822 Lexington Street, Second Floor, Waltham, MA 02452 (781)893-0990 Fax (781) 899-6977 A Franchisee of Burger King Corporation G>' 7Ze�> MASTORAN CORPORATION 61619 3529 CITY OF SALEM Nov 23 09 2009FOOD3564 Nov 23 09 305 . 00 0 . 00 305 . 00 305 : 0"Oa 0 . 00 305 . 00 r + . ....-. -- ,.,,.,._.....,—. 61619 1 MASTORAN CORPORATION ACCOUNTS PAYABLE SOVEFCII1 822 LEXINGTON STREET - WALTHAM, MA 02452 DATE — 5-7515/110 - 5 000000061619 AMO Rv 23 2009 $305 . 00 8 a PAY ******************* Three Hundred Five and 00/100 ******************* c TO THE ORDER CITY OF SALEM ID AFTER 6MONTHS ` OF BOARD OF HEALTH / 1 120 WASHINGTON STREET 4TH FL SALEM, MA 01970 wqo tt� I . I'06 i6 1911' 11:0 1 i0 7 5 I Sys: 8499 20 2 7 12 211' MASTORAN CORPORATION 61619 3529 CITY OF SALEM Nov 23 09 2009FOOD3564 Nov 23 09 305 . 00 0 . 00 305 . 00 { ,.. 305 . 00 0 . 00 " 305 . 00 1 SF, I-1S0 TO REORDER,ML YOUR LOM SAFEGUARD DISTRIBUTOR AT BOP824M HNZpl0p10 L009WRi310 � 9SARGUARD. urxouu rs cs a oenxs'J. ®qv �ry O O ENDORSE HERE . 1 DO NOT WRITE. STAMP OR SIGN BELOW THIS LINE RESERVED FOR FINANCIAL INSTITUTION USE cP f i 'r{°•y X74 •'y .�� L'} � _ ",� ",fy�Y Sir r I i f r � "1�.'a e �r��'P+r� �•7`''�� a a r �t'�t� :�'� �``�.-, l,. gra �^�.. ' , •._• �� (, tP L7r fie: r r r I G � RS-60 The security features listed blow,as well as those s not listed,exceed industryguidelihes• i Security Features: k Micropriniee Bwdw: 3e n'r/pa m nre bwa,.^.-ars as rror,.+i'ne wben {I'10'ACGIIiN,I. 1 Wamrng Banc: •AWrla nane'ar:r 6ou I,nt.uMaOia aea.^•yhaiva. Security Sereco Backer. •b•_a�-a nneam•. a �.r y,<'^:.rcn^•{nutlure 1 , (`,OiOree BSCkS�Ulre: •Po xm pui_4x e9n'naL.�M'^�!. ChnnacrdY::en_�:iva Peper: •._vwarx=e�.ity eypaar nrR.0 a{a;,,.ra o-� ' e5'e...vta ere:a�e ' Hent BenslY..e lrt, •re-...rns,ewan. Hr'u mJ . s.- n,,. e.. larekn9er d breAM c r d.Tu�'r.qe K„MJe,•d mx.=a ' � _ Pa".l1.ck '._ 3 a certiq.cat.e mark bl fe C�..ak Pa.r^ f Sv- +s Ax,r.;, ti' _• CITY OF SALEM BOARD OF HEALTH Date: December 7, 2009 Name of Establishment: Burger King Address: 259 Highland Avenue Owner: Marc G Rochon and Robert Smith Phone: 781-893-0990 The proposed owners of this establishment Marc G. Rochon, Project Manager and Robert Smith, District Manager presented a Floor Plan and Menu for review in accordance with the State Food Code. The floor plan and menu are approved as presented. Any changes to the approved floor plan must be approved by the Board of Health prior to implementing them. CERTIFICATION There must be a Certified Food Manager working at this establishment full time. A "Person in Charge" or"PIC" must be available at this location when the CFM is not present. The PIC must have knowledge of sanitation techniques, holding temperatures, operations, etc. FLOOR PLAN A Hand Sink must be located in each food prep and service area. The hand sinks must have wall hung soap and paper towel dispenses. These must be stocked at all times. The hand sink must be used for hand washing only. All floors, walls, and ceilings where food, utensils, paper products, etc, are stored, prepared or served must be intact, impervious, and easily cleanable. A three bay sink for washing, rinsing and sanitizing all utensils equipment, dishes is available. If a dishwasher is going to be used it must have a final rinse temperature of 180 degrees in the final rinse OR an automatically fed chemical sanitizer in the final rinse with an audible alarm. MENU/FOOD PREP All food must be purchased from a wholesaler licensed by the State. Fruits and vegetables must be washed prior to preparation. All food must be held at 41T or lower, or 140°F or higher, at all times. Food may not be added to containers in holding unit. Instead, a sanitized container with new product may replace the existing container and the old product may be placed on top of the new product. There may be no bare hand contact of ready-to-eat foods. Gloves, tongs, or tissues must be used when handling such food. UNDERCOOKED FOODS All food items will be fully cooked, nothing will be cooked to order. CHOKE SAVING A person trained in choke saving techniques must be available whenever this establishment is open for business. EXTERMINATION Monthly services of a Licensed Pest Control Operator are required. Please keep receipts for inspections. SANITIZING SOLUTION Sanitizing Solution must be accessible at each prep station and for the patrons' tables. Test strips corresponding to the kind of sanitizer, must be on hand to check concentration of solution. Solution must be made daily, tested, and the results recorded on a log sheet for examination by Board of Health inspectors. Solution may be prepared in the 3`d bay of the 3-bay sink and spray bottles may be filled there. Spray bottles with clean paper towels may be used, as well as wiping pails with wiping clothes always held in the solution in the pail. These must be clearly marked .1sanitizer". Outside area of premises, including the dumpster area, must be kept clean and sanitary. TRASH Trash must be kept in appropriate trash receptacles and a grease barrel must be used to hold discarded food grease. The trash area must be kept in a clean and sanitary manner. ODOR Exhaust air must be filtered in such a manner to prevent the release of food odors to the outside of the premises. A change of ownership inspection will be conducted by 12116109. David eenbaum Date Acting ealth Agent N /,2- 7 - 69 M c G. Roc�iod( ` Date P ojects rManager /... % .�.ri T1! is- 7 -os Robert Smith District Manager MORRELL ASSOCIATES Current Date: 10/20/2010 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 10/13/2010 (781)837-1395 www.morrell-associates.com Customer#: FB13-10 poen[,a ♦sa aera rcs C LBK LLC L Burger King#3564 L 10/17 C Highland Ave./Rte 107 I A E T Salem, MA N T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC ND 0 0 i 2010 .,.r.�.t� : MASSACHUSETTS STANDARDS Machine: SPC s 50,000/9;Coliforms 50/g Other: SPC:5 50,000/9;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products, 17th Edition,American Public Health Association, 2004 / MORRELL ASSOCIATES Current Date: 5/17/2010 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 5/11/2010 (781) 837-1395 www.morrell-associates.com Customer#: FB13-10 uosscu ese ocu res Burge C C Highly King ./Rte eG�l� 3564 L 10/16- LBK LLC O Highland Ave./Rte 107 $7 I ED E T Salem, MA NI �IAI - ?9fl10 T O N BACTERIACOUN-Pu"V - Sample Standard Plate Count1g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC MASSACHUSETTS STANDARDS Machine: SPC!g 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST " Products, 17th Edition, American Public Health Association, 2004 Board of Heai2i, / ! MORRELL ASSOCIATES Current Date7/27/2010 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 7/13/2010 (781) 837-1395 www.morrell-associates.com Customer#: FB13-10 •OA11Qla •2800/I iEd C LBK LLC O Burger King#3564 L 10/17 C Highland Ave./Rte 107 I E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake 2,400 < 1 EPCC MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliform s 50/g Other: SPC s 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products, 17th Edition, American Public Health Association, 2004 Board of He3ltf3 / ® MORRELL ASSOCIATES Current Date: 6/21/2010 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 6/8/2010 (781) 837-1395 www.morrell-associates.com Customer#: FB13-10 ro++eu �saor+�rsa C L Burger King#3564 L 10/16- LBK LLC OC Highland Ave./Rte 107 A E T Salem, MA N I T 0 N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliform s 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST G Products, 17th Edition, American Public Health Association, 2004 Board of rleatth MORRELL ASSOCIATES current Date: 9/24/2010 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 9/9/2010 (781)837-1395 www.morrell-associates.com Customer#: FB13-10 �OI1�F4 X5600/I IfB i C LBK LLC L Burger King#3564 L 10/17 OC Highland Ave./Rte 107 I E T Salem, MA N I T 0 N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC Cr OCT 0 4 2010 caTv SA 1 ;,r.tYC3 OF 1-t -�'_.CH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliforms 50/g Other: SPC is 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST ( Products, 17th Edition, American Public Health Association, 2004 ® MORRELL ASSOCIATES Current Date: 8/23/2010 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 8/11/2010 (781)837-1395 www.morrell-associates.com Customer#: F613-10 Y 088 Eft 888008(Eb C LBK LLC L Burger King#3564 L 10/17 0 Highland Ave./Rte 107 I E T Salem, MA N I T O N 4 . BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake 620 < 1 EPCC SEP U 11010 C. . . .. "HLEM FC).,iil� i7F HEALTH MASSACHUSETTS STANDARDS Machine: SPC:r.50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products, 17th Edition, American Public Health Association, 2004 52 1171-�e Soa:d of Heal") Interior Menu Board Layout .. :£'3T K::L"t� ti.' t- • .s;. 9K'.v <)",,,n_:st,'".v:r4 40.::: WHOPPER® 3.39 WHOPPER JR.® 1,00 Spicy CHICK'N CRISPTM 1.00 French Fries Med 1.79 Lg 1.99 King 2.19 DOUBLE WHOPPER® 4,39 CHICKEN TENDERS®5 PC. 1.00IRodso Cheeseburger 1.39 Onion Rings Med 1.79 Lg 1.99 King 2.19 TRIPLE WHOPPER-w/Cheese 5.79 Small Soft Drink 16oz. 1.00ISmall ICEE 1.39 CHEESY TOTS- 9 Pc.1.70 1212c.2.00 Steakhouse Burger 4.29 Small FF or OR 1.00IMozzarella Sticks 1.39 - Loaded Steakhouse Burger 4.99 Side Salad 1.0010utch Apple Pie 1.00 Drink Flavors BK-Stacker Double 3.19 Triple 3.98 Quad 4.99 CHEESY TOTSTM 6 Pe. 1.3910tis SpunkmVerfnl Cookies 1.00 Fountain Drink Med 1.60 Lg 1.80 King 2.00 Double Cheeseburger 2.99 °!Y�gti¢v"" +,: 'sPg?F liir �+'�''" :' • ,�"', "^^-;r' +t; ""+j ICEE Sm 1.38 Med 7.88 Cheeseburger 1,20 Top w/TENDERCRISPO Chicken 4.59 Nestle Pure Life Bottled Water 1.60 [Hambur er 1.00 Top w/TENDERGRILLO Chicken 4.59 Mmw M.w Orange Juice 1.39 mm.ee m.w Apple Juice 1.20 • Ken's Dreseings Available: R ch-Cuw-Lite Mm-Honey Muaerd 1%Low Fat/1%LOW Fat Chocolate Milk 1.39 TENDERCRISPO 3.99 • - - :" -' 1 :' ='- " BKJOETM T/RID Sm 1.00 Med 1.60 L$1.80 TENDERGRILLO 3.99 Kids: Hamburger 3.59 Cheeseburger 3.59 Chicken Tenders®5Pc.3.59 Mocha SK JOE®Iced Coffee 2,20 Chicken Sandwich® 3.49 Big Kids:D.Hamburger 4.59 D.Cheeseburger 4.59 Chicken Tendered bPe.4.59 jVffdk '„• ' - . .,tea:" Sides:Molts®Strawberry Apple Sauce or Fries Milk Shakes:Coffee4hocolate-Van111aStrawberry BK-Chicken Fries SPc.2.29 9Pc.3.29 12Pc.3.99 Drinks:Chocolate/Milk,Apele Juice,Soft Drink Sm 1.99 Med 2.29 L_9 2.89 BK BIG FISH®Sandwich 3.20 Toddler Toys Available Upon Request Oreo BK Sundae Shake 16 oz 2.50 22oz 2.80 BK VEGGIE®Burger from M...Farms 2.99 Picture Menus Available Upon Request Dutch Apple Pie/Otis Spunkmeyer Cookies 1.00 CHICKEN TENDERS®6PC. 2.69 PAY IT YOUR WAY® HERSHEY'S Sundae Pie 1.50 DRIVE THRU MENU BOARD LAYOUT �- r- I . WHOPPER® 3.39 WH PPER JR.® 1.00 Spicy CHICK'N CRISP 1.00 DOUBLE WHOPPER61 4.38 CHICKEN I tNutKsw 5 Pc. 1.00 Rodeo Cheeseburger 1.39 ]TRIPLE WHOPPERTM wl Cheese 5.79 Small Soft Drink 16oz. 1.00 Small ICEE 1.39 ISteakhouse Burger 4.29)Small FF or OR 1.00 Mozzarella Sticks 1.39 (Loaded Steakhouse Burg, 4.99)Side Salad 1.00 Dutch Apple Pie 1.00 BK-Stacker Double 3.19 Trials 3.99 Quad 4,99 CHEESY TOTSn 6 Pc. 1.39 Otis Spunkmeyer®Cookies 1.00 Double Cheeseburger 2.99 Cheeseburger 1.20 Hamburger 1.00 French Fries Mod 1.79 Lg 1.99 King 2.19 Add Cheese OAO Add Bacon 0.80 Onion Rings Med 1.79 Lg 1.99 King 2.19 �owN41t P"t7S1McF.li'NlLrlfA'.Cdl: CHEESY TOTS"' 9 Pc 1.70 12Pc 2.00 TENDERCRISPd1 3.99 TENDERGRILL® 3.991 DRINK FLAVORS Chicken Sandwkh0l 3.49 Fountain Drink Med 1.60 Lit 1.80 Kinq 2.00 ICEE Sm 1.39 Med 1.99 ]Nestle Pure Life Bottled Water 1.60 ++y..t`4fiirta�:i:�a:nru.lo%ti lnnm wmo Orange Juice 1.39 mmmwles Apple Juice 1.20 �9iC^12hTTc 1e es 6Pc.2.29 8Pc.3.29 12Pc.3.991%Low Fal/1%Low Fat Chocolate Milk 1.39 ISK BIG FISH®Sandwich 3.20 SK JOE®TIRID Sm.1.00 Med.1.60 Lq 1.80 BK VEGGIE®Burger from M...Forms 2.99 Mocha BK JOE®Iced Coffee 2.20 CHICKEN TENDERS@ 8 Pc. 2.69 _ Milk Shakes:Coffee-Chocolate-VanillaStrawberry Top wl TENDERCRISP V Chicken 4.55 Sm 1.99 "Med 2.29 Lj 2.89 I op WI I LNUtKGKILLW Chicken 4.59 Urea UK'"Sundae Shake 16 oz 2.50 22oz 2.80 Ken's Dressings Available Ranch-Caesar-Lite Italian-Honev Mustard Cookie Douph Pie 1.50 HERSHEY'S Sundae Pie 1.50 d11:l:'Ilptls Spunkmeyer®Cookies 1.00 Hamtaumer 3.58 Double Hamburger 4.59 {� {11 .�y�al�]� . a '' •S Cheesebu.Ver 3.59 Double Cheeseburger 4.58 Sides: foal ® raw'airy ppa auceor Fnes CNrCKtrl .Ver 51.1 3.59 CKrCKtN I tNUk:FfSV air 4.59 Drinks: 1%Lm Fat RepulaH1%Low Fat Chocolate Milk Picture Menus Available Upon Request Minute Maids Apple Juice or Kids Soft DrinkfBip Kids Soft Drink PAY IT YOUR WAY® Toddle Tovs Available Upon Request Revised Lunch/Dinner Value Meal Menuboard Layout 1 2 WHOPPER® DOUBLE WHOPPER® 5.69 6.39 3 4 TRIPLE WHOPPERw w/ WHOPPER JR® cheese 7.19 4.19 5 6 Steakhouse Burger TENDERCRISPO Chicken Sandwich 5.99 6.19 7 8 BKT°'CHICKEN FRIES TENDERGRILL® 9 Pc. Chicken Sandwich 5.49 6.19 9 10 Original Chicken Bacon Double Sandwich® Cheeseburger 5.99 5.69 11 12 BKw Double Stacker BK BIG FISH®Sandwich 5.69 5.19 POS VALUE MEALS Double Cheeseburger $4.99 Italian Original Chicken Sandwich $5.99 CHICKEN TENDERS®8 Pc. $5.29 BK TM Chicken Fries 12Pc. $6.19 2 Cheeseburgers $5.29 BK Veggie Burger $ 4.99 Loaded Steakhouse Burger $6.69 BKTM Triple Stacker $6.19 BKTM Quad Stacker $6.99 Go Large $0.50 Go King $0.80 A La Carte WHOPPER JR®with Cheese $1.30 Italian Original Chicken Sandwich $3.60 Bacon Double Cheeseburger $3.19 Chicken Tender Sandwich $1.39 Salad Base $3.39 Add a protein pouch to salad: Chicken Club Salad $ 4.99 TENDERCRISPO $1.20 TENDERGRILL® $1.20 Chili Cheese Fries $2.99 substituted in Value Meal +0.80 Apple Sauce a Is carte $0.99 Substitute Shake or ICEE in a VM $0.59 Substitute Shake/JCEE in Kids/Big Kids Meal Free Bacon 2 Pc.(Sm.Sandwich) $0.50 SHAKE`EM UPT Fry Packets $0.40 Bacon 4 PC.(Lrg. Sandwich) $0.80 Cheesy Tots instead of French Fries=NO CHARGE L Interior Breakfast Menuboard Layout SEC CROISSAN'WICH $3.80 SEC Biscuit Sandwich $3.80 DOUBLE CROISSAN'WICHm $4.50 Enormous Omelet Sandwich $4.70 1 SMALL VM 2 SMALL VM 3 SMALL VM 4 SMALL VM $2.50 Sandwich Only $2.50 Sandwich Only $3 10 Sandwich Only $3.60 Sandwich Only French Toast Sticks 5 Pc. $3.40 Sausage Biscuit $2.90 Cini-Minis 4 Pc. $2.90 Pancake Platter $3.80 5 SMALL VM 6 SMALL VM 7 SMALL VM-8 SMALL VM $2.00 French Toast Sticks Only $1.00 Sausage Biscuit Only $1.00 Cini-Minis Only $2.40 Pancakes Only BK— BREAKFAST VALUE MENU Breakfast POP •- = • • �� VALUE MEALS INCLUDE SMALL COFFEE AND SMALL HASHBROWNS OR MEDIUM*$0.50 o0 LARGE.$1.00 • ,, _ , A LA CARTE: VALUE MEALS: BK JOE® $1.00 Small 12oz Cheesy Bacon BK WRAPPER: $1.60 Medium 16oz 1 Wrapper $ 3.20 $1.80 Large 20oz 2 Wrapper $ 4.40 HASH BROWNS $1.00 Small 13-15 PCS. $1.60 Medium 23-25 PCs. $1.90 Large 36-38 PCs. CHEESY TOTSTM $1.40 Small 6 PCs. $1.70 Medium 9 PCs. $2.00 Large 12 PCs. Sm Cheesy TotSTM instead of Sm Hash Browns = +$0.39 Med & Lg. Cheesy TOtSTM instead of Med & Lg. Hashbrowns = No Charge Orange Juice instead of Coffee = No Charge Exterior Breakfast Menuboard Sausage Egg & Cheese Sausage, Egg&Cheese CROISSAN'WICHO $3.80 Biscuit Sandwich $3.80 1 SMALL VM 2 SMALL VM $2.50 Sandwich Only $2.50 Sandwich Only DOUBLE CROISSAN'WICHw $4.50 Enormous Omelet Sandwich $4.70 3 SMALL VM 4 SMALL VM $3.10 Sandwich Only $3.60 Sandwich Only French Toast Sticks 5 Pc. $3.40 Sausage Biscuit $2.90 5 SMALL VM 6 SMALL VM $2.00 French Toast Sticks Only $1.00 Sausage Biscuit Only Cini-Minis 4 Pc. $2.90 Pancake Platter $3.80 7 SMALL VIV18 SMALL VM $1.00 Cini-Minis Only $2.40 Pancakes Only a, PIP IN BKw BREAKFAST VALUE MENU lei e Citp of ba lem, Ca acfju�ett� Office of the City Council ' J UP fall 1 COUNCILLORS-AT-LARGE ROBERT K.MCCARTHY WARD COUNCILLORS PRESIDENT 2010 2010 THOMAS H.FUREY CHERYL A.LAPOINTE ROBERT K MCCARTHY JOAN B.LOVELY CITY CLERK MICHAEL SOSNOWSKI STEVEN A.PINTO JEAN M PELLETIER ARTHUR C.SARGENT III JERRY L.RYAN JOHN H RONAN PAUL C.PREVEY February 4, 2010 JOSEPH A.O'KEEFE, SR. Ms. Melissa Goldberg Accounts Payable Manager Mastoran Corporation/LBK, LLC Franchisees of Burger King Corporation i tIS 4 ZO10 822 Lexington Street,2nd Floor ul I Y OF SALEM Waltham, MA 02452 BOARD OF Hr--ALV Dear Ms. Goldberg: At a regular meeting of the City Council held in the Council Chamber on Thursday,January 28, 2010,the City Council voted to grant permission to Burger King located at 259 Highland Avenue to operate during the days and hours of Sunday through Wednesday,6:00 A.M. — 12:00 A.M. and Thursday through Saturday, 6:00 A.M.—2:00 A.M. with the following conditions: l.) This will be a six (6)month trial unless problems occur beforehand 2.) No eating in parking lot after the dining room closes at 11:00 P.M. 3.) Signage shall be posted in the parking lot and other appropriate areas that states "No Loitering" Before your six month trial period expires you should submit a letter to the City Council asking for these extended hours to become permanent. This action was approved by Mayor Kimberley Driscoll on February 3, 2010. Very truly yours, 12 CH YL A. LAPOINTE CITY CLERK Cc: Police Chief Solicitor Building Inspector Board of Health SALEM CITY HALL • 93 WASHINGTON STREET • SALEM, MA 01970.3592 •WWW,SALEM.COM / MORRELL ASSOCIATES Current Date: 2/16/2010 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 2/9/2010 �osasu .sneers res (781) 837-1395 www.morrell-associates.com Customer#: FB13-10 C L Burger King#3564 L 10/16-LBK LLC C Highland Ave./Rte 107 I E T Salem, MA N I T 0 N BACTERIA COUNT Sample Standard Plate CounUg Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC ECEAj --® MAR - 12010 cn ti - BOARD r ri MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association,-2004 y_� J f owd a`if Y➢F':wtt ! MORRELL ASSOCIATES Current Date: 4/20/2010 P.O. BOX 288 Marshfield, MA 02050 Date Samples Taken: 4/712010 (781)837-1395 www.morrell-associates.com Customer#: FB13-10 ypll.tL{t IE60C111F8 C L Burger King#3584 RECEIVED L 10/18- LBK LLC C Highland Ave./Rte 107 A Salem, MA MAYO 4 2010 E T IN I T N wF Nt��,TM 1 BACTERIA COUNT Sample I Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliform s 50/g Other: SPC s 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products, 17th Edition,American Public Health Association, 2004 ac,aw or E#c=.w+'"h J ` MORRELL ASSOCIATES Current Date: 3/22/2010 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 3/9/2010 (781)837-1395 www.morrell-associates.com Customer#: FB13-10 C L Burger King#3564 L 10/16-LBK LLC OC Highland Ave./Rte 107 1 E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC r APR -12010 J, SALEM MASSACHUSETTS STANDARDS Machine: SPC!g 50,000/g;Coliforms 50/g ` Other: SPC!g 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 Board of Heafth oND1 Citp of �&alrm, flaggarWettg R, � ®ffire of the Citp Council ' _ I Citp A)all COUNCILLORS-AT-LARGE ROBERT K. MCCARTHY WARD COUNCILLORS 2010 PRESIDENT -1 2010 THOMAS H.FUREY CHERVI ,i' LAPOINTE ROBERT K.MCCARTHY JOAN B.LOVELY Cf MK, R MICHAEL SOSNOWSKI STEVEN A.PINTO a 9� JEAN M.PELLETIER ARTHUR C.SARGENT III ey V JERRY L.RYAN M�7/ 20 JOHN H.RONAN 20PAUL C.PREVEY QOgR4�FHF.'0 May 19, 2010 JOSEPH A O'KEEFE, SR. Ms. Melissa Goldberg Accounts Payable Manager Mastoran Corporation/LBK, LLC Franchisees of Burger King Corporation 822 Lexington Street, 2"d Floor Waltham, MA 02452 Dear Ms. Goldberg: At a regular meeting of the City Council held in the Council Chamber on Thursday, May 13, 2010, the City Council voted to grant permission to Burger King located at 259 Highland Avenue to operate during the days and hours of Sunday through Wednesday, 6:00 A.M. — 12:00 A.M. and Thursday through Saturday, 6:00 A.M. —2:00 A.M. with the following conditions: l.) These extended can be revoked at anytime with just cause. 2.) No eating in parking lot after the dining room closes at 11:00 P.M. 3.) Signage shall be posted in the parking lot and other appropriate areas that states"No Loitering". This action was approved by Mayor Kimberley Driscoll on May 17, 2010. Very truly yours, C ��,�. CHE YL A. LAPOINTE CITY CLERK Cc: Police Chief Solicitor Building Inspector Board of Health SALEM CITY HALL • 93 WASHINGTON STREET • SALEM, MA 01970-3592 •WWW.SALEM.COM I_.('4„k•, c .i I _ -�.- -'v "�\ .r^: ./'6..,.1wnr.'Ts r, hn-.. �.J•' .�.� ^"* I Massachusetts Department of Public Health Salem Board of Health l 120 Washington Street,4th Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax(978) 745-0343 Name D� T�Pa of Ooeration(s). Type of Insoection J( it IK(!I -///to -9-pFood Service ❑ Routine Address L i% I / .f Risk ❑ Retail ® Re-inspection r? (f e! d k Level ❑ Residential Kitchen PreviInspection Telephone ❑ Mobile Date--o`74 (" Owner HACCP WN ❑ Temporary ❑ Pre-operation UW LL` El Caterer El Suspect Illness Person in Charge(PIC) Time ❑ Bed&Breakfast ❑ General Complaint In:4K',' ❑ HACCP Inspector " h ) / Out: Permit No. ❑Other Each violation the ked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT . _ I _ I I I _ . , ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH ' rv' _ . ... ,. ., PROTECriONFROMCMEMICALS�� El2. Reporting of Diseases by Food Employee and PIC ❑ 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals - FOOD FROM APPROVED SOURCE; 11, 111' ' ' , , ❑ 4. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Nazardous Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 1 B. Cooling PROTECTION FROM CONTAMINATION `• El 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing CONSUMER ADVISORY ,- ❑ [122.11. Good Hygienic Practices Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code. This report, when signed below C x by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2)(590.0 order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(5so.004) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food �6. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 7. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: S 5901nspecfFomi614 dm11�/ //; � Inspector's Signature: - Print: PIC'sSignature: � �� Print: �! �,Mr��_ I Page lof '4ages a Violations Related to Foodborne Illness ' Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 18 Cross-contamination I 1 590.003(A) Assignment of Responsibility"•` I 3-302.11(A)(1) Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge* I Cooked and RTE Foods* 2-103.11 I Person in charge-duties Contamination from Raw ingredients 3-302.11(A)(2) Raw Aninuil Foods Separated from Each EMPLOYEE HEALTH I Other"` 2 590.003(C) Responsibility of the person in charge to i Contamination from the Environment _ require reporting by forxf employees and i 3-302.11(A) Food Protection- appbcantsx ! 3-302.11 Washing Fruits and Vegetables 590 003(F) Responsibility Of A Food Employee Or An ( ( 3-3(A.I t Food Contact with Equipment and Applicant To Report To The Person In Utensils" J Charge* ( Contamination from the Consumer I 590 003(G) Reporting by Person in Charge* I 13 306 14(A)(B) ( Returned Food and Rescmce of Foci* 3I 590.003(D) I Exclusions and Reatrictmns* I ( Disposition of Adulterated or Contaminated 590.003(P.) Removal of Exclusions and Restrictions I Food 3-701,11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food=' 141 Food and Water From Regulated Sources I 19 Food Contact surfaces - 590.004(A-B) Compliance with Food law., ' 4-501.111 Manual Warewashing-Hot Water 13 201.12 Food in a Hermeticalty Scaled Container* I Sanitization Temperatures* 13:.01.13 Fluid Milk and Milk Products* I 14-501.1 12 Mechanical W'arewashinn Hot Water 13-202.13 Shell Eggs" Sanitization Temperatures* - --- 13-20'.14 Eggs and Milk Products,Pasteurized' 4-501.113 Chemical Sanitization-temp., pH, 3-202.16 ke Made From Potablc Drinking Water- concentration and hardness. I 4-601.1 1(A) Equipment Food Contact Surfaces and I i 5-101.1 I Drinking Water from art Approved System' I 590.006(A) Bullied Drinking Water" __ Utensils Clean* 590.(K)6(B) Water Meets Standards in 3;0 CMR 22.0" I 4-602'11 Cleaning Frequency of Equipment Food- I Shellfish and Fish From an Approved Source I Contact,Surfaces and Utensils* 4-702.1 i Frequency of Sanitization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of Equipment*, Shellfish* I 1 703.11 I Mothods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP I.Wed Chemical* Sources* 10 ( Proper,Adequate Handwashing Game and Wild Mushrooms Approved by --- "n C 11 Cl 301 - . ean Condition--Hands and Arms Regulatory Authority 2 -- - 3-202.18 Shellstock Bdentification Present* ( I 2-301.12 Cleaning Procedure* 1590.004(C) Wild Mushrooms` 2-301.14 When to Wash` I 3-201.17 Gane Animals* ! I Il Good Hygienic Practices i S Receiving/Condition I 2-101.11 Eating,Drinking or Using Tobacco* 3-202.11 I PHFs Received at Proper Temperatures* I 12-401.12 ( Discharges From the Eyes, Nose and 13 202 15 I Package Integrity* Mouth* 3-101.11 Fowcf Safe and Unadulterated* 3-301 12 I Preventing Contanunauon When Tasting'_ 6 Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification * 590.0(14(F) Preventing Contanination from 13-203.12 Shellstock Identification Maintained`" ( Employees* Tags/Records:Fish Products I 113 Handwash Facilities I 3-402.11 Parasite Destruction* I Conveniently Located and Accessible 3-402.12 Records,Creation and Retention* I 15-203.11 Numbers and Capacities* 590.0040) Labeling of Ingredients' 15-204,11 Location and Placement* f 7 Conformance with Approved Procedures 5-205.11 Accessibility, Operation and Maintenance /HACCP Plans Supplied with Soap and Nand Drying 3-502.11 Specialized Processing Methods" Devices 3-502.12 ( Reduced oxygen packaging.criteria` 16-301.1 t Handwashing Cleanser,Availability 18-103.12 Conformance with Approved Procedures* I 16-301.12 Hand Drying Provision 'Denotes critical item in the federal 1999 Fond Cade of 105 0%IR 590.000. CITY OF SALEM I BOARD OF HEALTH Establishment Name: ,, n Id. 2c—� <�f�: ,� �// Date: /f�ii� Page: ::n of _21Item Code C-Critical Item O lv DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item - Verified ( PLEASE PRINT CLEARLY - � - I ""6n�.(i ��.J . .,r 4, , ? I 1I fv i U1 /'fir��t? �/� ., (�_�_//• /.�� I �7 , . tln 't U .. a ln..-/ �-1.. 1" /7��___ �./ .�h, i ler, f& I li�Y,� d lrYl V.J Ji'1G Alii/ / 7 (i n!n LvJ �' r Kt? 04 ,,,-J 'l A` ✓nT v � I lA,f.._� .".t r'n : (/i G�V� Zv. J �t/f0nt /ate,/ < p c. i I - I I I I I I ° I t i Discussion With Person in Charge: Corrective Action Required: I ❑ No UCS- Yea I have read this report, have had the opportunity to ask questions and agree to correct all gin—Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twent five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure ;our food permit. 0 Voluntary Disposal ❑ Other: f ?-5+t 1 Wt C:t PHFs Reserved at Temperatures Violations Rotated to Foodborne fitness Interventions and Risk i >u rding to Lay. Cooled to ' Factors(Items 1-22) (Coot) i 1=F/45"F Within a Hours. PROTECTION FROM CHEMICALS ( 3-501 15 Ctxrlin.Methods for PHFs 14 Food or Color Additives 19 1 PHF Hot and Cold Holding 3-50?.--(F) Cold PRFs Maintained at or below 3-202.12 Ad htil'es'r 5'Ip tx)atF, 41`1-15"F' 3-302.14 Protection from Urappimod Addltlycs' - i 3-54i.ibia) IhriNit cMaintaatedatorabove 15 Poisonous or Toxic Substances i 1.401' ' ` 101.11 Idrnu h'mr.infnrmatinn - Orlgieai 4 onl users^ ReJd at or abuse 130 V, I ?0'.11 C�,mmnn;vamr TimeasaPublic Health Control -21)t.11 \c>r.atx,n- SLnaCr` ------� ' i rini,: as a Public I iealth Control* -`� - --"-I ' -5- 1''t"mcC}ic"tint!?ICRC ?-�D212 t'nnd!d,»t:of t'[,::` , ! '-.'03 t, Cs';.i; C'tnxain.i: - Prrd::Ft ;tn;`; REOUIREMEt'!TS FOR HIGHLY SUSCEPTIBLE 104,11 4nmo'7e",C'ro,n:. Chooit.!ds, -7- 1 _ P PULATiONS tPfS — --- 1 - - --- ( ! -11 St!!. + ::,lt!:'np:,,cunicd Pre I'd,'(.pied Juices and int dad,n_}rtj,..rkir:,..f nt",'a_ j ( itocrra•trs with Narmm' Iabais' 0-t.ld_.—_ 1) at aatr.i;rarrm' ._- -- ----- - �--i--- - -'_'------� _ 2011.l! tin.i;,rn}a? F.,,kl trust„ct Lunn.::ass' 'r= i:..:: or P%al,ali`, C",ora''i Amaral F( ,d mid I ! ={;,,----- fJ,cF:+ ?' ,,t,ic: N... :',rttr:! .crf ' --- '--_Sr--_Ct_,-_`_- +i F:cd Pacl:acc %o, R,:-.cr;ea 1 ! __..�_.—__'"5^,t,t;i':);•in�--._ .---- -'-'---- —- -- CONSUMER ADVISORY T4MEITEI:IP”RA'k Uit'" CONTROLS + 2^ A;. :.:,t'•. i't,.!;•{ ; rr} ::,t`t;lnp;i::n c.t r"-------------*--' ----- %---'-', i ;!,la, t t-..W. 11ia= ec. R.,x. Cndct.�,x•r c:{, ; t 1 1tn prove Cook ;.;`e..ntpetaw sfa! 1 ---,i1 }: b1 ._. - �-.')liFs , .i��:,:I�C Pr.a:c'2:v'.'d :"ia,.?^nldd•C n " P' i 9j s 1(ti.};'fi:, ir:' � -',.,; 5,•d. Ha+ k.;'q + "'`s t;: •... .• SFEt.1t;L 8E`.:r1HF.N4ENTcu : : :) Rcbrat:na 1st`t")i rst•,,„S V Tr:. . .. :0 1S1_ ,: _ --i!'.1 i1 lila l:, i' il iv .e;. - Ilia:GiS'?�-.fits , . dG'.I ifhi ilit'.:':'nv2 iL^'I ,. ; mwrri S14:z:t:r,,', G„iP. ,-n,, . .., .. ,. x'tat',,i;: vrr, <:•'i .i,,, 40,3.;IW) i:-n.''s,fail. Pua..as' ;?`II F'',•l 7- P.% . . „ ?;<;,i}`,,la,;.J /•, 40-' ii(C; Reillrt!11n8,1.'1111!.a;.}ppgsc`?1 n!'li:-O lrem Lx'oOd fly N.!Pr3cFu:as^ FC_ 590 Ok i proper Cooling of PHFs •-7 Fyx;_,n,_--,rx}t'rC'a t!o',,"-..------'-fit= 1--• ---- _--_}___.—_.—_—_.___— 1 �r.i•:rriC--', hn6},;,,,y- g f_ ;s.�n i (, 5 Tris i l+r\7 :ln,bne C:w! `d PH1=c I,nn: LU^. ts' - -% - - -- ,, 7,i'F ,l,4un ? Iltmr t t- _ . ._ __ __Tit C-___ _ ' .ti i , .•t. Fri:;. ��: V-r ^FC.-., t OC`7 d:j7-5 F wt(1,11 a Pmts,. ' 3 2 - Po,e.r`.�u< `.;.�<.. t,i,te'._rs ----- FC 1 , t-ii it: � ; t_,!mi, Pk lb: 'tita.iy Fr'nt riathttN , _ -J Sp_�:,+'F.,;.,rrn:r>,,;: - -_�V Find':Cdii tTe (Ii:'fCy�CL::•t"�'1-;.fi l: � �!� ` {'il1Pr ' .. --. . 'kl,.:........_.;t,t":,m ti ,it u�i�: !.!„}',,wl, arc„ .,.. ':Pi •q.,ty f, Ar 6 l� t- u✓ _ ��`YV • .qtr , + v-rY. �rrr'w^.' ..aa..sT. Y., r .. s.s.T,}.,rehY. , . ..-«,..wrS..4...r}*'Ffi,nr:rT rh..,Jw�.',.e+r`""",.+..-�" '�"": 7 : t ( Ma achusetts Department of Public Health Salem Board of Health 1 kr 120 Washington Street,4th Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION,REPORT Tel. (978) 741-1800 Fax(978) 745-0343 Name ''_ Date Type of Operation(sl Type of Inspection /,Ilb 1/0� 10--Food Service .0_Routine Address ��nrC Risk' ❑ Retail ❑ Re-inspection Level ❑ Residential Kitchen Previous Inspection Telephone / E] Mobile Date: CIa Ci¢6 Llr� OwnerHACCP YM El Temporary Pre-operation I ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) I Time ❑ Bed&Breakfast ❑General Complaint j In:3-1' ❑ HACCP Inspector DOut: -D. Permit No. ❑Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ ; action as determined by the Board of Health. '.FOOD PROTECTION MANAGEMENT,,. .. ,,.. � ,. _. . .,.,. ❑ 12. Prevention of Contamination from Hands r ❑ 1. PIC Assigned/Knowledgeable/Duties W w_ ,,, ❑ 13. Handwash Facilities y EMPLOYEE HEALTH i PROTECTION FROM CHEMICALS .. ..... u., " ❑ 2. Reporting of Diseases by Food Employee and PIC -- - - - •- „ El 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals f.FOOD FROM APPROVED SOURCE „:M " " , "nNiEtTEMPERATURE CONTROLS(Potemla0y Hazardous Fends) ❑ 4. Food and Water from Approved Source ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans - ❑ 18.Cooling ;'PROTECTION FROM CONTAMINATION >,,�ra. Hot and CCold„Holding ❑ 8.Separation%Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY,SUSCEPTIBLE POPULATIONS(HSP) ❑21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing El11. Good Hygienic Practices CONSUMER ADVISORY ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board. and Risk Factors(Items 1-22): of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days`as determined by the Board today, the items checked indicate violations of 105 CMR ' of Health. 1 590.000/federal Food Code. This report, when signed below C N+ by a Board of Health member or its,agent constitutes an 23. Management and Personnel (FC-2)(550.003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) cited in this report may result'in suspension or revocation of 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food 26..Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you �27. Physical Facility (Fc-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above,address 29. Special Requirements (590.009) within 10,days of receipt of this order. 30. Other DATE OF RE-INSPECTION: S 5901ns IFom 14 a' 1/�-^�`' "- V ",d 0 n17 Ins ector s Signature: (/ Print: PIC's Signature: 1 Print: Pae of -a es .k Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 18 I Cross-contamination I 590,003(A) Assignment of Responsibility" ( ( 3-302.1 I(A)(I) Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge* I _ Cooked and RTE Foods* j 2-103.11 Person in charge-duties j I Contamination from Raw Ingredients 3-302.11(Ak2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH I I Cdrer' 2 590.003(C) Responsibility of the person to charge to I Contamination from the Environment require reporting by food employees and I ?-302.11(A) Food Protection* applicants* ( 3-30215 Washing Fruits and Vegetables 590.003(F) Responsibility Of A F(x)d Employee Or An ( 3-304.11 Food Contact with Equipment and Applicant'Fo Report To The Person in Utensils* l Charge, I Contamination from the Consumer 590.003(6) Reporting by Person in Charge* I ( 3-306.13(A)(B) ( Returned Food and Reservice of Fond" _ 3 590.003(D) Exclusions and Restriction," Disposition of Adulterated or Contaminated 590.003(F) Removal of Exclusions and Restrictions j I I Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Focxf* 4 Food and Water From Regulated Sources ' 19 Food Contact Surfaces I 590.004(A-B) Compliance with Food law* ( 4-501.111 Manual Warewashing-Hot Water 13-201.12 Food in a Hermetically Sealed Container* ( j - Sanitization Temperatures* 3-20t.13 Fluid Nhlk and Milk Products-' ( 4-501.112 Mechanical W'arewashing-Hot Water 3-202.13 Shell Eggs' I Sanitization Temperatures* 3-202.14 Eggs and Milk Products. Pasteurized* I 14-501.114 I Chemical Sanitisation-temp.,pH, 3-202.16 Tee Made From Potable Drinking Water- concentration and hardness. 5-I0I.I l Drinking Water from an Approved S}^.;tem" j 14-601.11(At Equipment Food Contact Surfaces and 590.006(A) Bottled Drinking Water" I Utensils Clean' 1590.006(B) Water Meets Stwidards in 310 CNIR 22.0" I ( 4-0()2'11 Cleaning Frequency of Equipment Food- , ( Sheldrsh and Fish From an Approved Source I Contact Surfaces and Utensils* 4-702.1 1 Frequency of Sanitization of Utensils and 4-201.14 Fish and Recreationally Caught Molluscan I Food Contact Surfaces of Equipment* Shellfish* I 14-703.11I Methods of Sanitization-Hot Water and 3-201.15 I Molluscan Shellfish from NSSP Listed Chemical" Sources' Game and Wild Mushrooms Approved by 11f1 ( j Proper.Adequate Handwashing Regulatory Authority ( 12-301.11 Clean Condition-Hands and Arens* 13-202.18 Shellstosk Identification Present* ( I -301.12 Cleaning Procedure* I 590.004(C) Wild Mushrooms` I 12-301.14 When to Wash` _ I 3-201.17 Came Animals* ( 11t ( Good Hygienic Practices g i Receiving/Condition ( 12-401.11 Eatinrz•Drinking or Using Tobacco* 3-202.11 I PHFs Received at Proper Temperatures'' ( 12-401.12 Discharges From the Eyes, Nose and 13-202.15 Package Integrity* ( Mouth* 3-101.11 Food Safe and Unadulterated * ( 3-301.12 Preventing Contamination When Tasting*_ 16 Tags/Records:Shellstock I 112 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* j 590.()(W(F.) Preventing Contamination from 13-203.12 Shellstock Identification Maintained" j Employees' Tags/Records:Fish Products I 113 Handwash Facilities 3-402.11 Parrsitc Dcstrucdon� I j Conveniently Located and Accessible 3-402.12 Records.Creation and Retention* I 15-'_03.11 j Numbers and Capacities* 590.004(J) Labeling of Ingredients` I 15-204.11 I Location and Placement* 7 Conformance with Approved Procedures 5-1-05.11 I Accessibility.Operation and Maintenance IHACCP Plans I I Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methtxls* I Devices 3-502.12 Reduced oxygen packaging,criteriaj 6-301.11 Handwashing Cleanser,Availability -.. j 8-103.12 Conformance with Approved Procedures* I 16-301.12 Hand Drying Provision 'Denotes critical nein in the Federal 1999 Food Cale of 105 CNI R 5001000, CITY OF SALEM BOARD OF HEALTH Establishment Name: l��, . . ^` c ti E� � 'r, ! �.. Date: / /a 1 /_o Page: of �t Item Code C-Critical Item V ✓ DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item verified / PLEASE PRINT CLEARLY �I I '/- ' i _� 'DA / L i /J.7"--J��1 /i.(� /l. ) n-a C rI- ,I✓ ��. /lir 7/i 1 /'-1�5 /�,. �r r'l /. ,. , /^t5ln Aw VsG , -F�./�n. r ) ,.,. O f O -43 an-ir -} l!ry ia.'lr ("liePn — , /n '`r `I" ' - - ( !lull �.n Y, nr�/ IG/J[l l..• _,� /'onlnin 7//10hy y.vi�� •.• - - ,• I, I,M SI �`l� �l/r/,.�,j� ,.� ��V-�L K/r,n� �Pr,� —rn �O�G � ) /fifi, '7L .J r/1:�L, -A4' /�S_l !'`14'-"� AW IiiII `a.Pa-rr A)z) G / �)�/n) ��/ �(.��—r/t r - C�V17AnCY 1..j,k1 0 A�/)Y1- r f//SOr AOW7"/ 4./ r'�O Discussion With Person in Charge Corrective Action Required❑ No \P' Yes °s I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ inspection, to observe all conditions as described, and to Exclusion violations before the next ins P ,�Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenA,�-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure yoqr food permit. �j�/(/ ❑ Voluntary Disposal ❑ Other: r k . _ JFT)o' IAl(') PNFt Received at Temperatures Violations Related to Foodborne Illness Interventions and Risk lcwrding to Lank Cooled to Factors(/teem 1-22) (Cont) I 41'F/45'1`Within 4 Houas x PROTECTION FROM CHEMICALS j SOl 15 Control,A'irthnd:>for PHFs j 14 j Food or Color Additives j j 14 i PHF Hot and Cold Holding j 3-202,12 Add tines' _j S0'.IhlH) Cold PHFa i lanitained at or below ' 54r OSk(i) j 3-302.14 Protection from t inapnro-ed Addulvel,^ j i };Q i i f+(A) I lot PI-{I=< %bintainecl at or above IS j Poisonous or Toxic Substances 1401_ ' j i 101.11 kh;ntd}'imt lnfi,rmadnn -Originalbf:l= K w,l,1-1a1d'Ai of aboee l3CFf'. + Containe[<' Time as a Public Health Control _ __ ,>_ Pin,+',a.. 1 Public ! elA!h r'unu'vh i-201,I 1 Say:u.uon-SU r,ate" --------___-� --j.---- "-" r l:..f">t`r2 nc"tlII�91i t1! 7_202.11 F:^et6oU on -Pr:•s<nu'.md i. .::' 7-'02.12 (lntdluon,of the" .- i 7_x()3 I I taxi' Container; -.P,oll:M:•+,n., i REQUIREMENTS FOR HIGHLY SUSCEPTiBLE - — — POPULATIONS(HSPS--� 104.11 Janie/err.('roma -Chemic !e' -- --- -..-�— j 7-'04 12 ('h,•ntit;lh i�,r W&hwlllo 1'rnd:,ce_(;i' :;,t' { 21 ! ;-Mt'..' A', t:n{`teurl.cd Pre I•,:c}'aced Jinccs and 1 7-.'.(1414 Drat){:.Agent..Crnr:ia'------ -- 7 20.5,11 - Ii.'rri.d!:-r-wa.iiI1.'s,,rvl PCr.v:ro;.l.atdt<.,:J.Cr:reca !-s - .- SU\ I.iI Eil;i3: UR',U oof r Piecat?::tuli.3il_':cCd lli..o!,�Ld.' Animal Fold and -206.!! 17-1pfs.1? ', r;t•c!'s' i>,x S:.nlon:,- ,- ,._- ____,_— •-.'Qn [; i l�ctc`r. ::e 'Inure: . i'�s;f.oa:r,, .utd ! ,-_.___._.. ._-_.-_1'_ -_..___- ._. \S,v ------ 5u"a?'R ADVISORY __ ! 1.' ,v 4-.'- II'--- ot,,L,:o� Al- re:, Fo<t'd +t f'ot:=umI tuon o; _ T1tt�FJt[(u?FERATtiP.ECOtdTRO_LS _ _ j Prap, Cokiv.g Tep-e.a__ 'vIia:,,i Fx .i f'tav .:rt Illi:', t'uden:wkrd,:; t'ri,t'S5:!: . i'ii,:un.lrr . r , or' '.t i.C��.S.:i,.,y„i,� t.., k.u•'7i;r?)_ —i ,F - '--;•",ll ,..- ------- _..._.___. -_.. __.-__.. . _..-..__..-._.__.____.J 40 ;I'„ c"7 - - K,t, "- i., rv,, { EPECW 71,EG:!R1zML TT, - -' -- Y , i(:11+_ .-. .-'4iR:ut�• q:: .:1 },t:.LS> - 1" , i' :: i i 5 ' '`. , ,,.. ') :!t!.:., ,,. < l J:.ltt.q ' .�V,•:1:.\: ti'.. II. I tA,.=tli" J,K,ti. teal”, ;lkl,. tai-, { '.S}o"t. tt.iz iht !:nl ! I aJ a . p,=?-ATED :'(}.,=.c t1 Fri 74•i. rh4 i:.:;: ;-ap}.:LAi;<,U• Pi-ii.. lh:"i ( • ;c Otcbt,23-,iii) -403,11(bI Mwi+ ,not +,: ' 'a , '. I I i` - 11:ept•J t:di` ;,n, a<i ,,.u, � ... 1! :., :.t.!,_ ii':h,r. .. •tP '"f.t,.k :n;1: Trn.. _ .a4• ;`t..,f: .,.rR=: . ., .. :.f"J;i, :r1"Itl!111= 11: ,,:.t 1.;• 3-403.1 itf) C„n;,,tzt:tail*. t4ca,;..:z' n-('s= I r...} :.... . a a': F . , . tc :.. ..a r,: :<�' :nrvd o,., ....rt ;,ii "IR t i " j t-#i7? !i(t : �,t'::,Fnirt^.Lrt,i,:::� i',,•;t<,^.t,, ll�c ttCm ' Goof}Reta,t Prac;rces _ _ — FC _.. -59G G0±. i _ tda:lag,:mc'•i a_,;Flt -- -- _FC- 2 - -k�,= -"- - iti I Proper Cooling of PHFs i `�''o•^d'c4xf P'ci��L<: . _ _ C- FC `+ j 901,; I(A) ! -,o,,!m:Gx,k•'d Pure fror:: 141'F b`i "pq,ryn±a4ld Ulong,:n ! n..`E' N',thtn 2llour:.i Irl ('nn;, t(i'i _-?Feo ity .VOi -- ' "t ' -50Lt6 7, Crrfu;,;blip= i+ ,4r Error:Uubiuu _ - _ _ ':r., ~•„r.u'cr„e'=�::__.._. _ ._ __-._ _ _.__ .i�:'a .- rC. ..,dAttc 1::;'re,1:ciuc it;7`:':.. 3' - ' CITY OF SALEM : BOARD OF HEALTH EstablishmentName:_EL. q�r, �j �,-� 4j:�iIr.,i,� Date: ��f �r�il Page: of 64 Item Code C-Critical Item(/ DESCRIPTION OF VIOLATION/ PLAN OF CORRECTION Date" t No. Relerence R-Red Item ((// . l ,- f ' PLEASE PRINT CLEARLY Verified ooI J22p � X n (r i fK—r/1 IJ r"oc, e �r l - - I)1r^a_�rl h ,1y/1�7 n/G/� _7/' .(/1_ /_ �)T,IJ-/�/.�.,( �.f��/��, 1 '� v.Lli c i, 1Q�/ A lY , 1 Yom///, r C�iF r D ^t—' Y�7 l_O I/�'h I/� �e�n�r, I 1 11 l I i�Co �a _I� .-_n.--„_ ��nit;S n l/""_�•{l.rZ/,vi v.�.K� r_!n l_c. ��jv� �_ �O/i�,l�l}-- t—,_��v� �,ofi��On � , 'r lay`. RA P "1,1 or-.i A—,I / k i.lf ev/ _CZe, L. _Ie vi/117r A)?,, A n�;�'r0 „An Ir?/iV`7 ' 3a f n,...., , 1, (kI 1 4;, Nn Yl /llcvr /, i„ nl-� c.Jn fI I1� 1� -T�1 (C�cLi,rlQ rte, /�i� r1 ,fie / n� 1�R✓t �� .ti ro� 17 , he-, Ck rlMr --t- -;(1(0,,, /AJ orleri C An, d os,r MoPfJ �AJ.l(f UF`I-rUeC�3S'�rt� CGL)invtr�tid .r-�,n/m Discussion With Person in Ci / Corrective Action Required: ( ❑ No Yes {)*. I have read this're, Ort, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ a., Exclusion violations before the�next ifispection, to observe all conditions as described, and_ to `p le-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that X{, noncompliance'may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. / /}� ❑ Voluntary Disposal ❑ Other:' I - , ) F�1_! Uri'} PHFI,Reuived at Temperatures Violations Related to Foodborne lllness interventions and Risk t :According to Lay. Cooled to Factors(1feMs 1.22) (Cont.) _ ( 41`1-14 Yf Witbin 4 H,furs. � f 3.501 15 i� Cooling Method.for PHFs PROTECTION FROM CHEMICALS IY I1 ( PHP HM and fold Holding 14 i Foo or Additives } 1-501 Witt) I Cold PH1'n Maintained at or belmy 1 ?-2U2.12 � .4dihtivo,*tive.' � i C9tt,1,k)4tF' 41°?45°1'^ 3-302.14 Prutecoon from L'nappro%ed ,kftd¢ivcs" 1 90,i 40-, 410 PI-IF,Maintained ai vY above Poisonous or Toxic Substances - Iol.11 bh'nlifvin' Intcemition -ikY,_"na: Id0l-, * ! ! b ^.. 2_Aa Ih{',t K„•ess,Htld a,or.ttwir. — ~'' Kt2 i t C ctum"n S'smc - 41,,;'{,•.c Time as a Public Health Control --`-- ,,, -_ as a uhh+ U::airh Contra'_ Seom.tu+,n-5a..ip -- - - ,t a -`-=`- -------- ---- }:' i� I air .• f'' tr t'or -I'1:'s:nac ur' t. ^ '---._- -- -- �-��--t-l-- --��-u Mt7,i .;: c ,.r; 7-:02.12 (Lndn:,af,+t(ll',c" ',( i 11 i `Co;.ic f'onu7 net: -1`S f>;t;>:: '+t. REOUIREMENTS FOR HIGHLY SUSCEPTIBLE --. - --- -- --- -- -- POPULATIONS{HSP 04.11 5ani:�'ret•.t'nlcrc+_-i'_h,utit:,ir -------- ---�--- —.— -.— t 7_,N 2 4 <`ittnu:,da t%,t tN,tahu.:c t' nw,.:.t n':�,.Y ' =€—i -t`t' it,l7 Cnpy.tcur,r:d Prs,+„ct_._V.l Roct.wid I .. -.--. _. taint I____ _ _ _ .-_.__ _____.__ .�-Ft1: Iiiii� 2.t'o; F'aaru:i..:d Get:• � ',;�.l l _— v tl}.+d:rt � f axj,',•nt � t.d,.,`ae '- ----- ---- . if .,I §! P.c!'a?i`, .:b.:d ..:tm _ a � -7 .-'�o.lc ti,c! L, 4.i•{ 5�.:i inn:_ i._--_ - : • .f,: }2 ('t alt„?:;'1, t ,• ., t______.__-_. __»__.___._-.... ._ _- _- _-- ..._....__..-_._. C.r,'�5.N5,10 FijCY{ :gryVft'0r{Y FiP4ci'i Ffri"L?aA'!'f1F£: (;:i."l i i`:",. 21 i'u;;.. . i l +.r'.HP: , i + v. . i Int 1 (_i 1 •y_ _ >t,i.ib4r ,, ... '" "; ......: <.::" I :::ut ai S',.. .. 'v=..:xz-' ..;,r• ! : _ 9,1 c: i.:1:,'.::;.h ill it Int''1: .. " iltat:g rt :): , ,:..,,.p a•; .. •� L G:'�'Si:,'.'iif, .�4d•' .: ,.C'i.. ,r.. ,;... .,i v , v,. :'•..:'t; :: , r Of J IIC. e' ..,.nl't.,,d la !'t,n^ .,., ,i;il .. ,n:. . <. .,., cC ..... '', . ,<v:; .:if ' !r( ' ,"; , -j i", f*•':^<n: =i•t! ItarA T C:eod Reru,i f-r3C_.tm:rs ti;.__. F6:A1',rat`-tuYS t"�icChn: -- -_.. •.4ir- ,r.' a; P,over Coating n*PHFs i : iPi :r,a.t oh•,' —� r =:•tt,.r . PHPr :,,qa l :0, f , ta: t1E:-,r.•; Fr�'__ �• . _ i .. i_`.___.. r _ _.. . .. .. ....... .. Y 411U;1 7 titt,lt�:.:'!I IYU:n +�1. � •Y Ctn�� r� r ��Fr F( _ • }' t,.t!IIi Of • I-. 1 ....h::\;: - J n'a,C'I`..e .➢f.'.. n „ 'ae i'i iF: \i:., F,^n. ,. i .'''__ _ .. - �:• fifth-: - .- .._ ._ .. .. tin,:";di:RC !:.t n,i•r,.t< ;: i CITY OF SALEM BOARD OF HEALTH / Establishment Name: df. ,f�r�z 4�: t L/� �E �(r. ywA ,lr_ Date: I„z�,)t J ,r Page:Z) of /! Item Code C-Crltfcal Item%T Reference /DESCRIPTION OF VIOLATION f PLAN OF CORRECTION "/oate R-Red nem _ r PLEASE PRINT CLEARLY -� Verified If 'I(� I" 1 _ I,`.+_ ... rte-• + vir r� , r i— -� f '..� c J J � rr tA) i .-�., r y , /= r lr.n.r �i^. . .w-/.Jt` ILI ,��, A4 r s?0 �..1 t!av lw � C�- .-��. ?� � ��lU��' 1,J� �y,-L✓ C-(, Ir,,� � (.r/ Irk .��i�rrlG !"�G _�1�.+, II i /^ f 1 i A� 1)_ _ r't D.+rti t Iry .Z / +tAbirf': t.A f c7000� /n.-1 �I/l-110/1 I' A' cel Ar)ICI CI -k- aAVla�t i Discussion With Person in Charge: T III Correct ve Action Required: ❑ No p —Yes f I I have read this report, have had the opportunity to ask questions and agree to correct all ❑ voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion }� Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. i understand that /f noncompliance may result in daily fines of twenty-fivelollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. d {/v 0 Voluntary Disposal ❑ Other: r?-51 r 1.)4W) —-- PHf f<Re.c•rved at Temperatures - Violations Related to Foodborne Illness fnterventions and Riski Acwrding to Lav Cooled to Factors(!tents 1-22) (Cont) ' 11`7=/45"1=Within l Hours. }-Sd1.15 Ctxrlinglklrtho& for PHF,, PROTECTION FROM CHEMICALS ' i9 I PHF Hot and Cold Holding 114 Food or Color Additives 2(t?.12 Ad Ltiecs" I 3-5(t..la il) Cold PHFs%lamtained at or below I 303.14 Protection from Unaopro',ed Addcnes' Iv; 1> I1 Poisonous or Toxic Substances i L I b :1; f int PHI-1\tain(ttmed at or aboir If1i.11 Idemify}tt' infn:mat:nn Ougmti a0't E tn,,i ib;.\) Rt+?at: Ncfd a;or.,bot: 1301., + ' Time as a Pubic Heafth Cann of : ,�IZ.1( {:,:mnnm tiara: 41�„r6 i.;,„ ,mt.nnor>' I �----i---- --__- --------`----- l? 1 "i- -------------- -----' ^_tY'! f;�ct;iu:on Pr'xncc and 1•... 1 7-202J2 I C,'udttion,of REQUIREMENTS FOR HIGHLY SUSCEPTIBLE f ?'4311 f Toxic fl,ntamcv, -Iflol WtOl � POPULATIONS IHS S:uuu.-.et;.Cn u'na-_Ci,cmii= - ----- --1---:---- —_-- r2�4.1� mf,,t I.ln},nrcun coai d Pr:-,:��}.:: cd Juict: d kt•;e;;^ca'.tni: \t'zrri �i:;l'ais ! i 204.14 _ D_r'iu,: •lcrnt'. pa,lr”; ed I.m..,` I r ...'•5 i? Incw-arta! kn>;J CcLubv u^t s . ,can'� ----- k_�.—._�____ :'.v,.r . Cuts::i 4cttn:;i Ftt.x.3 and pr, i) P«.iru't:i is>r Pe. ILA" {'i,rp: __ :IX',. t ac',;a_'r lr R•: �cne? I It.:.king f'1d}J lTLL@cE16ATfsRC COW HGLS ., ,r` .*an.,. tt:•:.: t' 16 ! I Proper Cookfrg; t„per MI's i,-,for , L7 +i I r ! HO a::Rn3 f4, ,'�� !i� 9}', i• ( I ti” 61 F _ _ i{SBies. ?%_Ai37 r : ,fd:.t: �, .,. . ... . C:n,u..:::1aiP (°:u,z,::.; !i!! i".r1 ,4rut.. ::r.,.> r.. ., .. -. •i3• f�,. . . ,,,?:',...i�. . . ilii hh( ' ... ... 5f:i i `?i:: i Remau+rtr,Ln,l;reu F„.a,�n�of tstr: lisa+ Goe:?+;e:au PrnC+,•es .. .'C' -3J Obi1. . i dS i 24 ' I Prapet Coaling of PNFy _. , 1t2,X9,'.9 d Plil=: �o,c: 1d`i'('i,�' :_ ,. - - 1n"E tYuhut Z !iot„:,;:ui (-r,::,i r'rt. ;ff - - - ,- Mad. E'n'et:unt'.c„t I -- , . . 1 lit_ __,.Ott:... ..- - ..- - __.---- January 8, 2010 Mr. Jim Shalkoski Massachusetts Via E-Mail i shal koski a,,whooner.com RE: Dear Mr. Shalkoski: From time to time, we receive inquiries about the propriety of handling Burger King® sliced cheese on the sandwich prep boards at room temperature. In order to address some of these questions, I have attached some reference material for your information and further distribution as appropriate: 1. Guelph Food Technology Centre microbial challenge and shelf-life study showing Burger King sliced process cheese can be stored at room temperature 24°C (75.2°F)for up to 24 hours with no significant increase in bacterial level, including pathogens. 2. An expert opinion from the Food Research Institute at the University of Wisconsin stating that, due to the cumulative bacteriostatis efforts of pH, salt, fat and(the lack of) moisture in BURGER KING product, there is little risk of pathogenic microorganisms becoming a problem in our type of operations. 3. Several published articles demonstrating that pasteurized process cheese does not support the growth of pathogenic bacteria. 4. A copy of BURGER KING'S Operations Manual description of proper prep board set up. The limited exposure provides ample protection for the cheese once its package is opened. 5. Excerpts from the FDA's 2009 Model Food Code, which states that it is acceptable to hold ready-to-eat potentially hazardous food outside controlled temperatures as long as adequate controls exist over holding time. BURGER KING operating procedures provide this control with a 4-hour maximum hold time. BURGER KING CORPORATION 5505 Blue Lagoon Drive•Miami,Florida 33126•Phone(305)378-7917•Fax(305)378-3402 - 2 - Hopefully, this information will be useful for those who may be interested in the rationale behind our standard cheese handling procedures. If you have any questions, please call me at(305) 378-7917. Sincerely, BURGER KINGCORPORATION Mary L. Sandford Manager, Food Safety and Regulatory Compliance MLS/dfb Enclosure(s) 1 �� January 8- 2010 Mr. Jim Shalkoski Massachusetts Via E-Mail i sh alkoskinwhonner.cont RF,: MAEaAW (ICE. Dear Mr. Shalkoski: In response to your inquiry concerning mayonnaise and tartar sauce, I have enclosed some technical publications including a third party microbial challenge study and third party lab test data referring to the microbiological stability of mayonnaise and mayonnaise based condiments. As you can see, the fundamental chemical characteristics of these products preclude development of pathogenic (food poisoning) bacteria. Burger King label products, such as mayonnaise and tartar sauce are typical in that their pH values are under 4.0. We feel that, as long as mayonnaise products are handled in a sanitary manner, they do not require refrigeration. If you need any further information or assistance,please call me at(305) 378-7917. Sincerely, BURGER KING CORPORATION Mary L. Sandford Manager,Food Safety and Regulatory Compliance MLS/dfb Enclosure(s) BURGER KING CORPORATION 5505 Blue Lagoon Drive•Miami,Florida 33126•Phone(305)378-7917•Fax(305)378-3402 I You're preparing salads or sandwiches for a summer outing where there s no refrigeration. You'd like to add mayonnaise but you're afraid that it will hasten food spoilage. Should you take the mayonnaise along and mix it in at the last moment or leave it out altogether? Neither, says E. M. Foster of the University Of Wisconsin- Madison Food Research Institute. "The popular belief that mayonnaise stimulates the growth of food poisoning bacteria in food is false. In fact, just the opposite is true. The sooner you add the mayonnaise, the safer your food will be," advises Foster. Salmonella and staphylococcus bacteria frequently cause food poisoning. Saimoneilse are aften found in poultry, eggs and other animal products. Staphylococci grow in soft, Creamy foods. roast fowl, baked ham and chicken, ham and potato salads. Foster explains why these bacteria won't grow in mayonnaise: by law• mayonnaise and salad dressing must contain vinegar, and it often contains lemon or time juice, These ingredients make mayonnaise very acidic. The pH of American mayonnaise,a measure of its acidity,is below 4.1.salmonellae and staphylococci need a pH of about S3 to grow.In mayonnaise alone,these bacteria will die off in ' a few days. "Pasteurization destroys sa€moneltaa, but the U.S. Food and Drug Administration doesn't require manufacturers 10 pasteurize the eggs they use in mayonnaise because they know that salmonellae and staphylococci can't live in an acidic product like mayonnaise," says Foster. Food Research institute scientists recently conducted an experiment to demonstrate mayonnaise's effect on these food poisoning bacteria They added the bacteria to plain chopped up chicken and ham and to Chicken and ham • salads Prepared with mayonna€se. After leaving the foods at room temperature for 24 hours, they measured the bacteria levels.The bacteria grew very little in the salads containing mayonnaise, but they grew rapidly in the plain meat, reaching millions par gram. This proves that mayonnaise inhibits bacterial growth, explains Foster. it does not stimulate growth as many people believe end £.N.t /November-0eeember 1978 a U .S . Public Health Service FWAI 2009 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service • Food and Drug Administration College Park, MD 20740 Potentially Hazardous Food (Timeffemperature Control for Safety Food). (1) "Potentially hazardous food (timeltemperature control for safety food)" means a FOOD that requires time/temperature control for safety (TCS)to limit pathogenic microorganism growth or toxin formation. (2) "Potentially hazardous food (time/temperature control for safety food)" includes: (a) An animal FOOD that is raw or heat-treated; a plant FOOD that is heat- treated or consists of raw seed sprouts, out melons, cut leafy greens, cut tomatoes or mixtures of cut tomatoes that are not modified in a way so that they are unable to support pathogenic microorganism growth or toxin formation, or garlic-in-oil mixtures that are not modified in a way so that they are unable to support pathogenic microorganism growth or toxin formation; and (b) Except as specified in Subparagraph (3)(d) of this definition, a FOOD that because of the interaction of its Aw and PH values is designated as Product Assessment Required (PA) in Table A or B of this definition: Table A. Interaction of PH and A„,for control of spores in FOOD heat-treated to destroy vegetative cells and subsequently PACKAGED AW values PH values 4.6 or less > 4.6 - 5.6 > 5.6 <0.92 non-PHF*Inon-TCS non-PHF/non-TCS non-PHF/non-TCS FOOD** FOOD FOOD > 0.92 - .95 non-PHF/non-TCS non-PHF/non-TCS PA*** FOOD FOOD > 0.95 non-PHF/non-TCS PA PA FOOD PHF means POTENTIALLY HAZARDOUS FOOD ** TCS FOOD means TIME/TEMPERATURE CONTROL FOR SAFETY FOOD *"* PA means Product Assessment required a 15 Table B. Interaction of PH and Aw for control of vegetative cells and spores in FOOD not heat-treated or heat-treated but not PACKAGED Aw values PH values < 4.2 4.2 - 4.6 > 4.6 - 5.0 > 5.0 non-PHF*/ non-PHF/ non-PHF/ non-PHF/ non- non-TCS non-TCS non-TCS food TCS food < 0.88 food** food non-PHF/ non-PHF/ non-PHF/ non-TCS food non-TCS non-TCS food 0.88 -0.90 food PA*** non-PHF/ non-PHF/ non-TCS food non-TCS > 0.90 —0.92 food PA PA non-PHF/ non-TCS food > 0.92 PA PA PA * PHF means POTENTIALLY HAZARDOUS FOOD ** TCS FOOD means TIME/TEMPERATURE CONTROL FOR SAFETY FOOD *** PA means Product Assessment required (3) "Potentially hazardous food(time/temperature control for safety food)" does not include: (a) An air-cooled hard-boiled EGG with shell intact, or an EGG with shell intact that is not hard-boiled, but has been pasteurized to destroy all viable salmonellae; (b) A FOOD in an unopened HERMETICALLY SEALED CONTAINER that is commercially processed to achieve and maintain commercial sterility under conditions of non-refrigerated storage and distribution; (c) A FOOD that because of its PH or Aw value, or interaction of Aw and PH values, is designated as a non-PHF/non-TCS FOOD in Table A or B of this definition; (d) A FOOD that is designated as Product Assessment Required(PA) in Table A or B of this definition and has undergone a Product Assessment showing that the growth or toxin formation of pathogenic microorganisms that are reasonably likely to occur in that FOOD is precluded due to: 16 (i) Intrinsic factors including added or natural characteristics of the FOOD such as preservatives, antimicrobials, humectants, acidulants, or nutrients, (ii) Extrinsic factors including environmental or operational factors that affect the FOOD such as packaging, modified atmosphere such as REDUCED OXYGEN PACKAGING, shelf life and use, or temperature range of storage and use, or (iii) A combination of intrinsic and extrinsic factors, or (e)A FOOD that does not support the growth or toxin formation of pathogenic microorganisms in accordance with one of the Subparagraphs (3)(a) - (3)(d) of this definition even though the FOOD may contain a pathogenic microorganism or chemical or physical contaminant at a level sufficient to cause illness or injury. "Poultry" means: (1) Any domesticated bird (chickens, turkeys, ducks, geese, guineas, RATITES, or squabs), whether live or dead, as defined in 9 CFR 381.1 Poultry Products Inspection Regulations Definitions, Poultry; and (2) Any migratory waterfowl or game bird, pheasant, partridge, quail, grouse, or pigeon, whether live or dead, as defined in 9 CFR 362.1 Voluntary Poultry Inspection Regulations, Definitions. "Premises" means: (1) The PHYSICAL FACILITY, its contents, and the contiguous land or property under the control of the PERMIT HOLDER; or (2) The PHYSICAL FACILITY, its contents, and the land or property not described in Subparagraph (1) of this definition if its facilities and contents are under the control of the PERMIT HOLDER and may Impact FOOD ESTABLISHMENT personnel, facilities, or operations, and a FOOD ESTABLISHMENT Is only one component of a larger operation such as a health care facility, hotel, motel, school, recreational camp, or prison. 'Primal cut' means a basic major cut into which carcasses and sides of MEAT are separated, such as a beef round, pork loin, Iamb flank, or veal breast. Priority Item. (1) 'Priority item" means a provision in this Code whose application contributes directly to the elimination, prevention or reduction to an acceptable level, hazards 17 Lliaa Do qua hoof the laths ahoul mag000aiso? Who Is The Associalloo for oressins _ Mayonnaise is one of the safest products you can • s.. : .:a.. bring to your next picnic - r ,p„ `" or event. It also contains - The Association for Dressings and Sauces is aninternatian2l Vitamin E and heart-he - x, j ' ' Ip•}: ° - s. ' 'S).: association of salad dressing, mustard and other "" ``' r. "`• _ ods.You may have heard some g ,a.,'. -":,. a s'.•',..e. condiment manufactureransuppliers. Web s d their suppliThe ADS of the fallacies about this ver- ,wwtermn and on � �, "'' � �, -7.` / sitedressings-sauces.org,contains infoatiod ti satile condiment,such as C.^. mayonnaise safety,links to government agencies providing food mayonnaise should never Fns,. safety information and health related research associated with be left on the counter °_%' industry products. - or that it jar of " � '• mayonnaise --�:�;:. shouldn't be left - s*i = in the sun.but .`yf"` �^`-� \ / these are wmmon - `• "" ; misconceptions e •,„ s,w,,;,;•t% K ; that are just not true.We'd like to enlist F' F',u. -' ''• ""your help to spread the word about mayonnaise! More than 60 years of research has proven that commercially prepared mayonnaise does not cause foodborne illness. In fact, these commercial products are carefully prepared with ingredients such as vinegar,lemon juice and salt to create an "" f unfriendly environment that slows and even inhibits the ', '`t •I. .,� grovth of bacteria and,indeed,can kill it.Commercial meyo- - '„ /" -'� saX' T t nnaise and mayonnaise-type salad dressings also contain pasteurized eggs that have been heat treated to destroy harmful bacteria and ensure product safety, so you can be sine about inviting mayonnaise to your next piclue or gathering. ., . s ¢ j3t TME g5SOC1AilON f0& y'+ "�"\ 'y'�,a•+ (y �•'!a Mayonnaise can also be part of a healthy diet. Mayonnaise DRESSINGS - contains Vitamin E, which may protect postmenopausal 6 SAUCES 5. women against strokes,according to research published in the fonrrEn /uurnnl of CInlirnl NuGitian.A study published by The For more information on dressings and sauces;contact u': 5s;•= New Elig(nnA Jaurnrt(of Medirine also found a significant recur _ - - :�:; a• ..- {;M•,.•�K, The Association for Dressings art&Sauces`. - "};;Nis .$,,1,:. tion in risk of heart disease among women who ate the most - . " >r:»; ,,.;r.,.a,,.. 5775 Peachtree-Dunwoody Road _ ,.a: �,, •, _ Vitamin E-rich foods, such as mayonnaise. Additionally, did Building G, Suite 500,Atlanta,GA 30342 - - • you knoll,that mayonnaise is naturally free of Gans fats and is .,°•.i y;=,+:°�F` (404) 252-3663 bF. . made with heart-healthy oils such as soybean and canola?And }{ made with omega-3 fatty acids, which E-mail:ads r�kellencompanyn some mayonnaise is com s_ r, E rya s.-sjt. 4a,� 41w�• g Web site:twvw-dressings-sauces.org �r"sa`t -•n "' ^„ zu, have been shosar to reduce sudden death from hear attacks < ;:at ssm.�- "' :'"n• ' ,and have also been linked to the positive treatment of de res• - - .g�-a •r" • ' - -€'de"""=' K° n;c, cion,arthritis and colon inflammation. a 'r' q' `Y's• s-.t =' - `' ` ' ' - '*'-_ m(}ppvlight 2005 by The Axsnclatinn for Urcssings and Scums. 'E Mf+�=s^' -` a .:Y-�_ ' ''" •` ;;}„ ''- [permisslnrt to re not firm hlnke,Wine Mnvnnllnieu!in witnlcroµ,-°'' x''°�`_i`r;+;f; �..',y,?�°'�•'��.,; Read on to learn more and Make Mine Mayonnaise. P 3;� e",,,�•�,: or in part is granted provided customary endit is given _ 1r r { : 4� qr� _•n a '^'ylµ4,-, ;'r } yx a $F f .. .-_,.,_.,. .,.... .,V :-v':7?L�'�:r,� ;:,x>:•.:-7s�=-.mat;'=�-„:,w;h - —p Some QQ�� J e QQN'5... Q. Where did the "mayo myth”begin? q t QQuui�p 9h o 9 A. Many years ago, it was not unusual for dressings,mayon- naise in particular, to be prepared from scratch. When making "Commercial"Cornmercial mayonnaise is amort the safest of foodborne illness. Is this true? g mayonnaise,home cooks used unpasteurized eggs hdhich scientists foods when properly handled.Most harmful bacteria A. No. Commercial mayonnaise and mayonnaise-type dress. now know can sometimes be contaminated by Salmonella bacteria. die off within hours in the presence of mayonnaise, Ings are carefully prepared under strict quality controls. These Also,homemade mayonnaise,unlike commercial products,may largely due to its high acidity." commercial products contain pasteurized eggs that are free of not contain enough salt and vinegar to counteract the growth of P P di Mlrhrtel P. Doyle, FM1.U.,.1'rofrasor and Dinrctor, Univtrsity of Ga+gin, Salmonella and other dangerous bacteria.Additional ingredients harmful bacteria. The introduction and advancement of coo- 8e g Cnuer for Frond-Safrtp . such as vinegar and lemon juice create ahigh-acid environment mercial mayonnaise has given American consumers access to a that slows, even stops, bacterial growth. Salt is also an variety of good tasting,safe products. - - - important ingredient in commercial mayonnaise - "Commercial mayonnaise and other. commercial that contributes to the unfavorable environment ' dressings are prepared under strict.quality controls, for bacteria. �"-��''�F> Q. How can I make sure the foods I serve and acidulents and salt are added that prevent the at a cookout are safe, growth p wth of food-poisoning bacteria.In fact,hazardous bacteria die off if placed in the commercially prepared Q. What happens if I leave mayonnaise s A. Remember these simple rules from The Association product." unrefrigerated for a long period of time? ' ' for Dressings and Sauces and the U.S. Department of `` ••' Agriculture: Doe as L.Anhei;Ph.D.C/mtr, Uuiversiy ofFlorida,Department of Food A. From a food safety standpoint,commer- and Science Nutritiomftrnter Adutg Deputy.Dirnctor,FDA's Centerfor Fwd, cial mayonnaise and mayonnaise-type _ Avoid Cross-Contamination. Wash hands, utensils Safety and Applied Nutrition - dressings are perfectly stable when ga` and other food contact surfaces after contact with raw stored at room temperature after .c"' meat or poultry. Make sure all salad and sandwich "Contrary to popular opinion, mayonnaise and opening.Quality, not safety, is the _ ingredients are fresh and properly washed. salad dressing when added to salads or sandwiches only reason the labels on these products suggest that they be '. ;_<% practice Cleanliness. If soap and water are will not increase spoilage or public health hazards, refrigerated after opening. a unavailable, take along disposable, wet hand- but actually retard'spoilage,and growth of pathogen- Refrigeration or a hand sanitizer to clean hands before ft microorganisms." Refrigeration ensures that the commercial7;' ' t and after working with food. mayonnaise keeps its fresh flavor fora Richunl B.Smia7fi " e,P .D., Minvl+iolo o Mays and Sn(nrl Drtsr(u Y P S+'I Y S longer period of time. Please review - - +i+h ?; Keep hot foods hot and cold foods ARevien,"Journal of FW Fmtectim+ the product's label for more infor- cold. Kee perishables in a cooler with P all P oration on storage and shelf life. ice or freeze-pack inserts until serving time. - T ,� . ..,w+ ',"' ."Mayonnaise is not the cul. .� a,,.5�_. , .> "wtzs".".`: Make sure that food is cold or frozen to r :,M; �.,,r...eyg�.,1,u.,11y 1 •.r prit in foodborne illness. touch before placing it in the cooler or cold Q. If mayonnaise isn't a food %"�. 1yrc5-': -i thermos.Use a thermos designed for hot foods to The culprits are foods that safe problem,what is? :;�} `�' `'' s r i .. B -.� are not prepared,served or safety p keep soup,chili and stews at a safe temperature for - ...�, �„w �'; _' stored properly.” A. Unsanitary handling and preparation of several hours. Refrigerate leftovers at 35-45°F within : ,`'^ foods in home kitchens and Foodservice operations P g are ,WAS J, 1i'"�'n`�4 f, two hours when the temperature of the food serving area t{; :.� Y;. ,"e-:r+s� . Anierimu Uietrnr pose the greatest threat of bacterial contamination of food. is below 90°f and within an hour when the temperature is above 90°F, . - According to the Centers for Disease Control and Prevention, foodborne illness cases are often traced back to:raw foods that • Don't hold the mayo! Today's commercial mayonnaise are mishandled or contaminate other foods;undercooked meat. products are made with pasteurized eggs, healthy oils and poultry or eggs;and,unsanitary kitchen habits and poor storage the right blend of vinegar and salt to impart good flmror and temperatures. Many of the foods typically used with mayo- fiht bacterial growth. So not only can buss consumers B g Y Y nnaise, such as chicken, ham or potatoes, arc much more enjoy the good taste and convenience of commercial mayo- susceptible to bacterial growth than the mayonnaise itself. mhaise,they can do so with the assurance that these productsWhen preparing these foods, follow proper procedures for have been manufactured under the strictest requirements handling and storage. that meet and exceed today's food safety standards. ,31: �a,4`�s'`- r+,,"ha - - ::G%.- s.�.,,•s �%':�:,y�[ .;e::.�„- - -;:! .,, ,;at. _..;.q"".... .-,;_•;:. ::e�-: - " .,'T - 1"� "_jt?d°�#d�8: V 9� 05 �'k..rw'f'.z'S.-.t.-.•` _ - I .,,2,f.S.i�l*�,q{ �aa t�,'Ja k'. g,�7,�3�*''Y-i . ._•f„ .t. a d0��,y a ,�itx _ tClt 'w.r•,s.a.,: - ,j.y K-, f?y*x C"F• ( n p�::i»3'W,'h;' '4P v •I .Sv j < ..'.i ^4, .Y.�` Mayo Clinic Staff, Mayo Foundation for Medical Education and Research (MFMER). 2005. Excerpted from MayoClinic.com, August 12,2005. "Mayonnaise: A common cause of food poisoning?" "Commercially produced mayonnaise is an unlikely cause of food poisoning. This is because it is made with pasteurized eggs, which are heat treated to kill harmful bacteria, such as salmonella. It also has a high level of acidity—from ingredients such as vinegar or lemon juice— which inhibits bacteria growth." Agricultural Research Service, United States Department of Agriculture. 2005. Excerpted from the Journal of Food Protection, August 2005. "Effect of Mayonnaise pH and Storage Temperature on the Behavior of Listeria monocytogenes in Ham Salad and Potato Salad." "...mayonnaise, regardless of its pH, has an effect in reducing, but not preventing, the growth rate of L. monocytogenes in ham salad. The growth-reducing effect was likely derived from the acidity of mayonnaise." "Since potatoes alone support growth of L. monocytogenes,the inactivation of L. monocytogenes in potato salad is likely due to the presence of mayonnaise." Food and Drug Administration. 2002. Excerpted from the U.S. Food & Drug Administration, Center for Food Safety &Applied Nutrition, Foodborne Pathogenic Microorganisms and Natural Toxins Handbook ("Bad Bug Book"), Pathogenic Bacteria, Salmonella spp. "Commercial salad dressings and acidified sauces are microbiologically safe. Manufacturers follow strict quality controls and diligently comply with FDA-mandated Good Manufacturing Practices in production of these commercial products. Commercial salad dressing and sauce products are also made with pasteurized eggs that are free of Salmonella and other pathogenic bacteria and further ensure the safety of these products. As such, these commercial products do not have the food safety risks associated with their homemade counterparts, which contain unpasteurized eggs. Homemade versions also may not contain sufficient quantities of food acids like vinegar(acetic acid)or lemon juice(citric acid)to kill harmful microorganisms. As with all foods, the accidental introduction of harmful bacteria from other sources must be avoided, particularly post-manufacture. Consumers should follow sanitary food handling practices in dealing with all foods, including salad dressings and sauces to maintain-their safety and follow manufacturer's directions to keep food refrigerated." THE ASSOCIATION FOR DRESSINGS AND SAUCES 5775 Peachtree-ounw.ody Road • Building G, Suite 500 • Atlanta, GA 30342 (404) 252-3663 • Fax (404) 252-0774 • E-mail: ad,01cellencompany.com Food and Drug Administration. 2000. Excerpted from the Federal Register, August 18, 2000. "Agency Information Collection Activities; Submission for OMB Review; Comment Request; Food Safety Survey." "FDA is very much aware that commercial mayonnaise is not a high food safety risk ..." Sally Squires. 1998. Excerpted from The Washington Post,June 30, 1998. "Mayonnaise Malaise? Research Suggests Summertime Fears of the Popular Salad Dressing May Be Overstated." "When people gather to picnic and cook outside during the summer months, they often worry that mayonnaise-rich foods, such as potato salad and coleslaw, may cause food poisoning. But mayonnaise frequently gets a bad rap. Commercially prepared mayonnaise in many cases is mistakenly fingered as the culprit in food poisonings when other foods are often responsible. There's even evidence that mayonnaise may offer some slight protection against food poisoning .." Doyle, M.P. 1996. Statement by Michael P. Doyle, Ph.D., Professor and Director, University of Georgia, Center for Food Safety and Quality Enhancement. "Commercial mayonnaise is among the safest of foods when properly handled. Most harmful bacteria die off within hours in the presence of mayonnaise, largely due to its high acidity. As with all foods, individuals handling edibles should use proper hygienic practices and good judgment in preparing and storing foods. Precautions should be taken to avoid contaminating mayonnaise with harmful bacteria through contact with potentially hazardous foods or infected human carriers." Archer, D.C. 1989. Statement by Douglas L. Archer, Ph.D., Acting Deputy Director, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration. (Formerly Director, FDA Division of Microbiology). "Commercial mayonnaise and other commercial dressings are prepared under strict quality controls, and acidulents and salt are added at levels that prevent the growth of food poisoning bacteria. In fact, hazardous bacteria die off if placed in the commercially-prepared product. After its container is opened, commercial mayonnaise may lose certain appearance and quality attributes if not refrigerated. Commercial mayonnaise is frequently mixed, as a dressing, with other foods which do support the growth of hazardous bacteria. Thus, the refrigeration of such mixed foods is prudent. The United States Department of Agriculture's 2 Safe'Food Book(Home and Garden Bulletin#241)correctly states that 'mayo(real, commercially prepared)is not a villain!' As the book further states correctly that'adding mayonnaise (re., commercially prepared)to food slightly increases that food's resistance to food poisoning.' Homemade mayonnaise is not subject to the same rigorous quality controls as its commercially-prepared counterpart. The composition of homemade mayonnaise, including the salt and acid levels, may vary greatly. Homemade mayonnaise should be carefully prepared and stored in the refrigerator." United States Department of Agriculture. USDA News Division. Washington, DC. Office of Information. August 11, 1983. Summary: "It's wrong to blame the mayonnaise," says Stanley Green, a microbiologist with the U.S. Department of Agriculture's Food Safety and Inspection Service. Research now shows that mayonnaise doesn't cause these incidents." "Actually, adding mayonnaise to meat, chicken,fish, potato and similar salads slows the growth of most food poisoning bacteria," Green said. "Why? Because mayonnaise is slightly acid, and food poisoning bacteria can't grow in that environment. And mayo's twin, salad dressing contains even more lemon juice, making it even more unfriendly to bacteria." Foster, D.E. 1979. Does Mayonnaise Increase the Risk of Food Poisoning? Food Research Institute, University of Wisconsin- Madison. (Unpublished) Summary: "For maximum safety mayonnaise should be added to sandwiches and salads as early as possible, not held separate until the very last minute. Mayonnaise will actually help prevent the growth of food poisoning bacteria. Mayonnaise is an effective bacterial growth inhibitor because of its acid content. Food poisoning bacteria can grow in a normal mixture of food and mayonnaise, but their rate of growth depends on the amount of mayonnaise present as well as the temperature and composition of the food. Mayonnaise does not take the place of proper food handling procedures. So if you are concerned about food poisoning, don't spare the mayo. The sooner it is added and the more that it is used, the safer the food will be." 3 o� oo Oo U .S . Public Health Service 2009 U.S.DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service • Food and Drug Administration College Park, MD 24740 3-501.16 Potentially Hazardous Food (Time/Temperature Control for Safety Food), Hot and Cold Holding. (A) Except during preparation, cooking, or cooling, or when time is used as the public health control as specified under§3-501.19, and except as specified under$ (B) and in ¶ (C ) of this section, POTENTIALLY HAZARDOUS FOOD(TIME/TEMPERATURE CONTROL FOR SAFETY FOOD) shall be maintained: (1)At 57°C (135°F) or above, except that roasts cooked to a temperature and for a time specified in ¶3-401.11(B) or reheated as specified in ¶3-403.11(E) may be held at a temperature of 54°C (130°F) or above;P or (2)At 5°C (41°F) or less.P (B) EGGS that have not been treated to destroy all viable Salmonellae shall be stored in refrigerated EQUIPMENT that maintains an ambient air temperature of 7°C (45°F) or less.P (C) POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE CONTROL FOR SAFETY FOOD) in a homogenous liquid form may be maintained outside of the temperature control requirements, as specified under¶(A) of this section, while contained within specially designed EQUIPMENT that complies with the design and construction requirements as specified under Q 4-204.13(E). 3-501.17 Ready-to-Eat, Potentially Hazardous Food (Time/Temperature Control for Safety Food), Date Marking. on-premises preparation - prepare and hold cold (A) Except when PACKAGING FOOD using a REDUCED OXYGEN PACKAGING method as specified under§ 3-502.12, and except as specified in¶¶ (D) and (E) of this section, refrigerated, READY-TO -EAT, POTENTIALLY HAZARDOUS FOOD(TIME/TEMPERATURE CONTROL FOR SAFETY FOOD) prepared and held in a FOOD ESTABLISHMENT for more than 24 hours shall be clearly marked to indicate the date or day by which the FOOD shall be consumed on the PREMISES, sold, or discarded when held at a temperature of 5°C (41°F) or less for a maximum of 7 days.Ps 85 commercially (B) Except as specified in J( (D) - (F) of this section, refrigerated, processed food READY-TO-EAT, POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE . open and hold CONTROL FOR SAFETY FOOD) prepared and PACKAGED by a FOOD cold PROCESSING PLANT Shall be clearly marked, at the time the original container is opened in a FOOD ESTABLISHMENT and if the FOOD is held for more than 24 hours, to indicate the date or day by which the FOOD shall be consumed on the PREMISES, sold, or discarded, based on the temperature and time combinations specified in (A) of this section and:Pf (1)The day the original container is opened in the FOOD ESTABLISHMENT shall be counted as Day 1;Pf and (2) The day or date marked by the FOOD ESTABLISHMENT may not exceed a manufacturers use-by date if the manufacturer determined the use-by date based on FOOD safety.Pf (C)A refrigerated, READY-TO-EAT, POTENTIALLY HAZARDOUS FOOD (TIMEITEMPERATURE CONTROL FOR SAFETY FOOD) ingredient or a portion of a refrigerated, READY-TO-EAT, POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE CONTROL FOR SAFETY FOOD) that is subsequently combined with additional ingredients or portions of FOOD shall retain the date marking of the earliest-prepared or first- prepared ingredient.Pf (D)A date marking system that meets the criteria stated in TT(A) and (t3) of this section may include: (1) Using a method APPROVED by the REGULATORY AUTHORITY for refrigerated, READY-TO-EAT PO IENHALL Y HAZARDOUS FOOD (TIMEITEMPERATURE CONTROL FOR SAFETY FOOD) that is frequently rewrapped, such as lunchmeat or a roast, or for which date marking is impractical, such as soft serve mix or milk in a dispensing machine; (2) Manking the date or day of preparation, with a procedure to discard the FOOD on or before the last date or day by which the FOOD must be consumed on the promises, sold, or discarded as specked under%(A) of this section; (3) Marking the date or day the original container is opened in a FOOD ESTABLISHMENT with a procedure to discard the FOOD on or before the last date or day by which the FOOD must be consumed on the premises, sold, or discarded as specified under¶(B) of this section; or 86 (4) Using calendar dates, days of the week, color-coded marks, or other effective marking methods, provided that the marking system is disclosed to the REGULATORY AUTHORITY upon request. (E) Paragraphs (A) and(&) of this section do not apply to individual meal portions served or rePACKAGED for sale from a bulk container upon a consumer's request. (F) Paragraph (B) of this section does not apply to the following FOODS prepared and PACKAGED by a FOOD PROCESSING PLANT inspected by a REGULATORY AUTHORITY. (1) Deli salads, such as ham salad, seafood salad, chicken salad, egg salad, pasta salad, potato salad, and macaroni salad, manufactured in accordance with 21 CFR 110 Current good manufacturing practice in manufacturing, packing, or holding human food; (2) Hard cheeses containing not more than 39% moisture as defined in 21 CFR 133 Cheeses and related cheese products, such as cheddar, gruyere, parmesan and reggiano, and roman; (3) Semi-soft cheeses containing more than 39% moisture, but not more than 50% moisture, as defined in 21 GFR 133 Cheeses and related cheese products, such as blue, edam, gorgonzola, gouda, and monterey jack; (4) Cultured dairy products as defined in 21 CFR 131 Milk and cream, such as yogurt, sour cream, and buttermilk; (5) Preserved FISH products, such as pickled herring and dried or salted cod, and other acidified FISH products defined in 21 CFR 114 Acidified foods; (6) Shelf stable, dry fermented sausages, such as pepperoni and Genoa salami that are not labeled "Keep Refrigerated"as specified in 9 CFR 317 Labeling, marking devices, and containers, and which retain the original CASING on the product; and (7) Shelf stable salt-cured products such as prosciutto and Parma (ham) that are not labeled "Keep Refrigerated"as specified in 9 CFR 317 Labeling, marking devices, and containers. 87 3-501.18 Ready-to-Eat, Potentially Hazardous Food (Time/Temperature Control for Safety Food), Disposition. (A)A FOOD specified in¶ 3-501.17(A) or (B) shall be discarded if it: (1) Exceeds the temperature and time combination specified in n 3-501.17(A), except time that the product is frozen;P (2) Is in a container or PACKAGE that does not bear a date or day;P or (3) Is appropriately marked with a date or day that exceeds a temperature and time combination as specified in 13-501.1 7(A). P (B) Refrigerated, READY-TO-EAT, POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE CONTROL FOR SAFETY FOOD) prepared in a FOOD ESTABLISHMENT and dispensed through a VENDING MACHINE with an automatic shutoff control shall be discarded if it exceeds a temperature and time combination as specified in¶3-501.17(A).P 3-501.19 Time as a Public Health Control. (A) Except as specified under¶ (D) of this section, if time without temperature control is used as the public health control for a working Supply Of POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE CONTROL FOR SAFETY FOOD) before cooking, or for READY-TO-EAT POTENTIALLY HAZARDOUS FOOD (TfME/TEMPERATURE CONTROL FOR SAFETY FOOD)that is displayed or held for sale or service: (1)Written procedures shall be prepared in advance, maintained in the FOOD ESTABLISHMENT and made available to the REGULATORY AUTHORITY upon request that specify:Pf (a) Methods of compliance with Subparagraphs (B)(1)-(3) or C)(1 Y(5) of this section;Pf and (b) Methods of compliance with § 3-501.14 for FOOD that is prepared, cooked, and refrigerated before time is used as a public health control.Pf 88 I� II Time— (B) If time temperature control is used as the public health control maximum up to up to a maximum of 4 hours: d hours (1) The FOOD shall have an initial temperature of 5°C (41°F) or less when removed from cold holding temperature control, or 57°C (135°F) or greater when removed from hot holding temperature control;P (2) The FOOD shall be marked or otherwise identified to indicate the time that is 4 hours past the point in time when the FOOD is removed from temperature control;Pf (3) The FOOD shall be cooked and served, served at any temperature if READY-TO-EAT, or discarded, within 4 hours from the point in time when the FOOD is removed from temperature control;P and (4)The FOOD in unmarked containers or PACKAGES, or marked to exceed a 4-hour limit shall be discarded,P Time— (C) if time without temperature control is used as the public maximum up to health control up to a maximum of 6 hours: 6 hours (1)The FOOD shall have an initial temperature of 5°C (41°F)or less when removed from temperature control and the FOOD temperature may not exceed 21°C (70°F)within a maximum time period of 6 hours;P (2)The FOOD shall be monitored to ensure the warmest portion of the FOOD does not exceed 21°C (70*F)during the 6-hour period, unless an ambient air temperature is maintained that ensures the FOOD does not exceed 210C (70°F) during the 6-hour holding period;Pf (3)The FOOD shall be marked or otherwise identified to indicate:Pf (a)The time when the FOOD is removed from 5°C (41°F) or less cold holding temperature control,Pf and (b)The time that is 6 hours past the point in time when the FOOD is removed from cold holding temperature control;Pf (4)The FOOD shall be: 89 (a)Discarded if the temperature of the FOOD exceeds 21°C (70°F),P or (b)Cooked and served, served at any temperature if READY-TO-EAT, or discarded within a maximum of 6 hours from the point in time when the FOOD is removed from 5°C (41°F) or less cold holding temperature control;P and (5) The FOOD in unmarked containers or PACKAGES, or marked with a time that exceeds the 6-hour limit shall be discarded.P (D) A FOOD ESTABLISHMENT that serves a HIGHLY SUSCEPTIBLE POPULATION may not use time as specified under¶¶ (A), (B) or (C) of this section as the public health control for raw EGGS. Specialized 3-502.11 Variance Requirement. Processing Methods A FOOD ESTABLISHMENT Shall Obtain a VARIANCE from the REGULATORY AUTHORITY as specified in § 8-108.10 and under § 8-103.11 before:Pf (A) Smoking FOOD as a method Of FOOD preservation rather than as a method of flavor enhancement;Pf (B) Curing FOOD;Pf (C) usin4 FOOD ADDITIVES or adding components such as vinegar: f (1)As a method of FOOD preservation rather than as a method of flavor enhancement, Pf or (2)To render a FOOD so that it is not POTENTIALLY HAZARDOUS (TIME/TEMPERATURE CONTROL OF SAFETY FOOD);Pf (D) Packaging FOOD using a REDUCED OXYGEN PACKAGING method except where the growth of and toxin formation by Clostridium botulinum and the growth of listeria monocytogenes are controlled as specified under §3-502.12;Pr 90 REPORT affiGi , rC Guelph Food Technology Centre MICROBIOLOGICAL EXAMINATION OF SLICED PROCESSED CHEESE OVER A 24 HOUR PERIOD MICROBIAL CHALLENGE AND SHELF LIFE STUDY January 16, 2008 Carlos Lean-Velarde, M.Sc. Nathan Larson, B.Sc (Hon.) Joseph Odumeru, PhD. Food Microbiology Laboratory Services Division University of Guelph Guelph ON., NIH 8J7 for 1t—��-5j�ry" r'}',G,nW71 1 �../ GGFTC &LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH REPORT 1. SUMMARY In this study, sliced processed cheese from each of 5 production facilities was examined. Each facility submitted samples from each of 3 different production lots in its original packaging. From these samples, a shelf life study was conducted over a 5 day period with samples held constant at a temperature of 24°C (75.2 °F). Aerobic Colony Counts (ACC) were determined as a measure of bacterial growth at 0, 1, 2, 4, 6, 24, 48, 72, and 96 hours. Analysis of a total of 90 samples resulted in mean ACC counts that were estimated at 144 cfu/g at the 96 hour endpoint, well within acceptable food safety limits. A second experiment was then performed by challenging selected product lots with Listeria monocytogenes, Escherichia coli, Salmonellae, and Staphylococcus aureus over a 24 hour period. Two lots were selected on the basis of pH (selecting those that had a pH closer to neutrality), and high water activity (Aw). Analysis of 64 samples inoculated with the selected microorganisms at a 104 cfu/g bacterial load and incubated at a temperature of 24°C (75.2 °F) indicated that mean counts for each of the challenge microorganisms remained static during the first 8h, and increasing thereafter by <1 log at the 24 hour endpoint. An increase of less than 1 log is not considered significant. During the experiments, the visual appearance and odour characteristics of the product remained constant during the first 24 hours of incubation. Similar results were obtained using the ComBase Predictor Pathogen Modeling program for the four organisms used in the challenge study. The results of this study showed that sliced processed cheese can be stored at room temperature 24°C (75.2 °F) for up 24 hours, with no significant increase in bacteria level including pathogens. LABORA TOR Y SER VICES DIVISIOA1- UNIVERSITY OF GUELPH i REPORT 2. OBJECTIVE To perform a microbiological examination of the sliced processed cheese product utilized by Burger King. The primary objective was to examine the microbiological safety of the product when held for a minimum of 8h at 240G i (75.2°F). To this aim, the study was divided into 2 sections: A. Shelf Life Study: Focusing on bacterial growth over the initial 8 hours of incubation, and continuing over a 96 hour period. B. Microbial Challenge Study: Focusing on growth of selected pathogenic microorganisms over the initial 8 hours of incubation, and continuing over a 24 hour period. LABORATORY SERVICES DIVISION- UNIVERSI7T OF GUELPH 2 REPORT 3. MATERIALS AND METHODS 3.1 Shelf Life Experiment Samples from 2 production lots from 5 manufacturing facilities were incubated at 24°C (75.2 °F) for a period of up to 96 hours and analyzed at time points 0 (To), 1 (Ti) , 2 J2) , 4 M) , 6 (T6), 8 (T6), 24 (T24), 48 (T48) , 72 (T72), and 96 (T96) hours for Aerobic Colony Counts (ACC). At each time point 2 samples were tested from each of the 10 lots as described in the, Determination of the Aerobic Colony Count in Foods, Health Protection Branch (HPB) method MFHPB-18, Compendium of Analytical Methods, Vol. 2, October 2001. 3.2 Microbiological Challenge Experiment A mixture of up to 4 selected strains per challenge microorganism was used to artificially inoculate samples from 2 representative production lots of sliced processed cheese product. Table 1 describes the selected strains for each of the challenge microorganisms used in the microbial challenge experiments for.- Listeria or:Listeria monocytogenes, Staphylococcus aureus, Salmonella species, and Escherichia coli. LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH 3 REPORT Table 1: Challenge Microorganisms Listeria monocytogenes ATCC 19115 L10548 (isolated from cheese) L10523 (isolated from an outbreak investigation) L10530 (isolated from raw milk) Staphylococcus aureus ATCC 25923 ATCC 27154 ATCC 13565 ATCC 27664 Salmonella S. Typhimurium ATCC 14028 S. Thompson ATCC 8391 S. Enteritidis ATCC 13076 S. Newport ATCC 6962 Escherichia coli. ATCC 95922 A challenge inoculum for each challenge microorganism was prepared by first growing pure cultures of each of the selected strains in Trypticase Soy Broth (TSB) or Brain Heart Infusion Broth (BHI) for 24 t 2 hours at 35 t 2 °G. The cell suspensions from each strain were then mixed to prepare an inoculum which contained an approximately equal number of cells of each strain (estimated by turbidimetry). The inoculum level was subsequently confirmed by standard plate count methods on TSA at 35 ±2 °C From 2 representative production lots of sliced processed cheese product, 25 gram samples were subdivided aseptically into 100x15 mm sterile polystyrene 25 mm Petri plates (Fisherbrand). For each challenge microorganism a set of 16 samples were prepared in this manner, 14 of which were artificially inoculated with a level of 104 CFU of the challenge organism per gram of sample, and 2 analyzed concurrently as uninoculated controls to ensure the product was free of the challenge microorganism. The samples were then incubated at 24°C (75.2 °F) for a period of 24 hours and analyzed at time points 0 (TO), 1 (T,) , 2 (Tz) , 4 LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH 4 REPORT (T4) , 6 (T6), 8 (Ta), and 24 (T24) hours for enumeration were To is considered 1 hour post-inoculum. At each time point 2 samples were tested by preparing a 1:10 dilution of the sample in 01% peptone water, and blending for 2 minutes using a stomacher (Seward). Tenfold dilutions of the homogenate were then prepared in 0.1% peptone water and analyzed as follows: A. Listeria monocytogenes enumeration 0.1 mL from tenfold dilutions of the sample homogenate were spread plated in duplicate onto BBL CHROMagar (BD Diagnostic Systems) and incubated at 35±1 °C for 48 h. Counts were then estimated from blue colonies displaying a distinctive halo due to the cleavage of the substrate L-a-phosphatidyl-inositol by the virulence factos phosphatidylinositol- phospholipase C and phosphatidylcholine-phospholipase C produced by L. monocytogenes. Selected colonies were then selected for confirmation by biochemical and serologieai means. B. Staphylococcus aureus enumeration 0.1 mL from tenfold dilutions of the sample homogenate were spread plated in duplicate onto Baird Parker Agar (BP) and incubated 20-24 hours at 35 ± i °C. Selected colonies were then selected for confirmation by biochemical and serological means. G. Escherichia coli enumeration 1 mL from tenfold dilutions of the sample homogenate were spread in duplicate onto 3MT`" PetrifilmT`" E. coli Count Plates and incubated 24-48 hours at 35 ± 1 °C as described in, the Enumeration of E.coli and Coliforms in food products and food ingredients using 3MTM PetrifilmTM E. coli Count Plates, method MFHPB-34, Compendium of Analytical Methods, Vol.2., February 2001. LABORATORY SERVICES DIVISION- UNIVERSITYOFGUELPH 5 REPORT D. Salmonella enumeration 0.1 mL from tenfold dilutions of the sample homogenate were spread plated in duplicate onto Salmonella Chromogenic Medium - Mark II (Oxoid) and incubated 24 ± 2 hours at 37 °C. Selected purple/mauve colonies were then selected for confirmation by biochemical and serological means. 3.3 Control Samples Two un-inoculated control samples for each challenge experiment were tested concurrently for the presence of L. monocytogenes, E. coli, Salmonella and S. aureus as described in section 3.1 to ensure the test lot was free of the challenge organisms. 3.4 pH Tests The pH of representative product samples was measured for each lot received from the various facilities in accordance with the methods in sections 8.6 and 8.7 of the Compendium of Methods for the Microbiological Examination of Foods. 3.5 Water Activity Tests The water activity (AN,) of representative product samples was measured for each lot received from the various facilities in accordance with the methods in sections 8.6 and 8.7 of the Compendium of Methods for the Microbiological Examination of Foods. 3.6 Pathogen Modeling Pathogen modeling was performed for the four pathogens used in the challenge study; L. monocytogenes, E. coli, Salmonella species and S. aureus. LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH 6 REPORT The Combase Predictor program available through the Ministry of Agriculture, Fisheries and Food in the UK, was used in the modeling, using water activity and pH parameters obtained for the cheese slices used for the pathogen challenge study. LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH .7 REPORT 4. RESULTS 4.1 Shelf Life Study Mean AGC counts of 10 samples performed at each analysis time point remained constant throughout the first 48 hours: To with a mean ACC count of 59 CFUIg to Toe with a mean ACC count of 52 CFU(g with no significant growth observed. At the T96 endpoint with a mean ACC count of 144 CFU/9, an increase of 0.38 log was observed over the starting time point To, An increase of less than 1 log of growth is not considered significant. Table 1 and Figure 1 describe the mean growth (ACC) over a 96 h test period. Table 1. Microbial Growth in Sliced Processed Cheese Incubated at 24°C over a 96 hour period 0 1.45 1 1.51 2 1.60 4 1.72 6 1.72 24 1.77 I 48 1.83 72 1.64 96 2.15 LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH R REPORT Figure 1 . Microbial Growth in Sliced Processed Cheese Incubated at 24 °C (75.2°F) for 24 h. 2.5 2 - (CFU/g 1.5 10 Log 1 - 0.5 - -*—Aerobic Color Count Time (h) ,- — — 0 I i I i I i I 0 1 2 4 6 24 48 72 96 SG T C &LABORATORYSER VICES DIVISION- UNIVERSITY OF GUELPH 19 REPORT 4.2 pH Analysis of representative product lot samples showed a mean pH of 6.07 with a standard deviation of 0.26. The lowest pH value was 5.75 and the highest 6.44 (Table 2). The results were used to select product lots for the microbial challenge experiments. 4.3 Water Activity(Aw) Analysis of representative product lot samples showed a mean Aw= 0.911 with a standard deviation of 0.014. The lowest Aw value was 0.894 and the highest 0.933 (Table 2). The results were used to select product lots for the microbial challenge experiments. .Table 2.PH and Water Activitv of Sliced Processed Cheese Product AMPI —23 AUG 07 2AA1 5.75 0.933 ( AMPI—24 AUG 07 2AE1 5.73 0.926 I AMPI —23 AUG 07 2AD1 BONGARD —25 SEP 07 B1 - BONGARD—26 SEP 07 B1 5.88 0.921 BONGARD —28 SEP 07 B2 5.83 0.902 SCHREIBER—24 SEP 07 GB 6.20 0.912 I SCHREIBER—01 OCT 07 GB 6.36 0.894 f SCHREIBER—02 OCT 07 LQ 6.11 0.916 I SCHREIBER— 03 OCT 07 LQ 6.07 0.891 SCHREIBER— 15 OCT 07 MO 6.33 0.898 I ( SCHREIBER—29 OCT 07 MO 6.44 0.912 4.4 Microbiological Challenge Two product lots: SCHREIBER — 29 OCT 07 MO (pH 6.44, Aw 0.912) and SCHREIBER — 15 OCT 07 MO (pH 6.33, Aw 0.898) were selected for the microbiological challenge test as they represent product with a pH closer to 7.0. GGFTC &LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH 10 REPORT Table 3, summarizes the data obtained after inoculating representative samples at a level of 104 CFU of challenge microorganisms per gram of sample and testing over a 24 hour period at 24 °C (75.2 °F). At each time point data is presented as the geometric mean value of 2 samples analyzed for each microorganism. The geometric mean was derived by reducing each value to its logarithm, adding these values and dividing by the number of determinations. Figure 2 shows a graphical representation of the growth of the challenge microorganisms over the test period. From 0 to 8 hours the challenge microorganism growth remains static within the same logarithm. An increase of less than 1 log is subsequently observed after 24 hours. An increase of less than 1 log is not considered significant. LABORATORYSERVICES DIVISION- UNIVERSITY OF GUELPH i 1 i REPORT Table 3. Mean Count of inoculated Sliced Processed Cheese incubated at 24°C (75.2°F), for 24 hours 0 4.26± 0.17 4.77#0.09 4.59± 0.13 4.08±0.05 1 4.39± 0.55 4.81 ±0.23 4.70± 0.22 4.08 t 0.00 2 4.46± 0.54 4.81 ±0.13 4.70± 0.01 4.09 ±0.05 4 4.48± 0.56 4.91 ±0.00 4.77± 0.03 4.09 t 0.20 6 4.69 ± 0.02 4.98±0.02 4.82 ± 0.15 4.34±0.06 8 4.75 ± 0.04 5.05 ± 0.00 4.82 ± 0.17 4.38 ±0.05 J 24 5.35± 0.01 5.12 ± 0.16 4.95 ±0.28 5.09 #0.55 Uninoculated 0 0 0 0 Control LABORATORY SERVICES DIVISION- UNIVERSITYOFUUELPH 12 REPORT I Figure 2. Growth of E. coli, Salmonella, L. monocytogenes, and S. 6.00 aureus in Processed Cheese Incubated at 24 °C (75.2 °F) for 24 h. - 5.50 0 5.00 ,:, 04.50 LL %r' E LL D v 4.00 0 tM J 3.50 3.00 - ,,. - .—S.aureus 2.50 - —A —Salmonella , �--L.monocytogenes --X—E.coli 2.00 0 1 2 4 6 8 24 Time (h) 13 LABORATORY SER VICES DIVISION- UNIVERSITY OF GUELPH IL REPORT 4.5 Visual Appearance and Odour Characteristics The visual appearance and odour characteristics remained constant during the first 24 hour test period in both the shelf life and microbial challenge experiments. 4.6 Pathogen Modeling Pathogen modeling using the pH and Aw parameters of the cheese slices used for the challenge studies was performed for E. coli, Salmonella sp., L. monocytogenes and S. aureus. Similar growth curves were obtained for the growth models and the results of the pathogen challenge studies (Figures 3 -6). Figure 7 shows the growth models for all four pathogens combined. These results validate the challenge studies' data. There was no significant increase in pathogen growth during 24 hours storage of the cheese slices at room temperature 24°C (75.2°C). CGFTC & LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH 14 REPORT 5. CONCLUSIONS The following criteria were met during the microbiological challenge test: 1. Control samples showed the test samples were free of the challenge organism before artificial inoculation of the samples. 2. The mean Listeria monocytogenes, Staphylococcus aureus, E.coli, or Salmonella count did not increase more than 1 log between two consecutive time points. 3. The mean Listeria monocytogenes, Staphylococcus aureus, E.coli, or Salmonella count did not increase more than 1 log by the last time point (24 hours) compared to the average count on the 16` time point(0 hours). 4. In both of the microbial challenge and shelf life study, the visual appearance and odour characteristics remained constant during the 1st 24h of incubation. 5. Aerobic colony counts remained within acceptable food safety limits. 6. Pathogen modeling growth curves and those obtained in the pathogen challenge studies were similar. In conclusion, the shelf life and microbiological challenge study performed demonstrates that the sliced processed cheese product used by Burger King can be held at a room temperature 24°C (75.2 °F) for up 24 hours, with no significant increase in bacteria level including pathogens. LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH 15 REPORT 6. REFERENCES I. Determination of the Aerobic Colony Count in Foods, Health Protection Branch (HPB) method MFHPB-18, Compendium of Analytical Methods, Vol.2., October 2001. lI. Enumeration of E.coli and Coliforms in food products and food ingredients using 3MT11, PetrifilMW E. coli Count Plates, method 4MFHPB-34, Compendium of Analytical Methods, Vol2., February 2001. III. Enumeration of Staphylococcus aureus in Foods, method MFHPB-21, Compendium of Analytical Methods, Vol.2, September 2005. LABORATORY SER VICES DIVISION- UNIVERSITY OF GUELPH 16 REPORT Figure 3: E. coli Model j ComBase Aredictur ` Jr Thermal } IPN m thermal �,Growth model Inactivation model.. survival model _ rTiMe48 1 _Static � Changing 91�NaC1E w, temperature kadd a row L J Escherichia coli w i[h CO2(%) .� Initial Phys.state(0- T(oC)(10-pH(4.5- Aw[0.961-CO2(%)1 Max.CateDbl.time level <=711 421 7.51 11 0-1001 hjg•conc(h) 14 l 0.165299 1�� 24 6.3 0.961 I 0 I 0.09 1 3.49 ( rennve ias2 row �: I FYedict 6rre(h) conc.(Log10 celwg) 0.00 4-00 —JJi 0.00 4.00 0.96 4.01 • }}} r� LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH 17 Figure 4: Salmonella sp. Model REPORT ComBase Pr ediccor Growth model +�mhermal ; Nan thermal inaetivation model_ survival model _ �llrastsr�c It�t � i� Static Changing j aCl Aw Time as.00 •—_ - —_ ,temperature �[ (h) - 1 add a row N. 4 salmonetlae wfth nkrfte(ppm) Max.rat Initial Phys.state[9- T(°C)17- pK13.9- Awt0.973 nitrite(ppme 6bl.time level <=711 401 7.41 -11 )[0-2001 (log.conc(h) Ih) ��_ O.Oa9787 �1�{g( 24 6.3 0.973 1 100 0.03 j tt o5 rerrove last row Y 4 bme(h) wnc.(LoglOcelts/g) + 0.00 4.00 0.00 4.00 0.96 4.00 ' rr i i LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH i, 1R REPORT Figure 5: L. monocytogenes =Model { ComBase Predicifor r , � , ,�Growth model Thermal r�Non thermal ) inactivation model survival mode# Chan n 9 f. Static— 1;► g tVaCl Aw Time 4a_0o- j ,temperature J�(h) J} II add a row P ti Listeria rronocytogenesfinnocua with acetic(ppm) J Initial Ph Y s.state[0- T (*C)[I- pH14.4- Aw[0.924 acetic(ppmMax.ratepbl.time (log.conc level<=7 11 401 7.51 .11 )[0-100001 th) (h) 4 ' 0.019841 JY.j[74 6.3 0.924 1 0 0.05 5.67 remove last row P j Redict [ P — +i ttre(h) conc.(Log10 celistg)°+ 0 0,00 4.00 0.00 4.00 0.96 4.00 �w +LYItlyW LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH 19 Figure 6: S. aureus Model REPORT j Col Are- dicfor }v i__ .fl'hermal ,LNon thermal ; Growth model F Inactivation model survival model Chan n rN,,Clg M • !Tinie�taticg a6.00 temperature _ h) 1 add a row fStaphylococcus aureus .1 Initial level T(°C)[7.5- - Aw[0.907- Max.rate Dbl time <=7 Phys.state[0-11 301 pH14.4-7.111) (log.cone/ (h) hl f 4 I 0.045049 24 I 6.3 0907 *I 0.12 ( 2.59 frermve last row Redia t bma(h) cono.(LogSocelWg)� , 0.00 4-00 0.00 4.00 0.96 4.05 t then Com$ase I About Corn$as7 CotIiase omBase _iYfodelline Pools ,� _. PredlCtQy _.Li or ' Predictor FAOs LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH 20 REPORT Figure 7: E.coli, Salmonella sp., L. Monocytogenes and S. aureus Models Comlsnase Aredictor 4 Growth model t +C.Thermal Lr- Non thermal inactivation model A—survival�moodel _I i Chan n a Statictemperature gg NM Aw Time 48.00 Et(h) t add a row Escherichia coli w ith 002(%) Initial Phys.state(0- T (*C)110-pH14.5- A._wl0.961-CO2(%)( (log cone DbLtime level <=7 11 421 7.51 11 0-1001 rh) (h) 4 0.165299 ISI 24 1 6.3 I 0.961 10 099 I 3.49 Staphylococcus aureus Initial Physstate 10- T(°C) pH 14.4- Aw Max.rateDbl.time level <=7 Il 17.5-301 7.11 10.907-11 (log.conc(h) th) �4 I! 0.045049 II 24 i� 6„9 0.907 0.12 2.59 listeria rrnnocytogeneshnnocus w 4h acetic(ppm) conc ' Initial Phys.state 10- T(°C) (1»pH 14.4- Aw m) [0- (log.acetic(pp Max.rate DbLtime level r-7 1) 401 7.51 10.924-11 t00001 (lo (h) � _ ) _...... �..4 - .. 6.Dt9841 1Ia 2416.3 � saln-one4ae w 4h nitrite(ppm) nitrite(pp Max.rate Initial Phys.state 10- T (°C) 17- pH 13.9- Aw m) 10- (log.conc DbLtime level <=7 1 4010.973-11h 1 1 7.4 1 O 2001 i/h) N 4 0.049787 i}h 24 Y 6.3 t 0.973 Y 100 A 0.03 p 11.05 LABORATORY SERVICES DIVISION- UNIVERSITY OF GUELPH 21 REPORT remove Wt row J FYedict d firm(h) com.(Log10 cellstg)J = 0.00 4.00 4.00 4 ' 0.00 4.00 4.00 4 0.96 401 4,01 '4 •. l I � i LABORATORYSERVICESDIVISION- UNIVERSITY OFGUELPH 22 Food Research Institute ' University of Wisconsin—Madison Department of Food Microbiology and Toxicology .M.• d. 1425 Willow Drive,Madison,W153706 608-263-7777 February 1 , 1989 Mr. Chet England Burger King Corporation P.O. Box 520183 GMF Miami , FL 33152 Dear Mr. England: Two articles which address the out-of-refrigeration display or dispensing of cheese are enclosed. The article by Tanaka et al addresses the antibotulinal properties of processed cheese spreads. The safety system is also applicable to processed cheese. Your process cheese slices comply with the Federal Standard of Identity and therefore contain less than 40% moisture. Figure 3 in the Tanaka paper displays the safety boundary for products containing 51% moisture. Process cheese containing 11% less moisture would have a safety boundary shifted sharply to the left. Thus, the risk of botulinal outgrowth and toxin production in Pasteurized Process Cheese is nil. The articles "Should Cheese be Refrigerated" was written to allay concerns of regulatory officials about retail display of cheese out of refrigeration for a week or more. The content is also applicable to food service situations such as you describe with out-of-refrigeration dispensing intervals 2-3 hours maximum. Process cheese, as described in the article, is pasteurized far more severely than legal requirements specify. Almost all microbes in a vegetative state, including xU pathogenic microorganisms are killed. Thus, the risk of pathogens via out-of-refrigeration dispensing of processed cheese is minimal . Very truly yours, Jonn H. Nelson Senior Research Program Manager JHN1s1f Enc. cc: M. N. Pariza Reproved from Dairy and Food Sanitation,Val.3,No.10,Pages 377-375(Oaolitr 1987) eeo,apee.usisea.P o aa,rot,row,In Sano SHOULD CHEESE BE REFRIGERATED? JOHN H.NELSON,Ph.D. Vice President Quality Assurance and Regulatory Compliance Kraft.Inc. Glenview,Illinois Cheeses are one of the oldest types of prepared foods, when weeks or months elapse between manufacture and Cheesemaking provided mankind with the means of concentrating store display,product will remain at optimum quality. and preserving milk at a time when refrigeration was unknown and Prinriples of food preservation were vague empirical can- Reasons for Oul-Of-Refrigeration Display cepa at best. Cheeses were included in the diet of early Egyp- tians and Greeks, Indeed, cheese is mentioned in Greek mythol- ogy, including one variety made from the milk of tigers. That tion is sales promotion. Attractive mass display of any cheese mass have had real gusto,but pity the poor tiger milkers. Product, strategically positioned and priced to motivate Rome imported cheeses from England,France, the Alpine areas consumer purchase is a proven technique for increasing and even Asia,all without the benefit ofrtfrigeeorion. sales. The removal of cheese from the confines of refriger- ated display cases is essential to this sates strategy. General Principles Foodservice oaMtions may need to have d=se cone Displays of cheeses out of refrigeration should be condi- niently at hand during food Preparation. Buffet food ser- tional upon ambient temperature limits and adequate stock vice may include a variety of cheeses or items which incor- rotation. Display temperatures should not exceed 78°F,and porate cheese,some of them at ambient temperatures. Product should not be exposed to localized heat sources, such as sunlight, refrigeration condensers, etc. Effective Technology of Natural Cheeses stock rotation is a must,but is rarely a problem,since most Natural cheeses are fermented foods. Conversion of promotions last only a few days, milk to cheese includes inoculation with very high numbers Mass display should be limited to products in original of harmless lactic culture microorganisms.These lactic or- packages-that is packages of food products filled ani sea- ganisms multiply as fermentation of the lactose to lactic led under good manufacturing or food handling practices. acid proceeds. Consequently, the pH decreases. The milk Thus, delicatessen sales of opened blocks or loaves of is clotted with rennet or acid and the curds separated from Cheese should maintain cheese in opened packages under the whey under controlled processing conditions. Some refrigeration, in an enclosure which prevents handling or natural cheeses are sold freshly manufactured but many are sampling by curious shoppers. cured or aged, again under controlled conditions for many Some cheese packages bear the statement "Refrigerate months or even years. after opening", reflecting concern that once a product is During"the manufacture of semi-soft, hard, and very exposed to the environment, it should be kept cold to hard cheeses, the cheese is subjected to relatively tong ex- minimize the growth of spoilage organisms that may be in. pyre to ideal incubation temperatures for spoilage micro- traduced into the product, organisms. For example,Cheddar and related varieties are Often, shippers for products displayed out of refrigera- maintained at 88-102OF during manufacture and are formed tion may bear the statement, "Store under refrigeration" or hooped at temperatures in the 90's. Cheeses may remain or "steep refrigerated." Such instruction reflect manufac- at warm temperatures during overnight pressing, cooling turers programs to control distribution conditions so that gradually thereafter. Many Cheddar-type cheeses arc cured or aged at temper- Presented o:Stat of Arm York Department of Agriculture and Mar• atures up to 60nF.Swiss cheese is held for a period of four Acts. Division of Food Inspection Services, Annual Imperims Update, to eight weeks at a temperature of 72 74'F to develop the May J. 1983, May 18, 1983, Sheraton Inn and Cohferencr Center, characteristic eyes and flavor of Swiss cheese.if storage of Ithara.New York. Cheddar or Swiss cheeses at room temperature had any in- 373 herem detrimental effect on the safety of the cheeses, then SEMI-SOFT CHEESES neither Cheddar nor Swiss cheeses would be safe to con- Refrigeration Desirable sume. Variety Metz.Moisture The safety of natural cheeses is "built in" by proper Surfaced Ripened management of the fermentation process. There are two Brie (50) main keys to proper control of cheese fermentation. First, Camembert (50) the lactic culture utilized in manufacture must exhibit vig- Brick 44 orous fermentation activity. A vigorous lactic fermentation Limburger 50 has been demonstrated to inhibit the growth of spoilage Mold Ripened mtcroorgantsm�s�an, ptho ens ani to inhibit, as well. Blue 46 toxin-p gAuriion bx SlaphylpcRGLy Second, the fermenta. Oorganzola 46 tion during cheese manufacturing must be carefully con- Roquefort 45 trolled to be neither too rapid nor too slow.The key analyt. 6 Varieties Ed " ical tool is pH measurement,particularly pH of the cheese Edam,Monterrey.Monterrey lack 44 24 hours after manufacture. Such freshly made cheddar Muenster.Munster 46 and related cheese must exhibit a pH of 5.4 or less. Aged cheese may have a pH exceeding 5.4,resulting from chem- Hard cheeses include Cheddar,Colby and Swiss cheeses ical changes in constituents. and have moisture contents of 36-43 percent. Generally, Display Conditions for Natural Cheeses hard cheeses that arc to be cured or aged are manufactured Guidelines for the storage of natural cheeses are primar- to contain less moisture than mild flavored hard cheeses ily related to the moisture content of the cheese. Although which may be marketed three months or less after man- salt, pH, and gross composition exert some effect, mois- ufacture. ture content is by far the most significant determinant of rHARDCHEESES1 how well a cheese will withstand temperature stress. Refrieeration Ootiona For the purpose of assessing susceptabilily to tempera- variety Mu.Moisture ture stress, natural cheese can be divided into four groups Cheddar 39 - soh cheeses, semi-soft cheeses, hard cheeses, aml hard Colby 48 grating cheeses. Swiss 41 Soft cheeses include cottage,bakers, neufchatei,cream, mozzarella and ricotta. Soft cheeses have moisture con- Hard cheeses readily withstand short-term out-of-refri2; tents exceeding 50 percent. They spoil readily when tem- eration display. at temoenmree of 78T or tees. Good con- perature stressed. Spoilage may be either organoleptic trol over ambient temperature is essential,since high tem- (flavor) or microbiological. They should always be refrig- peratures can result in unsightly oiling off of liquified milk erated at temperatures of 407 or less. fat.Good stock rotation is a must.Out-of-refrigeration dis- SOFT CHEESES play exceeding one week should be avoided. Refrigeration Essential Variety Mea.Moisture HARD GRATING CHEESES,GRATED CHEESES Cottage 80 Refrigeration Unnecessary Bakers (80) Variety Max.Moisture Neufchatel 65 parmesan 32 Cook(Koch) 80 Romano 34 Cream 55 Grated (18) High Moisture lack 50 (44 minimum) Low Moisture The fourth group,hard grating cheeses can be displayed Mozzarella,Scamorze 52 (45 minimum) out of refrigeration for extended periods, as can grated Low Moisture Park Skim cheeses.The moisture content of hard grating cheeses is 34 Mozzarella.Scamorze 52 (45 minimum) percent or less while the moisture content of grated cheeses Mozzarella,Scamorze 60 (52 minimum) is usually about 18 percent. Consistent with these low- Part Skim moisture contents, such cheeses can withstand extended Mozzarella,Scamorze 60 (52 minimum) out-of-refrigeration display although they will exhibit oil- Ricona (70) ing-off if subjected to temperature stress in excess of 0- Semi-soft cheeses include surface ripened Brie, and 851. Camembert, mold-ripened Blue and Gorganzola, and others - Edam, Monterrey, and Muenster. These varieties Process Cheeses and Related Products have moisture contents ranging from 44-52 percent. Al- Processed cheeses and related products are manufactured though such cheeses are capable of withstanding moderate by comminuting, mixing and heating blends of natural temperature stress, they should be refrigerated. Flavor de- cheese and in some types, other dairy ingredients. Emui- terioration result from prolonged temperature stress. sifying salts are incorporated to impart 3 smooth, homogenous body and texture.'The heat treatments arc suj ter how they are packaged. Cheese products that have re- ficient to render trocessed�q microbiologically inert, ceived the kind of treatment mentioned above and that are although very low populations of beat resistant organisms' packaged while hot in seated plastic or glass containers arc.present in some troduction Tots. have a shelf life by Kraft standards in excess of 150-270 Pasteurized process cheeses and related products can be days. Even when Kraft process cheese type products divided into four product groups - process cheese, cheese reached the "Best when purchased by" date stamped on foods, cheese spreads, and cheese products. Process the package, they are still suitable for consumption for cheeses are manufactured exclusively from cheeses without many weeks thereafter if they have been handled in a any optional dairy ingredients. The moisture content of reasonable manner. pasteurized process cheeses is limited to 1 percent greater Forasteu^rittd_ roass cheep and retated standard than the maximum moisture allowed in the natural cheeserp oduct4 thyro n�neeeddbbe nQ_hgilatios,a in Ecrmittin ou-of- or cheese blends from which they are manufactured. Pas- refrigeration dis 19-at temperature of T or less. Proper teurized process cheese foods must have a moisture content stock rotation is again a must and although we believe that not exceeding 44 percent, contain at least 51 percent a two week display is completely safe, a one week stock cheese and therefore may contain up to 49 percent optional turnover is recommended to sales representatives and cus- dairy ingredients. Pasteurized process cheese spreads must tomers. also contain 51 percent cheese but may exhibit a moisture Pasteurized process cheese products are presently not a content within the range 44-60 percent. Most pasteurized well defined class of products. Consequently, no general process cheese spreads on the market contain 52 percent recommendation can or should be made on out-of-refriger- moisture or less. ation storage or display. However, there is no reason to Pasteurized process cheese products are those products conclude that they cannot be handled and displayed in a that are all dairy,are pasteurized,but do not fail within the manner similar to other pasteurized process cheese types. requirements of the three standards just summarized. Pre- sently, there is no federal standard for pasteurized process Concerning Mold on Cheese cheese products although proposals for such a standard Despite continuing advancement in cheese packaging have been filled with or proposed by FDA. technology and the use of antimycotic substances, moldy The minimum requirements for pasteurization of process cheese continues to be a common occurance.Moldy cheese cheese and similar products set forth in the Code of Federal does not present a serious health hazard. The commonst Regulations specify beating the product to a temperature of cheese mold- the green or blue-green penicillia and white at least 15WF for 30 seconds. This timettemperature com- "dairy mold" are not toxin producers. In the unlikely bination would not adequately pasteurize milk. However, event that mold on cheese is a toxin-producing mold, pro- the same temperature has been proven effective for cheese fuse growth is required before significant toxin production because the pH of natural Cheddar cheese and most other occurs. This remote risk can be eliminated by trimming natural cheeses is much lower than that of milk. Also, the moldy cheese to a depth of 113 in. below the deepest mold emulsifying salts used in processing as well as added salt growth peneuation. This recommendation does not, of increase the level of electrolyte,thereby increasing the let- course, apply to mold ripened cheeses such as Blue, Gor- hality of this heat treatment to microorganisms.Therefore, gonzola,Roquefort and Stilton. pasteurization of cheese at this time/temperature is consid- Mold growth under refrigerated conditions presents no ered adequate by FDA and other agencies. known health risk. Common toxigenic molds cannot grow The usual practice in the process industry is to beat the well, if at all, at refrigerated temperatures. The scientific blended ingredients to a temperature substantially above literature records no instance whatsoever wherein growth 150°F, usually from IWF to 170°F, for a period of three of toxigenic molds on chase under refrigerated conditions to five minutes. Consequently,the heat treatments used in resulted in toxin production. pasteurization of cheese for the manufacture of process eheese and process cheese,products are far in excess of that Definition of"Potentially Hazardous Food' required to killtea hogenicor anisms including Salmonella A definition that has caused considerable confusion and and enterotoxigenic Staphylococci. Moreover these prod- misunderstanding in the evaluation of out-of-refrigeration ucts arc packaged and sealed with heat--usually at tempera- display of cheeses and other foods is that contained in the tures not lower than 160`F. Such heat treatment just pre- 1976 FDA Food Service Sanitation Manual for "Poten- ceding hot filling and immediate package closure imparts a tially Hazardous Food." longer keeping quality than would be the case if minimum -Potentially Hazardous Foods" means any food that heat treatments had been applied for the destruction of consists in whole or in pan of milk or milk products, pathogens, eggs, meat, poultry, fish, shellfish, edible crustacea, When process cheese and process cheese oroducts de- or other ingredients, including synthetic ingredients, teriorate, thev do a9t�s_a prle, exhibit microbiological in a form capable of supporting rapid and progressive sooilaee, Instead, they exhibit the results of lipid oxida- growth of infectious or toxigenic microorganisms.The tion. As is true with all foods containing fat, eventually term does not include clean, whole, uncracked, odor- them is a tendency for oxidized flavors to develop no mat- free shell eggs or foods which have a pH level of 4.6 L 375 or below or a water activity (a„) value of 0.85 or low proportion of moisture. Soft or semisoft cheese must less." be refrigerated whether or not they are in intact packages. W believe that natural cheese, pro -rl ,manufactured Hard or hard grating cheeses need not be refrigerated but via a vigorously controlled lactic temtentation is not' in a should not be subjected to temperature stress which could form capable of supporting rapid and progressive owt_h of cause oiling off. Open packages of any cheese should be infectious or toxigeme mtcr` ooiRam' stns.' Stmilar!v, ppas- refrigerated. Mold on cheese presents little or no health teprired process cheese and related products that have fxen risk, but moldy cheese should be trimmed and the trim- subjected to the pasteurization conditions oreviousiv rte,, mings discarded. scribed and which have been hot filled and sealed are not Tho definition for "Potentially Hazardous Food" "in a form capable of su000rt'InA and progressive doesn't offer clew guidance on whether to refrigerate growth of infectious or toxr enic microorRani^� cheeses. The definition requires adequate knowledge and it is important,of course,that both types of products be proper interpretation of what constitutes those renditions in the original,seated,package. Accordingly,an appropri- which will support the growth of pathogens and informa- ate legend on the package such as"Refrigerate after open- tion on whether contamination with pathogenic micToor- ing", is recommended even though the surface of cheeses ganisms has or may have occurred. are not a particularly hospitable environment for patho- PROCESS CHEESES AND RELATED PRODUCTS gens. Refrigeration optional, except for cheese products for which no general recommendations can presently be made. conclusion Type Max.MOISIUM Whether or not any cheese should be refrigerated de- Pasteurize Process: pends upon moisture content and cheese typo. Pasteurized Cheese 40-42 process cheeses and related standardized products re.dily cheese Food 44 withstand out-of-refrigeration conditions. Natural cheeses Cheese Spread 60(44 minimum) may not require rehigerarion if they contain a relatively Cheese Product (60)? 1 - - Joarnal of food Protection, Vol.54.No,9 Paget 6t52.66a(September 1991) 00i flmnRatlmW AtMadmim of Wk Food and Emmmem nd aeNWnm Growth and Survival of Listeria monocytogenes in Market Cheeses Stored at 4 to 300C CONSTANTIN G£NIGEORGIS•,MARIUS CARNiCIU,DAN DVTULESCU, and THOMAS B. FARVER Department of Epidemiology and Preventive Medicine,School of Verennary Medicine. University of California,Davis,California 45616 (Received for publication October 15, 1996) ABSTRACT United States. Canada,the United Kingdom, and Switzer. (and (2,3,5,12,19). The epidemiology of sporadic cases of Forty-mete market cheeses representing 24 types and 28 listeriosis remains obscure (13). For many years it was brands were purchased from local supermarkets. Pieces of cheeses thought that listeriosis was a zoonotic disease only (16). Of approximately I,5 x 0.5 cm were surface inoculated with logia is now sufficient evidence to indicate that L. mono- 3.95 to 4.36 cells of a Listeria monocytogenes pool made up of There five strains(Scat A.V7,RM-1,VPHI,VPH2)and plata[in Petri cytogenes is a widely distributed environmental bacterium dishes. After wrapping with cellophane,the dishes were stored at (9,17). L. monocytogenes is very prevalent in red meat, 4,8,and 30°C for up to 36 d. Of the cheeses.36.7%supported poultry, fish, and fresh market produce (7,14,151458). growth equivalent to a mean inoculum increase of I A log,n(range Listeria-carrying raw foods may present a major source 0.21 to 3.58) in at least one storage temperature.They included from,which other foods, including cooked foods, can be soft Hispanic type(Queso Preece.Panela Ranchero,pH 6.2-6.6), cross-contaminated in plants, supermarkets,restaurants,or Ricotta (pH 5.9-6.1), Teieme (pH 5.9), Brie (pH 7.2-7.7), homes because of inappropriate handling (9). Camembert(pH 7.3), and cottage(pH 4.9-5.1) cheeses. Ricona Studies on the prevalence of L. monocytogenes in was the best and cortege the worst substrate for growth. Cheeses cheeses have been refrom a number of countries not sunwm—a CQeria growth but char cheese),cream Fat _ including USA, UK,West Germany, Italy, Netherlands, Tilla Tillamook. include.Cotj(Hispanic hard Swiss, Cheddar, cream,blue, and Switzerland (4,7,2114,35) and the prevalence has Tillamook,Cracker Barrel,Monterey Jack.Swiss,Cheddaz,Colby. string,Provolone,Muenster,Feta,and Kasseri with values of pH ranged from 0.55 to 14.5%. The behavior of L.monocyro- 4.3.5.6, orocggs (American, Monterey Jack, Piedmont, pH 5.7- genes during the making and storage of a variety of cheeses 6.4), and:Li—`lit ager(ppF17 7.2) chases. A highly significant including Cottage,Camembert,Brick,Colby,Cheddar,Fete, (P<0.005) correlation of Llsterio growth with cheese pH values bice,and cold-pack cheeses has been evaluated(22,2326- �5.5 and absence of atanet cultures during the cheese manufactur- 30.37). Potential growth of Listeria during processing and ing was observed. Overall, the study demonstrated that crass- aging was demonstrated for Brick, Feta, and Camembert: comamination of certain cheeses with L.monocytogenes originat- The present study was undertaken in order to deter- ing from taw foods(meat,poultry,fish,vegetables),after opening mina whether market cheeses contaminated with Listeria of packages, may lead to significant growth of the pathogen during refrigerated storage, after the opening of the package could support aerobic growth of the pathogen at refrigeration or abuse tempera- tures. For many years Listeria manorytogestes was consid- MAS£RtAtS AND ME'itt0as ered an important veterinary pathogen associated with ani- mal encephalitis, abortioni and mastitis (6,17). Sporadic Sample collection human infections were manifested mostly as meningitis. Cheeses commercially produced in the USA or imported septicemia,abortion, and pe imatal disease(34). were purchased from supermarkets M Davis, Woodland, and In recent years food contamination with L. monocyto- Sacramento,California The cheeses were kept refrigerated at all genes became a major concern for the food industry be- times and used for inoculation and growth studies on the day cause of several outbreaks and rases associated with con- following purchase. sumplion of foods including milk and dairy products(2.35, Cheese analyses 12.13,19). Outbreaks and cases of listeriosis due to the All cheeses were analyzed for pH, water, NaCl,brine con- consumption of soft cheeses have been recorded from the centrgtion.and total plate counts(TPC).The pH was determined by homogenizing 10 It these with 20 ml distilled water and *Author to whom correspondence skald be sent measured on ALTER Selection 2000 doh Analyzer (Beckman JOURNAL OF FOOD PROTECTION.VOL.54.SEPTEMBER 1991 f LL Instruments.Inc-Irvine.CA)and a combination electrode(Orion, brine (%), and TPC as well as the level of inoculated L. gel-filled electrode, Model 91-05, Cambridge. MA). The water monocytogenes and the maximum degree of growth(+)or content of the chooses was determined by drying 10 g at 125°C for reduction(-)in log,a at a certain temperature after a certain 2 h.The amount of NaCl (wtw) was determined with Quanmb period of storage are shown in Table 1. titration strips(1). The percentage of brine was calculated from Of the 49 chases inoculated with log,3.95 to 4.36/ the formula: sample, 36.7% supported Listeria growth in at least one % Brine- (% NACU%NaCl +% water) a 100 storage to Cheeses ser included. Aerobic TPC were determined by homogenizing 5 g Of tttlrefBNfe, ppOmng growth cheese with 45 ml sterile warts(37"C)0.1%peptone water with soft Hispanic type (Queso Fresco, Panels, Ranchero), 0.1%Tween 80 and then plating 10-fotd dilutions on APT agar Ricotta,Telerne, Brie.Camembert, and cottage. (Difco Laboratories. Detroit. MI). The plates were incubated in For reasons of maintaining a desirable texture, soft a candle jar at 30°C for 2 to 3 d. Developed colonies were tested Hispanic cheeses have pH values of 2,6.0.Those we tested for catalase using 3%HQ,and gram-viscosity reaction using 3% were made from pasteurized milk and had pH values KOH (31). Gram-positive (G+), catalose-negative (C-) bacteria aging from 6.2 to 6.7. Of the seven soft chases we were counted as tactic acid bacteria inoculated with Listeria (representing 3 companies and 3 Preparation of Ilsteria inoculum types), only one declared on the label the use of lactic L. manocyrogents strains Scon A, V7, RM-1, VPH-i. and starters.Inoculated Listeria increased by an average of 0.87 VPH-2 from our collection were transferred from stork agar slant (range 0 to 3.18 log,d in 17/21 chases stored at 4, 8,and cultures to brain heart infusion(BHI)broths(Difco).After 24 h 300C for L to 36 d depending on temperance. The best at 35°C, 0.1 ml of each was subcultured in 9 ml BHI broth and growth was observed in a chase that had the highest pH then was incubated at 3YC for 18 h. Just before cheese inocu- and a flora made mostly of C+,G+bacteria. In the other lation.a pool of all five strains was prepared by mixing t ml from six chases, the flora was made exclusively of C-, G+ each culture in a tube and vortesing for I min. Listeria cells in bacteria(considered as lactic acid bacteria).The chase that the pool were estimated by plating on BIB, Modified McBride indicated on its label that a starter culture was used had the (MMA) (20), sod lithium chbtide-phertytedmnol-moxaiatum lowest PH(6.2)but still ser growth of L.monocyto- (LPM)(18)agars and incubating at 35°C for 24 to 48 K. genes. The step of processinpg at witthe starter was used Cheese inoculation and storage retrains unknown. Overall the findings indicated that in Using aseptic techniques,solid cheese squares(1.5 x 1.5 a the absence of stetter and the presence of a high pH thence 0.5 cm)were cut and placed in sterile petri dishes. For soh chase chases can support good Listeria growth during their shelf 2-3 g of cheese was placed in sterile plastic centrifuge rubes(50- life even at 4°C. The reported minimal temperature sup• ml capacity)with screw caps.Volumes of O.Ot ml of appropriate porting L. manocytogenes growth is -0.1 to -0.4°C (39). inoculum dilution were placed and spread on the surface Of each The presence of natural Lactic contaminants cannot be chase sample. The Petri dishes (wrapped with cellophane to trusted for their potential inhibiting effect on L.manocyto- minimi>e dehydratation)Amt tubas were placed in the refrigerator genes since :hc:r initial types and r Embers are not con. until all samples were inoculated Approximately I h after in- polled. Some lwuc acid bacteria,especially those produc- oceation was completed. multiple samples of each these were placed at 4,8,and 300C and incubated for a maximum of 36 d. ing bacteriocins or bacteriocin-like substances, have been shown to inhibit L.monocytogenes growth in culture media Estimating Listeria growth and fermented milks (8.25j2). Samples were taken at preselected intervals(depending on Ricotta chases (pH 5.9 to 6.1) supported Listeria growth of death of inoculum)from each of the 4, S.and 30°C growth (1.53 to 4.18 log,a increase in inoculum) at 4 to incubators and analyzed for Listeria. Solid pieces of cheese were XrC. All three samples contained vinegar. One of the placed in a calibrated centrifuge tube containing 10 and peptone three samples(TPC of<log,a 2.0 CFU/g)contained potas• waren with Tween 80. After voraexing for 2 min,dee suspended sium sorbate. Ricotta cheese was judged as the best sub- cells were diluted and plated on MMA and LFM agar. For soft strate for Listeria growth despite the expected antimicrobial chases 20 ml of diluent was added into each tube,the suspension effect of vine and !ossium sorban. The low brine was vertexed,the volunx was recorded,and> m dilutions p° plated on MMA and LI M aggro. The agate were incesned at (t0.7%),relatively high pH,and the low level of competing 35°C and them observed in the dissecting mitmscofw under microbial flora probably contributed to the rapid Usteria Henry's 450 transillumination for typical listeria colonies (18). growth. Following a consmraer complaint, L. monocyto- At the beginning of the sttdy,suspect cnIMM were checked for genes was iwlated from Ricotta cheese obtasrted from the carslase reaction,esculin femtentariar on esculin agar(14),mor- refrigerator of a woman who had died and samples ob- phology,motility.phase coarast microscopy,and odra biochem- rained from the dairy that produced this cheese(10). cal tests as describe!previously(14).With developed expeaiena, Telerne cheese (pH 5.9) supported slow growth of counting of Listeria colonies became eases and was basad mainly Listeria at 30 and 8°C while a slight decrease in numbers on microscopy(phase and dissecting)and esculin reacriea was observed after 36 d storage at 4°C. The inhibitory activity of the stertor bacteria was probably nullified by the RESULTS AND DISCUSSION presence of over log,,7.0 CFU1g C•,G+bacterial contami- nants. ,i During the period of April to December 1989, we As expected, both Brie and Camembert cheeses sup- � examined 49 marker cheese samples representing 24 types ported rapid growth of Listeria at all temperatures.This is and 28 brands for their ability to support aerobic growth of probably a reflection of the high pH in both the surface L.monocytogenes.Three chases were imported. The pH, (mean 7.4) and the center (meat 6.9) of the samples. JOURNAL.OF FOOD PROTECTION,VOL 34.SEPTEMBER 1991 u - I ._ GEMGEORGIS,CARMCiU,DUTULMCU.AND FARVER TABLE 1. Potential Srowth of L mmmcyasgtm(pool of 5 mains)inoculated in market cheeses stored aerobicaUY at 30,8,mid 40C for up to 36 d Chem ahanctermm Brine TPC Listeria Tanp.(-C) Days Maximum Smwth(+) Chem type pH % 101110 inowhcm atomge stomp or death(-)in (may) 1"'au/sample . Qum Fresco 6.6 6.6 634 4.08 30 3 +0.39 (la) (C-,G+ 100%) 9 14 - 1.30 4 30 >2.00 Queso Fresco 6.6 43 6.90 4.08 30 6 +03S (2) (C-,G+ 100%) 8 8 -0.05 4 10 -0.84 Queso Fresco 6.5 6.15 6.00 3.95 30 3 +0.74 (lb) (C-,G+ 100%) 8 6 +0.45 4 30 +0.28 Queso Ranchem 6.2 4.1 7.79 4.08 30 1 +2.60 (3) (C-,G+ 100%) 8 8 + 1.09 4 19 +0.29 Qwso Panels 6.7 3.95 7.87 4.08 30 1 +3.18 (ta) (C-,G+40%) 8 4 + 1.82 (C+,G+60%) 4 10 +112 Queso Panelta 6.6 3.48 6.4 3.95 30 3 +0,79 (lb) (C-,G+ )0o%) 8 6 +0.63 4 30 +0.21 Qcrosa Parvus 6.2 2.5 7.48 4.08 30 3 + 1.81 (3) (C-,G+ 100%) 8 8 0.0 4 36 +0.44 Ricona 6.1 <0.6 <20 4.08 30 1 +3.33 (4) (with K-sorbate 8 8 +1.11 and vinegar) 4 30 + 1.53 Ricotta 5.9 <0.7 4.26 3.95 30 1 >+ 2.83 (5a) (with vinegar) 8 6 + 1.75 4 36 + 3.58 Ricotta 6.1 4,71 <2.0 4.11 (2.11) 30 4(2)M +3.67(+3.74)1) (5b) (with vuwgu) 8 8(27) +1.88(+0.18) 4 22(36) +197(+3.69) Teleme 5.9 1.79 7.76• 4.36 30 15 +0.82 (6) (C-.G+ 100%) 8 36 +2.2 4 36 -0.42 Brie(7) 7.2(6,0) 2.5 8.17+ 3.95 (2.11) 30 2(2)0 > 2.6(+2.6)!) Surface(center) (C-,G+ 100%) 8 36(4) +231 (+1.13) 4 30(6) +059(+0.86) Brie(8) 7.7 (7.4) 338 7.4ty 4.13 (2.11) 30 300 +2.77(+197)0 surface(anter) (C-,G+ 100%) 8 9(9) +233(+2.29) 4 14(19) +035(+0.26) Camembert(9) 7.3(7.3) 2.49 724" 436 30 2(2) >+1.75(>+t.75) surface(anter) (C-,G+ too%) 8 22(15) +205(+2.18) 4 36(36) +0.64{ +0,71) Cottage cheese 4.9 1.00 6.414 3.95 30 8 >-1.95 (Ioz) (C-.G+ 100%) 8 18 +0.59 4 24 +0.39 Cottage cheese 54 1.04 7.120 4.17 30 8 >1.87 (10b) (C-.G+65%) 8 36 >-1.87 (C+.G+35%) 4 24 +0.34 Cottage chase 5.0 1.14 6.21 4.17 30 9 >-1.87 (Ila) (C-.G+80%) 9 24 +0.42 (C+,G+20%) 4 16 +0.41 Cottage cheese 5.1 Lib 3.0 4.11 (2.11) 30 4(20 +1.19(+2.19)N (I lb) (C-,G+ )00%) 8 8(14) +1.13(+ 1.19) 4 36(27) +0.94(+0.49) Cottage Chem 5.0 1.16 5.0 4.17 30 8 >.1,97 (12) (with wedc acid) (C.G+ 100%) 8 8 x-1.87 4 8 >-1.87 •:$tarter culture added: Is-Company 1,sample a;C-,C+w Catalase-cmgative or positive. G-,G+-Gram-negative or positive. 1)a Number;in parentheses mPttwt findings at the 10919 2.11 CFV/sample inoculum IeveL JOURNAL OF FOOD PROTECTION,VOL,54,SEPTEMBER 149) Competing C-,G+microorganisms considered as the starter overcome the inhospitable environment of cottage cheese bacteria ranged from log,a 7.24 to 8.17 CFU/g, and obvi- and eventually grew az.z4°C in 8/15 experimental settings ously did not have an impact on Listeria growth. Surface (5 cheeses x 3 temperatures). The findings indicated that molds did not exhibit any inhibitory effect on Listeria Listeria contaminating an opened cottage cheese package growth either, as reported previously (28). The frequent may grow by a factor of 10 within its shelf life time (15. isolation of Listeria from such cheese&in the past led Ryser 20 d). and Marth (28) to study the behavior of the pathogen L. monocyrogenes at levels of logo 3.95.4.36 CFU/g during the manufacturing and ripening of Camembert cheese. was unable to initiate growth at 4 to 30°C in any of 16 Their studies indicated that because of lactic starter and low types of cheeses which included: Cotija (Hispanic hard pH effect,growth of contaminating Listeria was practically cheese), cream cheese, blue cheese, Tillamook, Cracker i controlled during the first 17 it of processing-ripening. Barrel,Monterey Jack,Swiss,Cheddar,Colby,string,Pro. After this period, growth commenced and proceeded at a volone, Limburger, Muenster, rceass cheese (American, rate dependent on strain and rate of pH increase. The Monterey Jack, Piedmont), Fetaand Kassen (Table 2). ' minimum pH values of the surface and wedge of cheeses The highest number of decimal reductions of the inoculum needed for all test stains to increase 10-fold were 5.6 to 6.3 (loge) was>1.26 to>136 after 4 to 18 it at 30°C,0.06 to and 6.2 to 6.7, respectively. Terplan et al. (36) reported >2.36 after 4 to 36 it at 8°C,and 0.18 to>2.36 after 8 to similar findings for soft mold-ripened cheeses. In both of 36 it at 4°C. With the exception of Limburger(pH 7.2)and the above studies, there was better growth on the surface/ Piedmont processed cheese (pH 6.4), the other 14 cheeses wedge than in the interior of the cheeses. In our Brie and inhibiting growth of L. monocytogenes had pH values of Camembert samples. mean log increases at 4, 8, and 300C 4.2 to 5.7. Inhibition of L. monocytogenes growth in the were 1.78 and 1.63 for surface and center inoculations, high pH Limburger cheese is probably due to the extremely respectively. Ryser and Marth (28) inoculated the surface high levels (log,,7.98 CFU/g)of competing bacteria. in. of 10d-old Camembert cheese with four L.monocyrogenes hibition of growth in Piedmont cheese was probably due to strains and stored the samples at 6°C for up 70 it to the combining effects of added organic acids(lactic,citric. simulate postmanufacture contamination.Three of the four sorbic) and antimicrobial compounds originating from the strains increased by 2 to 3 log,,, a smaller increase than cultured milk and buttermilk ingredients. Statistical analy. when Listeria was present in milk before processing. in our sis (xr) of all collected data for the 49 inoculated cheeses studies mean logi4 increases after 36 it at 4 and 8°C were demonstrated a significant (P<0.005) correlation between 0.59 and 2.36, respectively. Based on the findings of this Listeria growth and cheese pH of>5.5. and other (28,36) studies. L. monocyrogenes can grow in Of the 16 types of cheeses which did not support the outer or exposed(after cutting) surfaces as a result of growth, all but the processed cheeses indicated on their cross-contamination and sufficient storage at temperatures label the use of starter cultures. All three process cheeses >4°C• contained ingredients which were made by processes irzorr Five cottage cheeses representing three brands were porating use of starter cultures. In addition,they contained challenged with log,4 3.95 to 4.17 of L. monocytogenes sorbic acid which has been shown to inhibit the growth of strain pool. One cheese was challenged also with a loge L. monocytogenes (11). Use of starters was significantly 2.11 inoculum. Three of the tabels indicated the use of (P<0.001) correlated with inhibition of L. monocytogenes starter cultures, one the presence of acetic acid, and one growth. with neither of these two variables. The pH ranged from The behavior of L.monocytogenes during the process- 4.9 to 5.1. Listeria inoculum increased by 1.2 to 2.2 loge ing and storage of Cheddar,Colby, Feta, blue, Brick, and in one of the cheeses (made from cultured skim milk) cold-pack cheeses has been reported recently stored at 30°C for 2 to 4 it. The microbial flora of this (22,23,27,29.3037). Growth of three L. monocyrogenes cheese (logia 3.0 CFU/g) was made up of C G+microor- strains inoculated into milk (500 cells/m) was observed ganisms. The flora of the other cheeses was made up of 65 during the processing of Cheddar cheese. All three strains to 100% C.,G+ microorganisms ranging from 5.0 to 7.12 increased by 0.1 to 0.8 log,a CFU1g during the 14th to 28th CFU/g log,,. The cheese containing the acetic acid did not it of ripening at 6 or 13°C.After this period the numbers of support Listeria growth at any temperature. On the con- L. monocytogenes began to decrease in all blocks of this trary, its environment was bactericidal and the numbers of cheese (27). No L. monocyrogenes growth was observed Listeria decreased by >1.87 tog,,after storage at>4"C for during manufacturing and ripening of Colby cheese (37). at least 8 it. Three of the five cheeses supported growth at The numbers of the pathogen decreased steadily during 8° C. which occurred between the 8th and 24th it of ripening and storage at a rate dependent mainly on the storage. Ryser et al. (26) evaluated the survival of L. cheese composition. monocytogenes during manufacture and storage of cottage L. monocytogenes added to pasteurized milk was able cheese. White inoculated in the milk, L. monocytogenes to grow and increase by an average of 15 log,, CFU/g was isolated from 52.7%of the 112 cheeses(pH 5.0 to 5.4) during the first 2 it of Feta ripening at 22°C. Depending on stored at 3°C for up to 28 it; they did not observe any strain, the pathogen decreased by only 1.28 to 3.07 log U growth of the pathogen. Failure of growth could have been CFU/g during the 90d storage at 4°C when the pH was as due to the inability of beat-stressed cells of L. monocyro- low as 4.30 (22). genes to repair at 3°C in a low pH cheese. In the case of L.monocytogenes increased by 0.58 to 1.22 log,Q CFU/ our experiment,nonstressed 18-h cell cultures were able to g during the first 24 h of blue cheese making. Growth JOURNAL OF FOOD PROTECTION. VOL. 54. SEPTEMBER 1991 l i AKniUt1,DtT IJUSCU.AND FARVER TABLE 2. Market cheeses not supporting growth of inoculated L.monocytogenes(pool of 5 strains at levels of logy*3.95 to 4.36)during storage of up to 36 d at 4 to 30°C. Cheese charecte istics Chase type Brine TPC Temp,00 Days Maximum death comporly pp % tog in storage storage in log 10 CFU/sampte Cotija 5.6 9.6 5,57+ 30 8 >-2.00 (3) (C G+20%) 8 IB -012 (C-,G+80%) 4 36 rL68 Cotija 5.5 12.5 6.41 30 6 >-2.00 (1) (C-,G+ 100%) 8 t0 -0.70 4 30 >-2.00 Cream chew 4.8 4.9 3.3* 30 12 >-2.00 (13) (C-,G+ 100%) 8 30 >-2.00 4 36 >-2.00 Blue cheese° 5.1 6.1 732* 30 18 >-2.00 (14) (C-, G+ 100%) 8 18 >-2.00 4 36 >-2.00 Tillamook° 5.2 5.6 6.83* 30 8 >-1.95 (15) TOIS111000 5.1 3.94 6.65* 30 3 >2.09 (16) (C-,G+ 100%) 8 36 >-2.09 4 36 x-2.09 Crocker Barrels 5.2 5.0 6.93+ 30 8 >-1.95 (13) (G.G+ 100%) 8 30 -1.95 4 24 -1.17 Monterey Jack' 5.0 1.0 7.00* 30 4 -0.85 (17a) Monterey Jaekx 5.0 1.28 8.62* 30 13 >2.09 (17b) (C-,G+ 100%) 8 19 >-2.09 4 30 >-2.09 Monterey Jack 5,0 30 >6,0* 30 4 >-1.40 (188) Monterey Jack 5.2 2.72 8.84* 30 13 >-2.09 (I 8b) (C-,G+ 100%) 8 30 >-2.09 4 30 x2.09 Swiss° 5.5 272 5.83" 30 7 >-2.09 Og) (C-,G+ 100%) 8 19 >-2.09 4 36 >-109 Cheddar(mild) 4,9 2.6 >7.00* 30 4 >1.26 (184) Cheddar(mild) 5.2 4.49 8.60* 30 7 >-2.09 (18b) (C-.G+ 100%) 8 30 >-2.09 4 30 >-209 Cheddar"(sharp) 5.6 5.4 5.93* 30 4 -0.38 (18) 8 4 -0.06 Cheddar•(Sharp) 5.2 4.77 4.0* 30 3 >-2.09 (19) (C.,G+ 100%) 8 36 -1.31 4 36 -2.04 Colby 5.5 4.93 7.6* 30 9 >-2.36 (20) (C-, G+ 100%) 8 36 -1.06 4 36 -0.91 String cheese 5.5 4.24 7,42* 30 9 >-2.36 (4) (C-,G+ 100%) a 36 -2.36 4 36 -2.29 provolone 5.6 4.62 4.26* 30 9 >-236 (20) (C-,G+ 100%) 8 36 .2.36 4 36 -236 umbr w 7.2 4.78 7.98" 30 9 >-2.36 (21) (C-.G+ t00%) 8 36 ' -2.26 4 36 -2.26 Muenster 5.5 3.8 4.53* 30 9 >-2.36 (20) (G,G+ 100%) 8 36 -2.36 4 36 -2.00 Anterican process 5,7 2.07 d 30 7 -2.04 Chem (sorbic asM 8 36 -0.90 (15) citric acids) 4 36 -0.18 JOURNAL OF FOOD PROTECTION, VOL, 54,SEPTEMBER 1941 TABLE 2. cant. Cheese characteristic Cheese type Brine TPC Temp.(°C) Days Maximum death(') company PH % los,s storage swrage in in w CFUPsampte Monterey Jack 5.7 4.42 6.88 30 9 >-2.36 process cheese (sorbic and 8 36 -2.36 (II) citric acids) 4 36 -1.84 Piedmont process 6.4 5.06 2 30 9 >-2.36 cheese (sorbic and 8 36 -2.06 (22) citric acids) 4 36 -1.62 Imported Feta 4.3 7,0 7.12" 30 4 >2.04 (23) (C-.G+ 100%) 8 8 >-2.04 4 8 >-2.04 imported Fero4.2 7.4 7.07* 30 4 >-2.04 (24) (C-.G+ 100%) 8 8 >-2,04 4 8 >-2.04 Domestic Fem 4.3 7.5 5.0* 30 4 >104 (25) (C-.G+ 100%) 8 8 >-2.04 4 8 >-2.04 Domestic Feta 4.3 2.2 7.14* 30 4 >-2.04 (26) (C-,G+ 100%) a 8 >-2.04 Imported Kassai 5.3 5.52 7.19* 30 8 >-2.04 (27) (C-,G+ 100%) 8 24 >-2.04 4 36 >-2.04 Domestic Kasseri 4.8 5.8 5.25* 30 4 2-2.04 8 8 >-2.04 (28) (C-,G+ 100%) 4 6 >-2.04 * = Started culture added: l7a=company 17,sampte a;C.,C+= Catalase-negative or positive; G-,G+w Gram-negative or positive: R= Raw milk and aged, ceased when the pH of cheese dropped to below 5.0 and the nisms to acquire similar resistance to L. monocytogenes numbers decreased markedly (2.65 to 2.73 logia CFU/g) growth. In the meantime such cheeses contaminated with during the first 50 d of ripening(13). An increase in cheese the pathogen during packaging or after opening of the pH from 5 to about 6 during the period of 50 to 120 d of packages may pose a significant risk if not to the general storage did not result in any growth of the pathogen. The healthy public,but more so to persons with a compromised gradual decrease in numbers of L. monocyrogenes during immune system. the ripening and storage of Cheddar,Colby,Feta,and blue cheeses as observed in the above studies is in agreement ACKNOWLEDGMENT with our findings for the saute cheeses.The inability of L. monocyrogenes to grow in challenged processed cheeses This teseatch was supported by the National Dairy promotion and and its gradual decrease with storage time observed is in Resaatsh Board through a gram adminuacmd by California Davy foods agreement with the research of Ryser and Marth (29) who Research Center. studied the survival of L. monocyrogenes in cold-pack cheese. I REFERENCES Of the cheeses studied, the highest concentration of brine was observed in Cotija (9.6 to t2.5�}, Obviously. I, ADAC. 1915.Official methods of analysis. Association Official Analytical Chemists.Arimpot,VA. the combination of high!rine,low pH(5.5 to 5.6).and the 2. Azadian. B.S.,G.T. Finnerty, and A.O. Pearson. 1989. Cheese use of starters in Cotija contributed to the creation of an bone Listeria taming tic in ;mmnnocompetax patiere Larim environment very inhospitable for the growth of L. mono- i:322.323. cyrogenes.Growth of the pathogens in Quean Fresco epees- 3. Bannister, B. 1987. Listeria maemcy(ogenes marring us associated with eating soft chase. J, Infect. 15:165.168. es with brines of 6.15 to 6.6% but pHs of 6.00 to 6.34 is 4. Beckers, H.J., P.S.S. Samom, and B.H.M. D elfpw-van Asch. understandable. L. monocytogenes can tolerate high salt 1987.The occurrence of Linnet monacyrogems in soft chase and environments and can grow in broths with salt concentra- raw milk and its resistance to bac Int J.Food Microbial.4:249- tion as high as 12% if pH is sufficiently high (33). 256. ` Overall,this stud has demonstrated that nonsoft cheeses S. Bills,J. 1989.Anatomy of a. arab.lSimV.S Sepoutttembeater pp.88, Y 36. to Foodborne listeriosis. Pia.of Syme.Sepember 7, 1988. made with the use of starter cultures and at pH values of Wiesbaden.FRG. BeWs Verlag.Hamburg. <5.5 as well as processed cheeses will not so gra 6. fifteu n,D.C, &H.Kampetmacher,sad M.J.Tartest-Anjet. 1987. Of L. rroC9ro$eneS at 4[0 3Q°C if contaminated from raw Listertasis. 1. Am.Vet. Med.Assoc. 191:1546.1551. �--- 7. Brut,C. and K.Se1apfn. 1988. Listeria and food Lancet i:1022. foods(meat, poultry, fish. vegetables) after the opening of 8, Camonati,C..G. Giraffe, and M.G. BossL 1989. Bacteriocin-like the packages by consumers. Soft cheeses not having theseinhibitor of Saeprorocrus WAS ago nst tlsur a mon cyroge as. J. characteristics will require additional inhibitory mecha- Fond Pmt.52:61a617. JOURNAL OF FOOD PROTECTION, VOL.56,SEPTEMBER 1991 006 GENIGEORGIS.CARNICIU,DUTULESCU,AND FARVER 9- Cox.LJ,1909.A perspective on listeriosis.Food TechnoL 43(12)32• Listeria species to raw chickens and soft cheese. Int. L Food 59. Microbial.6:317426. 10. Dana.&R., B.A. Weots,and W.E. Hill. 1988. Identification and 25. Raccach, M., M.C. Grath, and H. DaBarion, 1989. Antibiosis of enumeration of beet-hemolytic Listeria manosytogenrs in naturally some iactk acid bacteria including Lacm6acfl1w eiridophitaa toward contaminated deity products. J.Assoc.Off.Anti.Clam. 71:673- Listeria memxymgenrs.Ira.I.Food Microbiol.9:2542. 675. 26. Ryser, E.T., E.H. Marth. and M.P. Doyle. 1985. Survival of 11. EI-Shenamy.M.A.,slid E.H. Mans. 1988.inhibition and inactive- Listeria mmmrytogertis during mmudacum and storage of conage don of L iterea monorymgenes by sorbic acid. L Food Prot.51:842- churn, 3.Food Prot.48:746-750. 847. '27. Ryser..E.T.- and E.H. Marsh. 1987-Behavior of Listeria mono, 12. Farber. JX. A.O.Carter,P.V. Vamghese,F.E. Ashton, and E.P. cytogenes during the manufacture and ripening of Cheddar cheese. Ewan. 1990,Listeriosis natal to the co+arimpaan of alfalfa tablets J.Food Pmt.50:7-13. and soft cheese.N.Ent.1.Med,322:338. 28. Ryser, E.T.,and E.H. Mash. 1987.Fate of Listeria meaoryte. 13. Gallia, B.G., and C.Y. Broome. 1989. Listeriosis. J. Am. Med. genes during the manufacture now ripening of Camembnn cheese. I. Assoc. 261:1313-1320, Food Pmt.50:372378. 14, Genigeorl is, A.C., D. Dutulesm amt JF. Garayrabet. 1989, 29. Ryser,E.T.and E.H.Mann. 1988.Survival of Listeria mon icytn- Prevalence of Listeria spp, in poultry meat al Ne supermarket and genes in coldjulk cheese food during refrigerated storage. L Food Siaughtemuttse level.L Food ProL 52:618-624. Rot.51:615.621, 15. Heisick. J.E., D.E.Wagner, M.L.Mennen,and J.T.Peeler. 1989. 30. Ryser,E.T.,and&H.Matto. 1989.Behavior of Listeria manoaio- Listeria slip.found on fresh marker produce.Appl.Environ.Microbiol. genes during manufacture and ripening of brick cheese. 1.Dairy Set. 55:1925-1927. 72:838.853. 16. Hiro MW.1987.Review of evidence for zoonoic listeriosis.J.Food 31. 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Behavior of Listeria mono- province of Balogna J.Appl.Bacuriol.68:153.156. rytogenes during the manufacture and storage of Colby cheese. L 22. Papailtorgrou.D.K.,and E.H.Manh. 1989.Fate of Listeria mann- Food Pmt. 51'1215 . ryfogenes during the impufenuss, ripening will storage of Fela 38. Weigand, S.D. P.N. Sado, K.G. Colburn, J.D. Torkeison. F.A. cheese. J.Food Prot.52:82-97. Stanley. M.H. Krane, S.C. Sheids,and C.F.Thayer. 1988. the 23- Papagec rgim D.K.,and E.H. Marsh. 1989.Fate of Listeria mono- incidence of Usserua spones in flown seafood products. J. Food cytogenes during ate manufacture, ripening and message of Blue Rot,51:655.656. cheese. L Food Prot.52:459.465. 39. Walker,SJ.,P,Archer,and J.G.Banks. 1990. Growth of Listeria 24. Pini, P.N., and RJ.Gilbert. 1988.The occurrence in the U.K.of mnnoryiogenes at refrigeration cempesarum. L Apel. Bacterial. 68:!57.162. JOURNAL OF FOOD PROTECTION.VOL.$4.SEPTEMBER 1991 - X� nve}Lint4;: -?s "Journal�FaodpmteWon,Vint 61,Na 3.1998,Pager290-294 - CapMp4a hl(•11Yailahnadaean altaac Foodatb FmlmnmantW San tadnm =`-Survival of Bacterial Pathogens in Pasteurized Process Cheese if Slices Stored at 300C KATHLEEN A.GLASS! KRISTINE M.KAUFMAN,AND ERIC A.JOHNSON Ytt FoodResemeh Institute,1925 willow Drive,Untwnity of Wisconsin--Madison,Madison,Wisconsin 53706,USA p i MS 97-172:Received 30luly 1997/Accepted 2 September 1997 ABSTRACT ( Six lots of commercial pasteurized process cheese slices were evaluated for the ability to support the growth of four foodborne pathogens, Listeria monocytogenes, Staphylococcus aureus, Salmonella serotypes,and Escherichia coli 0157:117, _ during 4 days of storage at 30aC.Individual cheese slices were inoculated separately with each pathogen to yield ca. ld CFU/g. Slices were packaged in sterile plastic sample bags and stored at 30°C for up to 96 h.Populations of Salmonella serotypes and Escherichia coli OL57:117 decreased an average of 1.3 and 2.1 logio CFU/g,respectively,by 36 h and Salmonella serotypes t decreased an additional 0.6 logto CFU/g during the remaining 60 h. Populations of Listeria monocytogenes also decreased, although to a lesser extent,exhibiting approximately a 0.6•logto CFU/g reduction in 96 h.Staphylococcus amus levels remained relatively constant during the testing period,and were below levels that support detectable enterotoxin production.The process g cheese slices tested allowed survival but did not support rapid growth of S.aureus.whereas populations of L monocytogenes,E. coli 015TH7,and Salmonella serotypes decreased during the 96•h storage at 30•C. i Y t Pasteurized process cheese is a food that complies with MATERIALS AND METHODS a Federal Standard of Identity(21 Code of Federal Regula- tions(CFR)Pan 133;30).During manufacture,the product Cheese slices and proximate analyses. Six lots of alepasan- is heated for ?30 s at a temperature ?150°F, which is pac process cheese slices produced for commercial sale end packaged in 5-Ib loaves were obtained from two manufacturers sufficient to eliminate vegetative organisms but not the (three lots per manufacturer).The cheese slices were stored at 40C spores of Clostridium botulinum.As a formula safe product until inoculation. with regards to C.botulinum,the combinations of moisture, Formulations of the slices conform to Federal Standard of salt, and pH act as multiple hurdles to inhibit bomlinal Identity 21 CFR.Part 133.169(30).Ingredients included American growth and toxin production(12,24).However,postprocess- cheese,milkfat,water,citrate-and/or phosphate-based emulsifiers, ing contamination at home or in a food-service environment salt, sorbic acid, color, and lecithin. Other ingredients included by vegetative pathogens must be considered a potential risk enzyme-modified cheese,acetic acid,and phosphoric acid. factor for these products. Proximate analyses including pH,moisture,NaCl,and water ; The U.S. Food and Drug Administration (FDA) Food activity, were perfortned for each lot on duplicate uninoculated Code (29) defines a potentially hazardous food as one that slices and on control slices treated with 50 0 of 0.01 M can support the "growth and toxin production of C. botuli- Phosphate-buffered saline (PBS), pH 7.2 per slice. The pH was num"or the "rapid and progressive growth of infectious or determined directly with a Coming 340 pH meter(Coming Glass Works,Corning,NY)and an Orion 8104 combination pH electrode toxigenic microorganisms." "Rapid" is measured in hours (Orion Research, Boston, MA); moisture was measured by the rather than in days or weeks (27). This category includes AOAC 926.08 vacuum oven method(5 h, 100°0(22);salt was foods with pH>4.6 and water activity >0.85.By virtue of analyzed as chloride by an automated silver nitrate titration its pH and water activity, pasteurized process cheese is (Metrohm 682 titrator, Brinkman, Westbury, NY): and water - classified as apotentially hazardous food. activity (a•.) was determined with a CX-2 water activity meter _; Pasteurized process cheese and related products have an (Decagon Devices,Pullman,WA).Information regarding emulsi- excellent safety record in the United States(10).During the fier levels was provided by the manufacturers. past 50 years, very few foodbome disease outbreaks have Bacterial strains and media. The survival of four pathogens _ been attributed to contaminated process cheese products, was evaluated separately in pasteurized process theme slices Furthermore, no published evidence was found indicating stored at 30°C. Each inoculum contained three strains of a given that process cheese can support rapid growth of pathogens. pathogen.Where possible,acid tolerant strains,outbreak strains,or The objective of this study was to determine the potential for strains used in previous challenge studies were chosen(Table 1). growth of four foodbome bacterial pathogens inoculated on Strains were grown individually in Trypticae soy broth(TSB) pasteurized process cheese slices and stored at 30-C for up (BBL Microbiological Systems,Cockeysville,MD)at 37°C for 18 to 96 It. h(stationary phase)and harvested by centrifugation at 2,500 x g for 20 min and washed with PBS.Three strains of each pathogen were mixed in approximately equal concentrations based on optical •Author for correspondence.Tel:(608)263-6935;Fax:(608)263.1114; densities and inocula levels were diluted in PBS to deliver ca. 103 E-mail:kglaw@facsta&wim.edu CFU/g of cheese. f. Food Prot, VOL 61, No. 3 SURVIVAL OF PATHOGENS PI PROCESS CHEESE 291 TABLE 1.Bacterial strains used to challenge process cheese slicer Aerobic plate counts and mold and yeast taunts were dater- Strain designation Source Reference Coined for duplicate control samples at each testing interval after culturing samples on plate count agar(PCA)(Difco Laboratories, Escherichia coli 0157.H7 Detroit,MI)at 3700 for 24 to 36 It and on potato dextrose agar C7927 Human isolate;1991 MA 1,14,16 (PDA)(DHco)acidified to pH 3.5 with tartaric acid at 25°C for up apple cider outbreak to 5 days of incubation,respectively. F-90 Sausage isolate;1994 CA 8 dry-cured salami outbreak Statistical analysis, Two-way and ona-way analyses of vari- ATCC 43895 Raw ground beef isolate;MI 5,16 ante were performed on microbiological data by using the Minicab outbreak;CDC strain 933 Y.10 statistical software package(Mimmb Inc.,State College,PA) Salmonella to determine significant statistical differences(P<0.05)of mean S.enteritidis E40 Chicken ovary isolate 5,13 values between the lots and sampling intervals. The analysis S.heidelberg S 13 Human isolate;SHL 39902 5.13 included duplicate samples for each variable(lot-pathogen combi- S,typhimurium S9 Human isolate;SHL 40467 5 nation)and sampling interval. Staphylacoceus aureus FRI 196E Ham isolate;toxin type A,D MUL_TS FRS S6 Shrimp isolate;toxin type A.B FRI 952 Whipped butter isolate;toxin Proximate analyses of control samples. The cheese typeA slices from both manufacturers had similar formulations Lisieria monocytogenes with regard to ingredients, moisture and pH ranges, and Scor A Human isolate 4,5 emulsifier use. Lots obtained from Manufacturer B (MB) LMI01 Hard salami isolate 4,5 were produced in three different plants;lots from Manufac- LM310 Goat cheese isolate associ-, turer A(MA)were produced in two plants on different day& ated with Human sponte. Proximate analyses for moisture,pH,salt,and water activity neons abortion are summarized in Table 2.The addition of 50 W of PBS to control slices did not alter 4 or moisture values;therefore it Populations of each three-strain mixture and of individual was not considered a variable in this study. strains were verified by plating serial dilutions on Trypticase soy Microbial analyses of control samples. Mold and agar(TSA)and on appropriate selective media. Escherichia coli yeast counts were generally less than detectable limits(<15 0157:H7 was cultured on MacConkey agar with sorbitol(Accume- CFU/g) throughout the 96•h sampling period. Average dia Manufacturers,Inc.,Baltimore,MD),Listeria monocytogenes standard plate counts were similar among the six lots, on modified Oxford agar(Oxtrid,Unipath LTD,Ogdensberg,Nle, ranging from ca. 2.2 to 2.9 logto CFUlg at 0 time. Plate Staphylococcus aureus on Baird-Parker agar(Accumedia)with egg counts remained constant at ea.2.S Sag,o CFUfg through 72 yolk-tellurite enrichment, and Salmonella serotypes on xylose lysine desoxycholate agar(XLD)(BBL). h for all lots tested.At 96 It,bacterial populations increased significantly(P<0.05;>1-tog,o CF4ltg increase)in one of Inoculation method. Slices were equilibrated at room tem- three lots provided by each manufacturer(MA lot 3 and MB pemture(21°C) for 30 min before inoculation. Individual slices Sot 3),whereas the populations in the other four Sots did not were surface-inoculated on one half of the cheese slice with 50 0 of increase.Neither lo[that supported growth had a proximate a three-strain mixture for a given genus to yield ca. 103 CFOtg, Control slices for each lot were similarly treated with 50 pl of analysis significantly different from those that did not sterile PBS.Slices were folded so that the inoculated surface was support growth.although the pH of both permissive lots was toward the inside,placed into sterile oxygen-permeable polyethyl• at the upper pH range of 5.8 (Table 2). No obvious trends ene sampling bags(Fisherbrand 18 oz.capacity,Fisher Scientific, were observed relating growth potential to formulation. Pittsburgh.PA)and the bags closed by folding the ends of the bags twice and security tightly with the metal tabs.Cheese was stored at Microbial analysis of Inoculated samples. Survival 30°C under aerobic conditions for up to 96 h. of bacterial pathogens on inoculated process cheese slices is Microbial analyses. Samples were assayed at 0, 12,24,36, summarized in Table 3.No significant difference(P>0.05) 48,72,and 96 It storage at 30°C.At each testing interval,2 slices for each variable (lot-pathogen combination) were assayed for TABLE 2.Proximate analysisforpasteurizedprocesscheese s[ices pathogen populations. Two slices for each PBS-mated control were assayed for standard plate counts and mold and yeast counts Avg.(n=2)values of parameters analyzed° and an additional 2 slices were monitored for pH. Manufacturer moisture pH 96 snit Water activity For microbial analysis, the entire sample (14-g slice) was j diluted 1:3(wt/vol)in PBS and thoroughly homogenized for 6 min A Lot 1 39.4 5.66 2.35 0.926 with a Stomacher Model 400(Cooke Laboratory Products,Atexan- 2 39,7 5,94 2,57 0,926 dria,VA).Serial dilutions were made in PBS(1:10 dilutions)and 3 39.1 5.82 2.50 0.929 0.1-m1 aliquots were surface-inoculated onto duplicate plates of B Lot 1 39.6 5.61 2.47 0.929 appropriate selective media.Plates were incubated at 37°C for 24 2 39,7 5,70 2.45 0.925 to 36 It.When Salmonella spp.populations were low,<10 colonies 3 40.3 5.78 2.62 0.918 per plate by direct plating, the remaining diluted sample was enriched in lactose broth(28)and plated on XLD.The appearance 'Emulsifiers were added at a ram of 2.0 to 2.9%citrate and 0 to of-typical colonies on selective agar was considered confirmatory. 0.9%phosphate. , 292 GLASS ET AL J,Food Prot..vol.61,No.a TABLE 3. Populations of Listeria monocytogenes, Salmonella DISCUSSION spp.,Staphylococcus reveres,and Escherichia coli 0/57.•H7 counts on inoculated pasteurized process cheese slices stored at 30°C Our investigation revealed that the pasteurized process for 96 h cheese slices tested allowed survival,but did not support the rapid and progressive growth of the four bacterial pathogens A,$-:t SD togs CFU/ge evaluated. Time L mono- Satmonelta a Coli, Product formulation and food-handling practices ate Manufacturer cyrogenes S.uurcur spp. 0157:H7 two factors critical to the safety of pasteurized process cheese products.Most process cheese products produced in 0 time the United States,such as the slices evaluated in this study, A 3.62 t 0.02 3.11 t 0.10 3.52 t 0.07 3.97 t 0.06 are formulated to inhibit botalinal growth.Toxin formation B 3.46 t 0.06 3.04±0.10 3.58 t 0.06 3.77 t 0.11 12h um by C. botulinwas not evaluated in this study since A 3.44 t 0.14 3.14 t 0.12 184 t 0.17 3.36 t 0.10 previous work at the Food Research Institute,University of B 3.31 t GAO 3.15 t 0.15 3.40 t 0.38 3.21 t 0.27 Wisconsin-Madison,demonstrated that botutinal toxin was 24 h not produced in similar formulations of process cheese(K- A 3.35±0.04 3.06 t 0.09 2.52 t 0.08 3.47 t 0.12 Glass, unpublished studies). Conversely, nonstandardized B 3.19 t 0.09 3.01 t 0.04 2.36 t 0.19 3.20 t 0.23 products, such as high-moisture cheese sauce, may be 36 h process-safe rather than formulation-safe. Therefore, they f A 3.36 t 0.10 3.19 t 0.08 235 t 0.16 1.79 t 0.70 are thermally processed to inactivate viable C. botulinum 8 3.16 t 0.11 3.03 t 0.06 2.21 t 0.22 1.60 t 0.33 spores. These products must be kept refrigerated after _ 48 h opening to inhibit botuliral toxin production should the t A 3.19t0.102.98t0.i$ 2.24±0.23 t.82t0.tla � 8 B 3.05 t '_0.05 2.82 0.11 1.98 t 0.20 1.41 t 0.27 product become contaminated with C. botulinum spores 72 h after processing(26). A 3.08 t 0.17 3.07 t 0.11 2.10 t 017 1.74 t 029 The combined effect of pH, moisture, and salt in B 2.79 t 0.23 2.82,!0.13 1.79 t 0.27 1.35 t 0.34° standardized pasteurized process cheese may inhibit vegeta- 96 h five pathogen growth in a way similar io the mechanism of A 2.95 t 0.16 2.82 t 0.16 1.79 t 0.174 1.61 t 0.421 inhibition for C.botulinum(24,25).Although water activity B lag t 0.10 2.84 t 0.69 1.64 t 0.29 1.59 10.41 is not a recommended safety-control parameter in the standard deviation for three lots from each manufac- manufacture of pasteurized process cheese products(24), it Average tuner.Duplicate samples were assayed for each lot, appears to contribute significantly to the inhibition of })}° °Average t standard deviation for 4 of 6 samples with populations pathogen growth in these cheese slices.The 4(0.92 to 0.93) l detectable by direct plate count, 2 of 6 samples <138 tog,o of these formulations was at or below the minimum required j CFU/g,enrichments not performed on samples, for growth of most foodbome pathogens(9).Populations of Average t standard deviation for 5 of 6 samples with populations E. Coli 0157:117, Salmonella serotypes, and 4 monocyto- n detectable by direct plate count; i of 6 samples <1.18 logo genes decreased during the 4-day trial.Conversely,popula- CFU/g,enrichment not performed on sample. tions of S.aureus,which are capable of growth at a,e as low e Average t standard deviation for 5 of 6 samples with poputations as 0,86 (9, 23), remained generally stable throughout the detectable by direct plate count; 1 of 6 Salmonella spp. by 96-h testing period. enrichment(a I in 10 g)but not detectable by direct plate count. The minimum water activities for growth of Salmonella serotypes and E. call 0157:H7 are reported to be 0.94 and t_ in pathogen survival was observed among the six lots of 0.95,respectively,but both pathogens are generally able to cheese; therefore, averages with standard deviations are survive at much lower water activity, values(3, 9). E. coli reported for each manufacturer. 0157:H7 is considered more tolerant to sodium chloride Salmonella spp, and E. Cali 0157:H7 populations than typical Salmonella serotypes(9).However,in this study decreased significantly(P<0.05)during the 96-h storage at populations of both pathogens had declined to the same 30°C. Populations decreased by an average of 1.3 and 2.1 extent by 96 h. Populations of Salmonella serotypes de- 108,0 CFU/g for Salmonella serotypes and E. coli 0157:H7, creased 1.9 loge CFU/g during the 96-h testing period, - respectively,by 36 b.Salmonella serotypes counts declined whereas E.coli 0157:H7 decreased rapidly(2.14og,o CFU/g by an additional 0.61ogto CFU/g during the remaining 60 h, decline)within 36 h,then remained constant through 96 h. but were detected by enrichment in all samples. This suggests that while a portion of the E. coli 0157:H7 Populations of L.monocyrogenes exhibited a small but population may be sensitive to the environment provided by consistent decrease of 0.6 Ingle CFU/g during the 96-h the process cheese formulation,certain tolerant cells may be testing period.S. aureus levels remained constant with one able to survive. exception. A single slice from one lot exhibited a t-log,o In a previous study, E. Coli 0157:H7 grew slowly at CFU/g increase in staphylococcal populations above the 37°C in TSB supplemented with 6.5%NaCl,but declined by average of ca.IS logo CFU/g at 96 h.Testing of additional 3 logo CFU/g after 96 h in the presence of 8.5%NaCl(6). inoculated slices verified that this formulation could support The corresponding water activities for 6.5 and 8.5%NaCl in sporadic growth(one in three samples supported growth)at TSB are 0.96 and 0.94,respectively(K.Glass,unpublished 96 h,but not at 72 b. data).The 4 of 0.92 in the cheese slices tested in this study J. Food Prot. Vol. 61, No, 3 SURVIVAL,OF PATHOGENS IN PROCESS CHEESE 293 may be sufficiently low to inactivate E. coli 0157:H7 at moisture for the process cheese slices.The differences in the 30°C. lag phase of S.aureus on the cheese slices may be partially Inactivation of E. coli 0157:H7 in Cheddar cheese was attributed to incubation temperature(27°C versus 30eC)or also reported by ReitSma and Henning(21). Populations of to another unidentified factor.Although the time to growth E.coli 0157:H7 decreased 1 togto CFU/g during the first 14 varied between the two studies,the results confirm that S. days of Cheddar cheese curing at 6 to 70C and decreased an aureus may grow slowly on process cheese slices if contami- additional I logto CFU/g during the next 14 days.The rapid nated and held at abuse temperatures for >_4 days. Even inactivation of E. tali 0157:117 observed in our study may though sporadic growth of S. aureus was detected in the be partially explained by differences in water activity (aw cheese slices, the populations of S. aureus remained well 0.92 for cheese slices versus 0.95 for Cheddar cheese) or below the minimum 106 to lot CFU/g reported to support storage temperatures(30eC for cheese slices versus 6 to 70C detectable enterotoxin production(18, 19)during the 4-day for Cheddar cheese).Reducing storage temperature has been test period.Therefore,S. aureus is not considered a public reported to enhance survival of E.coli 0 157:H7 in acidified health risk in the process cheese slices tested in this study. media,apple cider,and mayonnaise(7, 16,31). All six lots of process cheese slices were microbiologi- The water activity of the cheese slices tested also limits tally stable under the conditions of extended temperature the growth of Salmonella serotypes.Early work by Christian abuse represented in this study.The products tested demon- and Scott(3)investigated water requirements for Salmonella strated the ability to inhibit significant staphylococcal growth oranienberg in dried meat, dried milk, and dried soup (P<0.05) and to inactivate L monocytogenes, E. call adjusted to various water activity levels by adding different 0157:H7,and Salmonella serotypes during 96 h storage at amounts of water.Data revealed that S.oranienberg grew in 30aC.While water activity may inhibit pathogen growth in meat and soup adjusted to a,,.0.93,but decreased at aw 0.92. these formulations, the synergistic effect of moisture,salts, Populations of S.oramanberg decreased in milk adjusted to and pH, or another factor such as sorbatc, may also a„0.93.While the minimum water activities for survival and contribute to the safety of these products. growth in these foods are lower than those reported in There results suggest that properly formulated pasteur- media, they agree with the results of our study demonstrat- ized process cheese products Could be exempt from the ing inactivation of Salmonella serotypes at aw 0.92. potentially hazardous food category because they do not L monocytogenes is considered a relatively salt-tolerant support the rapid and progressive growth of the pathogens 3 foodborne pathogen. For example,L monocytogenes Scott tested. Our study also supports the position that unopened A survived in 12%salted whey and skim[Wilk(pH 5.5 and packages of properly formulated pasteurized process cheese 6.0,respectively),exhibiting a<1.3-loglo CFU/g reduction can be safely stored unrefrigerated for limited times (17). after 130 days storage at 22eC(20).Miller(15)reported that Because safety may be formula-specific, further challenge L monocytogenes grows slowly in BHI adjusted to aw 0,92 studies should be conducted to verify the stability of other with NaCl (generation time 6.4 It, lag time 68.4 h), but is formulations in the category of pasteurized process cheese inactivated at aw 0.91 (D value, 159.9 h). The small, but and cheese food. consistent,population decline in our study suggests that the The cheese slices tested in this study did not support minimum water.activity for listerfal growth may be lower in rapid growth by vegetative bacterial pathogens. However, media than in process cheese products or that an additional the pathogens survived 96 h 30Regardless of whether inhibitory factor is present in the cheese slices. these process cheese slices weerr e exempt from the potentially hazardous food category, it is imperative that food handlers Staphylococcus aureus is able to grow at significantly prevent postprocessing wniamination to reduce risk to the lower water activity levels than E.coli 0157:117,Salmonella consumer. scrotppes,or L manocytogenes(aw 0.86 for S.aureus versus >0.92 for the other pathogens).However,other factors may ACKNOWLEDGhMNTS affect the minimum aw growth values of S.aureus.Kreisman We thank Ann Larson, Fatima Crumble Angelique Duerr,Amelia and Labuza (11) evaluated the survival of S. aureus in tmwan Rosa Carnery Rodriguez,Michelle Ceizyk ami Jeffery Diarb for process cheese food products formulated with water activi- their vWuable technical assistance with the experiments and Kraft Foods ties ranging from 0.81 to 0.94 and supplemented with 0.08 to and Schreiber Foods.Im for generously donating the cheese slices used for 0.1% sorbate. S. aureus grew in products with aw 0.94 but this study.We gratefully acknowledge Dr.John Nelson for critical review of this manuscript This research was supported by Kroft Foods and Schreiber not at 0.91 when stored at room temperature for 5 weeks. Foods,Inc..and by the College ofAgriculume and Life sciences,University The authors suggested that the inhibition at aw 0.91 may be of Wisconsin-Madison., partially due to sorbate, which has been,reported to delay REFERENCES staphylococcal growth(2, 11). Previous Work at the Food Research Institute(K.Glass, .1 Sesser,R.E.,S.M.Lea,J.T Weber,M.P.Doyle,T.J.Barrett J.G. J. McDermott, and J. Nelson, unpublished results) demon- Wells,and E M.Griffin.1993.An outbreak of diarrhea and hemolytic utemic syndrome £tom Ercherichia toff 0157:H7 in fresh-pressed stinted a 1-loglo CFU/g increase in S.aureus levels on retail apple cider.JAMA 269:2217-2220. cheese food slices stored 7 days at 27°C,but not at 4 days as 2. Boylan.S.L.,K.M.Acott,and T.P Labum 1976.sraphylococcur observed in our current study.The ingredient statement,salt, aureus challenge study in an intennediatc moisture food.J.Food Sci. and pH values of alI cheese slices were similar,whereas the at:9ta 9z1. 3. Christian, J. H. B., and W. J. Soon. 1953. Water relations of moisture varied from 44%for the cheese food slices to 40% salmonellae at 30°C.ADSL J.Bial Sol.6561-573. I -- /Y4 Ur b nr A" 1.Food PmL,Vot 61,No.3 4, Glass,K A„and M.P Doyle.1989-Fate and thermal inactivation of production in the presence of Iron-enterotoxigenic smphylococd. Listeria monocytogenes in beaker samin,and pepperoni. I. Food Appl.Environ,Mhcrubiol.39:1167-1171. Prot,52:226-231, 19, Nokm.A.L.,and M.S.Behgdoll.1982.Production of enWmOxin by , 5. 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Miller,L.G.,and C.W.Kaspar.1994.Escherichia coli 0157:117 acid products.Code of Federal Regulations,Tide 21.Part 133.Office of tolerance and survival in apple cider. L. Food Rat. 57:460-464: the Federal Register.U.S.Goverment Printing Office,Washington, =win 57:645. D.C. 17, Nelson,1. H. 1984. Some regulatdy compiiaace COrrcoms of the 31. Zhao,T.,M.P.Doyle,and R.E Besser,1993.Fate of enterohemoa cheese industry.J.Dairy ScL 67:2108-2119. magic Escherichia coli 0157:H7 in apple cider with and widmut 18. Nolen,A.L.,and M.S.Bergd011,1980-Staphylococcal emterotomn preservatives.Appl.Environ.Microbiol.59:2526-2530. k Cheese — Slices For Sandwiches Key Standards (Product Storage Product Holding F7 Room temperature 65F to 85F (16°C to 29°C) (if required by health 34F to `SOF j department,use a pan- (1°Cto4°C) Wthjna-panoficej 99)KM 0y:00�0 Quality Steps 1. Remove enough cheese for each board, Old or off odors indicate using M contamination, —112 block(92 slices)for Main Board — 114 block(46 slices)for Specialty Board — 1/2 block(92 slices)for Breakfast Board 2. Place cheese into clean ready pan without grate Cheese should not exceed —Main Board:113-size shallow pan height of pan. —Specialty Board: 1/6-size deep pan If health department requires —Breakfast Board: 113-size shallow pan refrigeration,use a pan-within- 3. Wrapremain unused cheese in food-grade condi of Ke,then place(n n9 9 �,,,� condiment well.Do NOT use plastic wrap and store in walk-in cooler Li grate. 4. Mark Board Prep discard label and apply to corner Discard and record as waste of pan any cheese upon expiration 5. Stock board and also at end of day. Focus Paints . Serve cheese at room temperature unless health department requires refrigeration ■ Processed cheese and natural cheese must be m kept in separate pans Release W4:0608 This manual Is the property of Burger King Corporation and may be used only in a manner and by persons approved by the Company. 64 Cheese—Slices Basics Main Board Basics K I Key Standards ±� JPreventing Cuts ■Use knives with blunt tips and finger guards to prevent Injury Preventing Contamination ■Store the knife safely away,between the ready pans,when not ■Keep raw and cooked product separated in use.Do NOT place knife near edge of Prep Board. ■Keep raw product smallwares and cooked product ■Use onlyapproved openers to open containers such as pickle smaihwares separate to avo�d cross contar .inabar.. buckets.Do NOT use screwdrivers or knives. as Use clean spatula with each new pan of sauce ■Do NOT place knife in sink full of water.Place on drain board of 3ax>mpaiment sink. ■Washtciean,nese,and sanitize equipme surfacesnt,hands,utensils,and works ' based on standards in the t( 7'1T:y tTITj Dally Operations section that follows L_ 1 ■Wipe outside of condiment containers(pans,tubs,squeeze To ensure food quality... boltles)with a dean cloth containing sanitizersolulion before !Taste storing as Do NOT mix old product with new product ■Do NOT mix different types of beef Dallies in the same PHU pan ■The FDA Model Food Code prohibits the use of food contact ■Ensure PHU pans with sealed lids are fully closed with no air surfaces that are not smooth.Such surfaces must be easily gaps sound edges cleaned,durable,safe,corosion-resistant,and nonaos hent. Surfaces also must be free of and resistant to breaks,open ■Ensure PHU pans are not cracked seams,cracks,chips,pits,or other imperlediuns. ■Use , as Do NOT use cracked or chipped ready pans and smallwams mm because bacteria grow in small cracks and crevices as Always serve cooked products that are: isAll products must be held in ready pan,original container, — Hof — Prepared in standard squeeze bottle,or approved,food-grade portion bags — Oreawasbng I Storing Chemicals I ■Always mark discard time for products allowed to be staged on as Store cleaning and san"I'mg products in a cabinet or on the heat chute bottom shelf off the floor.Do NOT store cleaning products or a Always prepare sandwiches with Ue correct amourt of fresh chem cats near food preparation areas,food,utensils,or food condiments equipment all Store chemicals in their anginal containers or approved, ■Check product clock regularly to imel that ho:d lime's not labeled dispensers exceeded if sandwich is expired,discard and record as waste ■Put sanitizer solution only in an approved zone container lAppearanee or bucket that is clearly labeled and maintained at proper as When taking product from steamer or PHU,do "Quick Check" chlorine concentration(50—200 ppm) for appearance.Discard if bun has excessive moisture,bun ■Red cloths are fully submerged in sanitizer solution to prevent has pruning°effect,or meat is toMpiace is missing. bacterial growth a Before you wrap sandwiches,check quality and appearance ■DD NOT crush sandwich during wrapping This manual is the property of Burger King Corporation and may be used only in a manner and by persons approved by the Company. Release Date:0608 Basics Main Board Basics 203 Key Standards (cont.) Board Hold Time End of Day—Storage/Discard (Serving Baconr• r_I��, ± Walk-in cooler at does a temperature Check at least 2 times a day. Cheese Dyad Discard and record as waste. Ketchup NIA Room temperature Temperature should be between (85'F and 85°F(18°C to 29'C). Lettuce DBDOOD Walk-in cooleriigreater than 3 hours left Mayonnaise NIA Walk-in cooler f Mustard NIA Room temperature Onions t18�D0 Walk-in coo(erifgrealerthan 3hours i left - Pickles NIA Room temperature Stacker Sauce N/A Walkdn cooler &0 Steak Sauce NIA Walk-in cooler ! Tomatoes(sliced) o9DDfl0 Discard and record as waste. _ Crispy Onions 2 Days Room temperature PHU Min.Holding Hold Time Max.per Pan Stacking (Sealed! Brats Temp(product) Unsealed Burger patties 0050 12 S!urgunt Seated No NOF WHOPPER'patties lVC) pp.y5D0 (6 for 9 Duke gled ShinSealed No Flexible Batch) Steakhouse patties OO:v5fl0 6 Shingled Sealed No • Loaded Potato Oy90 1 batch NIA Unsealed lit yes,low- Spread I profile Steamer Holding Tamp Hold Time Max.per Stacking (equipmmdj Stmtds _ WHOPPER®buns Level 3 or higher 7 Shingled Burger buns i35F a Shingled (57°C t 5°C) ! _ Com-dusted buns Toast to order Getting Ready Wash and Sanitize Hands Got Smallwares Knife Ready pans Ready pans Squeeze bottles and Supplies To slice sandwiches with grates "r without Use only clear squeeze upon Guest request To hold •,; grates bottles with color-coded condiments To hold �"' caps. Markerthat reed to be conchs is ■For ketchup and To mark held up off the pan so that do NOT need to mustard d!scard times liquid can drain,and to drain: a A.1.®Sieak Saace transfer products a Cheese a For other sauces on wraps, a Bacon ■Lettuce product holding squares, and pans a Orions(only Snot ■Onions in`qujX bags Tongs using'gwck'bags) aSlacker Sauce To. a Pickles PRD pane ■Tomatoes Sanitizes oQ,�t �',� a Handle cooked To holdso)ulton .,j�'s, cooked ■Where applicable, products products patties onion rings,jalapeino r'")9 ■Pull products from slices Spatulas PHU ■uds a Crispy Onions ■To spread ■Place patties on buns mayonnaise a HandleYe99a �} a/for each pan of patties 6'® Board Prep Labels mayonnaise ■Store in a covered Wraps/packaging 113-site ready pan Relates Date:gags This manual is the property of Burger King Corporation and may be used only in a manner and by persons approved by the Company. 204 Main Board Basics Basics 1 Now Many? To ensure that product levels are maintained, use appropriate PLS charts,and if available, KITCHEN MINDERTM',along with ... 1 � PHU Heat I9� a Chute Orders I Applying Condiments Cutting Sandw�i}c�h��es"f qr„ (Name kon Standard k ■Use safe slicing procedures; Bacon �r,•, Place half slices side by side on top 1 Be sure your hands and the knife handle are completely {(U�{t111�'11p�J�1�nJ of meat patty or cheese, dry For large sandwiches4 slices 2. Hold the knife over the sandwich,cuding edge down For small burger sandwiches: 3. Place you,other ham firmly over the knife e Single: 2 slices 4. Slice sandwich In half •Double,4 slices — Always cut away from your oody in Triple. 6 slices — Use a sawing motion `l ■Quad: 8 slices •Keep the knife clean throughout the day Cheese ® 2slices:face n2slictlyonmeatpalty. fSltc/sgsamnsdi s"in Hay(oaty$ragaastedby0ui 2 slices:tan 2 slices /�� t like a double diamond ( ) 1. Pull 2pieces ofwrap Mark the discard time and any special on meat patty so that 3 V V condiments on wrap on and set aside. corners of each cheese — Mark'1/2"m blank square slice slightly overhang the meat Daily. 2. Prepare sandwich and place on second wrap Mayonnaise While holding the bun,use plastic — Do NOT mark food or discard time on second wrap spatula to spread mayo^�a� e evenly because the sandwich mast be wrapped a second time from edge to edge on the bun crown or heel after sliding Lettuce (/� While holding the bun crown over the 3. Cut the sandwich,using sate slicing procedures e1.YrC'd, lettuce pan,sprinkle lettuce evenly to — Do NOT crush sandwich during slicing t`'Ld7�'1�J1 cwnpletely cover the oun crown. 4. Place the marked wrap on the Prep Board Tomatoes t slice:place in the center of the bun 5. Place the wrapped serif sandwich on the target area of the crown. marked wrap 2 slices:piece side by side on the g Wrap the sandwich bun crown If tomatoes are less than 2 in.(5 cm) in diameter,use 3 slices Pickles Place side by side to cover surface. Do NOT overlap. Ketchup Use a circular motion starting from outside edge of the K meat patty ane ending in the center. Onions Place evenly to cover surface so there es a bit of onion In each bite. Mustard Use a circular motor starting from outside of the meal patty and ending In center (spiral muslamJ^side ket&u;)swKi). Stacker While holding the bun,use a plastic Sauce spatula to spread sauce evenly from edge to edge on the bun crown Salic Steak Use a outside circular motion starting �y Sauce from outside of the bun ![VJ 1 crown and end;ng in center. Loaded Using potato spreader,spread one Potato podlon evenly from edge to edge on Spread the bun craw,. Crispy Using hands,evenly place a heaping Onions 9010 porton on heel. This manual is the pmparty of Burger King Corporation and may be used only in a manner and by persons approved by the Company. Release Date:0608 Basics Main Board Basics 205 Microwave Wrapping (1 Do NOT microwave lettuce,raw onions,or tomatoes - j Prepare wrap(place wraps in wrap holders,priNsd side up) JTa er■ure hot food... ( Before making sandwich: For large sandwiches prepared Pusb. 1. Mark discard time when using a WHOPPER bun or appropriate lop com<tusled bun. 1 sandwich ® 112 a 4 6 e o s e liell 12 2. Markicons icon,if approprata 2sandwiches® -asinglon,ifocherthan asld icon,patty 111mootag❑1 as To ensure hotness,prepare a If using the buddy system,each -Braid icon,if LTO or other 4:J 0 maximum of 2 sandwiches Team Member may prepare a -Condiment icons tunique at a time maximum of 2 at a time condiment requests should be marked in the Wank square) 3. Turn wrap over(panted side down) For small sandanches prepared Paso: 4 Position wrap so the sandwich name is closest to condiment using a burger bun: 1 sandwich well 2 sandwiches Wrap sandwich y 1. Fold the front edge of the wrap ria�^�^a mTMMMam (edge closest to you)over the 3 sandwiches® sa^dw,ch 2. Fold the back edge of the wrap (eda closest to the condiment ■Toereurehotiess,preparea itusingthe buddysystem,each wen over the front edge maximum of 3 sandwiches Team Member may prepares 3. Fob the open ends of the wrap into at a Ile, maximum of3 at a time. _ aSoxfold For sandwiches with lettuce, ,rQr, 4. Lift the sandwich tomatoes,or raw onions: (� 00S Tuck the ends uridemeat^ r,a„ — Do NOT crush sandwich a'®��."°,°°i ■Healony the bun heel In during wrapong patty(and,if applicable, cheese and/orbacon) For sandwiches without Buddy System for WHOPPER lettuce,tomatoes,or omoi Sandwich Preparation ■Heat the wrapped sandwich !e > (ROC Building) Starter(most efficient board person) Buddy System for WHOPPERO is Toast buns as MarK wrap Sandwich Preparation is Place paties on buns Starter(most el •Microwave meat and heeluent board person) ■Mark wrap s Dress bun crown s Slide sandwich to finisher ■Pei buns and place beef patsies on buns as Bump CRT bac if necessary ■Microwave meat and heel ■Dress bun crown FinisherisComplete sandwich heel n ■Slide sandwich tofinishers Gose wrap ■Bump CHT bar,if necessary Finisher ■Place sandwich on heat chute as Complete Duties Complete sandwich beet ■Starter—complete all but dressing bun crown ■Wrap sandwich OR ■Place sandwich on heat cnule ■Finisher—wrap and place sandwich on heat chute Manager Duties T^e Buddy System Guide for ROC Budding can be found on OPS ■Starter—complete all but dressing bun crown Connect. OR as Finisher—wrap and place sandwich an heat chute The Buddy System Guide can be found on OPS Connect. Release Date.0608 This manual is the property of Burger king corporation and may be used only in a manner and by persons approved by the company. 206 Main Board Basics Basics Equipment lira:mx-m— lCl71 The Product Quality Timer provides automatic tracking of hold time,the heart of the product management system.Lighted bars with buttons are found on Product Holding Units- Continually monitor the lights on the Product Holding Units to determine: a. Which product to use first • Which product is expired and needs to be discarded and recorded as waste • When to cook more product,if needed 1. When freshly cooked product is placed in the first "� 2 green lights for the same pan,touch the corresponding arrow button an the ( ) product must never occur. Pan Status Keyboard.The light will tum GREEN. �,,,j Check equipment programming for linking — GREEN=Use this pan first instructions. —This product will expire first 2. When freshly cooked product is placed in additional pan(s),push the arrow button and the light will tum GREEN,THEN YELLOW —YELLOW=Product in another pan,use green pan first 3. When indicator light flashes,cook more if needed ` 1 ♦ ` 1 — FLASHING GREEN or YELLOW=Product or f"� is about to expire,cook more if needed 1 1 40 4. The hold time is the specified bme a cooked ` 1 product may be held in the unit.The indicator will FLASH RED when the hold time is reached. — FLASHING RED=Product is expired, ♦ 1 please discard and record as waste 5. After a product has expired,discard theproduct, 0 record as waste,and push the arrow button. The indicator will tum RED or,when using KITCHEN MINDERT""and no product is needed, OFF. — REDINO LIGHT=No product allowed in pan 6. KITCHEN MINDERT" Restaurants ONLY When indicator is RED,more product is needed — RED=Cook more product �m�ral;,rrr:rrr.�lrmr, �rttri�:n► �.; ��'- , 1. Turn on power,wait a minimum of 20 minutes to reach operating temperature of 190'F±5°F (88°C±3°C) 2. Using a surface thermometer,take the Ensure lids are held in place temperature of the lower surface areas in the first to maintain proper seal. slot from the control box.Position thermometer so that it is centered from front to back—both the top and bottom slots(as shown). 3. Wait for the temperature to stabilize and record To ensure all elements are the reading on the Quality Checks Log or working,check other siots'.o equivalent toot be sure they are heating. This manual m the property of Burger King Corporation and maybe used only Ina manner and by persons approved by the Company. Release Date:0608 Basics Main Board Basics 207 r 1. Turn on power,wait a minimum of 20 minutes to Lower If lids are cracked ornot reach operating temperature Surface being held in place,repairf — Upper Surface Area:225°F±5°F ) replace immediately. (107°C±3°C) —Lower Surface Area: 195°F±5°F (91-C±2°C) o 2. Using a surface thermometer,take the temperature of the upper and lower surface areas upper in the second pan slots from the control box. Surface Position thermometer so that it is centered from front to back—both the top and bottom slots(as shown). 3. Wait for the temperature to stabilize and record the reading of the Quality Checks Log or equivalent tool Daily Operations ®Setup Ongoing Close a Prep ❑ Follow Fresh&Ready Product Holding System time frames and flow l�J lam/ ❑ Only if refrigeration is required by local health regulations (e.g.,cheese),prepare pan-within-a-pan of ice 1. Place product in a pan 2_ Take another pan and fill it half full with ice 3. Place the pan with the product into the pan with the ice 4. Place the pan-within-a-pan of ice in the condiment well Check frequently and replace ice as needed ❑ Use ❑ Do NOT reuse food containers(e.g.,mayonnaise tubs)for (000 condiments or other use ❑ Do NOT combine partially used pans or squeeze bottles �1► ❑ Remove enough whole tomatoes from walk-in cooler and store at �7 room temperature for next day's use Label/Mark ❑ Follow Fresh&Ready Product Holding System time frames and flow ❑ Check frequently for expiration Stock Board ® Refer to the Equipment Organization Guide for recommended layout of condiments in condiment well. U Use Stock Goldo Refer to the Equipment Organization Guide for recommended placement Storage `' of product ❑ To maintain product quality and proper temperature,stock only enough product for 2 hours ❑ To ensure proper airflow,do NOT block fan with product Release Gate:0808 This manual is the property of Burger King Corporation and may be used only,in a manner and by persons approved by the Company. 208 Main Board Basics Basics It Holding 00 u Cover all ready pans not in use with lids or food-grade plastic wrap — Covering condiments helps keep condiments fresh and helps avoid contamination — Store on condiment shelf or other convenient location ❑ Wrap any open,unused cheese packages with a food-grade wrap and refrigerate until ready to use u Keep all other condiments at room temperature at least 2–3 hours prior to use to ensure sandwich hotness ❑ Discard and record as waste any condiments exceeding discard time Leftovers 0 Li Wipe outside of containers with a cloth containing sanitizer solution �7 before storing ❑ Seal or place a lid or food-grade plastic wrap on all partially used containers Store at room temperature: ❑ Squeeze bottles with ketchup and mustard ❑ Ready pan with pickles ❑ Crispy Onions Store in the walk-in cooler at 341 to 40OF(1°C to VC): ❑ Bacon ❑ Mayonnaise ❑ A.1.0 Steak Sauce ❑ Stacker Sauce — if of acceptable quality,place in clean,sanitized ready pan, cover with lid or food-grade plastic wrap, and place in walk-in cooler ❑ Lettuce and onions(products with 8-hour hold time and if health regulations allow): — If more than 3 hours left on hold time: – Cover tightly(Seat or place a lid or food-grade plastic wrap on all partialty used containers) – Mark pans with remaining room temperature discard time – Return pans to walk-in cooter In order for these condiments to be held over,they need to have ample time left on the discard time to bring them back to room temperature(857 to 85°F/180C to 29°C)for next day's use. ❑ Squeeze bottles with sauces should be covered and refrigerated ❑ Store any promotional condiments per standard ❑ Use these condiments first the next meal period Discard and record as waste: ❑ All sliced tomatoes ❑ Cheese on board if not used by end of day ❑ Lettuce and onions N 3 hours or less left on hold time ❑ Any other product with unacceptable quality ❑ Other products expiring at end of day This manual Is the property of Burger King Corporation and may be used only in a manner and by persons approved by the company. Release Date:0606 Basics Main Board Basics 209 Make d To maintain stock on heat chutes and holding units,use: . Sandwiches u Heat chute charts,Production Schedule,and KITCHEN MINDERTM u Kitchen monitor o PHU U UsMf eMOM=Waffilammywrw 4AORMOAKOMMONSIM ® a Assemble sandwiches based on Quality Steps o Prepare sandwiches with the correct amount of condiments,to ensure you serve consistent and appealing sandwiches u Follow proper rotation of product o Check hold times Li Discard product when: — Quality is unacceptable — Expired u At the end of your shift,leave the work area clean,stocked,and organized . . �. FEN sunt Food a Sanitize food contact surfacestwork area Contact l / l�"sJ — During setup Surfaces —As needed —At least every 4 hours is u Clean and sanitize food contact surfaces/work area Hands o Wash hands and exposed arms,scrub nails if not wearing gloves,and sanitize hands(refer to Hand Washing topic) — Before setup — After situations where hands may have become contaminated —After changing gloves —At least every hour Sanitizer u Prepare sanitizer solution,following label Instructions Solution — Put sanitizer solution only in an approved zone"sanitizes" container with the word"Sanitizer clearly legible(min.100 ppm chlorine concentration) — Store it on the shelf underneath the board;not on the floor —Clean red cloths,fully submerged o Check sanitizer solution frequently(hourly recommended)and change: —When visibly soiled —When chlorine concentration falls below 50 ppm(measure by using test strips) Smallwares ❑ Wash,rinse,and sanitize smallwares and S> removable equipment parts noted in the mange sa»ezer aetro� Cleaning and Maintenance Surfaces topic 4 water when changing out (e.g.,tongs, pans,spatulas) i smathvares —When Changing to a new container of sauce —At least every 4 hours —At end of day Release Date:MO This manual is the property of Burger King Corporation and may be used only in a manner and by persons approved by the Company 210 Main Board Basics Basics 1 � Stock Board ® � Restock the following as needed: o Tongs u Markers to Board Prep labels o Knife u Pans and grates u Spatulas — Use a clean,sanitized spatula with each newly opened container u Packaging(wraps,bowls,etc.) Special Condiment Requests Foilow these proceduces when precaning and mark^,g specs; sandwiches. Guest Orders t WrapMi $ Swulwit lFzami le Heavy or extra H,overicon) 50%mare of WHOPPER's Sandwicn win heavy ,(yt condiment Condiment tomato(3 tomatoes instead of 2) /t�j Cheeseburger with heavy pickles(3 pickles instead of 2)' Light or easy condimenl L(over icon) 50%less of Hamburger with light pickles(1 pickle „n condiment instead of 2)" (\Y�iJY1 Minus condiment —(t^hough imp) Leave out Double Cheeseburger mms prek%s(leave out condiment pickles) Only condiment 0(circle icon) Prepare only Hamburger with ketchup only(leave out with omereo m„staro and pkkies) condiment K Plain Line through all Prepare with no Hamburger plain(no icons condiments condiments applied) �i� ft (,Mk.f—�1 t( With Additional/ °+'over icon,or Prepare with C�eeseburger wit',events(add lib ozi Substitute condiment °+"and condiment additional or 7 g onions) letter in blank substitute square condiment Double Cheeseburger with onions(add 114 oz.l 7 g onions) Cut in half '112"in blank Wrap sandwich in WHOPPER'Sandwich cul in half square unmarked wrap,cut12 in hal,and wrap in marked wrap 'ExampleappplIies to Hamburger,Cheeseburger, WHOPPER JR. Sandwich,and doubles This manual is the property of Burger King Corporation and may be used only in a manner and by persons approved by the Company. Release Dats:0808 Basics Main Board Basics 211 Use this chart when a Guest orders a sandwich with Marking Other Tartar Marmara condinerfs-of tans Cored part of the stanoam Condiments sauceSauce sandwich build Crispy Potato Maya Lettuce Tomato Oaten Mustard KetsAap Wckks SBO Bacon Chem Orions Spread IF the icon is onawrap, ,0 �e.�} I's It nuke a',i',ii over old? the icon Ifsquare icon ss not on a ❑ I n] ❑ ❑ ❑ o ❑ ❑ r•--i wrap,mark the blank +N +L •T M Mar MC W W aC !gyp—m11 an is oath a t on an and the letter code. Use this amount... on(g) JOLIB) Sixes Oz 4) 0z. g.) ag.) Shes to ug V2 Suces Sdces Oz(p) OL(9) i WHOPPER® ( 113 oz. 112oz 4on 2on 314o2. 2oz. Sandwiches 1 (9g.)on (149.) cheese patty (21 g) (S6g.) ketchup on or patty on on pickles ketchup crown WHOPPERA" 119 oz. 114oz 2on ton 112 oz. 2o1. Sandwiches (3g.)on (7g.)on cease patty (149.) (56 . ketchup pickles or patty on on ketchup crown Burgers Wit oz. 318 oz. 1 on 114 oz 113 oz. 2on 112 oz. 2 oz. (11 g.) (11 g.) crown (7 g.)on (9 q.)on cheese (14 g.) (569.) on on mustard pickles or patty on on crown crown mustard crown BKOK Stacker W oz 318 oz. 'on 114 oz. 119 oz. 119 or 2 on 112 oz. 2 oz. Sandwiches (14 g.) (11 g.) crown (7g)on (3g.)on (3g.)on bacon (149.) (569) on on bacon bacon bacon on on crown crown bacon crown Steakhouse 1r2 oz ` 4on 4on 2on Burger ((149.) patty cheese patty on or Dairy crown I Loaded 112 uz. 2on 4 on Steakhouse (14 g.) crown patty on Burger crown Release Bate:0008 This manual is the property of Burger King Corporation and may be used only in a mannerand by persona approved by the Company. 212 Main Board Basics Basics MORRELL ASSOCIATES Current Date: 12/22/2009 13.0: BOX 268 Marshfield, MA 02050 Date Samples Taken: 12/7/2009 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 Y 011�[lL fSBOCI/If8 C Invoices:Joyce; Reports:Lg Env O Burger King#3564 L 10/16 0 Highland Ave./Rte 107 I A E T Salem, MA N I T N BACTERIA COUNT Sample Standard Plate Count1g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC JANa42010 _tM �. 301'n0 0i_ F1EP�� MASSACHUSETTS STANDARDS Machine: SPC15 50,000/g; Coliforms 50/g Other: SPC:s 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 9r,d of Health / MORRELL ASSOCIATES Current Date: 11/13/2009 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 11/6/2009 (781)837-1395 www.m'orrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 C Highland Ave]Rte 107 A E T Salem, MA N I T O N a BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC 1 5� V 0' DEC -2 2009 SAt--EM OF HENTH MASSACHUSETTS STANDARDS Machine: SPC:s 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 .S a sS �4 }ic.3itn MORRELL ASSOCIATES Current Date: 10/27/2009 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 10/14/2009 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 0 Highland Ave./Rte 107 1 E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC T H jr MASSACHUSETTS STANDARDS Machine: SPC:s 50,000/g;Coliform s 50/g Other: SPC:s 50,000/g;Coliforms 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition,American Public Health Association, 2004 yy Lt 110:'-d 6(f Hca!!!" MORRELL ASSOCIATES Current Date: 2/23/2009 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 2/7/2009 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 OC Highland Ave./Rte 107 I E T Salem, MA N I T N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC RECEIVE® MAR ' 4 2009 MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliform s 50/g Other: SPC s 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 �1 I✓faarci Paf P+f'Faii�"S J MORRELL ASSOCIATES current Date: s/za/zoos P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 9/12/2009 (781)837-1395 www.morrell-associates.com Customer#: F89-13 Y ONP[[l •350<1.1 t(3 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 0 Highland Ave./Rte 107 A E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate CounUg Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC MASSACHUSETTS STANDARDS Machine: SPC!g 50,000/g;Coliform s 50/g Other: SPC:s 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST C � Products 17th Edition, American Public Health Association, 2004 Board of Heal'T, %.Or . _ I C� ® MORRELL ASSOCIATES Current Date: 8/20/2009 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 8/9/2009 Cal (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 0 Highland Ave./Rte 107 E T Salem, MA N I T 0 N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC RECEIVED SEP '2 2009 )I=.SALEM OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliforms 50/g Other: SPC15 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST C�l Products 17th Edition, American Public Health Association, 2004 l)Q"Ard 0i t??„9iifl MORRELL ASSOCIATES Current Date 6/23/2009 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 6/13/2009 (781)837-1395 www.morrell-associates.com Customer#: F139-13 MO Ref tf eeB OC ♦ffd C Invoices:Joyce, Reports:Lg Env L Burger King#3564 L 10/16 OC Highland Ave./Rte 107 I E T Salem, MA N T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake 280 15 + r MASSACHUSETTS STANDARDS Machine SPC s 50,000/g; Coliforms 50/g Other SPC s 50,000/g;Coliforms 20/g METHOD REFERENCE. Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition,American Public Health Association, 2004 P;CYsrrg of Heath MORRELL ASSOCIATES Current Date: 7/29/2009 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 7/11/2009 (781) 837-1395 www.morrell-associates.com Customer#: F89-13 wo+ee<< .ssoeu as C Invoices:Joyce; Reports:Lg Env L�� Bura—er King#3564 L 10/16 0 Highland-Ave./Rte 107 I E T Salem, MA N I T N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake r <250 EPAC < 1 EPCC geGONJ to pUG _41009 r,�M pOF gDAAD ti MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliform s 50/g Other: SPC s 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST C Products 17th Edition,American Public Health Association, 2004 Board of Health d MORRELL ASSOCIATES Current Date: 5/15/2009 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 5/9/2009 (781)837-1395 www.morrell-associates.com Customer#: F139-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 OC Highland Ave./Rte 107 I E A Salem, MA N I T N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake 310 < 1 EPCC MASSACHUSETTS STANDARDS Machine: SPC:5 50,000/g, Coliform 5.50/g Other: SPC s 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 l 4� EI N E JUN - 12009 JF'SALEM ,J OF HEALTH MORRELL ASSOCIATES Current Date: 3/20/2009 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 3/7/2009 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 C InvoicesJoyce; Reports:Lg Env L Burger King#3564 L 10/16 0 Highland Ave./Rte 107 I E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC 1E EIVE® APR _ 2 2009 .-EM yE4LTH MASSACHUSETTS STANDARDS Machine: SPCs 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST GG Products 17th Edition, American Public Health Association, 2004 �, Commonwealth of Massachusetts s it City of Salem Board of Health Kimberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Foo"etail Establishment Permit DATE PRINTED: 12/29/2011 ESTABLISHMENT NAME: Burger King File Number:BHF-2004-000088 259 Highland Avenue Salem MA 01970 LOCATED AT: 0259 HIGHLAND AVENUE SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes FOOD SERVICE BHP-2012-0222 Jan 1,2012 Dec 31,2012 $280.00 ESTABLISHMENT Total Fees: $280.00 PERMIT EXPIRES December 31, 2012 Board of Health This Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code,beofre any revonations,improvements,or equipment changes are made, all plans for:such must be submitted to and approved by the Salem Board of Health. Page 1 I CITY OF SALEM, MASSACHUSE'ITS BoARI)OF HE.ILTH 120 WASHINGTON,, 1rREF,r,4... FI t t()R T't?L. (978) 741-1800 KI1,IB R-EY DRISCOLL FAX(978) 745-0343 MAYOR IramcL11rD,1Iem.CoM LARIO RA RiDIN,Itti/RF.t tS,t.j I(7,(:P-Pti Hr3un i A(&,N,f 201/,APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT / } NAME OF ESTABLISHMENT_ r_ j�f1 —/� ---TEL ADDRESS OF ESTABLISHMENT fi - l'� vd •t rP f� FAX# 7,?If(i 96�7,7 MAILING ADDRESS(if different EMAIL-Business': a,1_ C'(_ a, 7Z)r[7.L_ Website: OWNER'S NAME 1 //� Z- C TEL# 7 / d 93,05796 ADDRESSOi GFX/ilrl �ti f / G°�CL�1T7//rr� . f/7 GL- QG�' STREET CITY STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S)L.L//}}f7 d^e.cx.. 1)91, -a-,_vr_-4L CERTIFICATE#(S) ��-A;q60_:3 (Required in an establishment where potentiiaallllyy hazardous food is prepared) EMERGENCY RESPONSE PERSON 5t��>r� . l./im G k HOME TEL N�;0_67 7Q J�o7 �j I DAYS OFOPERATION Monday - : TuesdayWednesday' I' Thursday Friday' Saturday Sunday I HOURS OF OPERATION �� Please write in time d dap. ! I < (For example 11 am-11 pm) 1AC2-n'7 (��i.LL-.+'7�.-i�r7�Ct-nn p3 �-•�'" TYPE OF ESTABLISHMENT .^, FEE (check onlvl RETAIL STORE YES 'tdO l less than 1000sq.ft. =$70 1000-10,000sq.ft. =$280 more than 10,000sq.ft. =$420 - - - -- .... = -----------------------------------------------------�_---------------- -------- - RESTAURANT vac NO less than 25 seats (Outdoor Stationary Food Cart$21 25-99 seats =$280 more than 99 seats 420 BED/BREAKFAST/--------------------YES-PNK06 ---------------------------------_-- ------------------ -$100 CHI!DCARE SERVICE$lNURS#NG HOM -------- -------- ----- ADDITIONAL PERMITS MAKE(not just serve) ICE CREAM,YOGURT/SOFT SERVE ,yiSD NO $25 TOBACCO VENDOR YES $135 ALL NON-PROFIT(such as church kitchens) YES O $25 'Please pay total with one check payable to the City of Salem. This Permit is not transferable and must be reissued upon change of ownership.The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements,or equipment changes are made,all plans for sue ust be submitted to and approypd by the Salem Board of Health. ursu nt to MGL Chap, r 62•,Tio49 orf y under thepains and penalties of perjury that I,to my best knowledge and belief,have filed all state tax r u and paid all st eta r W. Signature 1 l Date Social Security or Federal Identification Number nR Updated 5123/11 FOOUAP2011.adm CheckN&Uat r $ � Student Name ANDREA MIRANDA -. Class Number 897985 EXAM FORM NO. 10167 Exam Date 9202010 ` Expiration Date 9202015 Is Instructor Name RON DIMICK CERTIFICATE NO. 7312603 Sponsor Name Burger King 1112 Exam Locetion MA Exam Form Name 10167 .t. .' Overall Point Score 70 Overall%Spore 87 Passing%Soors 75 matus PASSED D 598 .. � � Partes Your•.,r. - Point Point Spore Spore 80 70 Domain Names I.Foods 36 29 A N D R EA MIRANDA II Cleaofies rza Meint. 9 5 Ill.Facilities 5 5 • '" � .< IV.Monitoring Food Personnel 12 10 V Temp.Measuring Devices 2 2 'or sbco,;W G comrletng tfra st.ndcres set ro^n v,the Se,Swe'Food Rotex on Manager Ce,ti`fcaton Examination" VI.Allergens 3 3 whioh-s accred tud by tIfe Amer;a,Nat Drat Standards for Food'mtecdor:(C-P). VII.High-Risk Populations 2 2 VIII.I-egal/Regutatory Issues 4 4 IX.Facility Leyout/Desfgn 2 2 X Training Employees 5 5 9/20/2010 mar° ma-maeurc am N.c on F..,00 oo: Fx"VINA, ,-9 r`u l KeMRnuaaNr 9/20/2015 Lu,u Y,a•,s,;q;6�4a:[.c a-r.moan.I rc.,.+<,:L:In,rts+e: SATE Cr Ex'z InATIO1. !tical w..,oo:.ir cr.c...e•1„c lei fan..::r:.::orw•a•.,::.: "s ,-e"m.=:r. - Ewm Fm,,,Na 10167 t p .12803 ServSafe"certirrcatron . I lt At(/l NATIONAL .. : :To ANDREA MIRANDA RESTAURANT ® P ASSOCIATION® ail Nme suwp[rrme.Frn.m o.n.rEvrrvnamn gnonoto tlORSv st'<.:.:2 rJiroN.C',r \f.[�_nt 9Cz.F.in",f>•tzcrrePo,$CI.:LiCnS� � Dn.oIE[pi•ni°n 9130/2015 + <'ff,t haeMel Na,utlaMRawna'on fl.,Crtn.l WeNi'von APrtlali Nw+utl ar.N 5[rv5a:°,n[L2°See.,u. r.,eepvrtm:mama'tr of Ih,Nat°ncI!1°mva,t Riwnev0,EEoen cnaFrva.°fm'L _ ..aief.uMar lF,:.wMhawnal Xa3ua,aMt,i3a[.aro:.[.morS lvC,axM.'y crmMi„LM0ry6 Ra ,N Falev"am Avpa'iSx, , r ihiSC<[uneq[0101st la,afwft[atl era2an0 -.Irc0.b� i�uu.w na•ua-,�ewvtl,-.n.iod • ,rvvE .xa YI07 , I� CAW �r 0259 HIGHLAND AVENUE Burger King City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: Violations Related to Good Retail Practices (Blue Items) 744-9467 Food and Food Protection FAIL Critical BLUE 'Owner: Comment: Large ice machine was noted open at time of re-inspection.Ice machine must stay closed while not in use to prevent Boston-Wyman, Inc. cross contamination. -PIC: Equipment and Utensils FAIL Non-Critical BLUE i Karen McCadden Comment:Walk-in freezer had some ice build up on condenser; PIC stated work order was in to repair it.Freezer is holding at Inspector: proper temperature.De-ice and repair to stay ice-free. Elizabeth Salandrea Date Inspected:Correct By: 3/11/2009 Risk Level: Permit Number: BHP-2009-0296 Status: SIGNED OFF !#of Critical Violations: 1 e Time IN: Time OUT: Urgency Description(s): BLUE: All other violations noted in the 3/4/09 inspection report have been corrected. Violations Related to Good Retail Practices (Critical violations must be corrected immediately or within 10 days)(Non-critical violations must be corrected immediately or within 90 days) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741.1800 GeoTMS®2009 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Mar 12,2009 ) Page I oft fi RED: Item Status Violation Critical Urgency Violations Related to Foodborne Illness Interventions and Risk Factors (Require immediate corrective action) &Cap City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2009 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Mar 12,2009 ) Page 2 oft ` 0259 HIGHLAND AVENUE Burger King City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: Violations Related to Good Retail Practices (Blue Items) 744-9467 Foodan ood Protection FAIL Critical BLUE Owner: Comment: Large ice machine had some grime build up on inner panel.Thoroughly clean&sanitize inside of ice machine. Boston-Wyman, Inc. 1t'C"5 o mall ice box at drive thru window was open.Ice box must stay closed or covered while not being used to prevent cross PIC: contamination. Karen McCadden / Inspector: t/Freezer next to fryolator observed to be open ajar after employee closed it. Ensure freezer is fully closed at all times to maintain (yL� temperature. Elizabeth Salandrea t o+ fx? h Date Inspected:Correct By: 1/Hamburger patty freezer observed to have�soqm�e patties loose on a plastic bag. Do not store food directly on top of bags or �Ae c2S 1k containers. +4-5s -lis 6c, i64� t�� 3/4/2009 Equipme and Utensils FAIL Non-Critical BLUE CW Risk Level: Comment: Handwash sink must be labelled"handwash only". Permit Number: —Walk-in freezer had some ice build up on condenser; PIC stated work order was in to repair it.Freezer is holding at proper BHP-2009-0296 temperature.De-ice and repair to stay ice-free. Status: Walk-in freezer needs general cleaning on the floor. PARTIAL COMPLY #of Critical Violations: (/ Floor to the right of the 3bay sink has some food debris on it. Remove food debris and clean floor. I j,/Floor on back dry storage area needs general cleaning. Time IN: Time OUT: !i Men's room must have"employees must wash hands"sign. Urgency Description(s): BLUE: Reinspection in one week, all violations to be corrected. Violations Related to Good Retail Practices (Critical violations must be corrected immediately or within 10 days)(Non-critical violations must be corrected immediately or within 90 days) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741.1800 GeoTMS®2009 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Mar 11,2009 ) Page 1 oft Item Status Violation Critical Urgency RED: Violations Related to Foodborne Illness Interventions' and Risk Factors (Require immediate corrective action) ZZ City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2009 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Mar 11,2009 ) Page 2 oft / MORRELLASSOCIATES Current Date: 1/16/2009 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 1/10/2009 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 C Highland Ave./Rte 107 I E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake 260 < 1 EPCC �9 4 ee2009 � 4 MASSACHUSETTS STANDARDS Machine: SPC:5 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 90ard . ; He"i!t s _ J / s MORRELL ASSOCIATES Current Date: 12/18/2008 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 12/13/2008 (781)837-1395 www.morrell-associates.com Customer* FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 C Highland Ave./Rte 107 I E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Counttg Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC DVED JAN -2 2009 MASSACHUSETTS STANDARDS Machine: SPC!g 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 Commonwealth of Massachusetts s b City of Salem Board of Health Nmberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 12/30/2008 ESTABLISHMENT NAME: Burger Kin g g File Number:BHF-2004-000088 259 Highland Avenue Salem MA 01970 LOCATED AT: 0259 HIGHLAND AVENUE SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions 1 Notes FOOD SERVICE BHP-2009-0296 Dec 30,2008 Dec 31,2009 $280.00 ESTABLISHMENT Total Fees: $280.00 PERMIT EXPIRES IDecember3l, 2009 Board of Health rw This Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code,beofre any revonations,improvements,or equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Page 1 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4r°FLCOR KIMBERLEY DRISCOLL ��,, QED TEL. (978) 741-1800 R $, �� ty FAx(978) 745-0343 MAYOR ■ • IDIONNEnn.SALEM.COM JANET DIONNE, NOV 2 52006 ACTING HEALTH AGENTv1= SALEM 00AR0 OF HEALTH 2009 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT l�loC - o r Ki r�r, # 35 (5 TEL# CM -c - '19 (4 - 44 G1 'I u 1 ADDRESSnFESTA°LISHN',,ENT ��`r kiyc ) 1Gn(1 Ada. ScxIQrYI FAX# SO$- 'No - a `)� 7 ;� 1 J MAILING ADDRESS(if different) HO l)rPPA-, Niel ?-A, IIS 1 L/? hliC_ MA h9G01 , EMAIL- Business': 9\<D 3S(4 6Drs e m, i f . (•,m Website: OWNERS NAME 3c sS c)In - W\ trvma✓1 .�Yt C. TEL# HOFS- '111 $ - SG 14 y ADDRESS ilr_� I�ra� c�C Hill Ra_ Urnit'q�, N'FGr,Ai_% �A 00-'601 STREET CITY ' ' STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S) Ve,(- yN i r_a M Y3 i u V CERTIFICATE#(S) V7 Ll a 331 (Required in an establishment where potentially hazardous food is prepared) ' EMERGENCY RESPONSE PERSON HOME TEL# I' DAYS OF.,OPERATION ' I:- Monday- i-Tuesday =' i Wednesday:-. r` Thursday Friday h.-- 'Saturday I Sundav'. I HOURS OF OPERATION Please write in time of day. —1--_� om _ �r( t {f1 hf (For example Ilam-11 pm) TYPE OF ESTABLISHMENT FEE (check onlv). RETAIL STORE YESNO less than 1000sq.ft. =$70 1000-10,000sq.ft. =$280 more than 10,000sq.ft. =$420 ------- ---- --------- ---------------------------------------------------- --- REST-AUAle eats = 140 (Outdoor Stationary Food Cart$21Y 25-99 seats _--------=T2_80) 1 more than 99 seats =$420 - ---------------------Y-- T - ---- - --- ---- O $100- BED/BREAKFAST/ ES-- N CHILDCARESERVICES --------------------------------------------------------------------------------------------------------------------------- ADDITIONAL PERMITS MAKE(not just serve) ICE CREAM, YOGURT/SOFT SERVE YES NO $25 TOBACCO VENDOR YES NO $135 ALL NON-PROFIT(such as church kitchens) YES NO $25 *Please pay total with one check payable to the City of Salem. This Permit is not transferable and must be reissued upon change of ownership.The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations,improvements,or equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 62C,Section 49A, I certify under the pains and penalties of perjury that I,to my best knowledge and belief,have filed all state tax returns and paid all gta taxes requir and r thl law. !l.2D (I/� C)L! - a-1 14 ,�-o rl g Signature / ---_— -—_� Date 7 —_--Social Security or Federal Identification Number Revised 424/07 FOODAP2008.adm Check#&Date 41;Tf _1.( 11' c r i Q�6 $ Ine¢,ommonweauh olMassachuseits o e�/�itic C�1dir�' r Department of Industrial Accidents 3 Office oflavestigatdons 600 Washington Street --, Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: General Businesses Annlicant Information / f, / / Please Print Legibly Business/Organization Name: I,/�es�e/i al rrlf� �1�G/2 ii[�/y�/ X i� Address: //O 51-,-ec-Qs t/,� R-1 City/State/Zip: W-21 q N It; i S , 17M 6.2601 Phone#: • 5-041 Are you an employer?Check the appropriate box: Business Type(required): 1.Er I am a employer with , employees(fiill and/ 5. ❑Retail or t tin pare).* 6. ❑Restaumnt/BwAs ting Establishment 2.❑ I am a sole proprietor or partnership and have no 7. ❑Office and/or Sales(mcL real estate,auto,etc.) employees working for me in any capacity. [No workers' comp insurance required] 8. ❑Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152,§1(4),and we have 10.❑Manufacturing no employees. [No workers' comp.insurance required]*: 11.❑Health Care/1 4.[] We are a non-profit organization,staffed by volunteers, �> With no employees. [No workers' comp.insurance req.] 12.[� 1 AKe r:%lr.� as f ccci" *Amy applieaot that cbwb bac#1 most also fill out the see<ion below showing their workes'eompmsation Polley ivfomatioa **U&e empotate officen;have acea$tedtLemschcs,but the corpotationhas odw employees,a wad=,mmpematim policy is required and such an organization should check box A. Ion an employer that Ls providing workers'�,,,,,t„„� w�,�, hrsrowncefor my employees. Below is the policy informadm Insurance Company Name: i)&jv-ha.: 15 \11(,17 Group -. nn Insurer's Address: /D [ )/ ;7i 5� f ltbOt-, Aid F/vd City/StatelZip: Al V 3/V Policy#or Self ins.iAc.# 94/OIL Expiration Date: /®f /®9_ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Fail=to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up in$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerftp r, der the pains and penalt a ofperjwy that the mformapon provided above is Due and correct Signature: Phone#: Off" `77?-,J O 4Z71 Official ficial use only. Do aot write do this area,to he completed by cdty or town o f iciaL City or Town: PermWUceuse# Isswng Authority(circle one): _ 1.Board of Health 2.Building Department 3.C'ityrrown Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone M www.mass.gov/dia *1SATION AND EMPLOYERS LIABILITY INSURANCE CERTIFICATE INFORMATION PAGE RENEWAL AGREEMENT Producer: Agent# 960 Gail Merchants WC Group Inc. Association Benefits Ins Agcy Inc eitish American Blvd. 529 Main St Ste 606 am, NY 12110 Boston, MA 02129 :ier Code: 34355) Certificate #: 014005030096108 Prior Certificate #: 014005030096107 Che Employer: Burger King Boston Wyman, Inc nailing Address: 110 Breed's Hill Road Hyannis, MA 02601 Fein: 042745078 Other workplaces not shown above: Type of Business: Corporation SEE SCHEDULED OF OPERATIONS Risk ID: I The certificate period is from 12:01 a.m. on 1/01L20— to 12:01 a.m. on 0 1/01/2009 at the insured's mailing address. A. Workers Compensation Coverage: Part One of the certificate applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Coverage: Part Two of the certificate applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident A 500-000 each accident Bodily Injury by Disease S 500.000 certificate limit Bodily Injury by Disease $ 500.000 each employee C. other States Coverage: D. This certificate includes these endorsements and schedules: WCO00000A(04/92) WC000113(01/06) WC000310(04/84) WC000406A(08/95) WC000414(07/90) WC200301(04/84) WC200302(05/86) WC200303B(07/99) WC200405(06/01) WC200601(06/92) The contribution for this certificate will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Code Contribution Basis Rate Per Estimated No. Total Estimated $100 of Annual . Annual Remuneration Remuneration Contribution SEE SCHEDULE OF OPERATIONS Total Estimated Annual Contribution 83,063.00 Minimum Contribution $ 269.00 Expense Constant $ .00 i 00 00, 01 A Issue Date: 12/20/2007 Countersigned by C - EXAM FORM NO. 4344 CERTIFICATE NO. 5742331 All fSeirvftf 5ervsafer C - ridtOrmulft er ® ® al i - Td VERONICA- M:YSI:.UUK for successfully completing the standards set forth by the National Restaurant Association Educational Foundation for the ServSafe®Food Protection Manager Certification Examination,which is accredited liy the American National Standards Institute (ANSI-Conference for Food Protection(CFP). Presented by the National Restaurant Association Educational Foundation 2/7/2008 /2008 DATE OF EXAMINATION 2/7/2013 DATE OF EXPIRATION Local laws apply.Check with your local regulatory agency for recertification requirements. SS /�/ N • r r •• (� National Restaurant Association ® Mary M.Adolf EDUCATIONAL FOUNDATION President and Chief Operating Officer a #0655 National Restaurant Association Educational Foundation www.nraef.org This document cannot he reproduced or altered. Massachusetts Department of Public Health Salem Board of Health Floor Division of Food and Drugs 120 Washington Street,4'" 9 Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name Date Type of Ooeration(s), Type of Insoection U a(,-( k iill.J Ci- ( 1-l4-0P) Food Service XRoutine Address a s g i II /I V Risk ❑ Retail ❑ Re-inspection t /Y Level ❑ Residential Kitchen Previous Inspection Telephone ❑ Mobile Date: °/ 7 7yY- 9y6 7 �HACCP YM El Temporary El Pre-operation Owner AoS 4-ov) _ W y"tah Lh C - I ❑ Caterer ElSuspect Illness Person in Charge(PIC) q ' Time ❑ Bed&Breakfast ❑General Complaint v_{�D✓1 r C2 In: 12-LIO�Al Sit g ;,006- ❑ HACCP Inspector \��telt N 1��L� Out:Js Perm-i4 No. 0 2,9 ❑Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT.'_; ._�'_, - „ , _ ., ,_ , , ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ® �.,... -.... .,. ....._.:.._ ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS" "' " ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded _ ❑ 15.Toxic Chemicals _.FOOD FROM APPROVED SOURCE„"�';„'"' ", ,. ';." �, d : TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4. Food and Water from Approved Source ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION .-'.-:.. .. -- 19. Hot and Cold Holding El & Separation/Segregation/Protection 290.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)-" ❑21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing CONSUMER ADVISORY El11.Good Hygienic Practices ❑ 22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related ❑ - Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code. This report, when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2)(590A03) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: S 5900Sp IFOm 14 dX Inspector's Signatur : l�y� _ c f Print: t /Q e PIC's Signature:, c - Print: //v� 0A iCa "�/�J//`�� ,l� I Page / of Page Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT ( 8 Cross-contamination I 590.003(A) Assignment of Responsibility* 3-302.11(At(]) Raw Amoral Foods Separated front 590.003(B) Demonstration of Knowledge* Cooked and RTE Foods* l 2-103.11 Person in charge-duties Contamination from Raw ingredients 3-302,11(A)(2) Raw Annual Foods Separated from Each EMPLOYEE HEALTH Other" J 2 590.003(C,) Responsibility of the person in charge to Contamination from the Environment r require reporting by food employees and 3-302.11(A) Food Protection' applicants* 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility Of A Food Faiployee Or An I 3-304.11 Fund Contact with Equipment and Applicant To Report To The Person In Utensils* Charge* Contamination front the Consumer 590.003(G) Reporting by Person in Charge` 3-306.14(A)(B) Returned Food and Reservice of Food- 3 590.003(D) Exclusions and Restrictions* I Disposition of Adulterated or Contaminated 590.003(E) Removal of Exclusions and Restrictions Food 3-701.11 Discarding of Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 4Food and Water From Regulated Sources ( 9 Food Contact Surfaces 590.004(A-B) Compliance with Food Law* 14-501.11 I ( Manual Warewabh ng-Hot Water 3-201.12 Food in a Hermetically Scaled Container* _ _ Sanitization Temperatures" - _ 3-20 1.13 Fluid Milk and Milk Products* 4-501.112 I Mechanical Warewashing--Hot Water 13-202.13 I Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Mill:Products,Pasteurized'* 14-501.t id I Chemical Sanitization-temp., pH, 3-202.16 ( Ice Made From Potable Drinking Wirer` concentration and hardness. 5-t01.I I ( Drinking Water from an Approved System' 14-601.1[(A) Equipment Food Contact Surfaces and Utensils Clean- 590.006(A) Bottled Drinking Water* ' 540 006(B) Water Meets Standards in 310 CMR 22.0* � ( 4-602.11 Cleaning Frequency ofF Auinent Food- Shellfish t Shellfish and Fish From an Approved Source ( Contact Surfaces and Utensils% 4-702.11 Frequency of Sanitization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of Equipment* Shellfish' ( 4-703.11 ( Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed I Chemical* Sources* 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved by I Regulatory Authority 1230E 11 Clean Condition-Hands and Arms'' 3-202.18 Shellstock Identification Present" 2-301.12 Cleaning Procedure* j t ( 590.004(C) Wild Mushrooms* 2-301.14 When to Wash' 3-201.17 Game Animals* 11 ( Good Hygienic Practices g ReceivingtCondition 2401.11 Eating,Drinking or Using Tobacco* � 3-202.11 PHFs Received at Proper Temperatures* 12-401.12 I Discharges From the Eyes,Nose and � 3-202 15 Package httMouth" � 3-IOL I1 � Fexid Safe and Unadulterated * 3-301.12 Preventing Contamination When Tasting*' 6 Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained" Employees* Tags/Records: Fish Products 13 ( Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located and Accessible- 3-402.12 ccessible3-402.12 Records,Creation and Retention* 5-203.11 Numbers and Capacities" 590.004(1) Labeling of Ingredients' 5-204.11 Location and Placement* 9 Conformance with Approved Procedures ( 5 205.11 Accessibility,Operation and Maintenance /HACCP Plans I Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging.criteria* I b-301.11 Hindwashing Cleanser,Availability 8-103.12 Conformance with Approved Procedures' 6-301.12 Hand Drying Provision Denote,:critical nem in the federal 1999 Ford Code m 105 CMR 590.000. I CITY OF SALEM Q J BOARD OF HEALTH Establishment Name: ►v V 2(ft 2 lC N G Date: ll —/y—�8 Page: Z of Z Item Code C-Critical ItemDESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY + l� �rSd 1,16 t9 b s-e✓v-ed W' p � I-f 1,2-7 lr5-01, fw mac: ; eces j std a.bo e`er �e wL�cCt1 c�I.t�l Fi t a.r-e_ce_ . , 1+ems t s a z,AJ o_t vvc> 40 vs�e ► s L 4-� I C a✓'z'�i board A0 y- I 1 I 1 Discussion With Person in Charge: Corrective Action Required:. ❑ No W-Yes I have read this report, have had the opportunity to ask questions and agree to correct all a/Goluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five do ars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. v ❑ Voluntary Disposal ❑ Other: 1 ?-�+i! )4IC.i Pt1f�c Rec:ivcd ai�1'ewtta:ratutes Violations Related to Foodborne Illness Interventions and Risk ! Accurdinr 10€.ay. Caoled u, { Factors filems 1.22) (Coni) _.}E _ _ $1�N-IYF Within I Houju 'x .t CiK+iiu,lReeha€�foe PIIN, PROTECTION FROM CHEMICALS 1 lg � PHF Hot and Cold Holding ; Food or Color Additives 3-5(;r €6r g) calci PFIF,Ivii,6wamed at or t'ulov, 3-102,14 ira:tr3;naU,rr,,.=.tiA+3Jit+ve�'' ! 1lot YNhrAtaitnainedaiorah,rve 15 Poisonous or Toxic Substances i 140'F. I:)E.If i i,!entifytt:v,in#t:;a:-,tion C=ciy•nz' j �_;+ii 16tA) Rkm,tsi4oldator.ibvvc1300F r i"orxuner.;` I 20 Time as a Public Health Control 1 7 102,11 f',rr ntun an+e 1+'+rr:it r f.+ra::ii:1-'r '` ! 3-%t €0 lime as a Public stealth Control, ` 7-201.1 I Srpaiwraun - Storar_e" E il0.1'H) Variance Reuuircn;esit 7-2D2 IS €?C'trt:ti,:n -pwss w-c ald 7-202.12 1 cnai ilionS of Uw- j 'r,,;ic{'t:ntamer:.._ REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7._o3.I1 C 7 X04.i f Sdaiti7eis,Critrri,,–Ch;:nic,6- POPULATIONS(HSP) + '0.3.12 Ctt•:tliicald tix `4ta,hro 'i'r+Xtri.'r.(.[?tc,n,,+. 21 ;-;;nt 11fA) t:npa cars r.cd Pro. -agcd Juices.at,) 1 m. j 1 Rrvertees with Wareing 7 —?04 14 € i vi ng e vei] .L'nterict' ! , 7 205 11 t.F[)II t rh} t,.ce„f Yastru;ized L.Sv: E 3 ^ 1 itis) i2.tw,x Kuimils OR kcd Animal €oud acrd 7-206.11 ! ltesrirrad i,tv Ye<ticide:,I. 1U."to, I Rax Serf Spn+tus M1oi SertcrT. ` 7 .'.06.12 j Rr 3 ti)' II'(:, I tn+tD c neJ P'.>< t Yatka.r h.rr lie-;,:n�cff. ' `r '..Ori.!? � Prrddn,„?Y,alder<.Yrat C,attrta ane � M1acn;tn:in CONSUMER ADVISORY ' 22 3.00:.11 f r'cnxunicr:ictrreo:F NKttvvl For C'owamptiun:a i TIMEFrEMPERATURE CONTROLS • rki,itrr.rl F•xxi.. iliac;,tc Raw C`nder-,a*krtl r:r i 16 ProperCookingT-empeaatureforI`rao+ih�Otslnh•nvi,.,rse'.,Y-.,,. to ?irn.te 3-401.11 AW tt.:> :e 45`r 15 i I {rgc-lnmrulratc 5er"nz ! {5'1.1_,e t.:tr^.I i Pz.�tein in�d Fqzz SuhSi:n tv fon kxw 5h011 3-401,11 tat 1) C+)m:r:rn(1ted Fish. 'Ainab t: name t• !':.',' 3-401.1103)(1,;2) NO ar,d Boo'€{,aa;t t-l(r F €2i nunSPECIAL REQUIREMENTS lnircr.:if 144.:t, ISS h. 1` ! 590Oi)lh A) J)t Vidat::tn: of ScUion 5911 tk WAI-(D)irr i al:�nnr;, mobil,fo,Ri t+n)yoraty acid 3-301-1I(A)0t Pottltrr-1Liid Game- Srafie l PEtta, I iesidcsnt;al kitchen opciatiom,.bould be j swflole C-ont'nmm,Fi;h, li:a[, ticbood under life apptopnote �ei:wns Y,uhrn or Raoirt-inti-P 15 i'-e, r shove if!.:l:ifed to fxxll(•rn� illness 3--101.1 1rC)(1) Whose iou,,ic- inu.ct Br,f Swal:k ! itle]ventitms and risk faclors Otb,r 1 540.009 vuflatio0¢relating t<r?otxJ retail i 1-401.f2 Rae ,�nr[nalIu:,,I:,CfhAcd,na 1 lxnctitc. .houleiIVdehitedt. idcrti2t) l� +littur;ae� i65,F x Spixial Ttegnir:mctfts. ,.401 1T(A)(Iph'1 Af thnet Plc's,:- I i;i'i' i5 s•C, _-� 17 Reheating for Hot Holding j VIOLATiONS RELATED TO GOOI RETAIL PRACTICES –%03.:t;Aif>=.t)1 PRE, tni-F ( x. ( (I€etag21-30) 3-W.I I(B) 4lico)Nuai 'r ib'*'t'??vt,mnr Staeding Crui(w ,i nJ n:,n-,rifwal violanom. wi:n h do na: ;elar.r,)dw Tama, I Jf)ue!horne, ilb<r a,. urvrr nott:orea,na;rizb-,fa.curs I:.o-daZf.en<•, ,.;n j•r 1-403.1!t(7} C'.;;mrn+a,ialEvPrtxesiadRTFFixxl finnafin:h:juli•,x-+ny'sernonen/the Ford Code and)(7iCd;k 3-403,1 i(F) Reniaminm+ Ln,hced Y<ations of !ioct I Item Good Retail Practices , FC 590,00 73 rm F4anflceni a:rr'Per.:e�ne! FC, .:? ! 00,'rt?sit. ' a _.._. ... ;st Proper Cooling of PHFS r< .._-..rC,d:ird rood Protection FC - 3 (y, �5 " ' 23kiJgautv'org,Iffl:t;ralFid4rrGUNen1Usd7stlaSiQ FFrC;:--4 501,14(A) COTu;Coxtk. i f :m: 41F to .i 0- W"I- ) "r`1ithtn : ltaurs;:gid From 0O65G i 2; Ph/5n^a'Fa.,�liiv Fly-6 .W7 I I"F!-t;"F 1i;t3dn T tir,nt:. 0r T.we kla'en:ais r0 - 7 663 l 3-501,141fi) Conlin PHF, vfadc Hum Ambient 29 _ �nxia!t3. tnr mettts Op "icmperaoire lig,,red:tWe is W'c;15,17 X36,--- �_021t''_ Within 4I€r>Z ,0 MORRELL ASSOCIATES Current Date: 4/16/2012 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 4/2/2012 YO RdE LL ♦EE OCId TEE (78 395 www.morrell-associates.com Customer#: FB13-10 C LBK LLC L Burger King#3564 L 10/17 MAY 02 201Z C Hawthrone Square Mall/Rte 107 I A 259 Highland Ave E CIN OF S,+LEM T Salem, MA N BOARD OF HEALTH T N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Ice Cream 390 9 MASSACHUSETTS STANDARDS Machine: SPC.-5 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products, 17th Edition,American Public Health Association, 2004 Dowd of Health MORRELL ASSOCIATES Current Date: 7/22/2008 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 7/12/2008 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 C Highland Ave./Rte 107 I E T Salem, MA N I T 0 N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake Mix <250 EPAC < 1 EPCC REGI C/ E® 'AUG - 4 2008 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g; Coliform s 50/g Other: SPC!g 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST C ( Products 17th Edition, American Public Health Association, 2004 Boo, s of �Iea:f d MORRELL ASSOCIATES Current Date: 3/24/2008 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 3/11/2008 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 YO P864L •S80t11 ffE C Invoices:Joyce; Reports:Lg Env L Burger King#3564 O L 10/16 C Highland Ave./Rte 107 I E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC RECEIVED APR -2 2008 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC15 50,000/g;Coliform s 50/g Other: SPC s 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition,American Public Health Association, 2004 soard 09, Health x / MORRELL ASSOCIATES Current Date: 4/24/2008 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 4/9/2008 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 O L 10/16 C Highland Ave./Rte 107 I E T Salem, MA N 1 T N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC RECEIVE® MAY 2—2008 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC ! 50,000/g;Coliform ! 50/g Other: SPC ! 50,000/g;Coliform ! 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 Board of Health / MORRELL ASSOCIATES Current Date: 5/25i2008 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 5/10/2008 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 YOP11LLl SS80CIA LLS _ C Invoices:Joyce; Reports:Lg Env OL 'Burger K ni g#3564 L 10/16 C Highland Ave./F I E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count1g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC RECEIVED IVED 'JUN 2 2008 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC ! 50,000/g;Coliform ! 50/g Other: SPC ! 50,000/g;Coliform ! METHOD REFERENCE: Standard Methods For The Examination of Dairyairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 v ® MORRELL ASSOCIATES Current Date: 6/26/2008 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 6/7/2008 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 OC Highland Ave./Rte 107 I A E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Strawberry Milk Shake <250 EPAC < 1 EPCC RECEIVED 'JUL 2-2008 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine. SPC s 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g //r METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 ® MORRELL ASSOCIATES Current Date: 9/23/2008 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 9/13/2008 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 u O��C4♦ •SBOtu�fE C Invoices:Joyce, Reports:Lg Env L Burger King#3564 L 10/16 0 Highland Ave./Rte 107 I E T Salem, MA N I T 0 N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g SAMPLE ATTEMPT MADE: NONE AVAILABLE: WAITING ON NEW MACHINE .CEI'VE® OCT -3'2008 ,.ALk-tv1 OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliform s 50/g Other: SPC15 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST G�l Products 17th Edition, American Public Health Association, 2004 i;o%ard fit el¢4 Zgi'th i a IMPORTANT MESSAGE FOR DATE TIME _ P.M. M OF PHONE AREA CODE NUMBER E:RENSION O FAX O MOB I F AREA CODE NUMBER TIME TO CALL i TELEPHONED J1,0LEASE CALL .I CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE //\2+*-�� - -��'H' Y SIGNED _ f.�d70C FORM 4009 r _` MARE IN ll 5 A Ski�'1 •`L.Y1vJ• �� rc�*Q 1 �,^.. Uti F tt�`. te{cr t� S310N }� MORRELL ASSOCIATES Current Date: 8/22/2007 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 8/13/2007 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 O L 10/16 O Highland Ave./Rte 107 I E T Salem, MA N I T N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Chocolate Milk Shake 370 3 RECEIVEED SEP 0 4 2001 CITY OF SALE14 BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC ! 50,000/g;Coliform ! 50/g Other: SPC ! 50,000/g;Coliform ! METHOD REFERENCE: Standard Methods For The Examination of Dairyairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 Saat d of Health / dMORRELL ASSOCIATES Current Date: 6/29/2007 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 6/20/2007 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 40dd Fla •Sd OC/I tfd C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 0 Highland Ave./Rte 107 I A E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count1g Coliform/g Strawberry Milk Shake 2,900 46 RECEIVE® IJUL 0 3200 CITY OF SALE BOARD OF H TH MASSACHUSETTS STANDARDS Machine: SPC15 50,000/g; Coliform s 50/g Other: SPC s 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 " =;narcl a° H,afth MORRELL ASSOCIATES � Current Date: 5/25/2007 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 5/22/2007 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 u ORR FIt RS6GC4 tf6 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 0 Highland Ave./Rte 107 I A Salem, MA E T N I T N 1 BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake 2=600 6 RtCEIVED !JW - 4 200" CITY OF SALEM BOARD OF HEALTH r MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliforms 50/9 Other: SPC s 50,000/9;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairv_ LAB ANALYST Products. 17th Edition,American Public Health Association, 2004 Uf and of i:diriti.l: MORRELL ASSOCIATES Current Date: 7/23/2007 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 7/10/2007 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices Joyce; Reports:Lg Env L Burger King#3564 L 10/16 0 Highland Ave./Rte 107 I E A Salem, MA N I T 0 N BACTERIA COUNT Sample Standard Plate Count/g m/g Vanilla Milk Shake 1,100 43 RECEIVE® 'AUG : 22007 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g; Coliform s 50/g Other: SPC s 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 �'1e3�t9 is"r 4ia,>,�rs,h A MORRELL ASSOCIATES Current Date: 10/16/2007 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 10/9/2007 ESBOCn�f6 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 x O�xE It C Invoices:Joyce, Reports:Lg Env L Burger King#3564 L 10/16 OC Highland Ave]Rte 107 I E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate CountIg Coliform/g Vanilla Milk Shake 320 < 1 EPCC RECEIVE® NOV 0 2 2007 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST 117Products 17th Edition, American Public Health Association, 2004 Board '), "H&.14h / MORRELL ASSOCIATES Current Date: 11/13/2007 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 11/6/2007 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 OC Highland Ave./Rte 107 I A E T Salem, MA N 1 T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Chocolate Milk Shake 1,100 < 1 EPCC RECEIVEED DEC 3- 7007 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST G (.!� Products 17th Edition, American Public Health Association, 2004 �� fie: ald Oi I@C aW) i IMPORTANT MESSAGE FOR V Q•n' l DATE :5 , � /U TIME """�/` M �i Y1 GIA o' OFEA PHONE / � (a 4Co DE NUMBER EXTENSION U FAX U MOE311 F AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL K CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAG ` 0 SIGNED V i FORM09 MADE IN PIS A i i r NOTES / s MORRELL ASSOCIATES Current Date: 12/13/2007 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 12/6/2007 (781)837-1395 www.morrell-associates.com Customer#: F89-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 OC �.R 107 I E T Salem, MA N I T N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC RECEIVED 'JAN _ 3 2008 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC:s 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 67- '504,d rs: Health A MORRELL ASSOCIATES Current Date: 1/21/2008 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 1/8/2008 (781) 837-1395 www.morrell-associates.com Customer* F69-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 OC Highland Ave]Rte 107 I E T Salem, MA N I T N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake 1,300 < 1 EPCC RECEIVE® FEB - 5 2008 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine SPC ! 50,000/g;Coliform ! 50/g Other: SPC ! 50,000/g;Coliform ! 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST `71 Products 17th Edition, American Public Health Association, 2004 Board or Health Id, MORRELL ASSOCIATES Current Date: 11/13/2008 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 11/8/2008 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce, Reports:Lg Env L Burger King#3564 L 10/16 0 Highland Ave/Rte 107 I E T Salem, MA N I T O N T BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake <250 EPAC < 1 EPCC � f MASSACHUSETTS STANDARDS Machine: SPC!-.50,000/g; Coliform s 50/g Other: SPC s 50,000/g;Coliform s 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST G ( Products 17th Edition,American Public Health Association, 2004 '/�/ 4 ECEIVED NOV 2 6 2008 �F Y EM H.=ALTH MORRELL ASSOCIATES Current Date: 8/22/2008 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 8/9/2008 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices'Joyce; Reports:Lg Env O Burger King#3564 L 10/16 C Highland Ave./Rte 107 I E T Salem, MA N I T N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g SAMPLE ATTEMPT MADE: NONE AVAILABLE: WAITING ON NEW MACHINE EN SEP`4'2006 ` MASSACHUSETTS STANDARDS Machine: SPC:r 50,000/g;Coliform s 50/g Other: SPC s 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST C Products 17th Edition, American Public Health Association, 2004 11 1 0259 HIGHLAND AVENUE Burger King City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: Violations Related to Good Retail Practices (Blue Items) 744-9467 Equipment and Utensils FAIL Non-Critical BLUE Owner: Comment: Ice machine in back has accumulation of grime on top inner panel.Thoroughly clean the inside of the ice machine. Boston-Wyman, Inc. PIC: Floor of walk-in fridge needs general cleaning. Karen Mc_C_add_en_ Floor of walk-in freezer needs general cleaning. Inspector: Walk-in freezer also has build-up of ice on fan;de-ice the fan. Elizabeth Salandrea Date Inspected:Correct By: 3/26/2008 _ Risk Level: Permit Number: BHP-2008-0298 Status: SIGNED OFF #of Critical Violations: 0 Time IN Time OUT: Urgency Description(s): BLUE: Violations Related to Good Retail Practices (Critical violations must be corrected immediately or within 10 days)(Non-critical violations must be corrected immediately or within 90 days) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741.1800 GeoTMS®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Apr 02,2008 ) Page I of 2 1 s Item Status Violation Critical Urgency RED: Violations Related to Foodborne Illness Interventions and Risk Factors (Require immediate corrective action) I City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Apr 02,2008 ) Page 2 of Commonwealth of Massachusetts s City of Salem Board of Health Iftberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Foo"etail Establishment Permit DATE PRINTED: 01/08/2008 ESTABLISHMENT NAME: Burger King File Number:BHF-2004-000088 259 Highland Avenue Salem MA 01970 LOCATED AT: 0259 HIGHLAND AVENUE SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes FOOD SERVICE BHP-2008-0298 Jan 7,2008 Dec 31,2008 $280.00 ESTABLISHMENT Total Fees: $280.00 PERMIT EXPIRES December 31, 2008 Board of Health This Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code,beofre any revonations,improvements,or equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Page 4 of 11 i� CITY OF SALEM, MASSACHUSETTS BOARD OFI-IEALTH v R' 120 WASHINGTON STREET,4'r'FLOOR TEL.(978) 741-1800 KIMBERLEY DRISOOLL FAX(978) 745-0343RECEIVED '��/� �\J�G"D$ MAYOR Iscx)TTOSAf.FM.0O3M R V vY JOANNE SCOTT, NOV'3 0 2007 HEALTH AGENT CITY OF SH:- :• BOARD OF HEALTH 2008 APPLICATION � FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT A1. 4 1J��C��I.*" / #,6_5_44 TEL# 9r7 - r/4 7111,ADDRESS OF ESTABL ISHMENT x. L? 7/r' / l/d l ® 1�11e ,SZ/t77 //Fk:-.5 x/90 o��7rj MAILING ADDRESS(if different) l/D L�rPrxBS ✓.�� aaG LL/li'{�- X12/Q l7/liS, /�� /Jeldal EMAIL-Business': Gt4r/1Pr mubur-gEtk'A_o 7 alo Website: j -- OWNER'SNAME 3n527oN VDW1//Y1'/RIJ �l-G, J TE'/L# AOR 'I'l�'bd ADDRESS 1/ca ( ) reels lull �ae� &Id d' hiwl2l is, MA 0-)kl STREET ( / nCITY I STATE ,/ / ZIP CERTIFIED FOOD MANAGER'S NAME(S), h I?�a�i r/ a PICT CERTIFICATE#(S)r-jt�V�'Sr3- (Required in an establishment where potentially hazardo s food is prepared) / EMERGENCY RESPONSE PERSON 4)JA) / / I R Sh 0)t RtJ HOME TEL# r/r/� f' — '7/ q~/ DAYS OF OPERATION ' Monday Tuesday Wednesday Thursday Friday Saturday Sunday j HOURS OF OPERATION — Please write in time of day. -- """p" ------ n 1 {For example Ilam-t tomj � tj !y ni tl qt tt PAr /lith m,cfvig At- TYPE !tt t'»rd NJ J�y'hf tl.c,Vt , �l TYPE OF ESTABLISHMENT FEE (check only) RETAIL STORE YES !O less than 1000sq.ft. =$70 1000-10,600sq.ft. =$280 more than 10,000sq.ft. =$420 RESTAURANT ................. . ..... .................. ........ ....... .. ...... . - --.-....-$-_1_40 $ NO less than 25 seats =$140 (Outdoor Stationary Food Cart$210j _ y /' 25-99 sects x280 LTLi;O Y"foocll-tzt%le e)u 7i' more than 99 seats - - - ---- ------ - -NO--- --------------------------------- ----------------------------------------------- -- -100- ----- BED(BREAKFAST! YES X CHILDCARE SERVICES-- ADDITIONAL PERMITS----- .-------------------------------- - -- - - - ---- ------ ----- --- j MAKE (not just serve) ICE CREAM, YOGURT/SOFT SERVE YES NO $25 TOBACCO VENDOR YES NO $135 ALL NON-PROFIT(such as church kitchens) YES NO $25 'Please pay total with one check payable to the City of Salem. This Permit is not transferable and must be reissued upon change of ownership.The Permit must be posted in a prominent location o , ,. . in the Establishment. - --In accordance,with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem_ Board of Health. Pursuant,to MGL Chapter 62C,Section 49A,[,certify u_nder the pains and penalties of perjury that I,to my best knowledge and belief,have filed all state tax r s a d � id all state taxes requir under the law. 1 / 7 c� a 7��v 7,-� Signatu Date J Social Security or Federal Identification Number Revised 4!24167 FOODAP2W$,adm Checkil&Uate ✓�1v( J(a7 070 S07Y40 Ap 1 I I I EXAMINATION POMM NO. 2019 CERTMCAT]ON MO t 3119919 SLodeM Xane ENEIR.a$&KlANA Obf M+rlblS wNN r r SYePl oats NTI29M I'MINIVINNIM £mhatbn opm xrymae olpa ryGa 0 Taagbm MA Chfflmnl bblT wbvnKT.M.bq 13.5 allow46FPgm Nana it ' +p fYzME)C vy sRw.m.xmobv' mt bm ax- ENEIDA SANTANA at lkamPo,mftme .l} I br Eue.rsMlty 0"R.MNl9 9M Standard}s"1 Mrlh M fAe NAtlgMI M06M9nRd APeotletbn F.lRlc"ltaRel FaXNM1Pn lM Ne Serv6aM•F"ai ProMelEn Eb%MMf t2arx0eHbR EaunMaOETA at PM.1 a— s5 XA+khb1130".1£00 CY dl13 GmMMloo br Food F$Msc16n(CFI') Obbatt% . at PaifM.%oo b YS . PrsFdNM9f MNAMoIaaiXMbNrmIdAAMc!"N"N BdumitoRdilOvPdmMs Mad}a vAASm v K.n rte. tl ATE OF 6kANI XAiI"N Eeint PoA.t SfaR et9t0 M 55 obobaboolFNAmea 2l..19 Plblw-4 Pt 9 a GATE Oi£Y91PAYtON R.RAaseARt[SIve TOM } } • tMMrAWbul M1.aM dRaX.�ib MaPfif.aoAnaM. Yrtpave TOMi�WXGf ) }o / � - 5NmxM"EN>Y leeda to t9 /�(I( Me1MaF Eryp.E[upplbt 9 NmJ1pr FOM Feeavad li B CONBWa��Ria�in OnOn�% NN 1t 4ARY Y,lhA.i Ea01[6A�II..aaM .al om.l Np OMI¢i"PX XATINO OFi1C ER TUY dOWi) M6U.Atlt AL 1. PART;f dpplAitOX N"lldidl Ke&t9NTdRf APSp[tBHpR EBU"AFIONAI FOUNtlAT10X Nilbw gbb.RMMMallan �I�� .. aNnrw+a0axrad.rwrArn. F.DUCAMNAL FOUNDATTON EDAWATI0N,l%t5OtMOATroNf REY o IMM' eahMbiwv - 1srNa m er afe 8%A141NA"ON FORM NO r 4001 n CERTIF[CATiON NO t 4042979 DUPLICATE � �® Certificateon J16(, Cwai plo br MODEMR Ry OX,WMe Uta EMROETis s9t fanh by ON;N.tI.El FWMnunnt AOs W-OdaOO11OO l FmndOUOn iw the GMry Dfae Food PrutectiOn Memw C-OkEfim EEMnsUon,r kh IF ,.d Wd W the Almrknn WH TTEI SMndElds InW W IANSIFCmlm.IOr Food RotacOnn(CFP). Presented by the National Restaurant Association Edueationei Foundatlon 9/16/2004 DATE OF EXAMINATION 9/16/2009 DATE OF EXPIRATION leolIwvr eek ae'Am wnr bM IMPARAr RIMY IF,IXe Iwnm mwnmmenN. 1 E N tlOft,OpmIIm XE m `� MnImM RMIanMAunLWn Emn:.anu�imM4Nn NEW=]RmWuwnt AssodMdun EDUCATIONAL FOUNDATION C enNwmellllrv.ararNn[mmwrwen sma FmoI., r � I ne c,ommonweaun of Nlassacltuseus / ✓� Department of Industrial Accidents ' Office of Investigations 600 Washington Street Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: General Businesses Aunlicant Information Please Print Let?ably Business/Organization Nam/e: I�a��o n /(// ✓hR� ticc��y Address: //O ff//7 eecl'-s /7/ �� Ri A/n; � y C/ City/State/Zip: 2/ )} )U/c i S , IN 6�:z60/ Phone#-. A-,'y- Are you an employer?Check the appropriate box: Business Type(required): 1.Er I am a employer with employees(full and/ 5. ❑Retail or part-time).' 6. ❑Restaurantllar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7. ❑Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any opacity. [No workers'comp.insurance required] S. ❑Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152,§1(4),and we have 10.❑Manufacturing no employees. [No workers' comp.insurance required]" 1 LE]Health Care 4.❑ We are a non-profit organization,staffed by volunteers, �// with no employees.[No workers'comp.insurance req.] 12.p Other l4 , Ott �OC // *Any applicant that checks box#1 must also fill out the seem below showing their workers'compensation policy information. "If the corporate agars have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organimtion should check box A. I am an employer drat is providing workers'compensation insurance for my employees. Below is the policy ueformadom Insurance ComrpanyName: X4,s-s IA1)s(V A: >e far l i 9)E'lt 11 %i�--- \A18, G/,su'n n� Insurer's Address: /D City/State/Zip: Z A i77, 1• y ® Policy#or Self-ins.Lic.#�//° CY> ®r��m �tio Expiration Date: /�� /®I9 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Fail=to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce70c�-az;-6-0/N /K due pains and penalties ofperjury that the information provided above is true and correct Sitmature: (� _ Date: Phone#: o QQicial use only. Do not write in this area,to be completed by city or town o0kidE City or Town: Permit/License.y Issuing Authority(circle one): _ 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: wwwmass.gov/dia RKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE CERTIFICATE INFORMATION PAGE RENEWAL AGREEMENT Producer: Agent# 960 Retail Merchants WC Group Inc. Association Benefits Ins Agcy Inc ) British American Blvd . 529 Rain St Ste 606 itham, NY 12110 Boston, MA 02129 :arrier Code: 34355) Certificate #: 014005030096107 Prior Certificattma #: 034005030096106 The Employer: Burger King Boston Wyman, Inc Type of Corporation Mailing Address: 110 Breed's Hill Road' Hyannis, MA 02601 Other workplaces not shown above: Fein: 04277-3078 SEE SCHEDULE OF OPERATIONS Risk ID: The certificate period is from 12:01 a.m. on i /01/7n07_ to 12:01 a.m. on 1/01/2008 at the insured' s mailing address. A. Workers Compensation Coverage: Part One of the certificate applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Coverage: Part Two of the certificate applies to work in each state listed in Item 3 .A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 900 000 each accident Bodily Injury by Disease $ 500-000 certificate limit Bodily Injury by Disease $ 900 000 each employee C. Other States Coverage: D. This certificate includes these endorsements and schedules: WCOOQOOOA(04/92) WCO00113(01/06) WCO00406A(08/95) WC000414(07/90) WC200301(04/84) WC200302(05/86) WC200303B(07/99) WC20C405(06/01) WC20060t(06/92) 4. The contribution for this certificate will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. ' A1.1 information bel7w 49 subject to verification and change -cy audit.. Classifications Code -ontr*ibution Basis Rats .Per Estimated No. Tota-', Estimated $10C of AhnuF--L Annual 3emunera-c:.on Fsmuae.,ation cntr1bLt-,..0, SEE SCHEDULE OF OPERATIONS Total Estimated Annual Contribution 130,355 .00 Minimum Contribution $ 268.00 Expense Constant $ .00 WC 00 00 01 A issue Date: 1/02/2007 Countersigned by MORRELL ASSOCIATES Current Date: 2/14/2006 P.O. BOX 266 Marshfield, MA 02050 Date Samples Taken: 211112006 {761}637-1395 www.morrell-associates.com Customer* FB9-13 YOAAf tf 156QC/A Iff ..-`moi C invoices:Joyce; Reports:Lg Env L urger #3564 10!16 A Highland Avef/Rte 1 Salem MA E � N O T N I BACTERIA COUNT Sample I Standard Plate Count/g Coliform/g Chocolate Milk Shake <250 EPAC < 1 EPCC RECEIVE® MAR - 4 2008 C11 OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g,Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g t tl J� �rZ�y METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition,American Public Health Association, 2004 60,1m) of Health i 0259 HIGHLAND AVENUE Burger King City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: Violations Related to Good Retail Practices (Blue Items) 744-9467 Equipment and Utensils FAIL BLUE Owner: Comment:Walk in freezer floor requires general cleaning. Boston-Wyman, Inc. PIC: Cres Cor Unit requires general cleaning. Coraylls Barrios Fryolator Freezer missing thermometer. Provide visible and accuraTe thermometer. Inspector: Physical Facility FAIL BLUE John Gehan Comment:There is a visible air gap at the back door. Seal gap to prevent entrance of rodents and or insects. Date Inspected:Correct By: 8/6/2007 Risk Level: Permit Number: BHP-2007-0309 Status: SIGNED OFF #of Critical Violations: 0 Time IN: Time OUT Urgency Description(s): BLUE: Violations Related to Good Retail Practices (Critical violations must be corrected immediately or within 10 days)(Non-critical violations must be corrected immediately or within 90 days) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Aug 06,2007 ) Page I oft Item Status Violation Critical Urgency RED: Violations Related to Foodborne Illness Interventions and Risk Factors (Require immediate corrective action) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Aug 06,2007 ) Page 2 oft Memo Send to file Location: Burger king Food Complaint Date: 5/8/07 Inspector: Janet Dionne, Senior Sanitarian As a follow up to initial inspection on 5/4/07 I spoke to manager on hand at time of inspection Zenaida Santana. She said that complainant went through drive-thru at Highland Ave. location. She then came into the establishment with a complaint that there was a worm in her sandwich. Zenaida said that the sandwich was a Jr.wopper with cheese. Zenaida stated that the worm looked green in color and said it looked like the type you find in trees. She refunded complainants money and complainant had called police. 9No other action was taken by the Board of Health at this time. �— a ne nior Sanitarian PPP - v"r - -UtAd 4 fi) M f �t1o1� / MORRELL ASSOCIATES Current Date: 4/17/2007 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 4/10/2007 (781)837-1395 www.morrell-associates.com Customer#: 769-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 O L 10/16 C Highland Ave./Rte 107 I E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake 1,100 22 RECEIVE® MAY - 3 2001 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC:s 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 Boaro of 4ea:th _5_�_a_?_ i5�d ��o_n Comfpl�n rets ve d bcl V- -enfl a2- Il2p_a_� t `/�ta��n in horn baw of 3 J - - i ne -t—/ns_ a- sa Und pC I�Cv� clow l94 cher Gv�// _ I - _ I I II i - I - �: I I i I� +I I � I�I I ra 4 a a J II � 1 1' Y 05/04/07 07:46 SALEM POLICE DEPARTMENT PAGE: 1 v5 .5n INCIDENT REPORT TTYRO04 -10 shift;„__C� date: 05/03/07 THURSDAY org/1st ---- - ----------------------—------------------------------------------------ ********** C 147 DISPUTE **rcv*clr* 18 :49 * 259 HIGHLAND AV apt: BK3564 SAL 147 147 475273 * FOOD DISPUTE 32 * ID # : 15313 ALARM # : 15313 84 -10 Rept: RODRIGUEZ, LUCIA 06/25/62 584-19-5764 64 PIERPONT ST PEABODY,MA 01960 Invo: SANTANA, ZENAIDA 03/29/68 HIGHLAND AV SALEM,MA call-back# 744-9467 *** UNITS) *** 23 * SAL P PTL DRISCO 84 -57 r> d> 18 :49 a> c> 18 : 59 k> h> *** COMMENTS *** 23 SAL 18 :49 :10 CD-147-FOOD DISPUTE 84 - 23 SAL 18 :59 :08 CLEAR REPORT TAKEN 57 - 23 SAL THE ABOVE REPORTING PARTY ADVISED AND THEN SHOWED THIS 89 - 23 SAL OFFICER A WORM SHE HAD FOUND ON HER BURGER. HER MONEY WAS 89 - 23 SAL REFUNDED BY THE ABOVE MANAGER. 89 - RECEIVED MAY ' 4 2001 ----------------------------------- --------------- officer' s signature date 25 ;1H0;40;36m 2;1H0;40;36m1;73H0;40;36mPD.SLGC1;8 / I MORRELL ASSOCIATES Current Date: 1/26/2007 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 1/23/2007 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 OC Highland Ave]Rte 107 I A E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count1g Coliform/g Vanilla Milk Shake 2,200 < 1 EPCC RECEIVE® FEB - 5 2007 CITY OF SALEM BOARD OF HEALT 1 MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliform s 50/g Other: SPC s 50,000/g;Coliforms 20/g ` METHOD REFERENCE. Standard Methods For The Examination of Dairy LAB ANALYST C�( Products 17th Edition, American Public Health Association, 2004 /d ® MORRELL ASSOCIATES Current Date: 2/28/2007 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 2/22/2007 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 .00atu asaocu raa C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 OC Highland Ave./Rte 107 A E T Salem, MA N I T O N BACTERIA COUNT Sample, Standard Plate Count/g Coliform/g Chocolate Milk Shake 420 23 RECEIVE® MAR 0 2 2007 Cl FY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPCs 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST G�( Products 17th Edition, American Public Health Association, 2004 Board 04 Aeaf'tl; IM ORP TAW `MESSAGE ) + FOR •. I_ ��(-�C�1 VL- DATE / A.M. � TIME�� M Af-? /7n 17)'AA rn)-'4, OF PHONF AREA CODE NUMBER EXTENSION O FAX ❑ MOBII F AREA CODE NUMBER TIME TO CALL TELEPHONED jc PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU I 1 RUSH RETURNED YOUR CALL I 1 WILL FAX TO YOU MESSAGE A !C O-il 12106 S /S yL»� nl10,AC4 57(4, A.} [ SIGNED yJ3 I�(.F7I8(.�'/Y_J_ Y��R FO t;401 IIN U.5\A. S310N MORRELL ASSOCIATES Current Date: 3/19/2007 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 3/12/2007 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 10/16 OC Highland Ave./Rte 107 I E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Strawberry Milk Shake 280 < 1 EPCC RECEI M u APR - 4 ZOQ7 CITY OF SALEM BOARD OF HFfH MASSACHUSETTS STANDARDS Machine: SPC ! 50,000/g;Coliform ! 50/g Other: SPC ! 50,000/g;Coliform ! 20/g METHOD REFERENCE, Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition,American Public Health Association, 2004 JI sfa r11!1S ( IMPORTANT MESSAGE FOR 4 DATE 452 �26 TIME /D P.M. M OF CODE /` PHONE 7 q71 7 AREA NUMBER EXTENSION ❑ FAX U MOBII F AREA CODE NUMBER TIME TO CALL TELEPHONED I ' PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE 96i d)T/k 7 EA Y% i PnCL.l V SIGNED n C FORM 009 MADE IN S A. NOTES i No Violation Notice March 2, 2007 John Gehan conducted an inspection at Burger King: Salem, MA 01970 Violation surrounded a customer getting sick.. No violations were observed at time of inspection. John Gehan Sanitarian CITY OF SALEM �/ ✓ k''// BOARD OF HEALTH �/) Establishment Name: gd/SirK Date: 1107 Page: of Item Code C-Critical Item r DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY 1 v�¢ IY7Gvcr � /LPa / . C'Girl-0�6ii.r Zil hol/ lw,- .-7✓ -Y '71,,o SlnrP l Z1LInac,,,Y �HC V do et 116,o 4'0 . I c Gca dr kv)ko,-). v,1as eaL �o (e on " &d" 6ZXa7 r 1 I i i I Discussion With Person in Charge: Corrective Action Required: I ❑ No I ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand tha5, noncompliance may result in daily fines of twenty-fiv dollars or suspension'/revocation of LI Embargo ❑ Emergency Closure your food permit. `�1%Z'`/ G�^yK �1 ❑ Voluntary Disposal ❑ Other: ++1 i-I!•_ PHFs Recei vert at Ten?peratures Violations Related to Foodborne Phtess Interventions and R,sk .Ac cording to law C,:oled ht Factors(Items 1-22) (Cont) .I I'FJ-t5"'F'vi ithin 4 Hours. ' ! 3-50;.iS Cnnliav\-letboxlsforl'1-11-s PROTECT ION FROMCHEMICAL.S ;q PHFHa.-neGoldHnlding 3-20_,.1_o Addidvec i4 Food oColor Additives -701 16(12) Colli PHI w.Maintained a; of below. I i 59U.0t1-4(FI -tI 'i$5" P^ 3-3UZ.14 PnneU;on t=o*n iJnapprooed Adc;ures" j F- 3 5( !. :Int PHFs Maintained at or above 15 Poisonous or Toxic Substances 1.10'F 7-10;.11 identifywelnformahon-Ch-i;^nal l uutainec;" 3-5 01.i6(A) Roasts',leld at or above 130c F. , 7-102 11 Common Name-Working C.wtainers' 20 Time as a Public Health Control 7-'_01.11 Separation-St•.nage' j 3-5U1.19 Time a1 a Public Heald?Contrelx 7 2U2 11 Restriction-Presence and Use* 59GJ;041H) baywnce Requirement 7-202.12 Conditions nt Usc- 7-20 11 Toxic C'ordainer c-Pwhibitions" REOUIREMENTS FOR HIGHLY SUSCEPTIBLE 7 204.11 Sani;izets,Critcnu-Chcno�als^ POPULATIONS(HSP) 21 1 3-:4)1.1';(A) t'rrrasteurized Prc-packaged Juices and 7-'_()•1.12 Cheu;icals for Wssh:n f'ruducc,Cri:oris" 7-204.14 Di yin;,Agents.Craena' I i Heve,aees w;th l4':unrnI Labels 1 7-205.11 Ineideni3l F xd Contact Lubru•ants' i 3-801 A I(B 1 Use„f Pasteurize(; rust;' 3-SW A 1;,D) Ra« err Padially Cooked Annum Food and 7-206.11 Rc siricted Use Pesticicks.Criteria' � h„s, geed Sfxuun:Not S_rved. 7-200.12 Ro d,,nt Batt Stauuos* 7-206.13 Tracking Powders, Pest Control and j 1 3-801 I l,'C) Unopened Fc iet Package Net Re-scn•zd. ' Monitorin;;^' I - CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-603 11 Concunrcr Adtisony Posted fur Consumption of 16 I Proper Cooking Temperatures for I An;,mi: Fonds':hat are Raw.Uudareooked or PHFs Kot r'uherwioc Processed to Eliminate c ECerv.+ ;JfR 3-4fiL11A(I)121 Fgg,- I5�"F !S Sec. i Parhoeins.' i Fggc- immediate Senice 1451'15sec+ ! 3-302,i R Risteunze.'Eggs Substitute tot Raw Shell 3-40i.1 i(A)(2) Comminutes Fish,Meats &Game i Eggs* Animals- I=5'F 15 sec. 4 SPECIAL REWUIREMENTS 3-401.11(B)(I) 2) Pork and Beef Roast- 130`P 1min" sy0.V09(.A)-(D) Violations of Section 59(l.0')9(A D)in 3-401.t1(A)t2) Ratites, lgjectedh?tats- 15>'F IS )-` sec. ( carotin,, mot.i?, food, ±cmperary and 3-401.I I(Au-4) Poultrv,Wild Game, Stuffed PHFc, res�dcutial kitchen operations Should he Sndfin*Coutamm;;Fish, Meat. dehitcd under the appropriate sections Poultry or Ratites-165'F 15 ,cec. above ii related to fooubornc illness 3-401.1 I(C)(3) Whole-a u,cle. In act Becf Steaks interventions ad risk factors. Other 145'F:: 590.009 violaCons re(atimz (o good retail 3-404.12 Raw Animal Fo-As("xtked in a i practices should be debited under 1+29 - Miciowme 165'F I Special 0equirententa. 3401.1 VA)(t)(h) All Othet PHF,-- 145`F 15 sec. " 17 Reheating for Hot Holding VIOLATIONS RaATED TO u^OOD RETAIL-PRACTICES ,-403.11(41&ill) PHFs I65'F 15 sec. * I (Iterw 23-30) 3-403.11(6) Microwave- 165°F 2 Minute Standing Cri r;r„1 wid non-rriticai cuintoa+,, u-14(j,oto not relate to the Tiutc* foodborne dines,,,inte+renliun.s unci risk"ra(rors tisita uFamr can be 3-4)3.11(C) Commercially Ptoienscd RTE.Food- ,found in dte,roYoa ing sn hone:of'he£aorl C 105 (YS7R 140°F= 590(Y)f 3-403.11(E) RemainingUnslicedPortions o(Beef item Good Retail Practices FC 584.000 Run sts* ( 23. Management and Personnel .003 18 Proper Cooling of PHFs ( 24. Food to-d Food Prorect:on F(-3 034 I "F cGuiUment ane Utensils FC-A 005 3-5 -I 01 1-!t A+ Cta,ung Cooked PHf ` eFs from 140F to 2 'Jvr .,< t "_ ---- • I �S. o:r Plunwm4 and Waste sG-S A00 70'F Within'I Flours and From itPF 27 Ph s:cal Faculty y =c--e 0107 to 4['F/45'F Within 4 Henri. '" 29. Poisonous or Tox e Materials i f-C-I .008 3-501.111(B) Cooling PRFs Made From.ambient ( 29, `'pcdsl Peowernerxs Temperature Ingredients to 41`F145`F 3o, Other Within 4 Ihmrs-# """'"""1;,2 ' Denotes mural item u'Ur fid-mal 1999 Foo-,)Code or;05 CNIR 590 )00' • 0259 HIGHLAND AVENUE Burger King City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: Violations Related to Good Retail Practices (Blue Items) 744-9467 Food and Food Protection FAIL Critical BLUE Owner: Comment:There is an employees soup and bread being stored in food prep area. All personal items to be stored in designated Boston-Wyman, Inc. employee areas to prevent cross contamination. PIC: Nancy Martinez Inspector: Physical Facility FAIL BLUE John Gehan Comment:There is a water stained ceiling tile in the dry storage are. Find source of leak and repair. Date Inspected:Correct By: i 1/29/2007 Risk Level: i Permit Number: BHP-2007-0309 Status: SIGNED OFF #of Critical Violations: 1 Time IN: Time OUT. Urgency Description(s): BLUE: Violations Related to Good Retail Practices (Critical violations must be corrected immediately or within 10 days)(Non-critical violations must be corrected immediately or within 90 days) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jan 29,2007 ) Page 1 oft Item Status Violation Critical Urgency RED: Violations Related to Foodborne Illness Interventions and Risk Factors (Require immediate corrective action) //yyam llr�� ll� City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jan 29,2007 ) Page 2 oft MORRELL ASSOCIATES Current Date: 11/27/2006 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 11/13/2006 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 11/18 C Highland Ave./Rte 107 I E T Salem, MA N ` I T `` N ` BACTERIA COUNT Sample —� Standard Plate Count/g Coliform/g Chocolate Milk Shake 170000 39 RL EI V`�E® DEC - 2006 CITY OF SALE BOARD OF HEAL MASSACHUSETTS STANDARDS Machine: SPC ! 50,000/g;Coliform ! 50/g Other: SPC ! 50,000/g;Coliform ! 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition,American Public Health Association, 2004 € oard or Health / MORRELL ASSOCIATES Current Date: 12/20/2006 P.O. BOX 268 Marshfield MA 02050 Date Samples Taken: 12/11/2006 .a.. .940c'.1's (781)837-1395 www.morrell-associates.com Customer#: FB9-13 C Invoices:Joyce, Reports:Lg Env L Burger King#3564 L 10/16 OC Highland Ave./Rte 107 I E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Strawberry Milk Shake 4,800 7 RECEIVED •�P IJM It 5 2007 CITY OF SALEM BOARD OF HEALTH r MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g;Coliform s 50/g Other: SPC s 50,000/g;Coliforms 20/g ` METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 aoard or ile-'ith yam, ^" a• W +tY'" "' foY^ t.i i Y di vir^k -3diY' . r.' �4 ',�,''-`�qE,.l' ,f ti��. ..,5 }` ra'ey,e;I'd- 5i r W *A,iJ "A-'1 r t� ri•l p{,vt.trB1� 'igl}G��.'V!'�T.tq $ .' .M �'IC".F.-'laY y�•di-' !>`++t N"'�4t�3''39« +f<� $9 . i s,'",. �.',x;.•. �w.� �. ..`c•_s Y.„`P.'; � v .4 ^r,,,.�i:@''=' ug4�""' y;�;� .`z'..`H�... x. .r`'aw7' ".3 • y i,t'x':�?;f ek' a:Ysi�$++�'Zws;gw'�'. r;-.. s." `3„_ -.a.. yaa .yti.*. {"t''CI of Salem'".:�"�r;:�giro'•�r tY Board of Health IGmbeiiey Drl' 120 Washington Street,4th Floor Maygr SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 01/04/2007 ESTABLISHMENT NAME: Burger King File Number:BHF-2004-000088 259 Highland Avenue Salem MA 01970 LOCATED AT: 0259 HIGHLAND AVENUE SALEM,MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes FOOD SERVICE BHP-2007-0309 Jan 4,2007 Dec 31,2007 $150.00 ESTABLISHMENT Total Fees: $150.00 PERMIT EXPIRES (December 31, 2007 Board of Health This Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code,beofre any revonations,improvements,or equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Page 1 of 3 r eV CITY OF SALEM, MASSACHUSETTS BOARD of HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 DEC ,.. 9 2006 TEL. 978-741-1800 / FAx 978-745-0343 CITY OF SALEM Kimberley Driscoll www.SALEM.COM BOARD OF HEALTH Mayor JOANNE SCOTT, MPH, FIS, CHO HEALTH AGENT 2007 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT X27,20 ilrfi #�J/�P//�ffJJ TEL# %7?-17`� - I� 7 ADDRESS OF ESTABLISHMENT o1((JJS�' t l� ih,tY/ GG1 J FAX# .'5"Oif�' 7?lo->2 777 MAILING ADDRESS (if different) //,h ae4Zo( /G'II-4?1 f7?lf.Y�2�42%d EMAIL--Business': /RR/�EV(f/)IV,�-G�/pet?k-; o r�o/4 Owner' G694aN Vy1n 4N _TIS' OWNER'S NAME J TEL# ADDRESS //d �rpr>i1S �1 �� _ h1?1 h rl f�1 S . �� STREET I CITY STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S)� CERTIFICATE#(S) n?/l 5 (Required in an establishment where potentially hazardous food is prepared) //'' EMERGENCY RESPONSE PERSON 4iiV /I11I-nSA/P, ,L4 HOMETEL# 7) BAYS OF OPERATION Monday Tuesday Wednesday Thursday Friday Saturday Sunday, i HOURS OF OPERATION Please write in time of day. (For example Ilam-ttom) T 17,9;n— Ypm ✓�J U" h h fill P ITh r /2,P 07 TYPE OF ESTABLISHMENT,��} FEE {check onlvJ RETAIL STORE YES �.-� less than 1000sq.ft. =$ 50 1000-10,000sq.ft. =$100 more than 10,000sq.ft. =$250 ----- ... .._.--.... RESTAURANT ES NO less than 25 'seats $100 25-99 seats =$150 more than 99 seats =$200 _..._.._----...._.-- ... -- ---- ---- ---_ -- . ..._.....------ ------.._._-- ---------- BED/BREAKFAST YES 5100 - -" " - ------ ----...--- -------- ------. .._. ...--- .. _._ .---- -..._ ... -' -. ...... . .. ... - ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGUR f, SOFT SERVE YES NO $5 TOBACCO VENDOR YES NO $50 ALL NON-PROFIT(such as church kitchens) YES N $25 'Please pay total with one check payable to the City of Salem This Permit is not transferable and must be reissued upon change of ownership. The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 62C, Section 49A, I certify under the pains and penalties of perjury that I, to my best knowledge and belief. ha v frl II state tax re urs a d paid all state taxes required under the :aw Signa re Date Social Security or Federal Identification Number - -' - --- -------------------- -----r�-�---�- �-- -------------------------------- - - - - -------- - Rev,sed 11/13/06 FOODAP2007.adm Check#&Date JL-,5—c= >� Il'o s Z5<1- l Lhe Commonweatth ojMassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Leeibiv Business/Organization Name: js �o U ILS YI�Ati c�,(/2 e/ R /J Address: //O 5feech City/State/Zip: WW L} N N i S , /7V o.260/ Phone#: Are you an employer?Check the appropriate box: Business Type(required): 1.Er I am a employer with eD employees(full and/ 5. ❑Retail or part-time).* 6. ❑Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7, ❑Office and/or Sales(incl.real estate, auto,etc.) employees working for me in any capacity. [No workers' comp.insurance required] $• ❑Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152,§1(4),and we have 10.❑Manufacturing no employees. [No workers' comp.insurance required]*' 4.❑ We are a non-profit organization,staffed by volunteers, 11.❑Health Caze// 1 — with no employees. [No workers' comp.insurance req.] 12.p Other-1/4 OCe 1 ��s'f �ooc� *Any applicant that checks box#1 must also fill out the section below showing their wodcers'compensation policy information **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an orga antion should check box#l. I am an employer that is providing workers'conPenaion insurancefor mYemPtoYees. Below is the policy info rmation. Insurance Company Name: 1Y).4s9/Y_/Ausells-flea; h9)1Pv1?�76,4,- V✓G ��ov� Lrn Insurer's Address: /0 [ )�, is 4/hC'!inalJ FI Ud . City/State/Zip: Z Asti A m , Y Policy#or Self-ins.Lic.# O/400S-0 800 9 O Expiration Date: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c7,u er the pain a s of perjury that the information provided abovee is true and correct.Simature:1-/ /14'114 //1/ l� Date: / Ja�v� Phone �� Oficial use only. Do not write in this Brea,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): _ 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: www.mass.gov/dia f5KERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE CERTIFICATE INFORMATION PAGE RENEWAL AGREEMENT Producer: Agent# 960 MA Retail Merchants W-_ Group Inc. Association Benefits Insurance Agc 10 British American Blvd. 529 Main St. Ste 606, The Schrafft Latham, NY 12110 Boston, MA 02129 (Carrier Code: 34355) Certificate #: 014005030096106 Prior Certificate #: 014005030096I05 1 . The Employer: <W Burger King Boston Wyman, Inc Type of Business: Corporation Mailing Address: 110 Breed's Hill Road Hyannis, MA 02601 Other workplaces not shown above: Fein: 042745078 SEE SCHEDULE OF OPERATIONS Risk ID: 2. The certificate period is ,from 12:01 a.m. on 1/01/2006 to 12:01 a.m. on Kzl j01 J2"007 ' at the insureds mailing address. 3 . A. workers Compensation Coverage; Part One of the certificate applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Coverage; Part Two of the certificate applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 500,000 each accident Bodily Injury by Disease $ 500, 000 certificate limit Bodily Injury by Disease $ 500,000 each employee C. other States Coverage: D. This certificate includes these endorsements and schedules: WC000000A(04/92) WC000112 (09/04) WC000406A(08/95) WC000414 (07/90) WC000420 (12/02) WC200301(04/84) WC200302(05/86) WC200303B(07/99) WC200405(06/01) WC200601(06/92) 4. The contribution for this certificate will be deter-mined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and charge by audit. Classifications Code Contribution Basis Rate Per Estimated No. Total Estimated $100 of Annual Annual Remuneration Remuneration Contribution SEE SCHEDULE OF OPERATIONS Total Estimated Annual Contribution 145,845.00 Minimum Contribution $ 268 ,00 Expense Constant $ .00 WC 00 00 01 A Issue Date: 12/22/2005 Countersigned by &; 111 HUNTINGTON AVENUE,AT PRUDENTIAL CENTER BOSTON,KA 02199-7613 JUDY A.GROVES DFRECT DIAL:617.239.0775 DIRECT FAX:617.227.4420 igcoves@p2lmerdodge.com September 2,2005 To Whom It Max Concern Re: Boston-Wyman,Inc. Mo&Mike,Inc. Boston Wareham, Inc. Boston N Barnstable,Inc. Boston N Beverly,Inc. Boston N Bridgewater,Inc. Dear Sir or Madam: This letter is to advise you that Boston-Wyman,Inc.,and the related entities referenced above(collectively,the "Debtors"),filed petitions for protection under Chapter l I of Title I I of the United States Code(the"Bankruptcy Code")on December 3,2004,in the United States Bankruptcy Court for the District of Massachusetts,Eastern Division, 10 Causeway Street,Boston,Masssachusetts 02222. Ali six bankruptcy proceeedings are currently pending and are being jointly administered under case number 04-19799 before the Honorable William C. Hillman,United States Bankruptcy Judge. The Debtors sought and obtained an order prohibiting any disruption of utility service without further order of the Court. In addition,any actual or threatened collection activities are subject to the automatic stay provisions of the Bankruptcy Code. Federal law prohibits any debtor in a Chapter I 1 bankruptcy proceeding from paying any amounts for goods and services that became due or relate to the period before the filing of the bankruptcy petition,except as permitted by Court order,including under a Chapter 1 I plan of reorganization that has been confirmed by the Bankruptcy Court. No such plan of reorganization has presently been confirmed by the Court in these proceedings. Therefore,you are hereby advised that Boston-Wyman,Inc. and the related entities referenced above are presently prohibited by Federal law from paying any amounts for goods and services,including any interest or penalties ascribed thereto,that became due or relate to the period before December 3,2004, The Debtors are,however,permitted to pay all amounts incurred in the ordinary course of business that became due or relate to the period on or after December 3,2004,and you are hereby notified that any payments received from the Debtors must be applied solely to the periods beginning on or after December 3,2004. Please contact the undersigned if you have any questions regarding the foregoing. Sincerely, 6'�y A. Grove 235419.1 MAIN 617.239.0100 FAx 617.227.4420 www.paimerdodge.com ( IMPORTANT MESSAGE ` FOR4r��JI J Jhh DATE /TIME — 'Q. 1. M C !J /�lwCPv� OF CJAg: t PHONE AREA CODE NUMBER EXTENSION ❑ FAX O MOBII F AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU I WILL CALL AGAIN WANTS TO SEE YOU ' I RUSH f RETURNEO YOUR CALL ' { WILL FAX TO YOU MESSAGE �d �z .e r' S /_v,� IA'A< 7'�i.K r 71A-4Q eS aZ4 E�n 14/Yo n. SIGNED , � �QPS. MAAOE IN �. _ NOTES 11/16/2006 Burger King—Complaint regarding Rodents. One burrow was observed. Manager to call LPCO and have exterminated. John Gehan Sanitarian MORRELL ASSOCIATES Current Date: 9/22/2006 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 9/19/2006 (781) 837-1395 www.morrell-associates.com Customer#: F89-13 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 11/18 OC Highland Ave./Rte 107 I E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Strawberry Milk Shake 5,100 7 OC r 2 — 2006 U CITY OF SALEM BOARq OF HEALTH MASSACHUSETTS STANDARDS Machine: SPCs 50,000/g;Coliform s 50/g Other: SPC s 50,000/g;Coliform s METHOD REFERENCE: Standard Methods For The Examination of Dairyairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 Board of Health MORRELLASSOCIATES current Date: 8/24/2006 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 8/21/2006 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 Y ORIIFL( ISf OCIA 1f6 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 11/18 0 Highland Ave./Rte 107 I A E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate CountIg Coliform/g Vanilla Milk Shake 1,800 34 ou � L SEP — 52006 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC s 50,000/g; Coliform s 50/g Other: SPC!g 50,000/g;Coliform s METHOD REFERENCE: Standard Methods For The Examination of Dairyairy LAB ANALYST Products 17th Edition,American Public Health Association, 2004 fioa!d of fi FiiYit 0259 HIGHLAND AVENUE Burger King City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: PROTECTION FROM CONTAMINATION 744-9467 Handwash Facilities FAIL ❑v' RED Owner: Comment: Mens restroom missing hand wash sign. Provide sign. Boston-Wyman, Inc. i Violations Related to Good Retail Practices (Blue Items) PIC: Equipment and Utensils FAIL BLUE Nancy Martinez Inspector: Comment: Mop stored incorrectly. Mop to be stored so that it can air dry. John Gehan Walk in refrigerator has accumulation of mold starting on ceiling. Thoroughly clean and sanitize ceiling. Date Inspected:Correct By: 10/16/2006 Walk in freezer has accumulation of ice on fan and ceiling. Find source of leak and repair. Remove ice. Risk Level: Ice machine has accumulation of grime on inside panel. Thoroughly clean and sanitize ice machine. Permit Number: GENERAL COMMENTS: BHP-2006-0077 I 901:lnspector to check with Health Agent in regards to hand sanitizer. Status: SIGNED OFF #of Critical Violations: 1 Time IN: Time OUT. Urgency Description(s): BLUE: Violations Related to Good Retail Practices (Critical violations must be corrected immediately or within 10 days)(Non-critical violations must be corrected immediately or within 90 days) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2006 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Oct 16,2006 ) Page I oft Item Status Violation Critical Urgency RED: Violations Related to Foodborne Illness Interventions and Risk Factors (Require immediate corrective action) 12, City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2006 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Oct 16,2006 ) Page 2 oft 4 ( IMPORTANT MESSAGE ) FOR DATE � TIM EM./� 1 M OF 7 / PHONE �f �- /y ola,- ,F7�/dd7l AREA CODE NUMBER EXTENSION III O FAX O MOBN F AREA CODE MBER TIME TO CALL/ TELEPHONED ' PLEASE CALL I CAME TO SEE YOU WILL CALL AGAIN I WANTS TO SEE YOU RUSH RETURNED YOUR CALLI WILL FAX TO YOU MESSAGE '✓`f'- .iS-v �4�i�-.�.-r SII -C/il.�iC�rt-�I SIGNED omMAO IN� S.A NOTES -- - - - J 1"o�c� Gini y (In to YPit�Y . MORRELL ASSOCIATES Current Date: 7/18/2006 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 7/12/2006 (781)837-1395 www.morrell-associates.com Customer#: F89-13 MO MPCLL 1500CII tl6 C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 11/18 C Highland Ave./Rte 107 I A E T Salem, MA N I T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake ; gag _ 11 AUG 3 — 2006 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS SANDARDS Machine: SPC ! 50,000/g;Coliform ! 50/g Other SPC ! 50,000/g;Coliform ! 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 ' fid IJ YA.'i1 C,§f yYB.:la(f,L'/ MORRELL ASSOCIATES Current Date: 6/19/2006 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 6/14/2006 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 YO RAf It �H800f ffS C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 11/18 OC Highland Ave./Rte 107 I A E T Salem, MA N I T N BACTERIA COUNT Sample Standard Plate Count/g Cokform/g Strawberry Milk Shake 400 2 Ivl� JUL 5 _ 2606 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS SANDARDS Machine: SPC s 50,000/g;Coliform s 50/g Other. SPC s 50,000/g;Coliform s 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition, American Public Health Association, 2004 F'Oar+d of ?4srWh MORRELL ASSOCIATES Current Date 5/16/2006 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 5/9/2006 (781) 837-1395 www.morrell-associates.com Customer#: FB9-13 409Pf1t SSS OCAS IES C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 11/18 OC Highland Ave./Rte 107 I E T Salem, MA N I Salem MA T N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake 310 1 JUN ® 6 2000 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS SANDARDS Machine: SPC s 50,000/g;Coliforms 50/g Other: SPC s 50,000/g;Coliforms 20/g METHOD REFERENCE. Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition,American Public Health Association, 2004 t CITY OF SALEM y BOARD OF HEALTH Establishment Name: Date: 9 2��i)6 Page: � of / a Item Code C-Critical Item ' DESCRIPTION OF VIOLATION/PL N OF CORRECTION Date No. Reference R—Red Item Verified - PLEASE PRINT CLEARLY t I � I i 3 I ` 4 -17 k / Discussion With Person in Charge: Corrective Action Required: I a? No ( ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ f inspection, to observe all conditions as-described, and to Exclusion violations before the next ins - p ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or sus:le nsio /;evocation of ❑ Embargo ❑ Emergency Closure your food permit. �j ❑ Voluntary Disposal ❑ Other: s'Cr PHFs Rece;v�d e:Temper,avies Violations Related to Foodoorre lttness Interventions and Rick Accutdi ng to Iae-Cooled to Factors(items 1.22) (Cont.) 41'F/=45'F Within 4 Hour's. ". PROTECTION FROM CHEMICALS I `71 I5 CoC Ylkoa d:,for PRFs ' I }9 PPF Hat and Cold Holding la I Food or Calor Additives t $01.16i13 1 Cold PHFs laintained at n'.b:.lov: 3-203.12 Additives* ( 590.004(\) 41'145' F" 3-302.1.1 Protection fr„m Unapproved Adtshhws” 3-;0".16(A) lfut PHF: Maintained at or abuse pK Poisonous or Toxic Substances :4C'•F 7-101.11 kientifvine information - Ot;,-rnal I 3-501.161 1.) Rnaats Held at or above 73(j'1'. " l ! Containers'' 7402.11 G,mnton Name-W'otl:vr„Containers, j 40 Time as a Public Health Contra! 1 7-201.17 Scparauan-Storage"' 3-501.11) Time r.,a Puhhc He-Ah Centro!* 7-201! 1 Re>triction- Pr::xrce'-d Use' I 590.0040-0 Variance Requirement 7-203.12 Concfitiortn of else= REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-"03 11 Tu,lc Containers mt Prohibitions POPULATIONS(HSP) 7-204.11 S;mitizars,Criteria-Checais".'� I - 7-204.12 Chemicals for W'afhuu Produce, Ctilena" i 21 3-80 L.!'.(A) i Unpasteur;red Prc-Packa^,cd Juices all([ 7-204.1 4 Drving Agents.Criteria- I 1 Bevera;trs with Warning Labels^ - - ?-8(U Il(B) Use A Pasteenized Fee:-' 7 {i5 11 Restricted Foal Contace ,Criteria* i I ;-SO1 I I:,P) � ^raw or Partially Cooked Aaiima! Food and r'06 1 l Restricted lin: Pestin(les,Criteria* k-tw Seed Sprouts Not Scr,•cd. ` 720 12 Rodent 6ati Sutinns'' ! 13-Siil.l I(Q, Unup;ned Feod Package Not Fe-served 7-206.13 Tricking Powders,Pest Control and Monitutinp" CONSUU;ER ADVISORY 22 3-603-11 Consumer Advisory Posted f r Cunsumption of TIME/TEMPERATURE CONTROLS An;nt�l F'.K,ds lbat are Raw,Undercooked of 2b Proper Cooking Temperatures far I Not Otberv,ise Proeessed to Eliminate PHF5 Path,o, Eggs- in:n;ediate S;nice 145"Fl`isec" ,cns.': 3 4f;1.1 iA{I)(2) Fogs- 1 iSeF I S.c. 3-302.1'- Pssteun €tr'zed E .StlbSrltllte ha Raw Shell I 3-40i,i i(A)(2) Comminuted Fish,Meats &Cattle i i4"'S Animals- I SSP 15 see. 'r 1 SPECIAL REQUIREMENTS -40!.1 l(B)(i)(21 Pork acd BedRoast- i 30=C 121 nils' I - 3-401.1 1(A)(,.) Ratite,,lnjectcu Meats-15 'F IS 590 009(Ai-(D) Violations of Section 590.009(1A)-(D)in sec * catering, nn)biie food. temporary and 3-401.1 I(A)(3) Poultry, Wild Game,Stuffed PHFs, residential kitchen: operations ahould be Stutfir e Coutannnc Fish,Meat, ciobitrd under the nm:opriate sec0o,ts Poultry,of Ratites-165'F 15 sec. *` above if reiated to roodbora'.illness ;_401.11iC)(3) Who!e-muscle,Intact Beef Steaks intet.-entions and risk factors. Outer 145'!';, 590.009•;iodations r.lating to good retail 3-401 12 Raw Animal Foo(le Conked in a ( 111-actiCCs Sb0ald be debiu;d umier//29- M;cruwave 165`FSpcci,u Regliirenx-rots. y-!01 II(A)(1)(b) All Other PH Fs-- 149'Fi5 sec. p7 Reheating for Hot Holding I VIOLATIONS R`LATEV TO GOOD RETAIL PRACTICES 3-403.11(A)&(D) Plies 165'F 15.see. ' ( (tterns23.30) 1-4n3.11(B) Microwave- 165'P 2 Minutc Standin)t C,itrrrd andnun-crit<ul riulutanr;. which do not route to der `time" ( foodbo'ne;!hres.s w1c;vcnr,on., and ri.r.i-Ja,for:i !ietrd above. ,nn be •� 13-403.111 C) Cummen'taiiy Procesed RTL Fail- i .jeonvl ire;,+hF1b1lun-i 1g n:ctio,u q(rhe F'nal Code ru;d 105 CMH i40'F* i 590.o(70. __ --- ------- I 3.103.11(6) Remaining UnsLced Puttiom oi'Becf ltam I ercoa Retail Practices j FC 590.000 j Roas:a" ( 23. I tvtanatrement and Personnel FC--2 .003 18 Proper Cooling g of PHFs I ! i=oud and Ford Protection FG- 3 004 j I 24. ! t.5. Fcuipment and Utensis FC-A 005 -j 3-107.14(:1) C'uulutg(-':caked PRFs from 140`\to i (:. 'NaR r,Plumbing and Was v I-C -u -.008 1 70'b Within 1.flours and From 70'F -ret, P!-,yyira'Facility FC-6 007 to 4 i`FJ45"F Within 4\loam. ' 28. Poisonous of Toxir VFterds FC- 7 ; 008 1-501 14(B) Gn4h g PHF:,:Made From Ambient29. 9t:�eciai Requir0 ements � 09 j Tciaperature Ing edients in 4l°F/45-F I K. i Caller ! -----� Within 4 Honrr' :""0f• ". -'.` Denote,cni cal aert m iht ftdc,al 1994 Puod Cudc or 105 C\5R 59it 060, CITY OF SALEM // BOARD OF HEALTH Establishment Name:�� f-�t P q.- Date: 6 �/,3/� Page: of I Item Code c—Critical nem DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY In (Ing , (lo�� irrs pu .. w I W& C ✓ 6vt - Cdv-6"t s (h) r- i% v"e'w I 1 1 1 I j 1 1 Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: - _ >, w'..., ..•. .r '- �.. �. ."z ism--.. ---... .. �. ,�. M" . d,,., r t. 3-50i id(C) PHF5,Receivedattemperatures Violations Related to Foodborne Illness Interventions and Risk According to Late Cooled to Factors(items 1-22) (Cont.) aI'F/45`F Within 4 Hours. " PROTECTION FROM CHEMICALS 3 50 L 15 Cooling MethlxiS for PHFs 19 PHF Hot and Cold Holding 14 Food or Color Additives 3-501.16(1:) Cold PHF, Wint,tiucd at or below 3-202.1'2 Additiee5" 1 590.004(F) 41°t45` F" 3-302.14 Protection Gom Unappro,ed Additives'" � 13-501.16(A) Itut PliFa Main[amed ut or above 15 ( Poisonous or Toxic Substances ( id0-F a 7-101.11 IdeContainers lnfonnahon- Original ( 3-501 16t.A) Roasts Held at or above Containers' 7-102.11 Compton Name-Workmq Containers! ( 20 Time as a Public Health Control 3-501.19 _ Tia:c as a PuULt Health Ceun'ol" 7-211 L I 1 Separation-Skn apO -- 7-202 1; Restriction-- Presence anu Use* 590.00d(H) Variance Requirement 7-202.12 Conditions of Use,, ',--?O3 11 'toxic Containers.-Pr h:baiorts* i REOUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 I Sanitizers,Criteria-Chemicals' POPULATIONS(HSP) 7-204 12 Chemicals for Washing Produce,Criteria'' ll 3-801.11(A) Cnpasteun.:ed Pre-packaged Jun.es and Ht,.vel[aes wd, Warning Labels* Criter7.20!.1i Dryine Agents. i ' ( 3-90L11(B) Us:;,f Pasteurized Hens' 7-205.11 ( Incidental Food Cunut ct. Lubricants` 13-301.11 i D) Raw or Partially Cooksd Animal Fixxl and 7-206.11 Restricted Use Pesticides.Criteria" � kaw Seed Sprouts Not Screed. 7-206.12 Rodent Bait Stations" � � 801.11 t C 1 lana, I �� < 7-210o.13 'Fre,king Puwdzrc,Pest Control and I erred Foul Packa�,e N'ot Re-.creed ?vfonitoring^ CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-603.' E Consorner Adetsory Posted for Consumption of P.rinml FtK:t& That an. Raw-. Undercooked tit16 I Proper Cooking Temperatures for ( Not Otherwise Ynu:esaed to Eliminate PRFs 1 3-40 1.1 IA(1)(2) Eggs- 155"F 15 Sec. Pathogens.` Eggs-Immediate Service 14.c`P15sec� gs 3-30_.13 Pasteurived Eggs Suhspturr ."or Raw Shell : , 3-401.11(A)(2) Comminuted Fish,Meats<&Came Eggs! Animals- 155"F 15 sec. '% SP£C1AL REOUIREMENTS 3-4(11.11(6);•1)(2) Pork and Beef R6s!Ei - 130 F i'_7 min"' 3-401.11(A)(2) Rahtcs,lnjcacd Meals-155'F 15 590 001)t A)-(D) Violations of Section 590.009(A)-(D) in sea * catering, mobile food,temporary and 3401.11(A)(3) Poultry,Wild Game.Slufted PRFs, tes:dential kitchen operations should be Stuffing Containing Fish,Meat, i debited under the appropriate sections Poultry or Ratites-1 WE 15 sec. _' above if ielau_d to foodborne illness 3-401.1 I(C)(3) Whole-musele, Intact Ileo(Steaks interventions tied risk factors. Other 145'F"' 590.009 violations relating to good retail -401.12 Raw Animal Foods Cooked in a I pracisceS Should be debited under #29-- Microwavc lo5`F* Special Requirements. 3-401 1((Aq1)I b) .all Other PHFs - 145`F i5 sec. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 1-403.11(A)&(M PHFs 165'F 15 scc. i (Items 23-30) 3-403.11(6) Miciowate- 165`F 2 R4mute Standing Critical wd«eh dr.aw:rlatr to t/rc Time" foodborne illness i«ternennrna�mid risA fu<'rors listedabove •an be 3-403.11(C) Commercially Pftcessed RTF Food- brand in the j(dloh ing screons of the Fond('nese and 1,05 C A4R i4WF.. 590.0U0. 3-•403.11(1) Remaining Unshced Portionsuf Beef ! Item Good Retail PracticesFC 590.000 1 Roasts:. 23. OAanagnment and Pei sonnsl FC -2 .003 24. Food and Food Ftdectior FC-3 .004 Proper Cooling of PRFs 18 25 ( F mpment and(ifensJs FC - 4___ .005 3-501 14(A) CouluteCooked PHFs from 140`Ftt, _q - -{ 26 Water,Plumbinq and Wasic FC-5 .006 70"F Within 2llour,and From 70'F 27. Physical Facility FC-6 .007 to 41'F)45"F Within,4 Hours. I 23. Poisonous or Toxic Materals FC--' .002 3-501.14(B) Coaling PHF:. Made FronrAmb[ent 29 Special Reourements .003 Tempetat ue ingredients to 41'-Ff45,F 130. Other Within 4 1 lours' ' -Dentes ci tried item at the frdo:al 1999 Fund Cad:or 105 Cbik 5W,000. I ' CITY OF SALEM BOARD OF HEALTH v Establishment Name: r'�K_ ��/,/r h PIC, Date: 6 /Iih Page: of Item Code C-Critical Itemv DESCRIPTION OF VIOLATION/PLAN'OF CORRECTION Date No. Reference R—Red Item - Verified , PLEASE PRINT CLEARLY FI - 1 LJ C'�- v 6Vt (zm S rN i, I n v e w -M-t_M ciwGw V'C C Cl( TIS ✓� I 1 Discussion With Person in Charge: Corrective Action Required: ❑ No I ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency closure your food permit. ❑ Voluntary Disposal ❑ Other: 1 ?14fR,-cere,I al'Fvmpc,.ttureq Viola Sons Pollarod to Foodborne Illness Intervenharni and Risk Ac-QtIw—o 1,r. Cool; Factors(items 1-22) (Cont.) 41^FMJ'F Withio,l fie PROTECTION FROM CHEMICALS if Co.'!un -Metho's 1131 PHIS Food or Color Additives !q P14F Hot and Cold Holding 14 1 1 ;-501.16'1.1 (; ., Maintained ai or below 3-20119 _".i P111's 3-,302 14 Protection front Unalitnowd Additives" 59U1,004(r) 41°/4,51 F- Ifilt PHFs Maintained at e 15 j Poisonous or Toxic Substances 7-101.11 Identifying Infointation-0i'winai 140T. CLIT'Lailler's, I I 3_j01 1`)"A) R-asts Hold t or:ih.we I�('F, 7-102,11 Common Name -N�orkinl-C.1-Hitainett 2f) Than vs a Public.Health Control II 5cparat:011 -Stoltooe^ 7o -l IC Time� a public Health Control WO.004(H) valiankc Re�qulremejlt 7-2U2 11 Restfiction-Presence and Use" 7-20"2.12 Conditions of lj,e, 7-203 11 'to6rcontaineti: - Prohibitions" REOUIREMENTS FOR HIGHLY SUSCEPTIBLE 204.11 Sanitizefs,Ctileria--Chemic:is* POPULATIONS OPULATIONS(HSP) 7-204.12 Chemicals for WoshingProduce,Criteria* 121 3 SOI II(A) Uovetaculizt ,: Prken-pna l*kaged Julscand Bges wih ne[,abi 7-204.1.1 Drying Agcois.Criteria' 3 301,1 413) Use of Pasteurized " 7-205.11 In 'Liental Food Comact.Lobricarrq^ j 7-206.11 Restricted tlne Pesticides.Criteim* 3-301,1 i(D) Paw or Pat fall v C-kked Apo roar Mood and i Raw cd Sprouts Not Sr:ped. 1 7-206.11 Rodent Bait Statioi,s- 31 801.1 UC) Unopened Food Packagi- N,-a Re-served 7-206.13 Tracking Powders,Prat Control and . kloitocinp CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-60 11 Corlitinw-, Ad-,,isix-v Pk)s,-,,' fo;-Cciisunaptioll of 16 I Proper Cooking Temperatures for ano; Pontis That are Raw.Uuderc,asked or PHFs N,q Othetwise P,oces,�ed to El onmaj, 1-401,1!A(l)(2) Eggs- 155'F 15 See. Eygq-Inatiediate Ser%i,x 145'1715Nt— 30113 1?a!,curi7Pd Lee.Suhs6tute for Raw Shell 3-401.11(A1(2) Comminuted Nish, bleat;&Game F;;tls* Anialat- 155"F I5 sec. ' 3101.1116 ;1)) (2) P,-,rk and Beef Roaqt - 130T 121 on. SPFCIAL REQUIREMENTS 401.11(A)(2) Rantcs.Inje,led bleats- 155'F 15 590 O1';9(A)-tDp Violations of Section 590.009(A)-1 in cfueriilig, plot Ile too-", temporary and "'.c. '13 U 1 3-401.11(A)(31 Poultry,Wild Game,Stuffed PTIFs, I rilmdent!"I kitchen operations Should be Sitffing 7mlainin,Fish,bleat, dJnted Undcr the appropriate roi rlate Sections Poultryor Ratites-165°F 15 see, above if related to f.-.)odhorrw illness 3-401.11(C)(3) Whole-rausio,Intact Beef Steaks intonentions and tisk factors. CItIter 145T- 590.009 violations slating to gond retail 3.411.12 Raw. Animal Foods Cooked in i practices sheisid be debited under 1{29-- Nficlowave I6-S'F * Spcciat Rctiuircrnej)tc. 3-a01I I(Afl)(b) All 01licr PHFs- 145'F IS w, 17 Reheating for Hot Holding j VIOLATICIAlS RELATED TO GOOD PI-TAiLl PRACTICES 403A 1(A)&(D) 111-IF, 165`F 15 sec. {]terns 23-30) 3-403.11(b) Nlicrovzm,ve- I 65`'F)M i out c StandinL, crific"71 ill"!lam ctiliced viololion., which do not 10(ile to the ltjodhorn,:dh,,5fS WWI V(Mfinni and i i.sk fiYtOrS tiAwdabove, (at,be 3-403.1 t(C) Contracteiall-v PrtwtsSed RTE Food- found in the folio vi,, se(i i(Ins(i(the Fwd(',:de and 105 CIIR i 40'F 590.1900, 3-403.11(E) Rejuaini,l, Un,ficed Portions of Beef Item Good Retail-Practices FC 1 590.000 RoaRW 23. I Management and Per onne, FC -2 11 .003 18 Proper Cooling of PHFs 24, Food!and Food PrUlciltion FC-3 coit I 25 -Quipmant oil,,[Utersils FC--4 C05 3--SO; Jz'llAl) Cooling Cooked PHFs from 14 1 IP, Walpi,Plumb7r.q ard Weste FC-5 .006 -01-Wiihin 2 Hourb and From 70'F 27, Physiral Facilely FC-6 007 to 41 T/457 Within 4 Hours. 28, 1 Poisonous or Trixir Materials FG--7 008 3-501.14(B) Cooling PHFs Made l-root Ambient 29 Special Requirements Temperature Ingredients`0 11 VT145:F' 30, rithe- Wnthin 4 floor, 1 Dellow;mucai ileo 11A the Gdcjal NV9 F,uxl Gine,a lo5 CNIR 590 CITY OF SALEM BOARD OF HEALTH Establishment Name: i Date: ��/7/(Jio Page: of Item Code C-Critical Item J DESCRIPTION OF VIOLATION/PLAN'OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY I Gv% � fry 01,26A /tee I I . I I . I Discussion With Person in Charge: Corrective Action Required: I ❑ No ( ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: i";(;I.:4(C) PHFe Recetvcd at "Temperature;; Violations Related to Foodborne Illness Interventions and Risk According to 1-aw Cooled to J Factors(items 1.22) (Cont.) ( i 4FF/451F Within 4 Hours. '' PROTECTION FROM CHEMICALS E 3- Ui 15 Cooling M thvds for PI"tFs J 14 ( Food or Color Additives 19 PHF Hot and Cold Holding 3-501.Ih(B) Cold PRFs t-laintaincd at or below 3"202.12 Additives" 590.001(1`) 41'/45" F^ 3-302.14 Protection trout Unappruoed Addtnvcs' 3-501,16(A) Hut PHFs Maintained at or above 15 Poisonous or Toxic Substances 7-101.11 Identifying lntormaioa-Ongmat Containers - 3-501 INA) Roasts Held et or above 13011` " - - ...,,.. 7-102.11 Cornmon Name- Working Containers" ( M Time as a Public Health Control 7-201.11 Separation-Storage" 3-501.i 9 T;mo as a Publi,Heairh Control* 7-20111 Restriction-Presence and tise* 590.004(H) Variance Requirement 7-2102.12 Conditions of Uw' 7-203 11 'Ruic Containers-Ptohit»tions" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanitizers.Crirenu-Chemicals POPULATIONS(HSP) 7-204.12 Chemicals for Washing Produce,Ci iteria' 21 3-801.11(A) i Unpasteurized Pre-packaged luicesand i Bc-.et'ages with Warning Lalbelsr 7-204.14 DrvingAgents,Criteria' � i-nQl,It(B) Use of pasteurizedFegs* I 'r-205.1 t I Incidental Food Contact I_ubrieants^ --- - ' 3-M)t.1 i(D) Raw of Patnally Ce,,sed Anitn.:I Fuod find 7-106.11 Rewicted""se Pesticides. Criteria* Raw Sced Sprouts Not Set%ed 7-206.12 Rodent Bait StatiunsM 3-901.11(C! Unopened Food Package Not Re-served 7-?06.13 Tracking Powder:,Pert Control and, B-fomtoringi CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-60.1 11 Consumer.4d visoi v Post,d for Consumption of ( Animal Foods that are Raw. Undcrwuked w'ifi Proper Cooking Temperatures for PHFs Not Othetwise Processed to Elirat nne , 3-40l.1 l A(1)(2) Eggs- 155'F 15,Sec. t athogen•.*` Eggs-hnmediate Service 115"F75sec," 3-3102.13 Pasteurised Eggs Suhsdtutr 10,Raw Shell C 3-401.11(A)(2) Comminuted Fish,Mcats,G Genu Eggs! Animals- I S5`F 15 sea 3-4(}i.i i(B)(1)(2) Pork and Beef Roast- 130'F 721 mi'inI SPECIAL REQUIREMENTS 590009(:1}-!D o 009 kA)-(I))Ratites, Injected Mcats-- 155°F i5 . ) Vielituons of Section .5 1)009kA)-(D) in Sec, . catering, mobile food,temporary;nrd 3-401.1lfA)0) Poulin;Wild Game Stuffed PHFs, resid;a:tial kitchen operations should be Slutl)nc Containing Fish. Meat, debited under the appropriate sections Poultry or Ratites-165°F 15 sec. above if related to foodborne illness 3-401.11(0(3) Whole-uulScle, Intact Beet Steaks interventions and risk tactors. Other 145°F e= 590.009 violations relatin_to good retail 3-x01.12 Raw Animal Foods Cooked in a ( practtce� should be debited under h29 - Miciowave 165`1-''" Special Requirenicots 3-401,11(A)(1)(1)) All Oilier PHFs - 14i"F 15 sec. 7 j Reheating for Hot Holding VIOLATIONS R,LATED TO GOOD RETAIL PRACTICES 3-403.11(A)&,(D) PHFs I65"F15 sec.' - - � (Items 23-30) 3-403.11(B) Miciowave- 165"F 2 N mile Standing Critical earl non-critical violattwra, ndnrh do,int „-late to the Time'' fordLornc rl4resr interverr:on,c and rick 6u tors listed db01,e, can be 3-403.11(C) Commercially Ptixessed RTE Food- found in the Jolloa ins se,tions o(the Four'Code and 105 CMR 14PT'" 500.000. 3-403.11(8) Rcmainin-UnslicedPordonsofBeef lien; I GoodRetsilPracucas FC 590.000 Roasts* I 23. 1 Nanactement and Personnel FC-2 003 IR Proper Cooling of PHFs '-'t. Food and Fond Protsctior. FC-3 004 J 25. Equipment and Utensils FC -4 1 ;005 '3-501 14(A) Cooling Cooked PHFs from 140'F to 26 Water, Plumbirq an Waste FC-5 .006 1,01-Within 2 Hours and From 70`1` I � 27 Physical Facii;ty FC-6 i .007 f to al`F/45F Within 4 Hours. ' 28 Posonou/or"lass t,Aatena-s FC 7 .Ops 3-501.14(8) Cooling PHFs Made From.ambient ( 29 SUerlal R,?gtarements 009 Tempetatute Ingredients to 4 CF/45"F 130. Other Within 4 hour>, °"".,':'•.��• •Denotes critical item:n ihr Rdend 1994 food Code or 105 C NIX 590 pop, ♦r�•T ~ F CITY OF SALEM t BOARD OF HEALTH f 4 Establishment Name: 'Y�f/SGs k//1C Date: //7/0(o Page: of ' Item Code C-Critical Item V DESCRIPTION OF VIOLATION/PLAN'OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY e r�ltr�a 411 1e- 1O1'7A11k1 `1 1111,,W.Aj /��/� U �Oi� �i. ✓><>`r1�y(lir� c � rn F 4' t � /�1�zlt.�» i'Ii Jr�•�5 � � lt/QS�'�� GtiGtl�' ��i/GG�� - //J��/?i�fe�� .�Ar r s t rDiscussion With Person in Charge: Corrective Action Required: ❑ No I ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ voluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditions as described, and to t ❑ Re-inspection Scheduled LI Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that ' noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure .I your food permit. ❑ Voluntary Disposal 0 Other: PHF, �'ecelved at Temper,nurec Violations Related to Foodborne fitness Interventions and Risk Ac,crdmt to ho, Cooled to Factors(items 1.22) (Calif.) .}{ F/45°p\4[tiiin 4(-loters. " PROTECTION FROM CHEMICALS 3-50:,!5 Cooling Methods for PHFs 19 PHF Hot and Cold Holding i3 FcodorCodorAdditives 3-50i.16:B) CoiuPHF;;rlainttinedato.I,zlcm i 3-20112 Addime'`' I 064(F) 3 `10? Id P[oaxnnn front (inauprov:d Acldittves* ( 3.5•„11.I6(1) Hot PFIFs Maintained at ar above 15 ( Poisonous or Toxic Substances ( 140 1; Gnnanlers" 7_101.11 Identirylq hifonndion-Original I 3-501 J 6(.4) Roasts Held at or above 130`F. 20 Time as a Public Health Control 7-102 11 Common Natne-Woman, Containers" .17 Ttime as a Public Health Control*',-201.11 Scparnd,m-Stulage" 7-'_02.11 Restriction-Pracun e m;d ilse'0 I 51M.0040-l', Variance Reauircntent 17-203.12 Condition:;of Use" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.1 J Toxic Cu:.Coiter -Prohibitions-` POPULATIONS(HSP) � ',-'204.11 Sat»tizers.Crirena-Chemirds^' 7-201.12 Cherticals for Wa.hmg Produce,Criteria" 1 21 3-300.1 I(A) Unpa,teunzed Pre-packagedJuices and 204.14 U[ping Agent,Criteria* Pcvetttee,with Warning i.abel� 1-205.11 ; ( :-SIH IVB; LJce of Pnsretaized Ee^_a* Jncid( ntal Food Contact 1_l'sn.ants^ I Sfit lllRnw or J'unaa}•Ca,kcd.4uimal Fcxd:rod 7-_06.11 Restricted Use testi,xies.Criteria` ! 1 fi) I 7-206.12 Rodent Hair Station,- ( 1 Rau:Seed�Prnuts Not Served. " 7 206.13 1 rackong Pnurders,Pest Control and I ;-SO1•!f(C) Unopened Food Package Not Re-served. Monituting* CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-60' 11 Comumer Advtsnry Posted iw Consumption of i Animal Faxls"Ihar:,n. Raw. Undercooked or I6 Proper Cooking Temperatures far I Not Otherµ;se Processed m Blimin.tte PHFs 3-401.1 1A(!)(2) Eggs- 155^F 15 Sec. Pathe„ens.* Eggs-Lmnediate Servi•,e i45`Fi5sec* 3-302.1} Pasteurized Egg,Substiinte tin Raw Shell 3-401.11(A)(2) Cum[nnmted Fich,Meals &Game Egx's L Animals- 155'F IS sec, # 3-401.11(13)i,1)(21 Pork LndHeeflkoast- 130'F 121 nun* SPECIAL REOWREMENTS 3-401.11(A)(2) Ratner, Injeacd Meats- 155"F 15 590.00t1(A)41?) `.'inlalions of Section 590.009(A)-(D) in sec. caterinc, mobile food,temporary and 3-401.1 1(.4)(3) Poultry,Wild Game, Stuffed PHFs, residential kitchen operations should be Siutling Containing Fish, Pleat, dchitc I under the appropriate sections Poultry or Ratites-Ib5°F 15 sec. * above ii relattd to loodborne ilf less 3-401.1 I(C)(3) Whole-musele, httact Beet Steaks bverventior,s Ind risi< factory Other 145"F 590.009 violations relating :o good retail 3-401.12 Race-Animal B,(ds Cooked in a practices should be debited under#29-- Mi.rowave 165`1 Special Requii ements. 3-40LII(A)(1)(b) AllOtheiPHFs- 145"F 15 sec. * f' Reheating for Hot Hold;ng VIOLATIONS R-LATED TO GOOD RF_TAfL PRACTICES z 103.11(.A)&(D) PHI-,, 165''F 15 sec. :_ (items 23-30) ?-=C!'J I M) lvlicrowaee- 165` F 2 "Inure Standing Criucal n;ul na,rrl;tic r.(violdhoi:e, rvG;ch de riot:z�Ltrc r<,i/ie foodborne illus into,venirmuz amd viA!looms listed above (mi be 3-403.11(C) C'nmmercialiy Processed RTF Food- foundin the)-)" },-ins sections gjthe Food Coth and 105 CMR 140"F" j590.000. 3-40.1. I(E) Reniainiu;Unsliced Portions of ReefI I Item Good Retail Practices FC 590.000 R 1 oasts" 1 23. Mal ar_:�i Persorrel FR;-2 01; Ig Proper Cooling of PHFs ( 24 Focd and=acd Prot-actior FC -3 '104 i 25. Equ'prnen;.and Utensils FC-4 .CCS -3 -3o w(A) Cooling Cooked PHFs room 1d0'F to ----- Ir 26 \Nater, Plamhinq and Waste FG-5 006 7 ' 0'F Within 2 Hours and From 70`F I.. --- 2,. Physical Facilry FC-- 6 .007 to I 1'F/450F Within 4 Hours. " 28. Poisonous or Toxic Materals FC -7 1 .008 3-501.14(B) Cooling PHFs Mad.:Prom Ambient 1 29, Special Reawrements 009 reuaperanire higredients lot 1'F/45"F j 30. Other , Within.1 I-Iourc:z •,cn,.,i:.a„s k *Uenot•.s c,*!:Ic.d item:n::n•:Aleral 994 Fnod Co:ie or 0:5 0.9b:590 000 MORRELL ASSOCIATES CURRENT DATE. 2117/2008 _ P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN. 211A/2008 (781) 837.1395 www.morrell-associates.com ire= FB9-13 L Irn�aes:Jayoe; Regals:tg Erry o +t I12f21 a Hktdiii nd Ave1 Rte 107 N T T N Salem,MA BACTERIA COUNT Sample Standard Plate Count/q Coliform/q Chocolzft Wk Shako <250 EPAC < 1 EPCC MASSACHUSETTS STANDARDS Machine:SPC<50,000/g;Coliform<501g Other:SPC<50,000/g;Coliform<201g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 / MORRELL ASSOCIATES Current Date: 4/19/2006 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 4/12/2006 (781)837-1395 www.morrell-associates.com Customer#: FB9-13 v09nf ll 15JOC+� EE C Invoices:Joyce; Reports:Lg Env L Burger King#3564 L 11/18 OC Highland Ave./Rte 107 I E T Salem, MA N I Salem MA T O N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake 920 < 1 EPCC MASSACHUSETTS SANDARDS Machine: SPC s 50,000/g;Coliform s 50/g Other: SPC s 50,000/g;Coliforms 20/g %�;F'( (✓ v�� METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST Products 17th Edition,American Public Health Association, 2004 MAY 0 4 2006 CITY OF SALEM BOARD OF HEA1_TH I i 3 MORRELL ASSOCIATES CURRENT DATE: 33AV2008 P.O. Box 268 Marshfield, MA 02050 DATE SC A PLtomer A N F89-13 T- (781) 837.1395 www.morrell-associates.com cInvokes Joyco; Reports.19 Env o Buser{Una t'WW E i 1/18 a Highland AveJ Rte 107 N T T O Salem, MA N BACTERIA COUNT Sample Standard Plate Count/q Coliform/a Strawberry Milk Shake {250 EPAC < 1 SPCC MASSACHUSETTS STANDARDS Machine:SPC<50,000/g;Coliform<50/g Other:SPC<50,000/g;Coliform<20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 90Q1� —i �I i i fi Tim CITY OF SALEM BOARD OF HEALTH i MORRELL ASSOCIATES CURRENT DATE: 1 1/14/2005 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 11/9/2445 (781) 837-1395 www.morrell-associates.com Customer #: F89-13 Snvoices:3oyce; Reports:Lg Env o,Burger King #3564 E i2/21 A Highland Ave./ Rte 147 N T T I N Saler, MA BACTERIA COUNT \ Sample Standard Plate Count/q Coliform/q Vanilla Milk Shake C 254 EPAC t. 1 EPCC DEC 0 5 2005 CITY OF SALEM BOARD OF HEALTF MASSACHUSETTS STANDARDS Machine:SPC<50,0001g;Coliform<50/g % } Other:SPC<50,000/g;Coliform<20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 86717 I i Ci, Massachusetts Department'of Public4 Health Salem Board of Health 120 Washington Street, Division of Food and Drugs Salem, MA 01970-35234 19 0-35234th Floor FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax(978) 745-0343 Name r Dat / TYoe of Ooeration(sl. Type of Inspection "', vG I [A, Food Service 1❑ Routine Address O y// / „/ �1 Risk ❑ Retail ❑ Re-inspection Tele hone �' "'yT r/^rI A'," P Level ❑ Residential Kitchen Previous Inspection P ❑ Mobile Date:! r�a �)j Owner �y-/y, HACCP YM Temporary ❑ Pre-opera ion I $ y /,A .urnn. I Al- I ❑ Caterer ❑ Suspect Illness Person in Charge((c)' Time ❑ Bed&Breakfast ❑❑ General HACCP Complaint In:%,o -30 inspector ( �� Out:]%� ? Permit No. ❑Other Each violation cKecked°requires an Zplanation on the narrative page(s)and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 580.009(F) ❑ action as'determined by the Board of Health. ! _ . . .. , FOOD PROTECTION MANAGEMENT;.'- ' . ;'„,,,.. . ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties -,. ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS'' ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals FOOD FROM APPROVED SOURCE ❑ 4. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling PROTECTION FROM CONTAMINATION " "' ❑ 19. Hot and Cold Holding ❑ 8.-Separation/Seg I regatio I n/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing 'REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) El21. Food and Food Preparation for HSP [:110. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices CONSUMER ADVISORY ❑ 22. Posting of Consumer Advisories Violations Related to Good Retail Practices k Number of Violated Provisions Related Critical (C) violations marked must be corrected To Foodbornp Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today,the items checked indicate violations of 105 CMR of Health. q 590.000/federal Food Code. This report, when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2)(590.003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food -26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have agright to a hearing. Your request must be in writing 1 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: S 5&llOs IFOm 14 dX Inspector's Signature: � '/I^/ r� Print: Ili PIC's Signature`, ///� _ Print: A/� Yn A �/I�`f�,f� ��-11 Page of�Pa ges Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT ( S Cross-contamination 159i).003(A) Assignment of Responsibility' 3-302.11(A)(1) Raw Animal F(hkls Separated from 590.003(B) Demonstration of Knowledge* ' 1 Cooked and RTE Faris* 2-103.11 Person in charge-duties 1 Contamination from Raw ingredients 3-302.11(A)(2) Raw ,'knium)Foods Separated from Each EMPLOYEE HEALTH Other' 2 590.003(C) Responsibility of the person in charge to I Contamination from the Environment require reporting by food employees and 3-302.11(A) Food Protection'" applicants" 3-302.15 Washing Fruits and Vegetables 590.6(}3(F) Responsibility OCA Faxi Employee Or 1n 3-304.11 Food Contact with Equtpruent and Applicant fo Report To The Person In Utensils* Charge* Contamination from the Consumer 590.003(G) I Reporting by Person in Charge* 1-306.14(A)(B) Returned Food and Rescrvice of Food* j 3 590.003(D) Exclusions andRcsrictions* ! ( Disposition of Adulterated or Contaminated 590.003(F,) I Removal of Exclusions and Restrictions I Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food" d Food and Water From Reguiated Sources ( 9 Food Contact Surfaces 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 3-201.12 poral in a Hermetically Sealed Container* Sanitization'1-eniperatures* - 3-201.13 Fluid Milk and Milk Products* i d-501.112 Nice bauical Warewashing-Hot Water � 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202 14 Eggs 4-501.114 I Chemical Sanitization-temp.,pH, :.nd Mill,Products.Pasteurized" � concentration and hardness. 3-202.16 lee Made From Potable Drinkin-I Water` i 1-601 11(A i Equipment Food Contact Surfaces and 5-101 A I Drinking Water from an Approved System* 590.006(A) Bottled Drinking Watcr* Cleanin Clean* - o ao , ( Q-602.11 Cleaning Frequency of Equipment Food- 590 006t B f Water Meets Standards m-�10 C•!viR_...0" Contact Surfaces and Cltensils'� Shellfish and Fish From an Approved Source 4-762.11 Frequency of Sanitization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of Equipment* Shellfish* " 703.11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from YSSP Listed Chemical* Sources* Game and Wild Mushrooms Approved by 10 Proper,Adequate Handwashing12-301.11 Clean Condition--Hands and Arens' Regulatory Authority - 3-202.15 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 590.004(C) Wild Mushrooms" 2-301.14 When to LYash* 3-201.17 Game Animals* it Good Hygienic Practices I g Receiving/Condition 12-401.11 Eating,Drinking or Using Tobacco* 3-202.11 I PHFs Received at Proper Temperatures* 2-401.12 Discharges From the Eyes, Nose and � 3-202 15 Package Integrity" I Mouth^ Unadulterated 3-1()1.11 Food Safe and i- r * 3-301.12 Preventing Contamination When Tasting* � 6 Tags/Records;Shellstock 12 Prevention of Contamination from Hands 3-202.15 Shellstock Identification* j 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained'' Employees* Tags/Records:Fish Products 113 Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located and Accessible 3-402.12 Reands,Creation and Retention' 1 5-'--03.11 Numbers and Capacities* t Record Cr Ingredients* ! 5-204.1 l I Location and Placement* 5)0.004(1) 9 9 -- --- 7 Conformance with Approved Procedures 5-205.11 Accessibility.Operatiim and Maintenance /HACCP Plans ( Supplied KIM Soap and Nand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packagng,crnefia' 6-301.11 Handwaching Cleanser,Availability 5-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision *Denotes critical item in the federal 1999 Food Code of 105 CMR 590.000. CITY OF SALEM '/ BOARD OF HEALTH Establishment Name: 2Qr. _K.n_ti !L' 7_iT4„ Date: ////JG Page: G� of ' ) nem Code C-Critical item- rJ DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified PLEASE PRINT CLEARLY' -1'je- 1/Pn--- 4,"J--r vct0e-r Akocls -jot. 7� ot. �/ K(��Lf p( �o(•�.1/� n�� - `1 r/t� `Jy PG !' Cil J y-- (',J�C/1 P 10 ti loll) 1!�/t I. J)U S 5b (<�((r rf— - -) k C1 0ri /� L, j 4,� s I 1 1 f r r 1 ! Un. 7ii Discussion With Person in Charge: I Corrective Action Required: I ❑ No es I have read this report, have had the opportunity to ask questions and agree to correct aVoluntary Compliance ❑ Employee Restriction lfa / ' violations before the next inspection, to observe all conditions as described, and to \ Exclusion P ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that f noncompliance may result in daily fines of t� ollars or suspen i is -cation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: f 3 �u 114(C) oHFe Recen•ed a:Tempetatures Violations Related to Foodborne Illness Interventions and Risk 'w cr ng to Law Cun!ed to Factors(Items 1-22) (Cont.) 41`F/45`F Within 4 Hours. PROTECTION FROM CHEMICALS 3- C1,vhn1"VlethrKlsforPHFs ( 19 ( la Food or Color Additives I PHF Hot and Cold Holding 3-202.12 AdditiNcs'K - I Cold Pi 11-s Maintained at or b-km 5%004(F) It 1/45"' F- 3-302.14 Protection from unapproved Additrres" ( 3_s0,(,I ti("c) ,'fol Pi-IFs Maintained at or ahuve, 15 Poisonous or Toxic Substances I j 140'1 7-101.11 Identifyinz Information-On ietna( ! ?-50),Ih :� - ° r � -) Ruasts Held at or move tat, f Containers" I i)? Time es a Public Health Control 7-102.1 1 Common Name -Wurkin$Cc,ntainer," ( z r Time a 17-101.11 5,paration-Storax.^ s a Public Health Contrui� • - I7^02.11 Rearicti„n-Presence:utd Use.' I i 590.00411-1) s,ar;net Requirrnicnt 7-201.12 Conditions of lice 17 ?D3 11 'Losic Containers-P:ulubitions" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) d•;;" 17-204.11 Sanitizers.Criter,a-Chemicris' 11.3 3-801 17iA) I tP' x in t:team rre- ed P �nekag'_,.d Juices caul � 17-109.12 Cbemic:ds for WashingWashingPrnchice,Criteria' I ( 7-204.13 Erving Agent,.Criteria j , Hcvefaces with Warning labels"' 3-801,111 H1 Use of Paxte liz-d Ee.:s* 7-2)5.1I ( Incidental Food Contaet. iribricants^ j � 1 3-S0,1,l t(`vl Row rn Par'dzily Ctxi}:ed Animal Ftnxl and 7-206.i 1 I Re>tricicd Ilse Pes!icnles Cruerai` ( R,t,*,Seed�Sprrxtis :G;t Sened..t 7-206.12 I Rodent Bait Stations' I 3-801.;1(C) Unopened Fox, Psekiwe Not Re-served. 7-206.13 'F7addng Po-dcrs,Pest Control and Monitcxingr CONSUMER ADVISORY TIMEfTEMPERATURE CONTROLS 22 3-603 11 Consumer Advn ory Posted Lx Cousump,ion of 16 Propet Cooking Temperatures for ; Animal Fcxdc khat.:rc Raw,Undercooked nr PHFs Not Otherwise Pmcessrd to Eliminate +--101.11 A(1)(2) FL,zs- 155'F 15 Sec. Pathogens^ Eggs-Immediate Service 145'P15sec 3-303.13 Pasteurized E gs StlbLt:n:te For Raw Shell 3-401.1I(A)(2) Cummnuned Fish, :Meats&-Came Eggsr At)itrot s- i 55'F 15 sec. !, SPEC'.AL REQUIREMENTS 3-401.i !(H n 1)(2) Pork and Beei'Roast- l30"F I?I min' I 1-401.17(A)t2} Ratites, injected Mcata- 155°F .5 590.009(A)-(D) Violations of Section 590.009((<A)-(U) in sec. j catering, moble toad, temporary and J-401.11(Ap3) Poultry, Wild Game,Stuffed PHFs, remdenital kitchen operations should be StuffinContauuns Fish, at Me , deb+ted under the aparepriaic sections poultry-or Rabies-i65"F 15 sec. ^` 36ove 1f rclaied to foodborne illness 3-i01.11(C)01 Who?e-muscle,Intact Beef Stcaks rnten-ertioms and risk tactors. Other 445"F m 590.009 violations relating to good retail i 401.i2 Raw Animal Foods Conked in.: practices should be debi4ed under 1129 - Microwave 165`P " ! Special Reyuirentcnts 3401.1I(A)(1)(b) Ail Othei"Ws - 145'F 15 sec. j 17 ! Reheating Tor Hot Holding j VIOLATIONS RELATED TO GOOD RETAIL PRACTICES f 3-403.11(A)&(ll) PHFs 165`F 15 sec. (Itenis 23-30) 3-403.11(B) Microwave- 165-F 2 Minute Standing C,atcal mrd nor-mit"al em[ation.s, which do no:relate nr the i I Time" loridbo,z:e i!hwry;iter:-enfinm'w+d,ism fav tor.;161rd above, (an be 3-403.11(C) Commercially Processed RTE Food- found;n Jac julinx4ng serlions q/the hood Code turd 705 CUR 140'F I 59ti,000. 3-403.11{L,) Rentainin^,tinchced tbrtivuc of Feel' ! Item Good Refait Practices FC490.000 ] Roaatn* 23. Idanaciercent;md Personnel FC-2 1 .003 ! j 24. F000 and Foxl Protection FC-3 I .004 1g Proper Cooling of PHFs ! 25. Equien-,ent and Utensils FC-4 005 3-501.14(A) Cooling Cooked PHF:. Crum 140"F 10 1 26 Water, P1rnnN-q and Waste FC-5 ; .066-1 -'01-Within 2 Hous•and Hour 70"F 27, Phvsical Facilely FC-6 ! 007 j to 41'F/45'F Within s Hours. 28. Pononous o:Toxic Materials FC--7 i .003 j 3-501.14(6) Cooling PHt4s Made From Ambieot ! 29. Special Reouire;merits .00& � Temperature hngredientsto 41"F/45'h 30. Other Within 4Hour,'b *[le:+ores enucei Ilan ui the I'Jerd 1999 Fund Co4c or 105 0611:59(100(1. CITY OF SALEM - BOARD OF HEALTH Establishment Name: Date: 2I 1-504 Page: ) of 4 Item Code C-Critical nem DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified r PLEASE PRINT CLEARLY (-a ns Ar T-)4 T- sToI, 3US\�m�Ni, f I I I I I `�757 ?i1�1�D75��f 1'ALt Gcti� �S� \N =CZal4tcs?S y htr i I S? 7�I/J 9�J1�� Ft)a\ Hca 2+ x��Za r l P�\NC mvS 9\:, • �� SAN\'h l;c�_ ��. \GLL S"p \A\=')') •' I I I I P 5 1 I I I ' 4 I I - Y�as�� •SyS��r.. 5<,�v��.� ��svr`�r1NY Sc ,\� '> >�.�� Ott 3\= o4J S�Ti , I I I. ST<i3uSl-� n-CWT Taw Us\: O1J�-V �iC�IK. �= 21ot.�'�2 V�r\L. ��•_?t> ,\l. c I I ec6r- o rm-^ AAS Y-N\\ Discussion With Person in Charge: Sr7tvtr A� �� Corrective Action Required: I ❑ No ( ❑ Yes y I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ t Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency closure your food permit. (, (i 9 .� ❑ Voluntary Disposal ❑ Other: I4.,(') PHFs Received at Teuq:eratures Violations Refaced to Foodborne Illness Interventions and Rist Aecortin,,il.:,I",Cooled in ! Factors(items 1-22) (Cont.) -51 h:, � 41'Fr4= F Wa. t 4 Hn�is. ' PROTECTION FROM CHEMICALS ( 1 5()I.IS Cooling Methods For PHFs 19 PHF Hot ano Cold Holding j 14 Food or Color Additives IF,iB; Cold PI fFs Maimaincd at cr bolo% ! '-202.12 Adihtk-es* j -30' Id Protection from Uaappi oval a:ltitiycsj 35 Poisonous or Toxic&obstances ' 3-`'•'l.tn(:1) HoIP11F= R4aitttamrdat,�t ;hnye 11U`F " 7-101.11 Idenntianc Inform.[tion-Original Containers), � 3->U L I6(A) Roo,,.Had at�+:shove i 30'F � j 7-1[11.11 C,mntnn Name -Working Colltamera" ' ( Zf? Time as a Public Health Con?roi j 101.1 3-50i.19 Tone";a':a Public Health Control' 1 Separation-Storage' j j 7-202.11 Restriction-Presenceant Us.:' ( Su0.004(Ti1 Marione:keyuuemeri j 7-202,12 Conditions of 1.7sc` j t-203.11 IoxicContainers-Prohibitions' REQUIREMENTS FOR HIGHLY SUSCEPTIBLE j0411 Sanitir.rs.Criteria--Chetmcnls" POPULATIONS(HSP) j Unpasteurized Pri Ll 3-R 7''0412 Chemiea!+tot P'ashing Prouuce.Criteria* O!.i 1(,11 .pa:kag?d.traces anr.' Beceraces with'Warnine I.,+hei,:: j 7-7.04 14 DryinI Agent,.(-riteriu n(li.l HB) Linc .i Pae:oorize:! Eggs^ 7-205 11 htcitental Food Cont.et,Lubrutant;' ( 0-801 1 I�,D) Raw or Now;ly Cooked Anima! Frond and j -,-If)5 .11 Restricted Use Pesticides,Criteria' ( Raw Seed Sprouts tent Servet, e j 7-2061 12 Rodent Bait Stations S-R01.11(Cj nopentd Pexn1 Par age Nut Rc-served "' '-205.13 Tracking Powders, Pest Control and itionitormtz' CONSUMER ADVISORY TIME(TEMPERATURE CONTROLS 22 3-80-+.11 Consutuer Advi:.ory Posted 6 r CimSmnption of Animal roods 1•hat ore Raw,TJndanool:rd ur j lfi Proper Cooking Temperatures for PRFs Not Otherwise Processed to Ehuunate r,N,,•e ..p�qr 3-401.11 At 1)(2) Eggs- 1 iS"FIS Se. Padno_ens.+'3-302.13 Pasteuuzed FSubstitute foi Raw Shell Ee_s-Immediate SerVILe !45`F tisec rt;; 3401 11;A)(2) Comminuted Fish. VTeats&Game Animals- 155E 15 SPECIAL REQUIREMENTS 3-401.11(13AI)(2) R.-kand Beef Roast- 130°; !21 call 3-401.I1(A)(2) Ratites,htjceted Meals- 1S5T (5 590.009(A)-t Di Viol.aums of Sec•tiott SJO.C30S'(,4)-(D) in sec. catering,mobile food, temporary and 3 401.11(4)(3) Poultry,Wild Game.Stuffed PHF::, ( residential kitchen op,nations should be Stu4in,Con !auung Fish,Pleat, debited ender the appropriate sect ions Poultry or Ratites-16;'F '.5 sec " above if related to foodhorne illness 1401 11(C)(3) Whole-muscle,Intact Bcef Steaks iDtcrventi,,s anct tisk tactors. Other 145'F" 590 009 violations rclating to good retail 1-401.12 Raw Annnal Foods Cooked in a practiecs should be debited under #29 - N9icrov:ave 165"F x Special Requirements j 3-401.1 I(A)(1)(b) till Utter PHP;-- 145'; 15 sec. 17 Reheating for Hot Holding ( VIOLATIONS R_FLATEO TO GOOD RETAIL PRACTICES j 3-403.11(A)&{D) PT1I 165T 15 sec (Ite'-w 23-3i)) 3-401.11(B) Microwave- 14.5°F 2 Minute Standin, Criir�of una non-cn;i:al iirlm;nni, tido h deo not relate '[•lute'I I foodborne illneea inlet veniionc and risk f'c.io s (sled above, can be 3-403.i I(C) Commercially Puxessed RTE Food- found in the f.,lb, irig Sm nuns of file Fwd Code an,!Itts C.+IR 140';'' 590.000. 3-403 II(E ) Remaining Unshccd Portions of Beef ' Item Good Retail Practices ; FC .590.000 Roasts" 1 23. Maragement and Personnel FC-2 003 j 1H Proper Coa!fng of PRFs j i 24 Fooc an `cod Protc+:tion FC-3 .004 25. Equiontent and Utensils ; FC-4 .005 ? 561 I•}(:1) ('noting Conked PHFs from 14()'F to ?6. Water.Phtrnbino and Waste FC•-5 .000 Wr Within 2 Hours and lemni 70`F 27 Phy--ica!Facaliki FC--6 .00' to 41 9-/45"F Within 4 Haws. ' j_28. Poisonous or Toxic Materials FC-7 .009 3-501.14(Bi Cuol+ng PHFs Made From Anabient r 2q.----I Special Reelunements j 009 Tanperaturcingredientsto41'F(4i°F j 30 Other Within 4 H,urs' `!)mono,milia((:«m in the ted:ral 19nu Fowl ci¢le o+ 10>CIM�'IIikf 0. CITY OF SALEM BOARD OF HEALTH � , Establishment Date: Page: of t Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION vDat erified fi. No. Reference f R-Red Item PLEASE PRINT CLEARLY .,,� -- S\(v1P�\=-� - C� �2� NG.�.. [=\ 2\7. �S-�oT�.L�� \�•43N c�4J S I T'�� . I 1 I PRcaP�[.ELIv !-3�...L. `�Fi- �,.�ro'l r�RF.c�c YY�.�S � �iL. ��3°\�,'LY.•1 'L,�,'vJ�-Rl::_.7 i � tJSv?t4 int r tJv�CrSS�z C .��N -o lY t4 Q�5 tVNK,�_0 I 1 q I L sTr14�i, \S\alt�\1_UC is vowt�C c�tL\\y C�.os,N b \\ M'aZr��N�� l0 \ YaN "�,` a I T}}O+ZO•,)b\�\.� C..�i�`N �N� SAN 1 T1Zv LaW 1 1 I`��'+y T 1 ) CSrt•r I I I _ 1 Discussion With Person in Charge: Corrective Action Required: I ❑ No I ❑ _ Yes } I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ inspection, to observe all conditions as described, and to Exclusion violations before the next ins p ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that a noncompliance may result in daily fines of twenty-fiverdollaIrs or usp nsion/revocation of ❑ Embargo t Ll Emergency Closure your food permit. JlA ❑ Voluntary Disposal ❑ Other: ! .3"?('.i 14(0, PHFs RecededctTzntperzutrc� I Violations Related to Foodborne Illness Interventions and Risk i .4ceordi ne lit F aa,G.,,led to Factors(Items 7-P?) (cont.) 4€ 'F/45 ; G1%itbin H<,urs, " i ! 3-5u1.15 Coolilin Method;for PI-[Fs. PROTECTION FROM CHEMICALS 19 € P HF He^and Coid Hooding 24 Food or Color Additives 1 3-501,16(13' ('old PFIFs Maiotaaud at or 1,di..v I 2.0_.12 Addin-,esr ( j ;9U.GU4(F? 41':!45":'* j i ?U'2 Id Pndechon Irian Unapplowd a:Idiuse`" ( i 3-501.i6(A, Hot FHFe.R4aintaiued at or ahoee j 15 Poisonous or Toxic Substances 4U"P. 7-IOLII IdentitJu":g3nfonnation-Ongiu.`' I ;-501.i6(A) Roash j Container;" Held at cr: ahu'.e ,3C°F j 7-1 U-1F I Counnun Name-WorWig Conuvaern` ( ?Q Time as a r~uo!ic Health Contras ! 7-'.{)l.I l Senarauon-Shvaec'" 3-50!.!9 T.n,c as a Public 13ealth Control" j j 7-201.11 Rc�lticiwa-Presence andL:"e:, j j J90.OU h;H1 G'anxu:e Rcc!airrrnent j 7'02.12 Condition.of I!ce" 7-2w 11 1 oxie C'untainets --Prol,ibttioro; ( REQUIREMENTS FOR HIGHLY GUSCEPTIBLE 7'(i4.11 Sonrtrzus.Critenn-C'he!mcnh;+, j PCPULAT€ONS(HSP) a 12: .3•-801.1 I(A) Unpae,euri Ked Pre-packaged Juices and '1-204 12_ Chemicals for Washme I!-lute,C'rireria^ j god,14 DrNinn,Aa.nts.Crn,,;j," j Bever::-,es with Warning- Label,;* I 1 Incidental Food Cont:ct,Lubricar::�" 3-801.1I'B) L!:.,of Pasteunze,I L'u"c:. 7 I I Restricted Use Pere-ide;,Criteria" I %801.!I(D) Ra" r,; Partially Cooked Animal F,-,od arid {,• j ' RaP'S.cd SPFAits Not Served, s' 06. j 7-_ 12 Rodent Bait Stations* 3-80L!I1 C1 Lao [n-d T'ood Packa,e Not Re- seined, 206.13 Tracking Po'wdera.Post Control ane! I j P j Monitor pe F CONSUMER ADVISORY TIME/TEMPERATURE CON'PROLS 22 3-603.!I Consumer Adtiso+y Posted f,-,r Consumption of 16 Proper Cooking Temperatures for I Annual F,x,de 'llrat are Raw. Undercooked of PHFs Not Othin* ise Processed to Eliminate c °rrr;: sins ?-401.!15(1}(2) Ergs- 15YF IS Se; Padio,iIl1 ` "' tSe>s-lmmedtatc Scrr.:e !4i-F i Stec" 3-302.:3 Rlacm'tzed Eggs Substitute for Rau Shell g �. 3=4,)Ltl(tt)(') Com,),im)ted Fish. Meats S Gain,- Eg. Amm:ds- 155"F 15 szc. '" i j3-41`11tl(Byl)(2) Put Is and Beef Roat- 130'F121in[n* I SPECIAL REQUIREMENTS I3.40111(A)(2) knOtes, hyectedMea!,-- 155"I^ I5 i>0.0,)97A)-(UJ Viola);ons of Section 590.009(5)-(D) in sec. " catering", inol:fde food. temporary and 3-401.11(5)(3) Poultq, Wild Ciante.StuiTccf PHF::. residenDal kishcn opectlions should he Stutlmg C'untainmg Fish Meat, debited under the appropriate sections Poultry or Ratites-16i"F 15 sec abot�r if related to foodhorne illness .3-401.11(0)(3) Whole-nmwle., fro!et Beef Stea6's j interventions and dsk factors. Other 145'F 590.009 violations relating to good retail i 3-4 1.12 Raw Animal Foods Cooked in a j practices should be&I-hied under #29- Microwave 165`F^ Special Requo-cincuts. 344.1 J WO)(b) All Other PHFs - 145^F 15 sec. j 17 Reheating for Hot Holding j VIOLATIONS R.:LATED TO GOOD RETAIL PRACTICES =03 I t(A)&(D) PIIFs 165'F 15 sec. " (items 13-30) 3-+03.11(B) Microwaee- 165` J,2 Muu,te Standinn ! Critical and nor-crineu/violations. which drz not relate to the Time i foodlurne Fib,c:a /actors it.sted obsre, can lir 3-403 11!C.1Connnercially Processed RTE Prod- Iound^r the fc(kwing sectimry Q(the Food(tide and 105 C.btn" 140°F` 59r1.`uttr. 3--303.1 i;E) Rem.,inuig Unsliccd Portions of Beef I nem 1 Geed Retail Practices FC 590.000 poadsl i23 f tanacrmert and Personnel FC 2 003 I 13 j Proper Cooling of PHFs I 24. Food and Food F,olecilon j FC--3 .004 2b ______ H anent and Utensils FC--a ,005 3-5111,14(A) Cooling Cooked PHFs from 140"F io 26. orale!,Pwmonp and Waste ( FC-5 .006 70-F Within 2 Hours and From 70'17 27 � Physical Farilt y FC-6 .007 to 41'Fb35'F Within 4 Hours. ^ ', 28. Poisonous or Toxic tvfaterials FC-7 008 _ 3-501.1,411) Cooling PHF�Made From Ambien 29. Special Recuirements "009 'F'empesxuure ingredient;to4t"Fi45`F 30 ! othet -- --------- Within 4 Hours, •-,':' "u 'Donow,ird,c it neo,in the federal 194 Food Gal.u, RP C,11R 5v0:,tlu. s MORRELL ASSOCIATES CURRENTDATE: 1/16/2006 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 1/11/2006 (781) 837.1395 www.morrell-associates.com Customer #: FB9-13 � Invoices:Jo ce Re orts:L Env p Y 3 p 9 Burger King #3364 E 12/21 A Highland Ave./ Rte 107 N T T I N Salem, MA BACTERIA COUNT Sample Standard Plate Count/q Coliform/q Vanilla Milk Shake 570 3 � yo FE B 0 6 2006 BOARnO FSALEM p ri MASSACHUSETTS STANDARDS Machine:SPC<_50,000/g:Coliform<501g ! Other:SPC<50,000/g;Coliform<20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 88499 r V MORRELL ASSOCIATES CURRENT DATE: 12/15/2005 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 12/12/2005 (781) 837.1395 www.morrell-associates.com Customer : F1R4-13 C L � Invoices:Joyce; Reports:Lg Env 0 Burger King *3564 N 12/21 AT Highland Ave. / Rte 107 T N Salem, MA BACTERIA COUNT Sample Standard Plate Count/q Coliform/q . . Strawberry/ fMil{. Shake < 250 EPAC <: I EPCC JAN 0 3 2006 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine:SPC<50,000/g;Coliform<501g Other:SPC<50,00019;Coliform<201g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 87696 Board of Health (PAZ6 120 Washington Street,4th Floor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTE 01/03/2006 WHO'S PLACE OF BUSINESS IS: Burger King File Number BHF-2004-0088 259 Highland Avenue Salem MA 01970 LOCATED AT: 0259 HIGHLAND AVENUE SALEM,MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions Notes FOOD SERVICE BHP-2006-0077 Jan 3,2006 Dec 31,2006 $150.00 ESTABLISHMENT Total Fees: $150.00 PERMIT EXPIRES December 31, 2006 Board of Health This Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code,beofre any revonations,improvements,or equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Page 2 of 23 CITY OF SALEM, MASSACHUSETTS ,;. BOARD OF HEALTH c Tp O 120 WASHINGTON STREET, 4TH FLOOR j[ SALEM, MA 01970 TEL. 978-741-1800 DEC 15.2005 STANLEY J. USOVICZ, JR. FAX 978-745-0343 p MAYOR WWW.SALEM.COM CITY OF SALEM '+,p/ Ed JOANNE SCOTT, MPH, RS, CHO BOARD OF HEALTH HEALTH AGENT 2006 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT /JAa1AJ KUnn -eJ3';W TE/L# 61 ADDRESS OF ESTABLISHMENT MAILING ADDRESS (if different)��— �1 vr, 9nil iJ OWNER'SNAME 1505k/7 A)?MAO ,L�e = �a ADDRESS 110 �lePct?s 7%��1 CITY WW,9n1)1S- STATE ZIP CERTIFIED FOOD MANAGER'SNAME(S)JOseoh 127e7CAdci,-1) CERTIFICATE#(s)0?//3932 (required in an establishment where potentially hazardous food is prepared - EMERGENCY RESPONSE PERSON 0fewCbase, D , M, HOME TEL# 1-174-831-9/2q HOURS OF OPERATION: Mon.7-1 Tue.-7 - 1 Wed.7 1 Thu.7-/ Fri.7-2 Sat. 7-a Sun.7-2 '1 I'S , .s,..,:.r k� aia*slt�:i.` rs','d�-,ti `;,r�n..�*;,,��-�'F.EE''fcheck-only) TYPE OF ESTABLISHMENT �� ,, „„ ;, RETAIL STORE YES' N 5;f”, , ? "� less thah"1000sg5,t.`!.' $ 50'. 1000,10,000sq.ft.'.'" =$100 more than I0,000sq-ft. =$250 - NO --------------e--ss---than----- ------s---ea -----------_$10---0--------------- RESTAURANT ES ^ ts r�1 25-99 seatiss =$150 l � more than 99 seats =$200 - ----------------------------------------------------------------------- ------ ----------- BED/BREAKFAST YES NO $100 - - ------------------------------------------------------------------------......--------.........-----------.......----------- ADCITICNAL PERP,4ITS MAKE (not just serve) ICE CREAM, YOGURT, SOFT SERVE YES NC $5 TOBACCO VENDOR YES NO $50 ALL NON-PROFIT(such as church kitchens) YES NO $25 'Please pay total with one check payable to the City of Salem . This Permit is not transferable and must be reissued upon change of ownership. The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 62C, Section 49A, I certify under the pains and penalties of perjury that I, to my best k leanhd belief, v it all state tax returns and paid all state taxes required under the law. 1!?-9-.�oo6- a 4-,2745o 7k ign ure / Date Social Security or Federal Identification Number --- -------------------------- - --- -------------------- ----�------------------------------------- Revised 11/03/05 FOODAP2.adm Check#&Date -3N.3y Ir��g-0„ DEC 0 6 RECD �� Vic WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE CERTIFICATE INFORMATION PAGE RENEWAL AGREEMENT Producer: Agent# 960 Massachusetts Retail Merchants WC Group Inc. Association Benefits Insurance Agc 10 British American Blvd. 529 Main St. Ste 606, The Schrafft Latham, NY 12110 Boston, MA 02129 (Carrier Code: 34355) Certificate #: 014005030096105 Prior Certificate #: 014005030096104 1. The Employer: Burger King Boston Wyman, Inc Type of Business: Corporation Mailing Address: 110 Breed' s Hill Road Hyannis, MA 02601 Other workplaces not shown 'above: Fein: 042745078 SEE SCHEDULE OF OPERATIONS Risk ID: " 2. The certifigate period is from 12:01 a.m. on 1/01/2005 to 12:01 a.m. on 1/01/2006 at the insured's mailing address. 3. A. Workers Compensation Coverage: Part One of the certificate applies to the Workers Compensation Law of the states listed here: MA B, Employers Liability Coverage: Part Two of the certificate applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 500.000 each accident Bodily Injury by Disease $ 500.000 certificate limit Bodily Injury by Disease $ 500.000 each employee C, Other States Coverage: D. This certificate includes these endorsements and schedules: WCOOOOOOA(04/92) WC000112(09/04) WC000402(04/84) WC000406A(08/95) WC000414(07/90) WC000420(12/02) WC200301(04/84) WC200302(05/86) WC200303B(07/99) WC200405(06/01) WC200601(06/92) 4. The contribution for this certificate will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Code Contribution Basis Rate Per Estimated No. Total Estimated $100 of Annual Annual Remuneration Remuneration Contribution SEE SCHEDULE OF OPERATIONS Total Estimated Annual Contribution 165 ,082.00 Minimum Contribution $ 267.00 . Expense Constant $ 00 WC 00 00 01 A Issue Date: 12/04/2004 Countersigned by 7 6t:A::5 0 aEc � 5 zaa� City of Salem SALEM Board of Health CITY OFEALTi�I 120 Washington Street, 4`h floor BOARD OF HEAL Salem, Ma 01970 December 9,2005 To whom it May Concern, I am writing to apologize that this is a few days late. Unfortunately the envelope arrived at our restaurant in Salem and was sent to our main office in Hyannis unopened and did not arrive here in time to be returned to you within your guidelines. It was stamped in here in Dec. 06 and was processed as quickly as possible. I would like to request that future mailings be sent to our main offices at 110 Breeds Hill Road, Unit 8, in Hyannis, Ma 02601. Thank you for your consideration. Cordially. Janis Carney Boston Wy Inc dtb/al Burger ng I ` 4 y s ; 9 BOSTON WYNIAN INC. 110 Breed's Hill Road 48• Hyannis,MA 02601 •(508)778-5044•FAX.(508)790-2777 A Franchisee of Burger King Corporation O DEC 1 0 ® CITY OF SALEM BOARD OF HEALTH City of Salem Board of Health 120 Washington Street, 4`h floor Salem, Ma 01970-3523 December 14, 2005 Gentlemen, Today we received an advisory in our office regarding Person Property Taxes due. We are currently in Chapter 11 in the state of Massachusetts and I have attached a letter Which explains how this affects our unpaid taxes and us. If you have any further questions please call 508-778-5044 and ask for Cheryl Wheeler. Cordi lly, Janis Carney, a Boston Wyman Inc. BOSTON WYMAN INC. 110 Breed's Hill Road#8• Hyannis,MA 02601 •(508)778-5044•FAX:(508)790-2777 A Franchisee of Burger King Corporation rry P"Au&R�t3 D GE t.LP 111 HUNTINGTON AVENUE AT PRUDENTIAL CENTER BOSTON,MA 02199-7613 Juov A.GROVES DIRECT DIAL:617.239.0775 DIRECT FAx:617.227.4420 igroves@pdmerdodge.com September 2,2005 To Whom It Mav Concern Re: Boston-Wyman,Inc. Mo&Mike,Inc. Boston Wareham,Inc. Boston N Barnstable,Inc. Boston N Beverly,Inc. Boston N Bridgewater,Inc. Dear Su or Madam: This letter is to advise you that Boston-Wyman,Inc.,and the related entities referenced above(collectively,the "Debtors"),filed petitions for protection under Chapter I I of Title I I of the United States Code(the"Bankruptcy Code")on December 3,2004,in the United States Bankruptcy Court for the District of Massachusetts,Eastern Division, 10 Causeway Street,Boston,Masssachusetts 02222. All six bankruptcy proceeedings are currently pending and are being jointly administered under case number 04-19799 before the Honorable William C.Hillman,United States Bankruptcy Judge. The Debtors sought and obtained an order prohibiting any disruption of utility service without further order of the Court. In addition,any actual or threatened collection activities are subject to the automatic stay provisions of the Bankruptcy Code. Federal law prohibits any debtor in a Chapter 11 bankruptcy proceeding from paying any amounts for goods and services that became due or relate to the period before the filing of the bankruptcy petition,except as permitted by Court order,including under a Chapter I 1 plan of reorganization that has been confirmed by the Bankruptcy Court. No such plan of reorganization has presently been confrmed by the Court in these proceedings, Therefore,you are hereby advised that Boston-Wyman,Inc.and the related entities referenced above are presently prohibited by Federal law from paying any amounts for goods and services,including any interest or penalties ascribed thereto,that became due or relate to the period before December 3,2004. The Debtors are,however,permitted to pay all amounts incurred in the ordinary course of business that became due or relate to the period on or after December 3,2004,and you are hereby notified that any payments received from the Debtors must be applied solely to the periods beginning on or after December 3,2004. Please contact the undersigned if you have any questions regarding the foregoing. Sincerely, y A.Grove 2354(9.1 MAIN 617.239.0100 FAX 617.227.4420 www.palmordodge.com - x. • - .A)tr^.+"ne4v+......,. v+F+ ..nw.. v.. � va. � -.. . �, r`-. ,. -Ji v. ..s•t ... Massachusetts Department of Public Health Salem Board of Health 120 Washington Street, 4t" Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax(978) 745-0343 Name �U ((JJ 2 7 / Dae Tyne of Ooeration(sl, Tyge of Insoection RI/)C SSZ 4- Iflicdor X Food Service ❑ Routine Address �/ I Ri(ak ` ❑ Retail � Re-inspection 14,�L Gillt _Ate , Level ❑ Residential Kitchen Previous I spectiop� Telephone 744_ ?46 ❑ Mobile Date: 1 ! V')S 7 rb E] Temporary ❑ Pre-operation Owner ,�.✓VGfG/1 � \)t HACCP Y/N I ❑ Caterer ElSuspect Illness Person in Charge(PIC) / Time ❑ Bed& Breakfast ❑General Complaint Inspector �1 In. Io )J Permit No. ❑ HACCP I ; lnse�� G out:/r,�rOther - Each violation c rcked r6quires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Ami-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 3. Personnel with Infections Restricted/Excluded ❑ 14.Approved Food or Color Additives ❑ 15.Toxic Chemicals FOOD FROM APPROVED SOURCE ❑ 4. Food and Water from Approved Source TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans [118. Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) E]21. Food and Food Preparation for HSP El 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices CONSUMER ADVISORY 41, ❑ 22. Posting of Consumer_,Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR cfHealth. 590.000/federal Food Code. This report, when signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-3)(5 0.005) cited in this report may result in suspension or revocation of the food establishment permit and cessation of food 26. Water, Plumbing and Waste (Fc-5)(590.006) establishment operation's. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have-a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590 009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION:N n / S 590lnspecfFoim6-140oc Inspector's Signature: �I ( Print: �J nwh K* 1 PIC's Signature: Print:JI/lllli� ��1�j`�� Page of Pages Violations Related to Foodborne Illness ' Interventions and Risk Factors(Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 18 Gro;,-romaminatian 1 590.00300 Assignment of Re;.ponsibility" I 3-4C2.i 1(A: 1) Raw Animal foods Separated from 590.003(13) Demonstration of Knowledge* Crxtked anr( R E Faxla* Prrum in charge-duties Coniamination from Raiv Ingredients 302AIiA)(2) Ray, AnurwlFoods Separated hrmF:rch EMPLOYEE HEALTH Other' 2 590.003(C) Responsibility of the person in•_harge to Con'smi-�atic�!rom the Environment require reporting byioed.mployzesand I I ?-3(12.1!(A) Fool Prot.cticn" a pItlietmt+°' ( g-302 15 Washing Fruits and Vecetables 590,003(F) Rcxponsibility Of.A Food Emplo)ec Or Art 3-304.11 Food Contact with ':3quipmcnr and - Applicant To Report To The Pc rson ht i tttenals'' Charge' Contamination,rem the Consumer 590m03(G) Reporting by Person in Charge'" I 13-306.14(A`(B) Rerouted Food and R:eurviLe of Food* I 1 3 590.0030) Exclusions andResrric+ions' ( Dibposit:onarAdu-lteraraaorGcntamin--;tad 590 003(F) ( Removal of E-xclusions and Restrictions i Food ?-701.11 DiscmdingotReconditioning Unsafe i FOOD FROM APPROVED SOURCE Fund, 14 Food and Water From Regulated Sources 19 Fccd Contact Surfaces �)('4�A B' Compliance with Ftwd Law'` i 4-501 111 Maoual W'arewashms-Hot Water 5.(.),J . ) 1 Sarotir-atton Temperatures* 3-201.12 Fluid in i Hand Mfli<l Seined Cantanner" ( 4-901.1 i2 A4echa Tical Warewashing-Ilot Water t 201.1 Fluid Milk and Miik R'i�ducts' � 3-203.13 Shell Eggs% Sanitization Teurraramrea` 3-202.14 Els and Mitl:Products,Pasteurzed,' I i 4-501.1 Id Chenucal Sanitization-temp.,pH, 3-2M.16 Ice Made From Potable Driukin,,t Water' I �unecrtr::t;on and hardness. " .S 101.1 l Firinking Water fr�nn kin Approved System' 4-60i,I 1(A) Equipment Food Contact Surfaces and lJtensils Clean^ 590.006(A) Bottled Drinking Wetter" ( 4-602 11 Cleaning Frequency of Feuinmenr Food 590(`06(13) Waici Meets Standards in 310 CMIR 22.0` i ` Conrad Sm-iaces and Utensils'` FishShearil and rich Froman Approved Source uscan I -1-702.11 Frequency of Sanitization of Utensils and 1-201.i4 ( Push anti Recreationally Qmght Molluscan Food Contract Surfaces of Equipment"- Shelhish" 703.11 Methods of Sanitization-Ito! Wvater h11 3 201.15 Molluscan Shellfish from NSSP I-istcd 1 Chenucal" Source,* 11Q Proper,Adequate Handwashing Game and'Mid hfushroomu Auproved by I Regulatory Authority 2.301.11 Clean Condition --Hands air-1Arnie^ 3-202.15 Shcl'.stoc),Identification Present* I 101.i2 CleanvigPnxcdure* 59t),004(C) Wild Mushroom,,': ( '-301.14 Wilk nin`r4'esh` I --.-..o1.I ' ' Game Animals* I l t ! Good Hygienic Practices, ( i Receiving/Condition I 2-40:Al Eating,Drinkingor lasing Tobacco* 3-262.11 PITFs Receiver(at Propel Te riNiatures_ I 01.12 Discharge;From the Eyes, Nose and - / Mouth' 3-202 15 Package Integrity'Ui;dj 3_101,1L Pieve:a:n-Cont_mination When Ta.tin� 3-101.11 Food Safe anddL'nauit:rated 6 TagsfRecorihe Shellsfoch ' 12 Prevention of Contamination from Hands 1 590.004(E) Presenting Contamination hom 3-202 .18 Shellstock lCentificat:un' Employee,' 3-:0.3.12 ShellsArck Id enti8catioo Maint:uned" ( 13 Candwash y Located Tags/Records:Fish Products 3402.; 1 Conveniently Locoed an•i Accessible Parasite Des*ruction:` 3-402.12 Records.Creation and Retention` 15-203.11 Kambers and Capacities* 590A04(J i Labeling of Ingredients' 5=204.1 l i,a:mien and Placement" ry Conformance with Approved Procedures 15-3`}?.11 Accessibility.Operation and Maintenance IHACCP Plans Supptied vt4th Soap and Hann Urrrna 3-507 11 Specialized Processing Methods" =t Devises 3-503.12 Reduee•:i axyg=n u::cl:aging:cit:er!a' 1 1.11 HatdwashineCtc,utscr,Acailxbility j 5-103.12 Conformance with Approved Procedures"" 6-3((I.12 Hand Dryin;;P- W;ion Llur,!ec,ritical ee�a in the tsd:mi i J99 Prod Axle•n 11};Cx,R Sti0.000. CITY OF SALEM / BOARD OF HEALTH lil I1 Establishment Name: �JfGr4c, Date: 1(4 /0Page: _� of Item Code C-Critical Item t� DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified f PLEASE PRINT CLEARLY �� -ai �� P �:l�J� .� tel, ci r��,I�rJ �,, �,._,r-�,, �_I�� Y -�,^ �� • IJ,,�!' 1 v - 4 I I I 1 I � I 1 • I 1 I 1 • z � I i e L Discussion With Person in Charge: Corrective Action Required: ❑ No —�es I have read this report, have had the opportunity to ask questions and agree to correct all - _}I,�Funtary Compliance ❑ Employee Restriction/ ' violations before the next inspection, to observe all conditions as described, and to Exclusion P ❑ Re-inspection Scheduled ❑ Emergency Suspension omply with all mandates of the Mass/Federal Food Code. I un qrstand that oncompliance may result in daily fines of twen ty-five vedoll f spension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. 0 Voluntary Disposal ❑ Other: r PHFs Rc,cereed at 1'cmpenaure; Violations Related to Foodborne tttness interventions and Rick According L::Idw Co-led to Factors(items 1-22) (Cont.) �1 'P745"FL4aI"iia ? Hours. ' PROTECTION FROM CHEMICALS 3.501 15 Cooiinr Vledrud,lox PHF. J j 14 I Food or Calor Additives ( 19 FHF Hot and Coed Holding 3-50!.16(fi) Coid mils,_li:a Wai=d a;o:'below J-203.1_" Additivee" ( 59Q0(14(F; -F1'I�iS'F" 3-302.14 R-O18C11Uii trout I?neppro}.ed Additives" ( 590',.J6(A) 41 ". j lg Poisonous or Toxic Substances t H, , hiaintmned at or aboee 40,F 7-U)1 11 IdentifyingInfonna(n,u- On;nnai 3-501.16(A) Roasts Held at or above 130'F. '- C„nuuners` • -7-102.1 i Common Name-Working;Containers* ( 2fi rime as a Public Health Control 1 ? ;el to Time a::a P:Jnli.. Health Control' j 7-201.11 S,paration-Stotage" j �-202.!f Re>trichun-- Presence and Use:` 1 x')0.004(1-!) vatianc�Reuuit'c:uenl j j 7-202.12 Conditions of Use' REOLIIREMENTS FOR HIGHLY SUSCEPTIBLE j 7-203.11 Toxic Containers-Prohibitions" j POPULATIONS{HSP') 7-204.11 Sanitizes.Criteria-Chemical, 7-204,12 ( Chemicals for Washtne Produce,Ci iteru0 121 1I(A) Unp.istemazed Pre-pad,aged Juices and 7-204.14 Beverages with Warning U hels- e 3-50L t Ii 3) Use of Pasteurized h^;_s 1 7-205.11 ( Incidental Food Contact,Lobe:cons ( - -- 3-80LIe(U) Raw or Partially Cooked Animal Etx,d and "7-206.1! Restricted lice Pesticides.Crilzr:a* Raw Seed Sprouts Not Ser.ed. " 7-206.12 Rodcro Bart Stations- j 13-801.13(C) Unopened Food Packasa Kot Re-served. 7-206.13 flackieg Powders.Peat Control cmd Monitorings CONSUMER ADVISORY TIMEREMPERATURE CONTROLS 22 3-60:.11 C onsumet Advisory Posted for Consumption of ,Aniutai RKx:e•1'baf are Ra:v,iJndercouk.ed or 16 Proper Cooking Temperatures for I Not Od;_rmise Prceessed to Fl[tmnate PHFs 3-401.11A(!)(2) Fggs- 155'F IS Sec Pathu;2ns.' _ !, Eggs-i htmrediate Service 145°rl5;,ecx 3-302.13 Pa,teunzed Eggs Substitute iia Raw Shell 3-401.11(A)(2) Conumnated Fish,Meats &Gain-, j Eggs'r' Animals- 155'F 15 sec. s 3-401.11(13)(1 e(2) Porkand licef Roast- 130'F 121' min' j SPECIAL REOUIREMENTS 3-401 11(A!t2) Ratites, Injcucd M(tats- 155'F 15 590 009(A)-?D) Violations of Section _i'ar009(A)-(I))in sec ' catering. mobile rood, temporary and 3 401.11(Ay(s) Poultr),Wild Game, Stuffed PHFs, resid.ntial kitchen operations should he StutlTmg Containing Fish, Meet, debited under the appropriate sevums Poultry or Ratites-165''F 15 sec. * abo•:e if related to foodbanc diness 3-41)1.11(C)(.3) Whole-muscle. Intact UeeiSteaks ur:erteutions,+:.d risk factors t7dlcr 145'17° 590.01.-9 violations refuting to good retail 3-401.12 Raw .Animal Foals Cooked in a i ptacttees should be debited under#29- Microwave 165"F"' Special Requirements. 3401 11(A0)(b) ,All CRhcr PHFs- 145°F 15 sec. '- j 17 Reheating for Hot Holding ( VIOLATIONS W:LATED TO GOOD RETAIL PRACTICES 3-403A l(A)kt(D) PHFs 165"F 15 sec. T j tlterns 23-34) 3-403.11(6) Microwave- 165°F 2 Minute Standing I Cr itieai aur(near-rr:!ic.r:!cru7,rrr•,rrs, n'l:icr,do reit re!me;n rite Time" ,firodbmna i!lness inteivenhuns and risk jw tors lured above. can be 3-403.1 11 C) Commercially Procetsed R'[6 Food- I ,l1ound in meJt041)ri,ing section. of the 7>,c.dI odc and 105 C.1,"R [401F" 5e0.Ofk)" -- --- -- Remaining Unsliccd Portions of Beef ( item Good Retail Practices FC 590.000 _ 1 -403.]f(it) h„sista" 29. Nianaclement and Personnel FC-Q .003 j Proper Cooling of PHFs 24 Peed and Foci Protection -C-3 .00-JR - CGuipmrni and Utenstls i-C-4 A05 5i 11.141 a) Cooling C'tK•ked PHYs from 140"F to ^6. Wafer,Perrrinci and Wnsta Fi•-5 .00E j '70'F Within 2 Hours and Prom 70'F � ' Physical Facilh,• F(-; -6 :007 I to 41'F/45'F Within 4 Hours. * ( 28. i Poisonous er Tont Materials FC-7 .008 3-501 14(B) Cooling PHFs Made From Ambient ° Mal Reouo�menis 009 - -�-e Tentpeiatute atcredients ur 41"F741'F --''t). t'!t^'1 -Within 4 Hours't .•'"`:°'"'.`"-`" ' Denoo's.mals J,icrn m the lure.ral 19'e,Fund Code or Iff Codi 590 tD N. MassS achusetts Department of Public Health Salem Board Health P 12Q Washington Street,4'" Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax(978)i745-0343 Name Date T pe of Operationtsl Tyge of Inspection l�urc,v,� V i 4 ( (( O's- I IlA)Food Service ❑ Routine Address L1� ' ) Ris ❑ Retail Re-inspection Level ❑ Residential Kitchen revious Inspection Telephone - . �f i f�� ry E) Mobile Date: ' F-1 Temporary ElPre-operation Owner �1 t lyv�, ) MHACCP YIN , El Caterer ❑Suspect Illness Parson in Charge(PIlC}e) , Ql) Time ❑ Bed& Breakfast El General Complaint ( ' I In:(0 ' I ❑ HACGP j 0 QUt:ll d Inspector rr,, ` Permit No. El Other \ 1(��11 tSi7f. n r I Each violation checketd requires in`explanation on the narrative page(s) and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13, Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC [114. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15,Toxic Chemicals FOOD FROM APPROVED SOURCE ❑ 4. Food and Water.from Approved Source tIMFJTEMPERATUREGONTROLS{Potentially Haiardous Foods} ❑ 5. Receiving/Condition ,. ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACGP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION ❑ 19.Hot and Cold Holding ❑ 8.Separation/Segregation/Protection/ ❑24.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REOUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices, Number of Violated Provisions Related Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Items 1-22):- of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today,the items checked indicate violations of 105 CMR of Health. 590.000/fecierai Food Code. This report,when signed below N-- by a.Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2)(590.003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (Fc-4)(590.005) the food establishment permit and cessation of food 26.Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order,you 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590 008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: t / 5 5901nsPh'IfPm6-14.tluc I \ eJjj/� inspector's Signature: .. ` �/' Print: PIC'sSignature:�.l l „� ya Print: A]A r7& V � I Pageof Pages Violations Related to Foodborne Illness Interventions anti Risk Factors(h erns 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT ( K ( Cross-con!annna7rn I j 51)0.003(A) Assignment of Respcns:bdiw 3-302.: ;(,1i(l i Raw A::,utal Foods Separated from 1 590.003(6) Gemoasm:l:on of l(trawledge" ( Corked and RTF:Fo;u is" 2-1(3.7 Person in charze-duties I Conramrna Ion from Haw iryredierb; 3-3011 VA)(2) Raw Animal Too&Sepanwr d fv,oj Each EMPLOYEE HEALTH U hrr' ? j 540.003;(-') Respomiodity of 8n;per-an in ch.nge to Gontemin arorr,',srr'he Ermiranraent 'eaui— rcpnrt+n_by fixrd empk>ye•es,and '-;03.1 I I A) Fond Protection' 1 aoplirtnts"` 3-sot 1 Wasinine Fruits and Vegectbiea j 590 003(F) Responsibility Of A Food Enipio4ee or an ( 3-504.7] Food Con?:ct with Equipment and Applieam'Fo Report to-Ihe Person In I4e^;ds* Charge" ( ( Coniaurm!,on tram rhe Consimm r 540.003(6) Repo;ting by Person in Charge` i j 3-=ii%.I-li njl6) Rr-tor:ped Fonaandkese:i•)ce of;'tRd' 3 590.030) ExciusionsandRcsoiciion:' � I O:'soosit no`AdolreratadcrCorrtsminated I 540.003('.) Renwvrl of Exclusions and Restrictions j Food 3Ii?i 11 Di;cardingurReconJitionin Un:afe FOOD FROM APPROVED SOURCE Foca^ J Food and t?rater From Regu;ated Source; 9 Food Contact Surfaces 590.1jUiRA-6) C.annlianre with Food Law:` :-SOI 11 I Manual VJoresi,ashtn_-Hot:Vater 3-201.1?- Food iu.: Hermeticalk Sealed C'itainer" Sanitization Tean)- tuures' 3-201.13 Rued Milk and'yUk Poxlu,ts* - _ ( a-501 11° Mechanirtl W'area;tching-Hort Witter 3-202A3 Shelf Lggs' ' Sanitization TemParaterta* ! , , 50111" ChemicalSanititalux:-tent H, ! 3-:A' Id F,:is mnf Milk P:o:.uas, Pasteurized" P•P 3-202.16 Iee Made Froin Potable:Drinxing Water„ ( cra:crouation and h:idncss. ' 5-10!.t 1 Drinking,Water fnan an Anpnned Spsiem` I --Crpl.l IIA) Equipment Food Contact Surface,and Ule:iQ;C'leawc 50(1.006(A) Bottled Drinking W'atrr* Ftp 11 Cl:ming Fre uene �ineni Food (, 590 1l()oi6) Water�er bteei:,Stand:udx i❑310 t:'>,iR Z2.1?": j ( 9 y of l `' ; I Surf:Shallticn and Fish Froman Approved Sowce Contac+ ccs anti Uerr;ils' I ( 9-.!2.(I Fwquea:_y of Sanitization of Utensil;anti 3-201.14 i Fish and Recreationally Caught Molluscan Pond Contao &truces of Equtnment* Shellfish" r _= 11 Methods of Saratization-}-tot Wrier and 3-201. 5 :4?oflu:;can Shellfish iiom \ SP hisl:�d I I coerilics!* iSoincen" Proper,P .Adequate Hondwashing Game and Wid,Mus.hrocros Approved by' j Authonty :?t)Lll Ueau Condition--Hands and Arens' •9aqua!ory - i .4-202.1s 1 Shellstock Identification Present;' j v3 01 12 CieaninProc:.Suro' 1590.0(AkU WildMustnrooms- 2-101.13 When to wash* 3-201.17 ; Garm .Animals* i � i t Good Hygier+ic Practices j 4 i Ree=ivinglCondition 2-dol 11 j Eating,Drinking or Using Tobrcco' i PH F;Received at Pcup,a Temperature,,f '- D1.12 Uischa;pie::}3 rim rho, Eyes, \„se and j 3-202.15 j Packacc Integrity- � I I lyfruth^ 1 4 3- 01.12 Preventing Contamination Wten Tastirw*3-1011 F?xcSafe ard Unad: erated I b Ij TagsiRecords•Sheilstock ( 12 Prevention of Contamination from Hands 320.2.1`: Shellstoch IdentrLuation590.0i)?tEi Pre�enting C',.saminattr.n fr»m 3-203.1' Shellauch Identification Maintanted” I Il Handwash faci;ities f Tags/Records: Fish Products G;nverien�iy tocafed dna Accessible : 3-402.11 Pafasnz Deatrurtion' j 5.203.1 i Number.;and Cnn"XitiesT 3-d402.:2 h.cords. Crean o^^. and Retenuua* Loration and Phtcernenl% 590,004(}) Labeling o?iagrea:ents' -1Q5J : Acce;;s;' ilit,t Operation and Llaintename j 7 Conformance with Approved Procedures - lHACCP Pians Sow.'red wkh,Snap 9^,d Hand DGinar 50311 Specialized Prucessn:e Methods" j j Devicas 3-502.12 Reduced oxygen!,-tctaging;cnleria* 6-301.11 HaadwashinvUoansmAra:lability ;(" . n j 6-101 I� Hard '0 yint,Proviswr. t;-: - 1_ C'unfonnanee u-ith Approvca rocedure.:" Ueno:a<rriiird nem in the 4deral i0^9 Pruxi Gxle m 105 CMR:•9'0.1100. CITY OF SALEM rte/ BOARD OF HEALTH Establishment Name: 11:" 1 1�1✓1G 3.5« Date: ///S/f�� Page: r7 of Item Code C-Critical item (f DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date • No. Reference R—Red Item Verified PLEASE PRINT CLEARL �-/s- // I / A 1 lJ ff ,M1 J1 tJ� �/IRGr 1 ( i )-b a �.PDIGtr� � }^.�e" <47i,AP C e< t! �ilv. //l .��r�1i✓l`o lC�� t.E ✓///,i /y '/ ,, l ('0 \ it !1'1l P I P S' Q IIIA Th O/1T , l r P,r G` I SIw1G: J/1 1 1 . 1 1 1 l 1 � • I Discussion With Person in Charge: I Corrective Action Required: I C3No I Yes Ll Voluntary Compliance C1 Employee Restriction I have read this report, have had the opportunity to ask questions and agree to correct all / violations before the next inspection, to observe all conditions as described, and to t , Exclusion P 6b Re-inspection Scheduled L3Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that '\ noncompliance may result in daily fines of twenty-fl ,,.,,dollars or suspe /revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: ti 350;. »(C) PHFs ke vivid at Tenr,;(iatures Violations Related to Foodborne illness Interventions and Rick Aa•ord:os to Law Cooled to Factors(items 1-22) (Cont.) 4P'F74ti F Within l Hours. ' PROTECTION FROM CHEMICALS 3 `SOI III Cachng Methods (or IIILFt. 14 PHF Hot and Cold Holding 14 Food or Color Additives 3-50!.1 of B) Cold PI-IFs, Yiaintained at tit nelow 3-207.12 Additive:" ( 590.iA)4'F) :t"745' F- 3302.1.4 Protection from t:nappioNed Additive^ P Hot I6 3-SOi. :.1) PHFsPlaimaieted at or above I s Poisonous or Toxic Substances ! Hot P 7-IC L 11 Identity:rw 1nlurmanr,n-Ori6md Containers" L I 1 3-5t)1 16(A; Roasis Held at or above 130°F. = 20 Time as a Public Health Control 7-102.11 Common Nanta-Working Crnttarn.:rs'1 � 7-..-,01.11 Separation-Sto::ige' ( 3-501,!S) Timc as a Publi:,Health Centroh 7-202 11 Restriction--Piesener and Use k ! ( 590.004(_1-1) `v'aramee Requirement 7-202.12 Conditions cif 1';.+" 7-203.1 t To:ic Containers-Prohibhh,n.0 REQUIREMENTS FOR HIGHLY SUSCEPTIBLE i 7-204.11 Sanitizes s.Criteria-Chemicals,` POPULATIONS'HSP) 77ti1.12 a 121 3i0ILI I(A, Cop.:;ta^ur¢ut Prc-packaged.fuices and Chemicals for Washing-rOdnCe,trite ria ' Bever(gzs".vith Warning[A 7-204.14 Drying Agents.Crtteria' .;-ti0;.1 :(B) Use ofPasteur ized)✓!ags^ 7-205.1 I ( Incidental Food Contact.Lubricants- ( i 3-S0I.1 i(U) Raw or Paittahv Cih:ked.Animal Food and 7-206.!1 Restricted 1'se Peeticidec.Criteria, 7-206.12 ( Rodent Bait Stations' Raw'tined FoAxtSproP Not ie of ^- "1-206 13 3-ROl.11 iCa Unope;led Part Package Iiot Re-served w 'Frackmg Powder:,Pest Control and Monito ring* CONSUMER ADVISORY TIME/ CONTROLS 22 3-603 It Consumer Adsisoty Posted f+),Consumptie❑of Anima Foods"that are Ravr,Undercooled or 16 Proper Cooking Temperatures tar Nf,l Otherwise Processed to E!'m late 3-40 I PHFs s;• `e,ka.-ter.:o:a f Patho EY£'s- h+nmediatSzrcice 14 - 3-30'_.13 Pm,teurized 12 vc Substitute for Paw Shell c -a.^F15secr ; 3-40!.11(A)(2) Comtmnntcd Fish,Meats k Gainc Ei'y:: Animals- 155°P t5 sec. ` 3-401.41(6);1)(2) ( Pork and Beef Roast - i 30"F 12; min* SPECIAL REQUIREMENTS 3401.11tA)s2) Ratnei,Injected R9cats-15YF15 590 009(A)-tD) Violation<.of Section 59ti.(k)9IA)-(D) in SY1. r catering, mobile Focal,tempos cry and 3 401.11tA)(3) Fuultry,Wild Game, Stuffed PHFs, restcfuntiai kitchen operations should be Stuthr.g Containing Fish, Meat, debib_d under the appropriate sections Poultry or Ratites-165"F I5 scc. ... above if related to foodborne illness 3-401.11!C)(3) \'chole-muscle, Intact Beet Steaks intervention, and risk factors. Other 145°F 590.009 violations relating to good retail 3=401.1: R:iw Animal Foods Cooked in a nfactices�I,ould be debited under G129- !vlicrowave Itis"F* Special Roquirernents. 3-401 II(At(1)(b) All Other PIiFs - 145-T 15 sec 17 Reheating for Hot Holding VIOLAT,'ONS R.ZLATED TO GOOD RETAIL PRACTICES 34WJ IiA)&i l)) PFIPs 155°F 15 we. a (Itetne 23-3?) 1-10;.11(B) Microwave- 165°F 2 Minute Standing Ci ri F<ui and non,riticc!vlok";r„..t, ttddrn do riot relate In the Time* ,foodborne dim-vs inter r6w,,,n::m+l riskJu<^ors tis;td avow eon be I(C) Commercially Processed P'[E Fex;d- found It the,.o?gnu ing sections nrrnc�Fond Code and 10, Cb1k 140`F` 590.00u. 3-?03.11(12) Remaining Dnsliced Porritmc of lie..f i Diem Goed Retair Prachces FC 590.000 Roasts:: 23. Mana9ernrnt ani Pei sores! FC--2 .003 - 18 Proper Coaling of PHFs ! = Food and r-ood F:otectien FC-3 .004 25. Enuipr-ent and lPenslis FC2 -4 .001 '?-501 14(•1) C'uoligCoaledPHF2F,. Water,PIu^Ling and haste fC-5 PHI-'s i-IocFto -- OU ---- ----� 6 70`'F Within 2 f lours and From 70"F ' 27. Physical Fac iitV FC-U GG7 to 4(°Fi45"17 Within 4 Hours. " ( 28. Poisonous or Toxic materials FC - 7 .008 '1501 14t B; Cooling PFIFs Made Prost Ambient 129. Special Requirements i .Go9 j Temperature Ingredients 1o41"F';di`F 30, Other Within.11 fours I e. Denu!re critical nem,In nUz Weral 1991;Fond f'„de or 105 CMI9 59C 81jo Massachusetts Department of Public Health Salem Board of Health 120 Washington Street,4t" Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name �/) 'y/ Date/ Type of Ooeration(s) Type of Inspection ✓P1,l� h t/Il _*35--Gi '1- �al �D� Food Service Routine Address _ ;} a Risk nRetail Re-inspection Telephone - � Z, , Level ❑ Residential Kitchen Previou7s1In pe tiioon_ 'F ❑ Mobile Date: / Owner R HACCP YM ❑ Temporary ❑ Pre-operation (% - - W,� 04 I/9 r_ I ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) ^ I Time ElBed& Breakfast ElGeneral Complaint El HACCP Inspector bCOr� I Out:t//;p. Permit No. ❑ Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties E] 13. Handwash Facilities EMPLOYEE HEALTH El2. Reporting of Diseases by Food Employee and PIC PROTECTION FROM CHEMICALS ❑ 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals FOOD FROM APPROVED SOURCE ❑ 4. Food and Water from Approved Source TIMETTEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition [116.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 10. Proper Adequate Handwashing ❑ 21. Food and Food Preparation for HSP ❑ ❑ 11. Good Hygienic Practices CONSUMER ADVISORY I ❑ 22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as.determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board _ M Health. today, the items checked indicate violations of 105 CMR C N 590.000/federal Food Code. This report, when signed below 23. Management and Personnel (FC-2)(590 003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(550.005) establishment operations. If aggrieved by this order, you t 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic�Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special RequiFements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: S 501 Ss UFoi 14 Eoc Inspector's Signature: _ Print: PIC's SignPrint: LPage of3 Pages rr Violations Related to Foodborne Illness ` Interventions and Risk Factors(Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT K I gross contam;ita';im I 590.003(:1) I Assiznment of Respowiibildy 13-303.1 I;A)(1) Ray.'Animal Fo,.rvire Sepaia,rd Isom 590.003(B) Demonstration of Krrmledge* j C")!:edfind Y.'I'E Foudsv: 2-103.!1 Per>on in chnrx c-duties j Contamrnaticn from,4a4v tngred:ents j 3-362 1 1(A)12) Rate Amn:al Foods Sepavated from Each ! EMPLOYEE HEALTH i Other'° 590.003,C1 Responsibility of the person in cheuge to CantanthwPor from the Envuonmeot require reporting by food employees and 3-302 11(A) Four! Protection' applicants" 3-392.15 W'ash;n_f',Uits and Vegetables 590 N)31fl Responsibility Of Food Fmployee Or Ai: ( 3-3,4.1 t Fo:a;Cotuact,:itli Fyuipm:m and Applicant To Report To'lhe Person It, Utensils Chm'yte" Contamrnanor from the Consumer 590 003(G? Reporting by Pinson in Ctu,rge3-306.11(A)(L) Returned Fcod and Ream r ice of Fond* j 3 50r)0013(l); Nsclusionsand Restrictions* Disposition of Advileratedor Conram:ratod i4q.0U3t 8) Removal of Fxclusxons and Rcstr'mon, Food - 3-7fL11Discar6m,orRe,nndttionn:2i;nsafe FOOD FqOM APPROVED SOURCE Fvod a Food and'Nater From Regulated Somcas 5 Food Contac:Surfaces I 590.O04(:\-ft) Compt;ancc .vith Frxxi Lau,` 4-501.111 Manual ti'arca•x:hinpt-FIot Wa;•.r j 3-20i.i2 Food to a Hermetically Scaled Comainrr, San it tion"1'e;nperatnres j 4-201.13 Fluid Milk and Milk Pruducts" 14-501 112 Mechaniccd Warcwashing_IToi Water j 3-202.13 Shelf E;egs^ Sinitzatiun TernperatuteF" j 3-202.14 Fgg�and Milk Products.P.:steur;zed" j 4-SUi.i 14 C'hc,nfcal Sanitirudion-tem" . pH, j 3-202 16 Ice Made Front Potable Drinking W-atei crmcenhation a.^.0 mrdt:cec. " j _ 4-601 11,,A) hyuipmentFcxn! Contac:Sintace;and i-7 tll.l t Urinkiap W iter from an Approvzd System` if 5(,'-0.006(A) Bottled Drinl:met4ate Utensm Cleat* 9-6(12.11 Clearing FrequencyolHympmentFuur.- 5W.006,1B) Watu Meets Standatds in 310 CMk 22 0' Conflict Surfaces and Utengk,;p SheiL7sh and Fish From an Approved Source !i } ( ( d-702.1! FreewineyofSainiwauionofi-ttcn,iisand 3-20i.Fl Fish and Reereationall ,Caught Molluscan ( rcxxl Contact Surfaern of E,;aipmeet Shellfish* 4-703.11 ivtethods cd Simi cation Ho:Water and 3-201.li Molluscan Shellfish from NSSP Listed i Chemical , Sources* to j Proper,Adequate Handwashmg j Game and W:id Mushrooms Approved by j 2-301.11 Clean Condition --fi-,nds and An ea' j j R-galetory Authority j 20^. l Y Sliellstock Identif:raion Presau* j -301.12 Cleainn,1'mcedure` !j j 540 C) Wild M .iu utxnns:� � 2-301J4 tilie:t h:'vPn;h`: _ j "itL17 Game Animals" 'If Goal Hygienic Practices Receiving/Condition ( 2-401.11 Eating,Dunking or U::;ne T;rcaecu* j 3-202.1; 1'HFs Rreerved at Proper-:'emperauu.ec" j '4W.12 Df.schn m es Frothe Eye;.7`:ose and 3-202.14; Pa.kaFe Intcrarny., ! I y Mouth* r 3-301 12 Preventing C:,utanunation'Alwn Tzstin,* 3-lOt.l I Fcxxi Satz and I hellsterate<t' 1° Preverhon of Contamination from Hands j ( e Tags tock Id Shellstock j S9n,U0-4(E) Pieventim^C'omauunation fren-, 3-2021% ShclL.kxkfdenliiicatinn' j 3-203 7 �. Handvtee;* .1_ She Istoc,. klentificatiun Mainuuned' 3 TagsiRecords:Fish Products ( Hanveinsh Facilities j j •convan;enthy t.ocated sod Accessible j � 3-402.1 ; PmasiteDest:nction° 5-703.11 Numbers and Capaciue. i ± "102.12 Records.Cr potion and Retention' j .5-204.1i LucaUon and Placement' 3,40.00 14(1f t ConformanceLabeling of with Appnts*roved ! j 5-205.11 Accecstbility,Oper.mon and Maintenance j 7 Conformance with Approved Procedures I /HACCP Pians Supohod cdtn Soap»ro Nand Crying 3-502.71 Specializuf Pntces.mg Nlethodi' Levices j , ( 6-30111 Ilmtdwashine Cleanser.Aailabihly3-50_.12 Reduced oxygen Pail og.criteua" 8-lo-'.12 Conformance unth Approved Procedures"` ( 6.301.E Maud D;yim?1'rot;sion j '!en=.acs cnlaai ne,n,❑Ua 'iuleril i°40 Pmol{:n.le or U).`•Cnih�9(I:J(IU CITY OF SALEM BOARD OF HEALTH Establishment Name: rf GrP, Vci �>/�l Date: h40 / — Page: a of Item Code C-Critical Item f DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified PLEASE PRINT CLEARLY / t J-J9 4 R L AA�01,_) i.on_ C1 e-v e) I Al 10 ,rY �-� n�1P� �. G/�,J�/1 F—S?in .T� Z'd 4O)')J r-X 1'/NG Pod _--F) kr'A r (�("J ✓pir A1,00 �) t2P ��i✓ nc� (, QfY� vU/1 �✓/r/��/ GfGo�. i� iCrGIGS A0 ('4' /44r.j I/e1 S /'T !'a e r svo2 r2"J/, IAtCn1JCLV,- N" ivf VJP �(/Q /lnN r Scn •�7p�C�Cc-�� e/ I�er.�. �� no�rd rn/ �A, �n� 7�n� � /� s. eL 6�f'� �iCti,.r<.ic oLiP✓tJ' -ate" �( 1, ��b✓ ihs �� PJurk -herze,,,, Av, d -4, 6,2 Dq 11.5 U I. ( 1c C JN [`�.a5/ fia t !.✓/a I I__ d'o�/. SY In�-rllV-, � /,c1��P/ AJL)stN �4C+n,n� /(1'. �c�v�✓/1�1e(�. r �11 •r17O� Discussion With Person in Charge: Corrective Action Required: I ❑ No lel— Yes ❑ Voluntary Compliance ❑ Employee Restriction/ I have read this report, have had the opportunity to ask questions and agree to correct all Exclusion violations before the next inspection, to observe all conditions as described, and to �e-inspection Scheduled ❑ Emergency Suspension Comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspensio evocation of ❑ Embargo ❑ Emergency Closure your food permit. �� 0 Voluntary Disposal ❑ Other: ;,;it-!, at violations RplliWQo Foodborne illness According to Sa v, Corded to Factors(ftems 1-22) Xorn.) IT;!S'FIii 4 Hours. 1-i ;'coling t,-litho'.i for.'Hr'sPROTECTION FROM CHENUCALS 14 1 Food or Color Additives 19 PHF Hill rind Cold Hril:linq 3-'if) 16(E) Co:d P[7rz 'V1'!lnl'lijle'l at or helo%k 3-202,12 1 Additnes' 590 F- 3 ',302.14 Filliection from Unappro%n"' Addiljvev' i Poisonous,or Toxic Sul,,tstances Uri NlPs Maintain-11i at orabo%e 140'17, 7-1W.1 1 ld'-ntiflma n1!l'rx:jlwn--origin,,! 1-5;1.i VA) R'1:;St:i Held l'-, ':;.l)ve 1-WYr. t 20 i 'time is a Public:Hea,-.ri Control 7-1011 conallo'l Nm" oi�-. o Thine,as a Ptjl)!ic 9C 'di( ow rot':.2o 1.!1 S'-pamion- Rcqriction-Pulr.ejweand I ji, 7-202.12 Condiflons of['re" I 7-203. RWVREMENTS FOR HIGHLY SUSCEPTIBLE 1 1 Toxic -Prohibit POPULA 1:0ilZ(HSPI 7-1104.:1 Smiiflwn;,Cr'leri:t-Gienacals* 7-'3()4.12 Che-meals f',f Wadmitz Moditep.,Criteria- 21' 80 J.I I(A) "llip'l,"teulized Pte-PaAag:d iuiecs a:+d -204 11 Diling Agetl:l,Criteria" J--�volage'With Warniliv T'abc ?;01.1 :(N Ll'e of Pasteurized Fq * 'zo 5 11 limb-nial Food Contact,Contact,LLJMC.11110� RS 3-�,,11.1 :(1), Paw ,r Plittiall v Ci�I M munal Fleet ind 11 Resirictvd Ul- Pel,O.ldo.s,Critcr!.�* If Not Svtved, 7-2 Rock-m Bait Statiorp;I 7-206,:3 and 3 80 i.11 X-) Unop-.'ed Prod Pauagw No: Re-ser vcd, CONSUMER ADVISORV TIMUTEMPERAT URF CONT ROLS 22 3 6!l,'.11 Ctvlsuujl:r A;-!Osopf Post v Or C-asulap6on of i6 Proper Cocking TernDeratures for Aram I F-cdls "flat are Raw, Under ooked or ?HFA ITol O,hemisc litoc:rood to J-!iinin,te IIS U-'�;,- I Il 5'F 15 Se,. ll- P.,steurizu4 Eges Substitute ter Raw S!,-N Llgt:-linmediate Sc wve :45'Fl See, 3-401.1 1(A)(2) Cvauimautt-li Fish, Matt, &Gain: Aninmis- I WF 15 sec. � SPECI AL REQUMEMENTS 3-40 L I I(Bq 1)(2 1 Pork P7�d Bzef kinv;t - 1'I(V F 121 mitit 590.009(AH-D) V iolatic-,,i W Sectio, 590.009(A)-f D) in - 40 1.11(AN-1) Rnfitesj Illit!("Id l0cats- 15i'F I catering, mobile tell-,rotan'turd 3 rcsiticifli"d IJ�Cheir opmations Otouid be-401.1 :(AW"I Pouluy,W;Y Ganit.,Stetted PHI-,,,, C�!ataijjim!Fish,Nl�at, S debited under the 'PlItOOrlelte lectl(v's fl(ml.ry or Ratiter-165 F iec. anov-- if mated it,fmdborntl iiioers 3-901.11:C,;3) hiritc, Boi'f ste%ks inton,-,'.,'ions and visk ru,,-tors. OG'.er 145r F 590.009 t"I'latir":S r-1atjrl2 to 0,0od retail, 101.1-1 �R aAiauilll Foods Cooked in a practices shorld be debitel-N unifier ivi:crokave 165"F 4, Sp.�Cia: 401.1 I'll Other FIHFS- I"5'F :5 wc 17 Reheating!or Hot Needing VIOLATIONS qFLATED M GOOD RETAIL PRACTICES 3-403.;lGh)&(1)) PHFF 165"P U sec. (;tents 23--W 3-403.1.1(E) Miclmtlive- 165°F 2 ty1jinne Standing C-'j ivc,,7 rvifical viOlOw,m, ,h1;1:,l,,,!o iio! elateto rile Tithe" loodhnme diners mterver,!L.-a awl risk Parrots lkI-dubole (on be 3-40 i UC) collumviall"pvo.essed RTE Fo')d- jOlind in rhe P'llltlllinl 3C(l,,,nLv r,!the Icm!Code anJ 105 CAP? 140T! I 51;0.190. i-403 111 E, Be�l' Remaining L nsliettl Poviom I�*^ firm cosd,Rein;,practices FO 4iw�ro RolisW "In -i Manantsm,;lt an�'Pamonn� '.� 7 ;8 Proper Coaling of PH!"s 2� Foil,,,r.d Food Piotmdon G-9 C04 '6, Fc -1 1 uipmcnt- id Urirsls FG -4 k05 �-"O I I PA, t2vulm- Cooktcl PHFs from NO F le 2G, i Vvp;cr,Plu nbinQ and Wa,:p FC-5 '10 i' Within 2 1.......and Frust 70"'F -- 07 to 41-F/45'F Within 4 211, i Poisonous or Toxic Miltz,.-�als C-7 OOj C,ailing tilde From iiiniblient Plemireirp 009 g Pl1J,',,M Soo- nh; Temperature Ingledic'nts to 111OF/115,r Gibet %k i i rin 4 1 loui, utillots v,II i I i! 11,it) te,till L,1 1499 F(Mll Cudc Or 10:1 CN 11"590(lilt;. CITY OF SALEM r _ BOARD OF HEALTH Establishment Name: �IJVII K 1✓1 -3-56 f Date: /Pz� a Page: of f Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION bate No. Reference R—Red Item - Verified J PLEASE PRINT CLEARLY �v/. (I I �n,� -�v I,�ceP(� �.� G��(Oi /��e�_l� /3r-J, ,<� I 40t ( 4-D C-1�ia. t IIIo24 "r-�> . / ck✓t>_-: � �n r.CY/L(/te A Pod'A ('�n111M� / I - r 1. U_2 77- 00 I ' I 1 ' - I 1 : I 1 Discussion With Person in Charge: Corrective Action Required: ❑ No les t ❑ Voluntary Compliance ElEmployee`Restriction/ I have read this report, have had the opportunity to ask questions and agree to correct all Exclusion violations before the next inspection, to observe all conditions as described, and to p �a�1Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that ^j noncompliance may result in daily fines of twenty-five dollars or suspension/re ocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: 3 `+r 1 1-!C.: PiiPt, Rec^ivea at Temperilwes Violations Related to Foodborne illness later ventions and Risk According to Lasa Cooled to Factors(Items 1-22) (Cont.) ; ':1=F;45"E t'ry idvt;4 Hours. PROTECTION FROM CHEMICALS I 3-?(2 1.15 C'oolinq Method.,for PH Fs 19 PHF Hot and Cold Holding 13I Food or Color Additives I i 50 603) Cold PFiF> Msrmaincd at ox f beln L 3- 02.12 Addiiiv"s'^ S400i)4(F) F` 15 ' 3-302.14 Protection tout Unapproved Additives:, 11,.50(.16%?.) H<a PRFs Pizm,ai ed at or oboe, Poisonous or Toxic Substances 7-101.11 Identif}v?g lnfartiatwn-Ololuu4 ( 3-5f,!.16(A) Roasts Held at or above 130°F. Contynersx I 7-102..1 1 Common Nome-W',ekirna Containers' ( 20 ':tine as a Public Health Control 17-'01.11 Sep.:ration-SL'a'age, ! 'i 5;)1 IJ Tine as a Public Health Corihul*' 17-203.11 Restriction-Presence and Uaea 590.004611 Variance Requirement 7-203.11 CondToxic ions of Use' REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-_'03.1 l Toxic Conels, rites --Prohibitions* I POPULATIONS(HSP-t � 7'204.11 J.utibzers.<'rirens-Chemiexl5-* f 7-2(61.12 t hunncals int Washing Produce, Ct noria" 21 3-SOL 1RAt Unpactcunced Pie-packaged Mice,and 7-204.14 Diyijig Agents,Criteria' I ( Se reraste.?with Warning l;abcla' ( 7-205 11 htcidenral Fnrxl Contac[.LutencuntsT ! 3-901 11(ft) � Use 0 Paste, rj Ent', ?-SOI 11(D) ( Raw or Partially Cooked Animal Food and 7-206,11 Restucted Use Pesticides.Crreria'" I Row Seed Sprouts \.It S-rred. r 7-211,,.1^- Rodent Bait St:uieus' 3-801.l 1(C) I Unopened Few Packattc Not Re-served. 7=206.13 Tracking Powders.Pest t'ontrol and Monitoring" CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 11 3-603.11 Ce-nsurner Advisory Posted for Con,uurption of Animal Fords That ore Raw,undercooked of 16 I Proper Cooking Temperatures for I Net Othetw:se Pr�ice.ss:d to Elinon.de Plirs 3-401.11.A(U(2) Eggs- 195"F 15 Sec. Pathogons." htmtediate Servic, 145'Fl Ssec* 3-302.'3 Patieunied Eggs Suh,tit u!e i-or Raw Shell ' 3-401.11(A)Q2 Cotmninuted Fish, Meats,F Gant, Eggsa Animals- 15°F 15 see. " 3-401.11(11,)(1)(2) Pork and Beef Ra.+st- 130`F 121 min" I SPECIAL REQUIREMENTS 3-401.1 t(A)(2i Ratites. Injected Meats- 155"F 15 5T)n09(hi-:D) Violations of Section 590.00%(A)-(D) in Fec. ` i caterim , mobile food, temporary acid 3-401.11(A)(3) Poultry, Wild Game,Stuffed Plies residethai kitchen operationS should Ik Sniffing Conta:n:n�,Fish.Meat, rlehited under the appropriate section, Poultry or Ratites-165-P 15 sec. above if related to foodborne illness 3-401.1l(C)(1) Whole-muscle, Intact B,cf Stzakr. in?erventions and risk lectors. Otltrr 145=F- 54(1,.(109 vietaUons rclatinr to good retail 1 31401.12 I Raw,.Animal Foods Co+ )kcd in a inicUces should be debited Ander#29 - Microwave 165'FSpecial Requirements. 3-401.11(1)(1)(6) All Other PHF,- 14ir F 15 sec. N 17 j I Reheating for Hot Holding VIOLATIONS R.:LATED TO GOOD RETAIL PRACTICES 3-403.;I(A)R-(D) I PHFs 165'F 15sec. * Meta,;1-3-30) 3-403.11(8) Microwave- 165°F 2 Minute Standing I Ciinaal and non-<r!hcut vLdtmorra, ulw h de nui :dais rn the '1'imc' ,Jaudbnrve i16a=s.;inu•rnrnnnna'and ri.tl;instars tistcd rrLurc. can be 3-403.11(C) Commercially Processed RTE Food- ktamd in rhe follon-tug scrricns of the Food Codes++d'1 ft5 CStfR 140"F.,. 590.000. _ 3-403.11(F) Remaining Unsbred Portions of Beef IItem Good RetailPncHces - -FC_- _ 59D.Ott0 -_) Roast:.": ( 23. Management and:Psracnn ; FC;- 2 .003 IS Proper Cooling of PHFs 24. Food and Foot Pro'ectlan FC-9 .00.1 "F `-o:.iPrnent and Utensil FC - 4 .005 j 3_501 14(A) Comate Cooked PI-[Fs from 140°F to ( 26, W aier.Piumc:nq are Write FC-5 1 .006 N)"F Wiihin 2 Flours and From 70'F 27. Phvsical>=cfl lv FC-6 007 I to 41"17(45'F Within 4 Hours. W _23 P:nsatous of Tcxit klafena!3 FC--7 008 3-501.14±131 Coohr-P1I1's Made From Ambient 2? Suocial Rcquirentents .009 Temperature Ingredients to 4l°P/45:F 30 Other - -- -_-------__� Within 4 l lours= Denotes entice!item m i:nIrdnril 1999 Forol Code nr 1051'PiR 59,1,000 A MORRELL ASSOCIATES CURRENTDATE: 10/17/2005 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 10/6/2005 (781) 837=1395 www.morrell-associates.com Customer #: F139-13 Inva>cea:Jayce; "f 0 Burger King #3564 N 12!21 �+Illl 10 T Highland Ave./ Rte 107 r NOV - 3 2005 �� o N Salem, MAA U1 I Y UI- JALtM BACTERIA COUNT Sample BOARD OF HEALTH Standard Plate Count/q Coliform/q II Vanilla Milk Shake { 250 EPAC 1 I MASSACHUSETTS STANDARDS Machine:SPC<50,000/g;Coliform<50/g Other:SPC<50,000/g;Coliform<20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Davv f/ Products, 16th Edition,American Public Health Association, 1992 85711 ( IMP/OR�TANT MESSAGE ) FOR DATE M �A�i�K^ Vf7/irl2�r�ri+J OF PHONE AREA CODE NUMBER EXTENSION ❑ FAX ❑ MOBII F AREA CODE NUMBER TIME TO CALL TELEPHONED C -r PLEASE CALL CAME TO SEE YOU I WILL CALL AGAIN I WANTS TO SEE YOU I RUSH RETURNED YOUR I WILL FAX TO YOU I MESSAGE _ a � SIGNED� �� a%ps FORM 4009 �/� ----- MARE IN U 5 A NOTES f MIORRELL ASSOCIATES CURRENTDATE. 9/19/2005 P.O. BOX 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 9/13/2005 (781) 837-1395 www.morrell-associates.com Customer #s FB9-13 C L InvoicesoJoyce; ReportsoLg Env o Burger King #3564 N 12/21 T Highland Ave./ Rte 107 T I U Salem, MA BACTERIA COUNT Sample Standard Plate CounUq Coliform/q Strawberry Mill: Shake C 250 EPAC 1 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine:SPC<_50,0001g;Coliform<50/g Other:SPC!�50,000/g;Cohform<20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 84892 o MORRELL ASSOCIATES CURRENTDATE 5/20/2005 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 5/10/2095 (781( 837-1395 www.morrell-associates.com Customer ffis FB9-13 C L Boston-Wyman o Burger King #3564 N 12/22 T Highland Ave. / Rte 107 T I U Salem, MA BACTERIA COUNT Sample Standard Plate Count/q Coliform/cl Chocolate Mill:, Shake 4 250 EPAC 1 EPCC JUN - 0 2005 CITY OF SALEM BOARD OF HEALTH ` MASSACHUSETTS STANDARDS Machine:SPC<_50,000/g;ColiformS 50/g Other:SPC<50,000/g;Coliform<20/g LAB ANALYST 1111161� METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 6119'1 _ MORRELL ASSOCIATES CURRENTDATE: 9l21/C445 -_- P.O. Box 288 Marshfield, MA 02050 DATE SAMPLES TAKEN: 4/12/2445 (781) 837-1395 www.morrell-associates.com Customer st: FB9...13 � B,stun -Wyman p Burger king #3564 E 12122 A Highland Ave./ Rte 147 N T T I N Salem, MA BACTERIA COUNT Sample Standard Plate Count/q Coliform/a vanilla Milk Shake < 254 EPAC < 1 EPCE Y-0) (q (C 9 ll L"1 9 y� MAY 0 3 2005 CITY OF SALEM SOARD `wF WPAI TH MASSACHUSETTS STANDARDS Machine:SPC<_50,0001g;Coliform<501g /r r Other:SPC<50,0001g;Coliform<201g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy I/ Products, 16th Edition,American Public Health Association, 1992 [/ 60525 1 MORRELL ASSOCIATES CURRENTDATE. 3/18/2005 ii� 41 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 8/14/2005 (781) 837-1395 www.morrell-associates.com Customer #: FB9-13 C L Bt stun-Wyman O Burger King #3584 N 12,22 A Highland Ave./ Rte 107 T T I N Salem, MA BACTERIA COUNT Sample Standard Plate CounUq Coliform/a St¢ <wberry Milk Shake : 250 EPAC i EPCC APR 0 ZOOS CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine:SPC<50,00019;Coliform<5019 Other:SPC<50,0001g;Coliform<2019 LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy _;! Products, 16th Edition,American Public Health Association,1992 V 79589 / MORRELL ASSOCIATES CURRENTDATE: 8/15/2005 I _{ P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 8/10/2005 -3 - (781) 837.1395 www.morrell•associates.com Customer #: FB9-13 Invoices:Joyce; Reports:Lg Env o Burger King #3564 N 12122 A Highland Ave,/ Rte 107 T T N Salem, MA BACTERIA COUNT Sample Standard Plate Count/q Coliform/q Y Chocolate Milt; Shake 22,000 32 SEP 0 7 2005 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine:SPC<50,000/gf Coliform<50/g �l ^ Other:SPC 5 50,000/g!Coliform<20/g LAB ANALYST METHOD REFERENCE:Standard Metnods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 IJ 83961 t p 7/21/2005g IIAORRELL ASSOCIATES CURRENT DATE. DATE SAMPLES TAKEN: 7/12/2005 P.O. Box 268 Marshfield, MA 02050 (781) 837-1395 www.morrell-associates.com Customer 0; F99-13 C L L InvoicestJoycea Reports:Lg Env o Burger King 43564 EC A Highland Ave,/ Rte 107 IN T I U Salem, MA BACTERIA COUNT Sample Standard Plate Count/o Coliform/a Vanilla MilL Shale 2811 8 D . r � CF AUG 0 3 2005 CIT`( OF SALEM BOARD OF HEAL'fH MASSACHUSETTS STANDARDS Machine:SPC<50,000/g;Coliform<50/g Other:SPC<50,000/g;Coliform<20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 ✓/ 83138 MORRELL ASSOCIATES CURRENTDATE. 6/15/2005 _ -_= P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 6/8/2005 Ei (781) 837.1395 www.morrell-associates.com Customer #: F89-13 C L lnvoicev:Joyce; Reports:t-g o Burger King #3564 N 12/22 T Highland Ave./ Rte 107 T I N Salem, MA BACTERIA COUNT Sample Standard Plate CounUq Coliform/a Strawberry Milk Shake i 250 EPAC r 1 EPCC TED) 9(9a 0 JUL 12 2005 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine:SPC<50,000/g;Coliform 5 50/g f Other:SPC<50,000/g;Coliform<20/g LAB ANALYST . METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 (/ 92171 Memo: send to file March 22, 2005 In response to a complaint about a hair found in a patron's salad at Burger King on Highland Avenue an inspection was conducted, the following were noted. There were no violations seen at time of inspection. All employees at time of inspection had hair restraints in the form of hats or ponytails. Prep area was observed and looked clean free from any hair. Salads were held in walk-in fridge and were covered at time of inspection. Janet M. Dionne Sr, Sanitarian ( IMPORTANT MESSAGE ) FORn',r A.M. OAT-L— M � TIEP.M. OF_ PHONE A E OOE UMBER I ION ❑ FAX D MOBN F AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL I WILL FAX TO YOU MESSAGE ,, ` SIGNED,� y VroPS. MAD IN USDA 1 _ Cc,�u�1 l,u-e�C i - /� / 1\r f kt ,� Y t, 4 �" l�` �V t i t �, �t • \�• t t, MORRELL ASSOCIATES CURRENTDATE. 2/15/2005 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 2/14/2005 _ (781) 837.1395 www.morrell-associates.com Customer 4: FB9-13 C L Beton--Wynan o Burger King #3564 E 12122 A Highland Ave./ Rte 107 N T T N Salem, MA BACTERIA COUNT Sample Standard Plate Count/q Coliform/a Lho_olate Milk Shake 1 ,200 ; 1 EPCC I MAR - 3 2005 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine:SPC<50,000/g;Coliform<50/g Other:SPC<50,000/g;Coliform 5 20/g LAB ANALYST METHOD REFERENCE,Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 �B�q 0259 HIGHLAND AVENUE Burger King City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Telephone: Item Status Violation Critical Urgency Nature of problem or correction 744-9467 Non-compliance with: Done Owner: Anti-Choking PASS ❑ Boston-Wyman, Inc. Tobacco PASS ❑ PIC: Ryan Rambros FOOD PROTECTION MANAGEMENT Done Inspector: PIC Assigned/Knowledgeable/Duties PASS ❑Q RED Janet Dionne EMPLOYEE HEALTH Done Date Inspected: Correct By: Reporting of Diseases by Food Employee and PIC PASS ❑Q RED 3/10/2005 Personnel with Infections Restricted/Excluded PASS ❑d RED Risk Level: FOOD FROM APPROVED SOURCE Done Permit Number: Food and Water from Approved Source PASS ❑Q RED BHP-2005-0258 Receiving/Condition PASS ❑d RED Status: Tags/Records/Accuracy of Ingredient Statements PASS ❑J RED PARTIAL COMPLY Conformance with Approved Procedures/HACCP PASS RED #of Critical Violations: Plans 1 PROTECTION FROM CONTAMINATION Done Time IN. Time OUT: Separation/Segregation/Protection PASS ❑d RED Notes: Food Contact Surfaces Cleaning and Sanitizing PASS RED 15: Proper Adequate Handwashing PASS ❑Q RED Urgency Description(s): Good Hygienic Practices PASS ❑d RED BLUE: Violations Related to Good Prevention of Contamination from Hands FAIL Critical ❑Q RED employee drive thru not using ice scoop. m Ice scoop must be used to prevent Retail Practices (Critical contamination from hands. violations must be corrected Handwash Facilities PASS RED immediately or within 10 days)(Non-critical violations GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 11,2005 ) Page I of 3 0259 HIGHLAND AVENUE Burger King must be corrected immediately PROTECTION FROM CHEMICALS Done Or within 90 days) Approved Food or Color Additives PASS RED RED: Violations Related to Toxic chemicals PASS ❑D RED Foodborne Illness Interventions TIME/TEMPERATURE CONTROLS(Potentially Haz Done and Risk Factors (Require Cooking Temperatures PASS RED immediate corrective action) Reheating PASS RED Cooling PASS Q RED Hot and Cold Holding PASS RED Time As a Public Health Control PASSd❑ RED REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PO Done Food and Food Preparation for HSP PASS RED CONSUMER ADVISORY Done Posting of Consumer Advisories PASS RED Violations Related to Good Retail Practices (Blue Done Management and Personnel PASS ❑ BLUE Food and Food Protection PASS ❑ BLUE Equipment and Utensils FAIL Non-Critical ❑ BLUE Ice machine-had rust accumulation inside. Thoroughly clean&sanitize same machine missing fan cover-replace. Water, Plumbing and Waste PASS ❑ BLUE Physical Facility FAIL Non-Critical ❑ BLUE some ceiling tiles not secure/inplace, all ceiling tiles to be secure. back door gap at bottom of door. Provide doorsweep. Poisonous or Toxic Materials PASS ❑ BLUE Special Requirements PASS ❑ BLUE Other-See Notes PASS ❑ BLUE GeOTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 11,2005 ) Page 2 of 0259 HIGHLAND AVENUE Burger King GeoTMS®2005 Des Launers Municipal Solutions, Inc. ( Rev. Mar 11,2005 ) Page 3 of 0259 HIGHLAND AVENUE Burger King City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Telephone: Item Status Violation Critical Urgency Nature of problem or correction 744-9467 Non-compliance with: Done Owner: Anti-Choking PASS ❑ Boston-Wyman, Inc. Tobacco PASS ❑ PIC' Ryan Rambros FOOD PROTECTION MANAGEMENT Done Inspector: PIC Assigned/Knowledgeable/Duties PASS RED Janet Dionne EMPLOYEE HEALTH Done Date Inspected: Correct By: Reporting of Diseases by Food Employee and PIC PASS RED 3/3/2005 - Personnel with Infections Restricted/Excluded PASS RED Risk Level: FOOD FROM APPROVED SOURCE Done Permit Number: - Food and Water from Approved Source PASS RED BHP-2005-0258 Receiving/Condition PASS Q RED Status: Tags/Records/Accuracy of Ingredient Statements PASS RED PARTIAL COMPLY Conformance with Approved Procedures/HACCP PASS d❑ RED #of Critical Violations Plans 1 PROTECTION FROM CONTAMINATION Done Time IN Time OUT: Separation/Segregation/Protection PASSd❑ RED Notes: Food Contact Surfaces Cleaning and Sanitizing PASS RED 6. Proper Adequate Handwashing PASS ❑d RED Urgency Description(s). _ Good Hygienic Practices PASS ❑d RED BLUE' Violations Related to Good Prevention of Contamination from Hands PASS Critical RED employee in not using ice scoop. Ice scoopoop must be used to prevent Retail Practices (Critical contamination from hands. violations must be corrected Handwash Facilities PASS ❑/ RED immediately or within 10 days)(Non-critical violations GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 03,2005 ) Page I o(3 0259 HIGHLAND AVENUE Burger King must be corrected immediately PROTECTION FROM CHEMICALS Done or within 90 days) Approved Food or Color Additives PASS ❑d RED RED: Violations Related to Toxic Chemicals PASS RED Foodborne Illness Interventions TIMEITEMPERATURE CONTROLS(Potentially Haz Done and Risk Factors (Require Cooking Temperatures PASS ❑d RED immediate corrective action) Reheating PASS ❑� RED Cooling PASS RED Hot and Cold Holding FAIL Critical RED •✓bacon out at room temp.All PHF to be held at 41'f or below as mandated ,,,,Silver King freezer-missing thermometer. Provide visible accurate thermometer maintained at temp of 0°f or below a mandated Time As a Public Health Control PASSJ❑ RED REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PO Done Food and Food Preparation for HSP PASS (] RED CONSUMER ADVISORY Done Posting of Consumer Advisories PASS RED GeOTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 03,2005 ) Paze 2 of 0259 HIGHLAND AVENUE Burger King_ Violations Related to Good Retail Practices (Blue Done _ Management and Personnel PASS ❑ BLUE Food and Food Protection FAIL Critical ❑ BLUE v4nes uncovered, ceiling tile above container not secure. —Tongs used for meat products being stored on table top.Tongs to be stored in sanitizing solution of 50-100ppm, between uses Equipment and Utensils FAIL Non-Critical ❑ BLUE vfnicrowave near hamburg prep area needs general cleaning. "Mop stored in bucket.Mop to be stored mop head up not touching any surface to air dry. .—Ice machine-some rust accumulation inside.Thoroughly clean&sanitize. ,Abe scoop stored ontop of machine. Ice scoop to be cleaned and sanitize and placed handleside up in ice, or placed in a clean&sanitized container labeled"ICE SCOOP ONLY" Same machine Missing fan cover-Replace Tube of petroleum jelly in with coffee stirers. keep coffee stirers separate from other items to prevent cross contamination Water, Plumbing and Waste PASS ❑ BLUE Physical Facility PASS Non-Critical ❑ BLUE some ceiling tiles not in place-all tiles to be inplace Back door many gaps-seal all gaps around door. Poisonous or Toxic Materials PASS ❑ BLUE Special Requirements PASS ❑ BLUE Other-See Notes PASS ❑ BLUE GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 03,2005 ) Page 3 of Based on a complaint regarding a suspect food borne illness relating to the consumption of a crispy chicken sandwich with cheese only at Burger King an initial investigation was conducted. The investigation noted the following with regards to the chicken, cheese and rolls: The chicken breast is received already breaded pre cooked and frozen. It goes directly into the walk in freezer, which is maintained at a temperature of 0 degrees Fahrenheit. When the chicken is needed one bag is taken to small freezer in near the cookline. This freezer had a temperature of 20 degrees Fahrenheit. The chicken is then cooked in a fryolator for approximately 4+minutes at a temperature of 360 degrees Fahrenheit. Once the chicken is cooked it is held in a heating unit until served. Temperature of the chicken at time of inspection was 168 degrees Fahrenheit, wish the unit maintaining temperatures of 185 degrees on the top and 192 degrees on the bottom. The cheese is received in boxes of 8; it goes directly into the walk in refrigerator upon receiving. The cheese is used on an as needed basis, it is stored on ice and the temperature at the time of inspection was 47 degrees Fahrenheit. The cheese and chicken are both received from Burger King's own supplier, Maine's Food and Paper. They are received on Monday and Thursday and orders are placed so that they will have enough to get through to the next delivery. The rolls are delivered every day except Wednesday and Sunday and come from Lepage Bread. It is stored near the cook line in its original package and on racks off the floor. All employees working in the cook line were wearing gloves at the time of inspection. ( IMPORTANT MESSAGE ) FOR ' 1 C�J9C�iU DATE T)h J 6 TIME �cai:LPT7f. e M t Y�l y ��q07 rI1 PHONE � � AREA7CODE NUMBER EXTENSION O FAX ❑ MOBN F AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH ' RETURNED YOUR CALL L' WILL FAX TO YOU MESSAG� /' 0l`�UA / rle.,, Qh�U 4�n9ha P rad;p �a cal.., LA 4JOLS flops MADE IN U.S.. A. . parti'l)PIlt Of PLiblic Health -- FOODBORNE ILLNESS COMPLAINT • - Date: 3/1/2005 MDFH Food Protection Program I Food protection Rogram. (817)983-6712 3o5 south Street..tamaica Rain. MA 02130 Division of Epidemiology (617)983-6800 WO #: 2005-03-CID Fax: 1617)983-6770 Enterica Laboratory: 1517)983-6609 PERSON COMPLETING INFORMATION., Name tom Foley Affiliation State DPM (DFD) Phone a (617)983-6747 REPORTER/ COMPLAINANT Name Jennifer Ajoyan Affiliation Consumer Phone#(781)3164757 Town: Danvers Address: 13 West Street Zip: 01923 ILLNESS INFORMATION #Persons it M Symptoms: Diarrhea vomiting Nausea .Abdominal cramps Onset Paniew ISunday. February 27 2005 at 5.00 PM Duration: More than 48 hrs IIF Person(s): Name Town Telephone Age(yrs}Occuparion Med- Prov. Aroyan,jennifer Danvers (781)3164757 28 teacher Salem Hospital Medical attention received (by anyone)? al[ Yes ❑ No ❑ unk Stool specimens submitted: (by anyone)? ❑ Yes ❑ No R Unk (to SLI) ❑Yes ❑ No unk Medical diagnosis reported? FOOD HISTORY 'Food -Sent-- Kra to Date 1 a Restaurant r Store Place Avail- to onset: Time: Exp: Foods consumed: wherepurchasad: Consumed: able? SLI? Specify. Earbest 2272005 Crispy Chicken Sandwich With 9..rger Kmp-Satem Car No unk 325 1.45 PM Chee6e Only No Drink. M,ghlana Ave. 2j26/2005 Cauliflower.Broccoli,strawberry unk unk' L Shortcake; Made At Home; Brought To Work And Consumed There 2/252005 2 Chinese Food Home unk unk D NOTES Pnmea 31112005 10 50 14 AM Complainant reports eating only chicken sandwich from Burger King on 2!27!05. No b'fast.Consumed sandwich in car while going to mall Became dl 5:00pm very nauseous.pains in stomach,severe vomiting:went to Salem Hospital ER:given morphine for pain and meds to control vomiting:kept overnight at Salem Hospital. Blood work done but does not believe stools were done. Food intake from 2125105 reports eating Chinese food but says same food items consumed by she and nusband ano nusbana not c husband also ate Burgar K ngfood outdtfferent food item Complainant states she does not usually eat breakfast;eats very little during the day. 311105 Report forwarded to Salem BOIL Pontea 3112005 10.50 14 AM ..f;tai+ j. �yy! +9� '^'A'*-'^ -'_t { _ �'x'?`2s ^`viw•atin ,„:+i ..'�..t +'.t ,r,'+�ti. ?r: z':9VR°° ,CITY OF SALEM,"MASSACHUSETTS P .y' }:fi'y"'.y^ a,` >� q 'BOARD OF HEALTH` " '3?"' 120 WASHINGTON STREET, 4TH FLOOR - '= 7..ia:"'•�o-'*p�r�"'�"�+ SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94, Section 305A and Chapter III, Section 5 of the General Laws, to operate a Food Establishment in the City of Salem is hereby granted to: Type of Establishment: FOOD SERVICE Name of Establishment: Burger King Address of Establishment: 259 Highland Avenue Owner's Name: Boston-Wyman, Inc. Restrictions: Application Date: 12/6/2004 Permit for Food Establishment 165-05 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 2005 This permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location in the Establishment, In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. II�1LX-C� HEALTH AGENT ' CITY OF SALEM, MASSAC BOARD OFTRHEALTH 1_7 U 120 WASHINGTON SEET, 4TH F R �a SALEM, MA 01970 DEC - 12004 TEL. 978-741-1800 FAX 978-745-0343 CITY OF SALEM STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO BOARD OF HEALTH MAYOR HEALTH AGENT 2005 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT ``''// NAME OF ESTABLISHMENT 1- i 0 �JJ��4 n TEL# 6175-74/4 -�T�7 ADDRESS OF ESTABLISHMENTay Ciio/, �7lA/7cj /0/UE9 Salem ink MAILING ADDRESS (if different)� [111 13 re�cCs YI ' d� P-,-449J,411/1i s V�M A OJ� OWNER'S NAME 063-66-r) 1J y 1"413 '�Ln49 TEL# JDdo-�/I� ADDRESS //D Hlle&_A RIO? CITY #11 A 14" vis . /714 STATE 1)77,4ZIP D�260/ CERTIFIED FOOD ANAGER'S NAME(S) TtrPnN A 'CaJd eYl CERTIFICATE#(s)a l12 Luisa Ma�f;�� ✓e 531719 (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON�Iwr haSe_ HOME TEL# A111 .91, Aar Aui Apr Aug An - aor HOURS OF OPERATION: Mon.�Tue.�Wed.7 / Thu. 7—/ Fri. am - Sat7n.,-._ Sun IAn-�2 Am TYPE OF ESTABLISHMENT FEE check only RETAIL STORE YES LNO� „ _ , ; ,,..,z, Less than 1000sq.ft.,, r.=$ 50 . 'a, '«, r , �• , - + rk ;1000-10,000sq ft i, $1D0 rr more than $250 rA51+t e "° w.,. qt' RESTAURANT "� ' ES -NO f� less thah 25�seats $1'00.. 25-99 seats =$150 more than 99 seats =$200 BED/BREAKFAST YES O $100 ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGURT, SOFT SERVE YES CP $5 TOBACCO VENDOR, YES 40 $50 ALL 440 -PPROFIT,Such as church kifchcrs) YES to $25 Please pay total with one check payable to the City of Salem This Permit is not transferable and must be reissued upon change of ownership. The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 62C, Section 49A, I certify under the pains and penalties of perjury that I, to my b st wledge a b fef have fled all state tax returns and paid all state taxes required under the law. I t re Date Social Securityor Federal Identification Number ------------ ----- ------------------------ ------------------------------------------------------------------------------------------ Revised 111 31 3 FOODAP2 adm Check#&Dale e:J//to /—, lo —d 01540 NOV 2 3 RECT / , f MORRELL ASSOCIATES CURRENT DATE: 1/19/2005 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 1/2/2005 (781) 837.1395 www.morrell•associates.com Customer #: FB9-13 C L Boston-Wyman. o Burger King #3564 N 12/22 TA !Highland Ave./ Rte 107 T I N Salem, HA BACTERIA COUNT Sample Standard Plate Count/q Coliform/q Vanilla Milk, Shale < 250 EPAC e 1 EPCC D C � � O FEO 0 3 2005 CITY l;s SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine:SPC<_50,0001g;Coliform<501g Other:SPC<50,0001g;Coliform<201g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association,1992 V "7:38 M CITY OF SALEMI, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741.1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94, Section 305A and Chapter III, Section 5 of the General Laws, to operate a Food Establishment in the City of Salem is hereby granted to: Type of Establishment: FOOD SERVICE Name of Establishment: Burger King Address of Establishment: 259 Highland Avenue Owner's Name: Boston-Wyman, Inc. Restrictions: Application Date: 1/13/2004 Permit for Food Establishment 207-04 r Frozen Desserts/Ice Cream 15-04 Permit for the Sale of Tobacco Products These Permits Expire December 31, 2004 This permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location in the Establishment, In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. HEALTH AGENT CITY OF SALEM, MASSACHUSETTS 1 -« BOARD OF HEALTH , � s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 DEC 152003 TEL, 978-741-1800 FAX 978-745-0343 p(G1 l Y ()I- ,SALEM STANLEY USOVICZ, JR JOANNE SCOTT, MPH, RS, CHO 80ARD OF HEALTH MAYOR HEALTH AGENT 2004 APPLICATION FOR PERMIT TOO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT ttlo P/' CJi l� Q �Jr�4I TEL#9°f-�q�'S4V-9"16 `I ADDRESS OF ESTABLISHMENT o� `�J �iC/{'I�dru dhOy p fet1 V�/ A MAILING ADDRESS (i(if diffe/rent) ��/a9 � A �`/i �� T>Oc7Gt" 8'. 71 an1.? 'S n261/ OWNER'S NAME ,�b.ST^a6tJ— L )21 f9,7J�YOY -'�/UL+ TEL X5£38'-SIV ADDRESS i10 sl-eecl `N./f -3 Ow CITY -HZ 4")O i sSTATE_ _ zlpo-?60/ / CERTIFIED FOOD MANAGER'S NAME(S)� ep CERTIFICATE#(s)c2/1- -. rZ- �•ICaSz IY1AR'kiNec. X539i� (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSO _-T n `h n NJ�� (2 1 A G HOME TEL# X74" its �" #W g1r M HOURS OF OPERATION: Mon./"IpTue.�1 Wed. ��/'Thu.�Fri.�WSatj- 7'IZ TYPE OF ESTABLISHMENT FEE check only RETAIL STORE YES NO less than 1000sq.ft. =$ 50 1000-1 "000sg.ft. *=$100 more than 1 0,000sq.ft. =$250 RESTAURANTYES NO less than 25 seats =$100 25-99 seats = 50 �jo spa fS more than 99 seats 00 BED/BREAKFAST YES 0 $100 ADDITIONAL PERMITS / 7 MAKE(not just serve) ICE CREAM, YOGURT, SOFT SERVEES $5 TOBACCO VENDOR � $50 ALL NON-PROFIT(such as church kitchens) YES O $25 Please pay total with one check payable to the City of Salom This Permit is not transferable and must be reissued upon change of ownership.The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements,or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 62C, Section 49A, I certify under the pains and penalties of perjury that 1,to my nowled ay�d elief, have filed all state tax returns and paid II State t xes required under the law. Si nit ure.e' 4Date:;-; Social Seciirik"y or'Federa! Identification,Number, ` Revised tit03103 FOOD- -------=-- L---- =-� - V - -- /0 AP2.adm,�.>`n:Check#8 Date off:.— �r (5 0-2!1 � uu�imi Massachusetts,Department of Public Health Salem Board of Health 120 Washington Street,4t"Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name/( �1 D to// Type of Ooerationlsl, Type of Inspection dogrsa elt z- ��/ /z�/cy I Food Service ❑ utine Address �� Risk Lj Retail tB Ae-inspection Telephonen7/ Lev1� ❑ Residential Kitchen Previous Inspection r7S^r/ - NO f'l'y ❑ Mobile Date: [I Temporary ElPre-operationOwner 6OaVle}J wVMAW ,�C HACCP Y/N I ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) Time ❑ Bed&Breakfast ❑ General Complaint In: El HACCP inspector n+-vt0 � Out: Permit No. ❑ Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH _ El2. Reporting of Diseases by Food Employee and PIC PROTECTION FROM CHEMICALS El3. Personnel with Infections Restricted/Excluded El 14.Approved Food or Color Additives ❑ 15.Toxic Chemicals FOOD FROM APPROVED SOURCE ❑ 4. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices CONSUMER ADVISORY ❑ 22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code. This report, signed below, when C N P 23. Management and Personnel (FC-2)(550.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (Fc-0)(990.009) cited in this report may result in suspension or revocation of 26 Water, Plumbing and Waste (FC-5)(590.006) the food establishment permit and cessation of food establishment operations. If aggrieved by this order, you 4.. 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: S 5901ne IFon IC dx Inspector's Signature flt i _ Print: I PIC's Signature: 'y_=A - Print: �%n./_y� �� I PageL of 2L Pages Violations Related to Floodborne illness Interventions anti Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT j 8 Cross-contami^a:rbn I 1 500.0030) Aycirnmeo:irf Rcsra•,ns:b,lity' '-302.;1iA)(1',, Raw .,niumi Fu,xt•:Sepaiatcd iom 590.003(B? Demonar rl on of Knoedcdges' I rooked anti R'll Foots* 2-IO;i.il Person in rharpe--duties I Contarr:inatron,'rom.Rae,:ngredien`s 3-302.11{A)(2) R-w Animal Food.:Separated iron Each EMPLOYEE HEALTH Olhet' 2 590.003(C) Respoimbility of the person in;haige to I Gonta!rinen'on`-om the-nvirooment ieyuire reporting by laud ewphtyee:;and 3,31%'1 !(A) Fo.xi Ymtr6en" _ _j applicants" 3-3[2.15 kkasii.:mzFruits and V.:eet::bles 0-03(F) Respu,:3ibi Hlr Of A Fm,u!ittg"„ve_Or:^`.n x_',,':d.U Focr:i Contact:vith Egvipment and Applicant To P,epurt'fo The Person In - - I I';;;-eds* Charge" ( C':;ntam,nation hom the Consume, 59(i Ui)3!G) I Reporting by person in Charge'•` ?-300.1-h A);B) I Retuned Food and Re,ernice of Ftxxl' 3I 590.003(D) Excla,dousand Rea!xict,on'" I Osoos,t'v,r of Adu:telateJ of Co,-aam,nateJ 5e0.003(F? Renrrval of CxAusmn;and Restrctions Fred Il.l 1 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE '-code Food and 4'✓aloe fro,^:Regulated:;o_v;-es ' j 9 Feed Contact Surraces 5915.004(A-B) Co;::oLance with Food Las+* ( 4-50:.111 lKa:mal Warewsshine-Hot Water 4aritimlion Tem,erittu 3--7.01.1? F"A in a Fermetic;Uy Sealed Container, I i , , -- { 3-20i.i3 Fiuid Vfilk and Milk Preduecs'° I 4-Sfj?.11:. *+te:i:nnical triarewashing- I1or`Vater i 3-201'3 Shcl: San;tiul�„t Tc::ivcraavrs'. 'rg°' ' - - - 3-402.;4 Eggs and Milk Product;. 1=,m.em zed' ! 1-501.1:<4 I f=itemird San;timllon tern:; , pH, " ?Crrtl'aUnil and I:al d'eSa. 'r 21(;2.16 Ice Made Flom Yutablt Drinkimr Water" t I lcU..l f(A: F,pti;nnent Food Cuaiact Snrfzres and5-11 .1.11 I Drinking Rate;from an Approved::,seem" Utensils C lean" Bovied Dunking Rater' ( =_602.11 t:'Iranine l.reu.;enc} t P of Fc ui men[Focxl- I 59')J)(:;.(k! 'Jialei Mets Starejarls: in:10 CMR 2=i;+' j -g - - SheUtislt.and dish From an AppnrosdurCoril':ct's,urtacc, rid Utens;l,Soce ( 11-702.11 Freuuene} o Saroiznh<:n of Ut ensile and 3-201.1? Fish an(!R=eationa!ly Ca ylit Mvllus�an Shelllisli" I rood Contact Suriacet �:,f Equipment* 71)3 11 M:tht;ds of Sanitization-Iior Water and 3-201,15 ;blollasran Shellfsh From NSSP Liscd I I s,: �- . , msec* i0 ( proper,Adequate handwashing j Game and Wild Mushrooms.4oprcved ry Rea,,,atory Abthoriv 2-301.11 Clean Condition-I and Artnc+ I i-202.iS Jhzll;trx•i; identificahoi: Presenia I 13-301 1% Clean.:?,Vrocedme' 590.0041 Q Wild Mashiuoms* j I :'-301.1- When to Wash: 2".0 1.17 gams Arimais* I I F1 truss Hygienic Practices Receiv:nglCondihon ; 2-401.1 i Eatinv-Drinking or Usinpjobaccn* I -202.11 PHFs Received at Proper Tem c t I -'-1C 1.12 D.achargc,Fmm ane Eyee, nose and P p '< 2 ( i i.T,-tuh^ I 3-_U 1; Package h egray` 3-W.1 l Food Safe:nd l hau3niterttcc ' I 2-301 1 2 Pr:,V-enting Cu,riartination`h9ien'Fa;tiu^_* p TagslRecards:Sheilstock ( i 72 P;event:on of Contamination from Nands �(lo ,,, * ( 590 00.{,E} precentim;ConggmID navfal f oin 3-_ .18 Sh=_llstoc"ldentificanon i 3-203.12 Shellin;ck identification Maintained'. I 'uiplovmst T.ags/Records: Fish Produch; I s 13 Handwash Facibiiee 1 C'enven,ently Located xiJ Accesnbte i-at)2-i l Para=its Dc,trnctinu* -J 3, I _ 1 I I IJumbcrs and Capacities;. I l Lc 3-d0'.'.7 !Lcdendc. Creation end Retetui:,n* s i i 590.0(11(71 labeling of Ingrechents' i ?-204 I latioa and - ' 9 Conformance with Approved Procedure7, ( = ';�.1 t :,cecssibility.Ope-ation and Maintenaue I 1HACCP Plans I ! SupFlred eqh Soap zed Nanta D7yinq 3-50-.11 Specialized Processing Mcih,ale.* j Devres - --- 3-502.12 Reduced ox)gen packaong,criteria` I I 0-301.11 -landwashniv C!;canwci. Availability 18.103.;2 C'oni'armauce with Atpmvcd Prmedures' i I 6-30 1.)2 j Hand D,ving Provimu;i *i?enair.cnbc<d uem:a the,.Je1a11999Fond Coacin IuCMR 590000. CITY OF SALEM BOARD OF HEALTH Establishment Name: ISURGga rv/f'/ ' Date: g-/g/`I Page: 2-- Of 2 Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY 27 n(� -- /�Poa-,!L Grt-mart O��-iN /rf �2�rJr of 3 /3.,eY •�`�'�v� I I � I ✓ALL rrr?dcs.z V/vc-�OP43 c fmgf5 I!V Z//-7/dy J 14 I � ri Id'4-W,_ 1/yv, 1 I i I . I - I 1 1 1 1 Discussion With Person in Charge: Corrective Action Required: I ❑ No I ❑ Yes 1 I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ inspection, to observe all conditions as described, and to Exclusion Violations before the next ins P Ll Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure 1 your food permit. �� ❑ Voluntary Disposal ❑ Other: 3 501 141:., PHFs Recr--,ved.a Tooperatutes Violations Related to Foodborne ftiness Interventions and Risk Accordi n<,to lay.Cooled to Factors(items 1.22) (Cont.) 4 i"'Fi45'F Within 4 Hours. ` 3-501.i 5 Ct"ohn,Ma ".:ode:: Massachusetts Department of Public Health Salem Board of Health 120 Washington Street, 4'" Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 NameDat¢ Type of Ooeration(sl, Tv Is of Insoection RORI'xR 14/N6 9swq I c9/17/e' I RFood Service LwjRoutine Address2�-9 N/d#L��Q �� Risk El Retail [IRe-inspection Level. El Residential Kitchen Previous Inspection Telephone .7yy , 9y�7 EI Date: Owneration /. >S ON W YAJAN /NC• I HACCP YM ❑❑ Caterer El ElSuspect rIllness Person in Charge(PIC) Time ❑ Bed&Breakfast ❑ General Complaint In: F-1 HACCP Inspector 600 1Wk"AA.P& I Out: Permit No. ❑ Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS [12. Reporting of Diseases by Food Employee and PIC El 14. Approved Food or Color Additives E] 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE El 15.Toxic Chemicals ❑ 4. Food and Water from Approved Source TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑ 20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 10. Proper Adequate Handwashing E]21. Food and Food Preparation for HSP ❑ 11. Good Hygienic Practices CONSUMER ADVISORY ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board rf Health. today, the items checked indicate violations of 105 CMR ZCN 590.000/federal Food Code. This report, when signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 5. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of 027. 6. Water, Plumbing and Waste (FC-5)(590.006) the food establishment permit and cessation of food establishment operations. If aggrieved by this order, you Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590 009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: S 5001,.IFort 14 d. �/ Inspector's SignaturelL , j 19 ,. ( .PIC's Signature: Print: ( Page of oP agesPrint: -low Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 8 gross-cont^mi ration I 500.00(A) 3-302.: !(A)(1; RM Annual NM's Separated frorn :390.003(B) Denionstretion of Knowledge I Cook,d and KIT Foods 03.11 Fel aur:incha.gedutie., Contamitiaton fra.-, Raw(nnedionts 3L1j(A)(2) Raw Annual Foods Separat.2d ir0ru Each EMPLOYEE HEALTH Other' I 59O 003(Q Respomibilitv:,f dv:pclv,n III ch,ule to Gunteminativr,"ont Environment require reporting by food cm,.pioyvcs and 1 3 3( (A) -,od applicants* Wadung Frv't,,and Vc,!,qables 590,003fF! Pv,ponsiluluy UTA foid Employee Or An Fqiuprneut and Applicant To Report To The Person In chill gel C.:ntif.roinaticn horn the Consumer 590.011Y,C) Reporo,og by Person in Charge' 3-306.1 ;'A)(B) Return,-d I...A and RetciN;ce of Find" 3 5911.003(D) Exclusions and Restriction" Disposition ri Adulterated ot,Contaminated 50,0030-l') Fetuo\al if Exdusious and Resiirotioas Fond 3-701 11 D:;cardingor Reconditioning Unlaf- FOOD FIOM APPROVED SOURCE Foodii, 41 Food and Ware(from Regulated Sources 1 9 Food Contact Surferes 590.0")IIA-B) Cunt;-lianet with Food Llov* )",:'L I xlimual warewa�hjllt-Hot 4N 11cr 3-201.1 S Fund in a Hermenc;d1v Seal,xt Container* fi T,mperaturcs 3-201 13 Fluid Milk and Nlilk Pioducvl" 4-5W.11 Mcclivnical Bit Water S.Illitizatiou T cmperarurv",* 3-207.13 Site]] Fc,,gs' 4-5.jl,114 ('1witocal Sanitimfion-temp.,pH, 3-202.14 and Milk Prodlu;U� T`aS'V`IIIi7Cd' o;.and hardness. :` 3-202.16 fee Made Fj om Potable Di;nkiril-Water, 4-001,1 I'AI Filuilnuoril,Food Centact Surfacc,.;and 5-101 11 DrIlikolg ater f,Inn an Avproved SYstern" 5910.W6(A) Bottled Drirl W,LerT litrsils Clean" 4-602.1 1 Clcarfivtg Frequenctiut !,quiluum Food- 590.006(B; .Vater Meet tenditoiq in.3;0 CM"R 22 0 Contact Surfacc,_ind Utcnsiir" Shellfish and F;sh Front 3n,Approved S-0 Urce Frequencynf.Simmie 1111M of LlIeTiSil8and 201.114 Fish and ke_,readooafly Caught Nvfolhiscam Food Contact sa:f&-es of Equipment sliefflish" 4-703. 1 I Methods of Sanitization—Hot A ater wid 1 3-201 15 Molloscan ShelffiQ)ituni NSSP Lit.lcd Sources` Proper,Adequate Handwashing Game and Wild Mushrooms Approvpd by 1 Regulatory Authorly 01.11 _�Ican,,Cjidifion -Par��s and Ajms� 2-301 1, 0'allin.ProuLdill e S101slocl,, orscot' 590.004i(') Wild klushroorw,l j 2--(}i ?-4 'Wh,,r in Waill, 24iIJ7 Gamic, Anim,,,.ls* it Good Hygienic Practices Receiving/Condition 2-401 11 Eating, Drinking,or Lsing Tobacco" 3-202.1 I PHFs Received at Nowr Temperature;'" ?_loi,I I flischarje;Flom the Lyes, Noce and 1 3-202 i5 Package hitegrivv' I Vioull), lot.]j Food Safe and Unadulterated 3-311)1.12 Provelllonl�,cvillalnir�avoo Ville"Titdofwl TagsiRecords:Shelistock ri Prevention of Gr -amination from Hands 3-202.1S Shellslrjek [citntificatiou 590.00-iill; Prt%euting Cumanimation from 3-203.13 1�'hellstock]it,nto-mation Maintained" Elllployces' I Tagsirlecotcls:Fish Products 13 Handwash Fae,!it'as 3-402,11 ParasiteCorve""ently Lm.uod acdAccessiblr i i-40'.12 rkcords.Cre;lijon aadRo:cnljon` 5-'t03.I I Numit',r,and Capaci,,ie;` I Labeling of imaredlonts* - 5 [;uCation an'; filazenicnt, • ronfor.'rancewith Approved Procerfoms 01�ej:jliou and Maintenance sippl,od WWI Soap and Hand Dtfirg 1HACCP Plans DPW(' 23 3-502.11 Specialised Processing Molhods* 6_;0 t.i liandwashoui,CleanNei,Availability 3-502.12 Reduecd oxygen pnkaFin;,,,crlteiia* , ls-lir 12 COnfoimloice wit!) Approved Ptmedurea�' .. .... 14md El-iing,Provistor, Penults ami it,the fc,leial 191-9 Food C,&,,; 105 CNIR 590 OW, CITY OF SALEM �f BOARD OF HEALTH Establishment Name: 6UR6-csR &1"6G Date: Br7/a`/ Page: of Z Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified PLEASE POINT CLEARLY I � JIG '+ �i� r' rfle/5' .fa�o�.to f.� hest J3r9K . Ri,�JcC .ti+dPr ,�f✓A id.Ar+6. s.nNir rd olejy /„f JrAM&26/T ",varOs .4 vr.Fr6Ld'. RGc�.s�� 12�. fNrrf.tM�G o.t,arrr . 79A- z07 94- WAiA- Ff f�ti O,cw„� .r� �c — o!L-- n4Xd es 2�r_ r•+lt_ _ °"JeUk.sa G,2c�z�ti ^A/S-t'Y✓Ar F7+& MoM6rS0- P(Lo✓IUd U�l'f 6r �4? «'rOAF M 1771s -,A4,0 4&Miff— /►J VNr 1 i 1 ?� G w Cl€�,fuc� r�+-mac/ ic,�E ,tif..ati.frin�s nn,rsin✓G rY�vt+. P/1-aviR� is- � serr,c-,m"Lo- cel rp-,440 A .&C60 IM rc.'r ae I / � I �? r " ��r/2s a��.�-�J we tJ ov tr-r rAr/�.t" a�►� A-z�- �4�M'r�-r Pe v�d� 1 1 e fdrf A vQ Isw.O eF SodIF f/dT tIl�/c vt� 66Loa�r L �iC 2r�f �(n,—ret A014 1700L-4 Klrt fod� r£N.PS .'1J4c>Lfks6r1f ft( P.bll GtC Discussion With Person in Charg&-T#*tdt 1774- I Corrective Action Required: I ❑ No I ❑ fes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ?n^� � {/„ ❑ Voluntary Disposal ❑ Other: ?-SU L!Z!((,) PHFs Received at Tcnilwralures Violations Related to Foodborne Illness Intervorrhons and Ris5 According to Ido Cooled to Factors(items 1-22) (Cont) 41'W45`F Within 4 Hour, PROTECTION FROM CHEMICALS i 3-501.!5 Cooling vied!ods for PRFs 19 PHF Hot and Cold Holding 1.4 I Food or Color Additives 1-SOL I6(H) Cold PHF.,Maintained at or below 3-207.12 Arfduil:xs'� 590 J)04(F) 4111150 P, 3-102,14 Protection hom linaporo,-ed Additives° I 3-501.I6(1) Hot PHFs Maintained at or shove 15 Poisonous or Toxic Substances 140_F. 7-1(1.11 ldentetpmg Information-Ougina( 3-5(:L 16(.`1) Roasts Held at or above 730-F Container 7102,1 I Common:'v:+n:e CJTong i:onlaii rs :+r'_' ( R 0 Time as a Public Health Control j j 3_-;01.:9 Time ae a Public Health Combo!* '_01.11 Separation--Siorage" 7-202.1 i I:e,tri:.icon-Pi sashes and 1Jse" i9U,Q0a.;H1 V.:r.anee Requirement 7-202.12 C"aldrtionc(S❑se' 7 203 11 'F,;x:c Containcr5-- Prohibitions REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 704.11 Sanitizes s,C:iterin POPULATIONS(HSP) 2£ 3-801 IPA)l,A) Unpnsteurizcd Pre-packaged Juice,,an([ 7-'_04.11 C;?c4:;cals for 1Nashut!z}r�dnce. t:ntera _ F3everaees with Warning I libels- 7-201} 7-^. Dtging Agents.C'riter�a" I - of - ' � 7 205.11 Incideni:a Food Contac:,Lnbucnrvs* I 1 --go],I l(Hi Use of Pastentized En,r' 7?06.1 7 Restricted Usr Feseicldcs.Catena* 3-SUI 11(D) Raw or Partially Cooked Annual Food and i Raw Seed Sprouts Not Served. = I 7 206.12 Rodent i9aa Stations, j 3-4U1.11(C') Unopened FoodPsc7;acre Not Re-served -- 7.206.13 Tracking Rnvdtr>.Pest Control and j -- Monitoring* CONSUMER ADVISORY 2', 3-603.11 Consumer Advisory Po,ted lin Cnnsu!nptrun of TiMElTEMPERATURE CONTROLS Annual Foods'I'hat ucc Raw,Undelc,;oked .r 16 PraPar Calking Tzmperaturss for ( PHfo Not Otherwise Procemed to Elismnate 3-401.11 AnH_'1 Egg:- 155=F IS Ser Patho,+ens.^ erg,rm +.,.Poor Eggs lumtceliate Service 145°171Ssec� 3-102.13 Pasteurized F.gf<Substiotte ibr Raw Shell Eggs. i 3-li)1.t1lAi(2) ConuuumtedFish, PArasw.G::ale i .4rrintais- 155-F Rs sec. 1' SPECIAL REQUIREMENTS 3-4UL11(B)(I;!2) Pork a:,d Hee} oast- 130'E 121 ntin'' 3 401.1 t(A)(2) i2at!tes. btiected Mcat,-- 155'F 15 590.0091A)-(D) Violanonr: of Section 590.009(A)4Fj) in catering. mobile fixrd,temporary and -4Ul.i i(A);3) Poultry,Wild Ciantc,Sm;Ted PH!s, residcntiai kitchen operations should he Stuttin,g,Containing Fish, Meat, debited under the appronriate s=erious Pouluy ur Ra:itcs-165°!r 15 sec T' above tf related to foodborne illness 3-0!.1;(i")(=) Whole-ntnscle,huacr Beef St:a'ss interventions and risk factors. Other I 145°F" 590.009 violations relating to good retail 3-401.12 Raw Anmsai road,Cooked in,,) practices should be debited under 829 - Microwave 165'F" ( SpecialRequiiem;nrs. 3-x01.1 VA.)(I;(b) .All Othcr FFIFs- I.15`F iS ;cc. ' 17 Reheating for Hot Holding j VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 403.11(X)&(1)) PHFs 165'F I_i Sec. * (Itetias 23-30) 3-403.11(b) bfivrvave- 165°F 2 i\h+nute Standing Criucai urrd non-rrilicai vu;latmn.q r:kn.'h do not relate to the Tiu:efoodborne diness intervenirum.unci risk fac torn'hoed obove, can he 3 403.11;(7) Comrnerciallp P(niessed RTE Food- fo.od in theJnllm'ing.sections of the Food Code and 105 0I.R I,0°F" 590.0(4 3-401111 E) Remaining I"nshced P:��rtions of Heer item . Good Retail Practices FC 1580.000 I Rnacta•: 23. Management ane Personnel FC-2 .003 lg Proper Cooling of PHFs I 24 Food and Food Protection FC-3 ! 004 25. Equif rr;net and Utensils FC -4 ! 005 '-507 i 4(,A) Cooling c olxa PHFs fro:. 1,10'F m 26. Water.Ptumbino and Waste FC-5 : .006 l 701° NValtin 2 [icor,,and Fro:u PIT 27. Physical Fac:lily FC-6 .007 I w 4!'F/45"F Within 4 Hot:rn. ' 29. Poisonous or Toxic Materials FC-7 .003 3-501.14(Ii) C:rtirg PHFr Ala& From Ambient ( 29 Special Reouirements 009 '£empeiatute htgiedient;to 41'17/45"y" 30. Other j Wrtlue 4 Hrurs° •;:11111,:r+.-z a.,< 'Dem ilea ci v aal h ;n.in the f dna al 1999 F:and Cate or 165 C i11R 590 nor. Aug-03-04 04:08pm From-D P H FOOD AND DRUG 617-883-6710 T-416 P 01/02 F-858 MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH DIVISION OF FOOD AND DRUGS 305 SOUTH STREET JAMAICA PLAIN , MA 02130 ( 617 ) 983 - 6712 FAX ( 617 ) 983 . 6770 FACSIMILE TRANSMITTAL SHEET FROM To 'L' jl�y_ ✓n„ r. KIM FO/LEY,R SI�,J((617)983-6747 GOn°��1'7" ��i It)7 ((•�(' DATE FAX NlMb��1 � � � TU'lnt NO OF IOAOE3 INCLUDING COVER PHON11 NLat8ER f SENDER'S REFERENCE NUMUEX RE NOUR uu.liteN{P.OUBRR 0 URGENT o FOR REVIEW Q PLEASE COMMENT O PLEASE REPLY ❑ PLEASE RECYCLE l Sus 50U)'H Sl'XEE7 JAMAICA PLAIN, Mn 02130 (617) 983-6713 (617)983.6770 PAX Aug-03-04 04:lOpm From-D P H FOOD AND DRUG 617-883-6770 T-416 P 02/02 F-858 Massachusetts Department of Public Health Division of Food and Drugs 305 South St. Jamaica Plain,MA 02130 Ph(617)983.6712 Fax(617)963-6770 Complaint Number: 04-137 'Date of Complaint 8/3/2004 '•_••-••-•'_'•_••–'............. _.............. Fooaoorne ulneas'1 [:1 it Yes Fill owl F000mrne Inness Fort Form of Complaint Telephone Source of Complaint Consumer (Complainant Name Anonymous Address. ❑ OK to give Owl Phone. Names to company Notes, Descnpken of Compra.nt: Complainant states mat line and daughter went through drive up wnnddw at Burger King On Mrgnleno Ave.. Salem.MA and when opened sandwich they had a Dug rooked into their sandwich-They returned the sandwich to me restaurant and spoke with the manager. Nature of Complaint. Adulterated(Foreign detect) ❑ Vistula"slid Care Provider Visit Date Name of Provider Product Information Product Brand Name Category. Product Name' Product Coae/Senal Numtrer: Product Sd:e/Weignt Package Type Sell By Date UPC Code E,rpoauotvBest used Date ❑ imported Product Date of Purchase ❑ Product Used -Date Used Amount Remaining Estruuanment Where Purchased I Manwfactureo By �Dmtr.Ouwd By. Burger King — — Wgnlan0 Awe. Salem MA Phone, Phone. I Phone. Complaint Received By- KF Referred To: LOOM Phone Numour (617)883-6717 Comments: Dispds�uon Page 1 of 7 Massachusetts Department of Public Health Salem Board of Health 120 Washington Street,4t Floor Division Of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax(978) 745-0343 Name Date/ /� I Tvpe of.Ooeration(sl Tyge of Insoection 2 e-.rF R rt2 elnvl''C b 2-5-ood Service ❑'Routine Address Risk [j Retail L] Re-inspection2- g 4'tir idi a✓(1 q lid I Level ❑ Residential Kitchen Previous Inspection Telephone 7�,y , 9W,ry P El Mobile Date: OwnerI HACCP Y/N I El Temporary [IPre-operation P I-) T' A A/'- ut/.N�l / AI i✓C. ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) I Time El Bed&Breakfast El General Complaint -7,f lftln F> u In. ❑ HACCP Inspector "„f"A,'A / N -4a . /rt. n iin,AJ0Z I Out: Permit No. El Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands El1. PIC Assigned/Knowledgeable/Duties 9/13. Handwash Facilities EMPLOYEE HEALTH E] 2. Reporting of Diseases by Food Employee and PIC PROTECTION FROM CHEMICALS E] 3. Personnel with Infections Restricted/Excluded El 14. Approved Food or Color Additives FOOD FROM APPROVED SOURCE [:115.Toxic Chemicals ❑ 4. Food and Water from Approved Source TIMErTEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION 19. Hot and Cold Holding V8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) E] 10. Proper Adequate Handwashing EI21. Food and Food Preparation for HSP ❑ 11. Good Hygienic Practices CONSUMER ADVISORY ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions vt C immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR ofd eaNh. 590.000/federal Food Code. This report, when signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an f?4. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils cited in this report may result in suspension or revocation of (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you /27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (Fc-7)(590.006) and submitted to the Board of Health at the above address 29. Special Requirements (590 009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: S WMm dFo�14 ea jam! _ InspeI r' Si natu Print: WIC's Signature ii1; 0 Print:-7"7,�,�� ,C � �'�l ,T t_� rte. Page)of 3Pages 0 Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) P40TEC-1ION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT I I Cros.=-conta�.mnatvn I 59U.0tJ3(a) Assignment of Responsibility I 3'02.11tAr(l) Rav, Animal Fonds Separated toxo 1 590.0030 Demonstration it Kiiowledp,e' I C.,oked and R I'E Foods* __ 1 2-103.11 Ferson in charge - ioa!es 1 Cont.%minmion irem Raw ingred'ents 302.11;A)(2) Base Animal Foa::;Sepnrs:.d from Each EMPLOYEE HEALTH Other` 2 590 003;{'; Re.;ponsibiliiv nt Il:e p:v:•on in ch.uae to I i:Jn..n7fna8on iron the E,,*ooment requite repoiung by fork!employees and I -io:.111A) Fond Pro'•cdiou" 1 applical u•'" 4b ashiur<Frnits and Vey;:ahies 59RUU3("1 Rcspon,ibility Of A P!nxi l:mpio..cc Or%,n 3-?iYl.1 l Food(::mart w:Jt F,quipmer•: and Al)pl temp 1'u Report To The Person Ch;n'ee' Cunfamination from the Constrracr 590 00316l Rceortia�,ltv Person in Charee' R,.aiumed is MA and Rct.ervke of Food" 3I 5`1;).(N13:D) 8>ciusuwsandGestrctinns* DNposWoncrAdultarateNorContaminatau I 500.:)09(F7 Reuruval of E,clui,nos ;nd Restrictions Discardi:-or Rec:a�ditiurang Unsafe FOOD FiOM APPROVED SOURCE Food ` di Foodand Water Frern Rortultted Sodress ! I9 Fcod Contact Surfucec 590.004tA-S) Compliance with Food ?_aU-" 14-SOi.I l l )-huma!'eL aernrew_shmc-Hot:\'alcr .) • SZni?ization Tneratures': �-201.12 Pond m.:Hermetical)\ Scaled C'�•ntam:rx' - ?01 1,, Fluid Mal.aed Milk Products." I 14-501.! i2 Tvfe.henical Warewashing-Act Water Sz:iaiza6:m'i'c::, t riures' -20 .13 Shell Eggs* i 4-50i.i i 1 Chemical Samneatinn" temp., nH, i 3 307..1 d F;exs and Milk P.udu_ts. Pasteurized:° untcc:'sran�n and harrSness 3-,.o2.15 Ire Made From'Pitiable I?rnkine Yater' 4-(;6:.? 1(A) Equilua ni Fotxi Contact Surface.and :i i01 11 Drinking Water tro:r,an Acproved Systeu: .4) ;;Dale: Dnnl.ieyt 9Jmer.' ( taensils Cleain' 4-602.1! I Otn:n_=re-u,acy tiEi.!ui}mentN;wc _ 590.0053) 'W.,urr Mecrs Shwdard,in 3i0C22. :' Contact Surtacc;and U'cnsilsr 1 5hell/rsh and F%sh Frn•r an Aoprr.•red Sonr<:r� 4-703.1 Frequ,rev of Sanitiz:,+ron of Utensils and ` ?"20!.14 1'i,h and Recreationrllp Ca, ,ht Mol-h.scan Pond Contact Surfaces of Fr;u:nmrnt* Shell;kh" 4-703.i: I Methods of Sam!ezation-Hot Crater and 3-201.15 Nfoltut can Shellfish from NSSP Bernd I Chemins!* I Sources* I i Game and V.1i.'d t fushrooms Approved by 10 Proper.Adequ:to Handwashing He9Nafory,'-•uffiorih✓ I "2-30 i.i Clean Ccndiil,-.n-Aamds and Anus' 3-202.18 .Shclkto(6 identrt:cation Pre,ent'. ! 2-301.:2 L-eanin;;PmceJ::re' 2-3,:1.14 LMhen to LGash` 591-0104(0 L'ylidA9udtmonts^ i I 3-201.17 Cian:c Amrnals r ;E Good Hygienic Practices $ Receiving/Condition I -�JI.II baL:ee, DrrLma er Using Tohaccw: 3-202.11 YHFs Re:,etved at Proper Temperature:* I ?1.12 Dim harges Front rhe Hy:s. Nose and 3-202 i5 Package lnterrity7 ( iviocih^ z-lul.11 Food Sade and Unadulleiated r ( 3-301 12. Preventing C,-+:tatciaatr-n When lasting* 1Prevention o'Contamination from Hands 6 Tags/Hecoras:Sttelistock ( 1 1_2 I 201 t# Shtkstock identification* ( 59o.UU4;Li i'rece;ttu:2 Couta:mnanoo; from 3-2W, I' ShellstockId.-nti`:ration Maintained` ( Entpk>)ecr, Tags/Records. F:ell Pr'Jvucts 113 I Handwash Facilities I Ccrve,vnty Loe, end and R•^cesvbk 3--402 J 1 Patasiu Dcstr.:ctinn' I 11 13-407 12 Records. Creation and Retention* -2r3 Nu:nbers and CaPa.mrs'. 590.0(14:3) Labeling of Inoredlents' i 5-264.11 1,Dcaitur and Placement'* ii =05 I ( Axe<sibilnv.Operation anJ:Maintenam_e q i Conformance with Approve:,Procedures I MACCP Plans ( uppheo w•th Soap and Nand Drying Oovires ?-S:J .I l Spedatized Processing ivicthckl5"" I ' SU2.1? Reduced oswen pacl.,.r'ing,cnterii, 16 3;:1 1 I Hi udaashinc Cleanser,AvailaLtlity I 9-iO3.12 Cratfotmance•with A;;pivve:i i'ro,edure>" 1 ( 6301.12 Hand Dryina Prrolr:!,n I 'Deni Ics critical acm is ti:e lei e:al :'d911 r(v'd Code:a 10:)('MR i9CA001 L CITY OF SALEM BOARD OF HEALTH Establishment Name: �'�iAgele l4'- / -/ ✓� Date: off- /6 - 01/1 Page: -�2 of 3 ' Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified I PLEASE PRINT CLEARLY /_7 c'v�i/+•e _fir-e� .�n/P rri e P _�,S/0�7�t9d> ,�I/o�elfr �P /-�GGb�i/liD /Ur, t3r7,;I/ SCCOO 0 t"/;�i� //'49 miv.-4-t-, �i O/� �J/ori P ( /-A/,S/De- /4WA; O /I /,L � ,SiriZY/L Gl if/nGrr/PDQ' ni" P//aCD/� �4picQ ;/ /64yeeS/fOIc� / r `� I - ��`��SPS r -,� /'r'//„9 /P x,r ee/ _Q�, 7 / 16,-- S,Pd 20SIZ9P dmW GUaL// 1A /f"-FWio s,7 -Xe,e -Is- - /� 6r P /�1�/ Pi�e�u i7c Zfa/� /t/pw�/< r/ Lc /�ccu,Ea }�PPAyiyi r-A °S I '/9 I /'� I ' J'l?a!/�sfilisc /N r''Ci9GPi./iera t" 7-/•U! �/� C� 7`�74'Ip DF G S l I of Ko ;G— —Ze Z�S r?isca -de/ rr /see cr6e11e ' I /3 c I" �? r s /iodrri 7Y7/4Si v9 S/�N GP�L�7�1D/d�/r'�S �I c,5 GUa�i f� : a I I — I Pro �cA s/vA-rvr,vy t a7 /� I- 1adiPs !/Y�rnrn l nc/ "e-e a,,cle4 /.v/e aG '/,/i� J�,�1r/1r..'<eZ, sA �per'o117C Z9 , n, oti�� ;/a v2 r4-ze4 I C Discussion With Person in Charge: Corrective Action Required: I ❑ No I ❑ Yes � t I have read this report, have had the opportunity to ask questions and agree to correct all L3 Voluntary Compliance ❑ Employee Restriction/ a Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension _ -comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure t+ your food permit. { iCA, CG, L! G ❑ Voluntary Disposal ❑ Other: .3.S61.14(C) PHFs Pcc::\td at Trtnperaturet Violations Related to Foodborne Illness Intervartiors and Risk X_coidin::to Lae Crwlcd to Factors(items 1-22) (Cont) I i'1`745'P Within 4 How s. " PROTECTION FROM CHEMICALS 3-50!.;5 Coohn4 9:L:cclskxFHFs j 19 PHF riot and Cold Holding la Food or Color Additives I-S01 trill;) Cold FI4Fq Maintained at or below 3-202.12 Additives* S1)0.0(;4(F) 11'145 '1-3021 Pry,tectioafroutUnappiot.dAddib%z,` ? ;--01L10(A) Hot?ill-sAlamrar:zdat orabmc ;5 Poisonous or Toxic Substances I40'P > ?-101.11 Ideninvo,glnformation-01iginal 3.51;1,16(A; RuagsHeld aro: a!wve 13:1'I'. Containers' l tic Health Control 2i, i t iasis US 2 Pub,tic 7,-102.11 Cunvuon Nana; - t44trking Containers* 3-501 19 Time as a Public I-1-elth ConiroP` 7-_61 11 Separarkm-Scor ge" 7-202.11 Rentrietion-Presence and Pse'^ 590.004(H: \%anane: P.rdniro!'dent ',--'.02 12 Cr•.ndu¢ats"i Pse' :'QU3 1 I Toxic Conrrinzr:-Pn Prohibitions REQUIREMENTS FOR HIGHLY SUSCEPTIBLE uPOPULATIONS(HSP)20-1.11 Sanitizers.Criteria--Chemmats* 21 1.701.1 (A) tinpaveari:e d Pm-p:;ckaged`rices aid2J4 L Chemicsis for Pashtk Fnr;hee;Crn;ria 1 Bece::nsts with Warn:n; 3a:hrls' ?-20.4.14 Dr pins Agent.,Criteria* ( ;-t,01.!:(b) Use or Pasteuraed 205 11 hicrdental Food ('onrad, Lubricant," 13-861 1!(Ell Ruin n Partial]) Corked Animal Raid and 7-206.11 Rct.trieted Use Pesncidc<,Criteria" I I Rau Seed Sprouts Not Served. r?06 12 Rodent Ban Stations' ( i-KUi- ; C lhtonted Food r 7-206.13 '(rackirw Powders, Pest Control and ( ( ) I ' od Package No Re-served D4onitunizgT CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-003.i 1 Gmsun:er Advisory posted for Cnn.unzption of Aminal F,exls ]'bar niu Rau-. Undercooked ut ]fi Proper Cooking Temperatures for PHFs Not Otherwise Processed to Eliminate _ Patntv * -;" ; .aoo, 3-401.11Al1)(2) Er,s- I>5'F IS Sar c Legs-Imm:dune sereice ids"Flaw:. ! "361,1; Pn steurized Egg::Substitute fin Kin Shell %4ul 11(A)(2) Comminuted Fish,Meats &Garne Animals- 155-F 15 sec. '. 401.1l(B)(I)(2) Poll,and BeerRoast- 130`FI21riliv, SPECIAL REQUIREMENTS 1 3 +OLII(Ad2r Ratires, InjectedMears- 155"715 590NOC(A)-(D) ViclulivnsofSection590.009(A)-(il) in set. . ( catel ng,mobile food. temporary and 3-401.11(A)(3 i Poultry,Wild Gaul_Sn,ffed PHFs, residential kitchen operations should be Stuflinq Containing Fish,Meat. debited under the appropriate sections Poultry or Ratites-165'F 15 �c , " above if related to foodborne illness 3-461!1(12)(3) Whole-muscle, intact Beef;teak; interventions and risk Factors. Other i5'F 1 590.009 violations relating to pod retail 3-401.:2 Raw Animal Foods Cooked in a practices ctiould be debited under#29 - Micuzwave 165-F* Special Requirements. 3-401.!](A)(1)(b) At I Other PHFs - 145•F 15 see. j 17 ( Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL-PRACTICES 3-403.)1(A)&(D) PHFs 165'F IS r;ee. " litems 23-30) 3-403.1 I(B) Microwave- 165'F 2 Minute Standing Ori4o;1 r„ru,,,,rx-,-riti<:+[oit,!wion,s, which do not relate in the TitnO, kr-dnorne dLres's inlemrnrions and tfrk iurror,hs+eu cbrn r, crz,r be 3-40".1110 Conuueru.dly Pia essed RTE Food- (onmri in rhe±ollur Ing ser uo,rs nlT/xe Four!Code and 105 C:YIK 14617` =10.000 3-403 1 1lE-i Remamme I%n<hced Portions of Beef .'tem '; Good Retail Practices FC 590.000 Roasts' 23, 1 Management and Personnel FC-2 003_ ' �-_---- 2a _ 1 FOW and Fcod Protection FG--3 Ona lg Proper Coaling of PHFs 25. j Equipment and Utensils FC- 4 ,005 I s01.!4(A) Cooling Cooked Pll7s Dorn ].16`17 to 2g. Wates Plinibincland Waste FG-5 009 70'F Within 2 1 tours^and From 70"F 1, 21. I Physical Fadlitv FC -6 .007 to 41'F/45'F Within a Homs. * 28. Poisonous or Toxic Materials FG-7 .008 3-501.i4(B) Cooling PHFs Mad, From Ambient F-9. Specia Requirements - .(t0� Tnnmcratnrehz,nerhentsN^1`17/45"p ; 30 Other ----- -- -- Wnlon 4 Hours" *Denoh,,rrincid nem m 0re'federal 1999 Fuad Code u: I0�C:\ik CITY OF SALEM BOARD OF HEALTH l `� :t Establishment Name: QC��GLF>e ��^�� Date: Z/)/D/D'/- Page: of 3 `- Item Code C-Critical Item DESCRIPTION OF VIOLATION f PLAN OF CORRECTION Date ,[ No. Reference R-Red Item �q PLEASE PRINT CLEARLY Verified r-etc, I �/VIE/ctrz ,CIrnL 4/1C) 2 [9PS_x1 />X_,5_aJ A f- - HZE 13 0 S"H( - 3-�E t9- c) Ar /'F 1 1 I I �Rfieic-ri 6- d- r0ts21A r� �4sr:b� '�• I 1 ` I kIlk";F_4AV fIn0 1 --Fod n rr'4-AIRY 1 t ✓J��ozoN _S N f^rfftatnr�_ � I { I 1 I' Discussion With Person in Charge: Corrective Action Required: No Yes G oee I have read this report, have had the opportunity to ask questions and agree to correct all ° voluntary Compliance ° E clusion Restriction/ violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of L) Embargo El Emergency Closure t, your food permit. f} P ❑ Voluntary Disposal ❑ Other: w �l F 3-501.1 yr(.:) PHFS Ret.eived at Teniper,aur:s Violations Related to Foodborne Illness Interventions and Risk Accordin,in Laic Cwled to Factors(items 1-22) (Cont.) 41"F/4>'P Within 4 Haws ' PROTECTION FROM CHEMICALS ( 1-501.15 Coohna Methods for PF1Fs � 14 Food or Color Additives 19 PHF Hot and Cold Holding 3-202.12 :ldditivert 3-501 16(B) Cold PHFS Maintained at or below' � � i90.004(F) 41'/45°F 3 302.14 Protection from I Inappiovvd AdditiNes I 15 Poisonous or Toxic Substances 3-501.10,tAi Hot PFIFsNlamtainedato, abane 140`' '1 1-101.11 IdentreInformation-Original I ( fytn I :_50 L 161A7 Rnas[s Held at-or abo,e 130NF Containers' 7-102.11 Common Namgc-WorkinContainers ( 20 Time as a Public Health Control 7-201.11 Separation-Storage" 3-501.19 Time as a Public I-tealth ControP 7-20111 Rcatriction-Presence and Use" I i .590 00x4(11) Val lance Redufrenteul 7-202.12 Conditions of Uso^ 7-?.03.11 'Toxic Cnntainers POP -Prohibitions* ( UFOR HIGHLY SUSCEPTIBLE 7-"_'(14.11 Sanitizcla.Cntelin-Chemicals* I POPULLATIATI REQUIREMENTS ONS(HSP) 7-204 1'_ Chemicals for AVa;hing Produce,Criteria" 121 3-8OL;l(A) Unpavper.zed Warnckaged Juices and Beve:aces tv,ih ltiantinI(Abels"` 7-204.14 Daring Agents.Criteria" 3-501.1 i(B) Us-of I'.;steurized Lg; s' 7-205.11 Incidental Food Contact,Lubricants" 3-S01 11(D) Raw of Partially C,k:ked Animal Fa(Ki and 7-206.11 Restricted Use Pesticides,Criteria` Raw Seed Sprouts Not Servcd. 7-206 12 Rodent Bait Stations' 3.801.i i(C) lhu+pened Food Package Not Re-creed. " 7-206.13 I Tra,.kir,Powders, Pest Control and Monitorm,* CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-603.11 i Cunsuuter Advisory Posted for Consoniptiun of _ .Animal Fo,,ds that are Raw, Undercooked or 16 ( I Proper Cooking Temperatures for Not Gi herwise Processed to Eliminate PHFS 3-401.1 1 At 1)(2) Eggs- 155''F 15 Sec Parlay*,ens.T Eg;,,- Immediate Service 145"Flisec- 3-302.13 Pasteurized Eggs Substitute for Raw Shell 3-401.11(A)(2) I CotmuinutedFish. Mears f.Crame I Fggs* An+nnds- 155'F 15 sec. SPECIAL REQUIREMENTS 3-401.11(13)(^)(2) Pork and Inef jected MRoast- 130`5 121 rnuY` 590.009(A)-(D) Violations of See(ion 590.009(A)-(U) in 3=LUI.11(A')(2) Ratites,Injected Meats- 155'F li catering,mobile fitod. temporary and 3-401.11(A)(3) Poultry,Wild Game. Stuffed PHFS. ' residents) kitchen operations should be Starting Containing 1-lsu,Dieat. I debiied under the appropriet,se, tions Poultry or Ratites-165'F 15 sec, above if related to foodburne illness 3-401.11(C)(3) Whnie-muscle, Intact Beef Steaks interventiona and risk factors. Cather 1450F H. 590.009 violations relating to good retail 3401.12 Raw Annual Foods Caked in a practices should he debited under #29 - Microwave 1659=* Special Requirements. 3-401.11(A)(1)(b) All Other PHFS-- 1451' 15 sec. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403A I(A)&D) PHFS 165''F 15 sec. ^` I (Items 23-30) 3-103.11(B) Microwave- 165°F 2 Minute Standing Critical anti non-crincul violations. which do not relate to:h,, Times` I �Ioodhorne illness bitemenrinus arms'tisk factar, lsted above, Cali be 3-403.11(C) Commercially Recessed RTE Food- found in the JoRowing se<zints tf the Fond Code and 105 CAIR 140"F* 500.0(k). 3-403,11(E) Remaining Unsliced Portions of Beef I Item Good Retail Practices FC 590.000 Roasts* 23 Management and Pei sonnet FC-2 .003 13 Proper Cooling of PHFS I 1 24. Food and Food Prot+rfion FC- 3 .004 j 25___ Equipment and Utensils 1 FC-4 .005 3-501.14(A) Cooling Cooked PHFS from 140'F'to 26. W ater, Plumbinq and Waste ! FC-5 006 ----- 70'F Within 2 Hours and From 70 F 27, Physical Facildv I FC-6 .007 to 41"F/45'F Within 4 Hours. ' 28 Poisonous or Tcxir,Fdaterials FC-7 .008 3-501.1=(13) Cooling PHFS Made From Ambient ( 29.--- Special Requirements Temperature ingredients to 41'F/45"F 1 30 Other W ii(tin-1 Hours:, °Drnole,eiifiael nun in the federal 1999 Food Code of 105(J:14R X90.000. Massa6husetts Department of Public Health Salem Board of Health ' 120 Washington Street, 4'h Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name- Date Tyne of Ooeration(s). Type of Insoection / X Al G 62 I Er Food Service �1outine AddressRisk EIRetail QRe-inspection o 697 Level ❑ Residential Kitchen Previous Inspection Telephone 1 /� ❑ Mobile Date:a_// -d Owner / / HACCP Y/NElTemporary ElPre-operation 7�'? j/yyj�j� , v�- I El Caterer El Suspect Illness Person in Charge(PIC) -r Time ❑ Bed&Breakfast ❑ General Complaint Y Fp�g /�Ai✓eaLan a l7srt Ji1r� In: ❑ HACCP Inspector 4 Out: Permit No. El Other Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals FOOD FROM APPROVED SOURCE ❑ 4. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling / PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑21. Food and Food Preparation for HSP E] 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices CONSUMER ADVISORY ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code. This report, when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (Fc-z)(s90.0 order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.0044))) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: 5 501 Vs tFom 14 dw n r �t,, ecto Sigi ur J Print: C-- sr .r'- 11 , �s�/./fin kr4'. PIC' ignature: Print: / Page�ofz2 Pages .sr �Ar �i4 �sFwt ?Rn�co-�rt� r Violations Related to Foodborne illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT j a iloss-conic ,inarron t 590.003(A) Assignment of Responsibility'" 3-362.1 it A)(:) Rain Aniin.r Fonds Separe;ed from 5o0.003(B) Demonsir.aion o'Knowledge" Cooked and P.'1::Foal;:_ 2-103.i l Pelson u:charge- duties Conramrnaaon niom Flaw ingred,ents -302.1 ItA)(2) rtes. Animal Fonda Separated from Each EMPLOYEE HEALTH Other 2 59U.0031c) Rcsponsibi I it y,$the puim'n ut ch,.:^ei flrmn the E,nvirorrreni require reporting by food employers.+nd .S-3{12. UA) ivixl Prv'tectiow' applicants* 'A'1;)2.1 it Washing Frwis and Vegetables 596003(F) Responsibility Of Fo,v9 iimpio}ee Or An 3-;03.11 14tiod Con!act with F:ququnen! and Applic.mt To Repnrt To I lie Porscu In Utensils* Ch irec" Cnntammz'ion foo the Cen^urger 590Jiii16) Reporting by Pet;ainilk Charge* 3-300.1:(.'•J(iii Retained Food sedReaci,.iczofFood` � 3 5c)0.003:1)) .u.lusionsandResudc!;oni" j ( Disposi!ionotAdulterated orContaminated 500.00',(FiRenw,alofExcluso-aan4iResir;dione. Fold 3-701.1i Diaca,dirl R con,lonar:na ltncafe FOOD FROM APPROVED SOURCE Foo 4 ' Food and Water From Regulated Sourros + 9 Food Coma.t Surfaces 590.004tA-B) Graiiliance with Fuad Law t 450 It I M!ujoal bVare•.vac,: ne..Hut Water i-201.1: ! Food in a Hermeticail} Sealed Conta;ner* ! Saniliration 7empzrahtres' 320L1 j Fluid Milk and Milk Products° ( G-SOLI1Z k?rchau,t al 1lrarewshinh I-fot Wnier ! i Sanitization Temperatures* 3-202.13 Shell Hggs:' 3 '_12.14 Eggs and Milk Piuducts.l'astct!rized' ( 4-50'.:1- Chemical Sanitization-temp..pfl, ?-20'.16 W"atei" conozi n i1na:.:nd hardness. _ Ice Ilinde From Potable i)nnking UI.I l Drinking Water fr,in an Artirra•ed SyAem„ -1 60 i. !(^.) Equipment FooC Centart Stn face,and : u,ei:,ill clean" 590.UtkiiB) Zi.r�lai iJrinking�V"atei'' ( 4 001.1 i Cleaning Frequercq of Egcipm.n, F(xxl- 590 UU6(it) .'-ter 41e;is SLurisuds in 3PJ C?v1F:22?J"' ( Contact Surfaces all Uten:;ilav Shells`and sh From nr,A?prover'Scuron i-li11.(! Fretlurncy of Sanitizateon of Uteu:•:!s and 3-101.11 Fiah and Re reationellJ C::ught i ,Ah.isc�n iFoca Gmtact Surfaces of Equipnient' S!zelliish, i . 3-201.15 Molluscan Shellfish from,NSSP I.ieted V-"�= I1 I+lcthndc,.f c; nuzatinn-Hot Waterand Crrenucal'' j Sourced` Proper,Adequate Handwash:ng Game and NPod Mu:mrooms Approved by Regutatori,Authady 2-301,11 Cl;sn Condition-f lands ar,d ,Gama* ! d 2-301.12 Clenrrre,Pro,-edure` 3-203.18 Shei,ctrct. P entd:eattou PresenP` 590.004(C) Wild Muahrnorm' 2-301.2=: When t;,Wash, 3-201 A 7 Game Adrmnls* Good Hyq!enic Practices � 5 ReceivingrCondition i 2401.1 it Eaiin$.Drinking or Using Tobacco' '• n--101.12 D sclipre-s From the Eyes, Vnge ce :,-202.1 I Pt{t=;Received at Peop;:r Ten:�peratnres." � _ �d 3=202.15 Fackaae httegrity` Mouth -_-- "s-3331 12 Preventing ContaminationTastimi' 13-Pll.Il Food Safe and Unadulterated" l i;,cn _ -� 5 Tags/Records•Shallstock ( 31 Prevention of Contamination from Hands 3-202.13 Sheltsux;k Idr:nt:ficrtion 590-1)"1(2), Fircventing Contamination frunr 20J.12. Shellsta_h]dentific.:tion Maintaitic:i'" Entnlo}ees' 13 Handwash Facilities Tags/Records:Fish Products Convsnie.•dy Cncated anr,'ArrPssible 3402.1 Pteltsite Destrur!on' `<_�,�; !• i t: i 3.-102.12 Rec,v,d;.Creation and Retentum" j 1 - i Ptun:bers an:.Capaci es^` `90.001(.1) Laheling of Ingredients' ! 5-"(A.I I Locative and Placement* 2':.5 1 ( Acee.e:abifity.tlper;;'u,n and Via:retenance 7 Conformance with Approved Procedures /HACCP Pians ; � Supphed kath Soap and hand Diyin 3-502.11 Specialized Processing Meth'xls* ile1r`e' 3-SD2.12 I Reduccd oxvgr»packa>:mg;enteria" ( b- itl I I Hrn�hrashiny.Clan;er,Availability 8-103.12 Conformance•.vith Appri,ved Pi exedit,e " ! .,-301 1'2 Hanoi Omni,Pm:i:;ion -Denairu critical ae:n i,tae to boil 1999 Fol r!CWie,., ;Un C-tlt.`90 poo '4 CITY OF SALEM BOARD OF HEALTH r ti Establishment Name: Date: Page: Item Code C—Critical Item v DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item r Verified r'1 PLEASE PRINT CLEARLY /., C f r � iL� /il Y v /fGL v%�1i7 Wim/s nr ✓s.! � v a- /iso /vs�� r��"z �2n/c � ve F ' I - I " - I I v I I I I •� I I I I I I I x p I I I Discussion With Person in Charge: Corrective Action Required: I ❑ No I ❑ Yes have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion s %,omply with all mandates of the Mass/Federal Food Code. I understand that L) Re-inspection Scheduled ❑ Emergency Suspension noncompliance may result in daily fine tweyty, lve dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure our food permit. 1 I ,your /l 6�nK �Ji/cz2c/""�-� _ ❑ Voluntary Disposal ❑ Other: e 3-5WA !(C) PI•.F, Recei red a!'fe:;;i:eram'ac Violations Related to Foodborne Witess h,tervenpons and Risk Arc coling to I:rev Cooed to Festers(Items 1-22) (Cont,) >I Fit 5'F Within a F;:.us 1 3-50i.:i Cooling Nimhods !:e'Piff. PROTECTION FROM CHEMICALS i4 Food or Color Addtiives 1 i 19 PFF riot and Cold Holding ' 3-501.1E 131 ( + id PHI's Maintain.-1 a: or below I 3-207., Additioen 3-302.!4 Protoctianthanlhta+,. 0 1 5`t`)')')4(F 4!;'45^P' j rpr vee ldditr.+c?' j 13-501.1',A H:c PHFs a 4 s Mt:i radins'd.tt -.,r above Poisonous or Toxic Substances ' 7-10i.li idenn ti!}mg Information I 3-501.1540 =t Roar Hr!d at of •ibovv 130°1: Contan:et5" i 7-Ili_'.l! Conuuun:tante -�Vorkinp Can ainets� 1 2p 1"ime aaa Public Health Control 3.01 1) tune as a Public Health cunt-JP` 7-201.11 S:paration-Sturaze` 1 7-207,11 Rearict+on-Presence and U'se' j rJ0 004(Hr Vara:::ce Nequirent�at 7-_u2.12 Conditions of lase" 7-203 11 Tunic Containers-Prohibitions'. REQUIREMENTS FOR HIGHLY SUSCEPTIBLE i ?64.11 Sanitizels.Criteru,-Chemical,* POPULATIONS(HSP) 2t 3-fi01.11.'A) Unpa eur:zed Pre-packaeetl luicei and 7-204.12 Chenucxlt, for Washml Produce.Criteria^ j - + Brrera:�ec wtih WarninI 1 abela* � 7-204.14 Divine A;',etns,Cr;feria"' ! 3-801.1 F:E) Fice or P;stemize.!Egos j 7-205 11 Incidental Foul Comact,Ljtbucams 3 205.11 Restricted UsePecrerde Criteria �t11 i I(D) Row of Partially C'tmked Arun:+! Fax.l and 7--^_Ob.12 Rodent Hail Stations'' ( RaN ericA SmeaSllr- frs cka Served. " ` 7-206.13 Tracking Powders, Pest Control and 3-SO€.! I(C) liunpe•ned=nod Pac}:.ize Not Re-sen'ed. mom:urine` L'ONSUMER ADVISORY TIMElTEMPERATURE CONTROLS 22 3-003.11 C+msutuar Advisoiv Posted fi;r Consumption of 16 Proper Cocking Temperatures for AnunA Hsad::'ilia;u are Raw, Undcaonkcd or PHFs Not C ii:era iso Processed to Eliminate : 3-401.I1Aill(2) Eggs- 155''1-' 15 Sec 302.13 PacteunzedE^+'Substiune fo Raw Shell Lggs-Emmedialc Service 145TI5sec: L� 3-401.1!(A)(2) Comminuted R,h.Meats ok Cisme .lnimals- I55'F 15 sec. ". SPECIAL. REQUIREMENTS j ?-40L1!tB)(Ul_I Pork and Beef Roast- 13WF t21 min" 590.009(A)4D) Viotatiomn of Sectio; 54QlIOy(A)-(Di in 1-101.1!(A)(2) Ratites, lmected94eau,- I55'F15 sec, * catering; malrife food, temporary and 3-401.11(AA3: Potdtrv, Wild Game.Stuffed PHF„ :cs:dc:;tii l kitchen operations should be. Stuffing Coulaininu,Fbh,bleat, dcb,:NzC l ander the apmoprlale Sections Poultry ur Ratites-1651` 15 sec " ahovc if iclated to locedborne illness 3 401 110')(3) Whole-muscle, intact Becf Steck, inlet rer.tions and risk factors. Other 145'-F„ -590.009 violauo,:, relating to ,00d retail 13-4()1.12 Raw Annual Foods Cooked is a I practice:.should he debited under ri 29 N6ciowate 165-P " Special Requirements. 3-401.11(A)(1)(b) All Other PHFs - 145'F 15 -:ec 17 Preheating for Hai Holding VIOL r'10f*'S R-LA TO G00D RETAIL PRACTICES 3-403.11f:1)r•tD) PFIFs 105"F 13 sec. ' (Iterns 23-30) 3-403.1 1(H) '.viic:'owav,- h5°F 2 Minute Rnmdim, Ctim ed and eon-critical violutions, which da not rdatr'to rhe' Pince* ( loodhorne and:rb;rectors hstecl above, cure be ' 3403.11(C Commercially Ptoces;ed RTE f+x,d- (ounl Its rhe 7r+1?;'n ing act/firms q/the Food Code uad 105 C'A1R 590.()(10 1 4-403 1 1(E) Rentalninc Unsltced Portions of Beef nem j Good Retail Practices j FC 530.000 Roasts': 23. U-nagrme-t and F arsonnel FC--2 .003 j Proper Cooling of PHFs I 24. Fond aro Fooa Pro:ecf if FC -3 004 25 Egwpmenl and Utensil; F1'-4 .005 _ 3-501 14:,A) Cooling Co oktri Pins from 1 i0"F it, FG-5-- A -"-_- -U---o"----- - 26. I Water,Pn'mbi^�q and Waste j ' 70"F Within 2 Hours and From 70'F 27. Phyaicai Pacih!y FC-6 007 j to 41°Fr45'F W'ithm 4 Hour. * 28. Poi---,)nous or ,Toxic Materials FC-7 008 13-SOI.i4(B) Cooling PHFs Made Pram Ambient i u '� cpeual ReguiremQnts 009 L. 'V'eneaeratun Ingredients to 41'F/•45'F �J Other Widun 4 Flours" ! ' 1 kmda:critical arm in the tedcntl 19'1917(...d C'odc ui 105 C'NIR 590 OW. r. .' THE-COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM Address: 120 Washington Street, 4th Floor BOARD OF HEALTH Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel: (978) 741-1800 Fax: (978) 745-0343 Name r� Date Tyyo/e.of Ooeration(;j Tvge of Inspection .4?cl z0r2 �/�7vG a-�7.O1f EP/Food Service I��toutine Address 1 JJ 1 7 Risk ❑ Retail Re-inspection 1-1/x6 Level ❑ Residential Kitchen Previous Inspection Telephone V ❑ Mobile Date: A- /0- Oy- � � 7 r✓- 9'L/4 7 �. Owner HACCP YIN El Temporary ElPre-operation EJ Caterer El suspect Illness Person In Charge(PIC)) r Time El Bed &Breakfast El General Complaint �P_7✓////LL .S�rn 776.'4.-, In: I ❑ HACCP Inspector J 1✓%%a i/.SA K/r Out: Permit No. 73 Other'APPiii�iJ-Uim Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors /Red Items) Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. Local Law ❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC'Assigned/ Knowledgeable/ Duties 13. Handwash Facilities EMPLOYEE HEALTH . ' PROTECTION FROM CHEMICALS ❑ 2. Reporting o.Diseases by Food Employee and PIC - ❑ 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/ Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4. Food and Water from Approved Source ❑ 16. Cooking Temperatures ❑ 5. Receiving/Condition ❑ 17. Reheating ❑ 6. Tags/ Records/Accuracy of Ingredient Statements - ❑ 18 poling El 7. Conformance with Approved Procedures/ HACCP Plans 19. Hot and Cold Holding PROTECTION FROM CONTAMINATION El 20. Time as a Public Health Control EJ 8. Separation/Segregation/Protection " REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ❑ 21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related a Items) Critical (C) violations marked must be corrected `' To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and-Risk Factors (Red Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board r "' today, th'e'iterns checked indicate violations of 105 CMR o Health. { r " ., 590;000/Federal Food Code.This report, when signed below C_N by a Board of Health member drr its agent constitutes an 23. Management and Personnel (FC-2)(590.003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) , r = cited in this report may result in suspension or revocation of °/ 25' Equipment and Utensils iRC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste ' (FC-5)(560.006) establishment operations. If aggrieved by this order, you 27. Physical Facility f `(FC-6)(590.000 have a right to a nearing.Your request must be in writing 28. Poisonous or.FT6xic°Materials (FC-0(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other' 1�10 DATE OF RE-INSPECTION: f °` �G h ctor's ° n re: / . Print: PInC's Signature:r Q� � Print: �e �Ct q� G 1 l�L 1 Page of Pages FORM 734A HOBBS&WARREN - BOSTON vof Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) PROTECTION FROM CONTAMINATION 8 Cross-contamination FOOD PROTECTION MANAGEMENT 3-302.11(A)(1) Raw Animal Foods Separated from I 590.003(A) Assignment of Responsibility* Cooked and RTE Foods* 590.003(8) Demonstration of Knowledge* Contamination from Raw Ingredients 2-103.11 Person in Charge-Duties 3-302.11(A)(2) Raw Animal Foods Separated from Each Other* EMPLOYEE HEALTH Contamination from the Environment 2 590.003(C) Responsibility of the Person in Charge to 3-302.11(A) Food Protection* require reporting by Food Employees and 3-302.15 Washing Fruits and Vegetables Applicants* 3.304.11 Food Contact with Equipment and 590.003(F) Responsibility of a Food Employee or an Utensils* Applicant to Report to the Person in Contamination from the Consumer Charge* _ 3-306.14(A)(B) Returned Food and Reservice of Food* 590.003(G) Reporting by Person in Charge* Disposition of Adulterated or Contaminated 3 590.003(D) Exclusions and Restrictions* Food 590.003(E) Removal of Exclusions and Restrictions 3-701.11 Discarding or Reconditioning Unsafe Food* FOOD FROM APPROVED SOURCE 9 Food Contact Surfaces 4 I Food and Water From Regulated Sources 4-501.111 Manual Warewashing-Hot Water 590.004(A-B) Compliance with Food Law* Sanitization Temperatures* 3-201.12 Food in a Hermetically Sealed Container* 4-501.112 Mechanical Warewashnig-Hot Water 3-201.13 Fluid Milk and Milk Products* Sanitization Temperatures* 3-202.13 Shell Eggs* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.14 Eggs and Milk Products,Pasteurized* Concentration and Hardness* 3-202.16 Ice Made from Potable Drinking Water* 4-601.11(A) Equipment Food Contact Surfaces and 5-101.11 Drinking Water from an Approved System* Utensils Clean* 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Equipment Food- 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces and Utensils* Shellfish and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils and 3.201.14 Fish and Recreationally caught Molluscan Food Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization- Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved by 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 2-301.12 Cleaning Procedure* 3.202.18 Shellstock Identification Present* 2-301.14 When to Wash* 590.004(C) Wild Mushrooms* 11 Good Hygienic Practices 3-201.17 Game Animals* 2-401.11 Eating.Drinking or Using Tobacco* 5 Receiving/Condition 2-401.12 Discharges From the Eyes,Nose and 3-202.11 PHFs Received at Proper Temperatures* Mouth* 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-101.11 Food Safe and Unadulterated* 16 � Tags/Records:Shellstock I � 12 Prevention of Contamination from Hands 590.004(E) Preventing Contamination from 3-202.18 Shellstock Identification* I Employees* 3-203.12 Shellstock Identification Maintained* 13 Handwash Facilities Tags/Records: Fish Products Conveniently Located and Accessible I 3-402.11 Parasite Destruction* 15-203.11 Numbers and Capacities* 3-402.12 Records,Creation and Retention* 5-204.11 Location and Placement* 590.004(1) Labeling of Ingredients* 15-205.11 Accessibility,Operation and Maintenance 7 I Conformance with Approved Procedures Supplied with Soap and Hand Drying /HACCP Plans Devices 3-502.11 Specialized Processing Methods* 6-301.11 Handwashing Cleanser,Availability 3-502.12 Reduced Oxygen Packaging,Criteria* 6-301.12 Hand Drying Provision 8-103.12 Conformance with Approved Procedures* - •Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. n CITY OF SALEM i BOARD OF HEALTH ' Establishment Name: V' ),o?e�e * . o Date: o2- 1'7-OV Page: 02. of t;2— item 2Item Code C-critical Item ' DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date 6 No. Reference R-Red Item Verified /1 PLEASE PRINT CLEARLY 1'/77IVQ �r>cf r�rzarrp rrfcn�t fieri "XeIke `� p � �7 �'�YCK�/r>e' f7FkJFrPr�'/1 LSt7G[ /mac �irf� is> /�7�'P.C/inLd ` 0 ril t 'g,5 'a"71-le/4/ /QA.oe '-.PgldleP '/nr.SSiivg ache )'{e eci ` ! r.� ,IV 9Pr�mor�Lr / I �.� /�iB�/hf3UC'g arm_ - /..P/c��i,csiry L7cC��csf . Ursr e cd �F ,-0. aF Ire .Tech'o' "�-,e ie emaA"e Aexs sls.ti�f 7r��sr Bc .Cc s�i Zed p �l�ce� I ,r elgalk-I2 r,e r�'ai. G' r,(/q – &&rLti/3 7r ' / Ch t l IGP�a t �. �Pser�la•�f o ae�s iti %j � �, t :771?1'r x I I �/u ad��Psr oo� o ems rti zaC"'/PS /f°iwsOccti�v� /Ylri1cdgt1 ali9/v Discussion With Person in Charge: Corrective Action Required: I ❑ No I ❑ Yes i 'I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ } inspection, to observe all conditions as described, and to Exclusion violations before the next ins p ❑ Re-inspection Scheduled O Emergency Suspension .comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars-or suspension/revocation of ❑ Embargo ❑ Emergency Closure r.your food permit. ❑ Voluntary Disposal ❑ Other: r _ '•J 4 P 3-5(11.1412) PI IFs Received at Ten)peretures ! Violations Related to Foodborne Illness Interventions and Risk Axording to I aw CoolW to Factors(items 1-22) (Cont.) 41'Fl45"F Wdhiu 4 Hors PROTECTION FROM CHEMICALS 3-501.11 Cooling Nlethcxls Far PIIFs Food or Color Additives ( 19 PHF Hot and Cold Holdinc t4 3-501.16(B r Cold F1iFs Maintained at or belnw 3-201.12 Arldtlrver` i90.004(F) 41''/45"F* 4-302 la Protection from Unapproved Additiscr> I 1; Poisonous or Toxic Substances 3-5U1.16(A, Hut PHFs Maintained at of abo,r, 7 101.11 Mennfwng Intimnation-Ong3-5U L 16(A) R[?oasis inal ! oims Containers" Held at or above 1311=F ^" 7-102.11 Common Name-Working Containers" ( z<) Time as a Public Health Control 7-'_01.11 Separation-Storage" j 3-50L 19 Tune a+ a Public Health('OntroP" 7-20211 Recniction-Presence and Use `0u.004(1-1i Varmnev Requirement 7=202.12 Conditions of Cse' 7-203 11 Toxic C'nntainees-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanitizers.Criteria-Chemicals' POPULATIONS(HSP) o 21 3-Ri11.11(A) Unpasteuriz it Pre-packaged Inices and 7-_U�4.1:: Chemicals for Washing 1 nxhicz.Criteria` j 7,104.14Di ging Agents,CI ueiia' Beveraers with Warning 7-205,11 Incidental Food Contact. Lubricants', :-Sfil.t I(B) Usz of Yastem+zed Eggs' 3-Sill 11(Di Raw or Paiuolly Cooked Annual Fo(O and 7-206.11 Restricted Use Pesticides,G'iteria'' Raw Seed Sprouts Not Served. i '7-206.12 Rodent Ban Stations" 1 3-SOLt!(C) Unopened Food Package Not Ru-served ' 17-206.113 Tracking Powders,Pest Control and Monnori°e'' CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Adviton Posted for Consumption of 16 Proper Cooking Temperatures for Aminal Foods That nre Rats. Undercooked or PHFs Not Otherwise Processed to Eliminate Pa hogeas.,,fano...r:;-l:ni 3-401.11A(1)(2) Eegs- 115`F 15 Sec, t_3 •2, hogs-Immediate Service 1.15'Fl5see, U_ 1.; Pastcurocd Eggs Substitute for Raw Shell 3-401.1 I(A)(2) Comminuted Fish, Meats C Gamc E'gss* Animals- 155 F 15 sec. SPECIAL REQUIREMENTS 3-401.I1(B)(I)(2) Pork and Beef Roast- 130°F 131 min"1(A)(2) RatitesInjected Meats- 155-F 15 Sy0.0U9(A)-(D) Violations of Section 590.009 (A)-(D) in > 401.1 , I ccumobile obile frmd. temporary and sec. 3-401.111A)(3) Poultry,Wild Game. Stuffed PHFs' residential kitchen operations should be i Stufnnt,I-ontainm;Fish, Meat, i .::.:il::..I ::oder the::yrrn"rou,. Poultry or Ratites-165'F' IS sec "° above ifrelated to foodborne ilhicss 3-401 11(2)(3) Whole-muscle,Intact Beef Steaks ( interventions and risk factor's. Other 145"F'' 590.(X)9 violations relating to annd retail 3-401.12 Raw Animal Foods Cooked in a ( practices should be debited under 929- Microwave 165'F a Special Requirements. 3-401.11(A)(U(b) All Other PHFs-- 145'F 15 sec. 17 Reheating for Hot Holding VIOLATIONS R_LATED TO GOOD RETAIL PRACTICES 3-403.11(A)&(D) PHFs 165'F 15 sec. „ (Items 23-30) 3-403.11(B i Microwave- 165'F 2 Minute Standing I Critical and Icon-critical violations, who h do not relate to the Pune' fuodborne dlnes.s intrmeunons and tisk fomites listed abort, Calf hr 3-403 1 1(C) Commercially Pioc"sed RTE Food- found in the following.ser eons of the l•ood C:odr and IQs 01R 14001* 590.000. '1=403 11(E) Remaining Unshced Portions of Beef Item I Good Retail Practices FC 590.000 Roasts* 23. 1 Management and Personnel FC-2 _.003 18 Proper Cooling of PHFs 24, 1 Food and Food Protection FC-3 .004 ?5 Equipment and Utensils FC--4 ,005 3-501 14(A) Cooling C;x)kecl PITFs from 140`F to tater, Plumbing and Waste IFC-5 .006 I 70°F Within 2 Hours and From'O'F 27 Phvsical Facility 1 FC-6 .007 to 41"F/45'F Within 4 Hour'. "" ! 28 Poisonous or Toxic Materials FC--7 .008 3-501.14(B) CasPug PHFs Made From Ambient29 Special Requirements 009 Temperature ingredients to 4 PF/45'F 30 Other Within 4 Hour,:. Denom,crigtdt acro in the feder:d 1999 Frad Cale 01 115 CN IR 590,0.00. MORRELL ASSOCIATES CURRENTDATE: 11/18/2004 P.G. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: li/15/2004 (781) 837-1395 www.morrell-associates.com CUEt43eter #: FB9-i3 C L L N t'rl '/10arl O Burger King #355a E 12/,2A Highland Ave.! Rte 107 N T T I N Salem, MA BACTERIA COUNT Sample Standard Plate Count/q Coliform/p LhocUlate llilk Shsl:e K 250 [PAC i EPVC MASSACHUSETTS STANDARDS Machine:SPC S 50,0001g;Coliformmc 501g ��f'j) Other:SPC< <50,00019;Coliform 20/g LAB ANALYST (` + METHOD REFERENCE:Standard Methods For The Examination of Dairy (/ Products, 16th Edition,American Public Health Association, 1992 "7t,22S I DEC d 2 2004 CITY OF SALEM BOARD OF HEALTH ` Ic� t MORRELL ASSOCIATES CURRENTDATE: 12/15/20Lt4 Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 1C/S/2t7rr4 (781 1 837-1395 www.morrell-associates.com Customer, *A P89-13 C L 6.•_to^. 11!Xarto burger King #3564 N 1Z (FL A HitlhlarA A'•/Q. / Rt.a 107 T 0 N Salem, MA BACTERIA COUNT Sample Standard Plate Count/g Coliform/q { •1 v t t st: Mi i4 Srake 420 5 �D JAN -3 2005 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine:,SPC<50,000/g;Coliform 5 50/g Other:SPC<50,000/g;Coliform<20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products,16th Edition,American Public Health Association, 1992 (/ 76786 JVIORRELL ASSOCIATES CURRENTDATE: 7/2212004 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 9/14/2004 (781) 837.1395 www.morrell-associates.com Customer #- F99-13 C L 1 Bos ion-Wyman C Burger King #3554 N 12/22 T Highland Ave./ Rte 107 T I O N Salem, MA BACTERIA COUNT Sample Standard Plate Count/q Coliform/a Strawberry Milk Shake 34,000 EPAC 45 C 95 � OCT 6 „ 2004 CITY OF S,'%LEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine:SPC<50,0001g;Coliform<50/g Other:SPC<_50,0001gI Coliform<20/g LAB ANALYST / METHOD REFERENCE Standard Methods For The Examination of Dairy / Products, 16th Edition,American Public Health Association, 1992 ' 74412 MORRELL ASSOCIATES CURRENTDATE: 10%20/2004 jo� P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 10/12/2004 FA?�_- (781) 837-1395 www.morrell-associates.com CustoceF p; FB9-13 C L Boston-Wyman 0 Burger ! inti #3564 N 1E/22 A Highland Ave./ Rte 10? T N Salem, MA BACTERIA COUNT Sample Standard Plate Count/q Coliform/q Vanilla Mxik. Shake 540 3 TONQI NOV 0 2 2004 ` CITY bF : ,,L;:r BOARD MASSACHUSETTS STANDARDS Machine:SPC<50,000/g;Coliform<50/g Other:SPC S 50,0001g;Coliform<201g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy j Products, 16th Edition,American Public Health Association, 1992 6 75305 MORRELL ASSOCIATES CURRENTDATE: 2/20/3004 P.O. BOX 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 2/11/2004 (781) 837-1395 www.morrell-associates.com Customer #: FB9-13 C L Bvtiton Wyman C Burger king #3564 E 12l2L A Highland Ave. / Rte 107 N T T C Salem. MA N ' BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Chocolate Mill Sh«f.e C 250 EPAC 1 EPCC F MAR 2 2004 C.1JLn�Ln tl L.n -------------- STANDARDS:SPC-Less Than 50,000/g Coliform-Less Than 10/g LAB ANALYST ( `" METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 'Saob j ' MORRELL ASSOCIATES CURRENTDATE: 3/19/2004 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 3/9/2004 ` -- _ (781) 837.1395 www.morrell-associates.com Custotoer Y; F139-13 C L Boston-Wyman o Burger king '*3564 N 12/22 T Highland Ave./ Rte 107 T I O N Salem, MA BACTERIA COUNT \ Sample Standard Plate CounUq Coliform/a Strawberry Mill. Shake 570 : 1 EPCC 25 APR 5 - 2004 CITY OF SALEM BOARD 01= HEALTH LM TANDARDS: Machine:SPC-Less than 50,000/g;Coliform-Less than 50/g /��Other:SPC-Less than 50,000/g;Coliform-Less than 20/g LAB ANALYST "'�!.L^�—ETHOD REFERENCE:Standard Methods For The Examination of Dairyroducts, 16th Edition,American Public Health Association, 1992 890t J )WO RRELL ASSOCIATES CURRENTDATE: 4/EO/2004 .� P.O. Box 288 Marshfield, MA 02050 DATE SAMPLES TAKEN4/8/2004 (781) 837.1395 www.morrell-associates.com Customer #; F24-1:3 C L Boston -Wyman o Burger King #3564 E 12122 A Highland Ave./ Rte 107 N T T O N Salem, MA BACTERIA COUNT \ Sample Standard Plate Count1q Coliform/q Vanilla Milk Shake Gg0 12 6N4 CITY OF SALEM BOA' D OF HEALTH STANDARDS: Machine:SPC-Less than 50,000/g;Coliform-Less than 50/g Other:SPC-Less than 50,000/g;Coliform-Less than 20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Davv v Products, 16th Edition,American Public Health Association, 1992 6468'; )WORRELL ASSOCIATES CURRENTDATE: 6/16/2004 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN 6/9/2004 (781) 837.1395 www.morrell-associates.com Customer #: rB9-13 Boston-Wyman o Burger King #3564 C E 12/22 n Highland Ave./ Fete 107 T I J Salem, MA BACTERIA COUNT Sample Standard Plate Count/q Coliform/q Vanilla fiilk: Shake tt < 250 EPAC 1 err LU14 CITY OF SALEM BOARD OF HEALTH STANDARDS: Machine SPC-Less than 50,000/g;Coliform-Less than 50/g Other:SPC-Less than 50,000/g;Coliform-Less than 20/g LAB ANALYST -- • METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 71506 ` �i190RRELL ASSOCIATES CURRENT DATE: 77/26P,004 DATE SAMPLES TAKEN. E P.O. Box 268 Marshfield, MA 02050 7t1.3ti0C14 ' 781) 837.1395 www.morrell-associates.com Customer #. FBI?-13 C L Bos>ton-Wyman o Burger Yang #3554 N 12/22 T Highland Ave./ Rte 107 T N Salem, MA BACTERIA COUNT \ Sample Standard Plate Count/q Coliform/p • � �. ... , .. .. . � � .ate _ Vanilla Milk Shake 310 1 ,i STANDARDS: Machine:SPC-Less than 50,000/g;Coliform-Less than 50/g Other SPC-Less than 50,000/g;Coliform-Less than 20/g LAB ANALYST .Y L-•� METHOD REFERENCE:Standard Methods For The Examination of Dairy Products,16th Edition,American Public Health Association, 1992 72578 MORRELL ASSOCIATES CURRENTDATE. 5/18/2QO4 r» P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 5/11/2(-U4 (781) 837.1395 www.morrell-associates.com Customer #2 F199-13 C L Br}ton-Wyman o Burger King #3564 E 1E/3` A Highland Ave./ Rte 147 N T T N Salem, MA BACTERIA COUNT Sample Standard Plate Count/q Coliform/q Chocolate Milk. ^aha};e 334 4 I'')1R1u, o I JUN 0 2 2004 CITY OF SALEM BOARD OF F EALTH STANDARDS: Machine.SPC-Less than 50,000/g;Coliform-Less than 50/g Other:SPC-Less than 50,000/g;Coliform-Less than 20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 70509 (IMPORTANT MESSAGE ) , FOR DATE TIME M PHONE AREA CODE NUMBER EXTENSION ❑ FAX ❑ MOBII F AREA CODE NUMBER TIME TO CALL TELEPHONED ��x„ PLEASE CALL CAME TO SEE YOUJ WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE Alar k9 A, SIGNED Y 7* vEDAC IN U9FA. NOTES _� sh CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET. 4TH FLOOR SALEM, MA 01970 TEL 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOL-I', MPH. RS. CFO MAYOR HEALTH AGENT COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94 , Section 305A and Chapter III , Section 5 of the General Laws, to operate a rood Establishment in the City of Salem is hereby granted to : Owner' s Name : Michael L Moe Wyman Name of Establishment : Burger King Address of Establishment : 259 Highland Avenue Type of Establishment : FOOD SERVICE Application Date : 01/14/2003 Restrictions : Permit for Food Establishment 260-03 Frozen Desserts/Ice Cream 15-03 Permit for the Sale of Tobacco Products These Permits Expire December 31, 2003 This permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location ' in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. HEALTH AGENT Ilk CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH f, 120 WASHINGTON STRECT, 4TH FLOOR SALEM. MA 01970 P, TEL 978-741 1800 a FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RE. CHO MAYOR HEALTH AGENT 2003 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT ( f1 �p A i4'V1 Of TEL# Plk-Vq-g��7 0 ADDRESS OF ESTABLISHMENT-,259 , MAILING ADDRESS (if different) Zw�/M '"ac oF1-;t-(J OWNER'S NAME PiCYIOJ �-J CLn(A �JW (I )I r"107 TEL# ADDRESOL0 ?JI OIG aA *) J P"10 - )-�k y CITY V-4 Ifl-"1/1 iA, STATE W Ck� ZIP CERTIFIED FOOD MANAGERS NAME(S) -�CLLb CERTIFICATE#(s) y I 0A WAHIR:L CCG (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON1 1-V\- 19M 1'�Q-yijz HOME TEL# HOURS OF OPERATION: Mon' i�LTue-Lf�-!LP4edl!rjf4(hu.l'-'I'IPOFri: TYPE OF ESTABLISHMENT FEE check only RETAIL STORE YES NO less than 1000sq.ft. =$ 50 1000-10,000sq.ft. =$100 more than 1 0.000sq.ft =$250 RESTAURANT YE NO 0- less than 25 seats -$100 25-99 seats (laD more than 99 seats =$200 BED/BREAKFAST YES NO $100 ADDITIONAL PERMITS MAKE ICE CREAM, YOGURT, SOFT SERVEY�S NO (,$$,5 t,/) TOBACCO VENDOR YES NO 0 ALL NON-PROFIT(such as church kitchens) YES NO $25 Please pay total with one check payable to the City of Salem This Permit is not transferable and must be reissued upon change of ownership. The Permit must be posted In a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 62C, Section 49A, I certify under the pains and penalties of perjury that 1, to my best knowledge and belief, have filed all state tax returns and paid all state taxes required under the law. S n, Dat I e Social Security or Fe era[ Identification Number Revised sed 11/2 Check#&Date ,2"79 - MORRELL ASSOCIATES CURRENT DATE: 11!1812003 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN 1 1/,11/2603 _ (781) 837.1395 www.morrell•associates.com Customer F89-1,x„ C L Boston-Wyman °Burger King #1564 E 12/22 A Highland Ave./ Fite 107 T I N Saler,, MA I ' BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Chocolate Milk Shakey { 250 EPAC 1 SPCC — - rt DEC 1 -Zf103 NEW Califarr.. Standard: t 5¢1, for BOARD Of- HEALTH Soft Ser-e, t 20/g for 'Hard IC STANDARDS.SPC-Less Than 50,000/g Coliform-Less Than 10/g I LAB ANALYST �_Lt METHOD REFERENCE:Standard Methods For The Examination of Dairy 4/ Products, 16th Edition,American Public Health Association. 199P 65620 1 J. MORRELL ASSOCIATES CURRENTDATE 10/1B/2003 _ P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN. 10/8/2003 (781) 837-1395 www.morrell-associates.com Customer #; FIV- 13 C L Roston Wyman C Btwger King #3564 N 12/2.2 T Highland Ave./ Rte 107 T I N Salem, MA BACTERIA COUNT Sample Standard Plate CounVg Coliform/g Vanil'6a Milk Shake 2.2.50 EPAC. i 1 [PCC I NOV 4 -2003 Wo :CCIYFOYM Standard; 50/g for S •tt Serve, 20/g For N,rd IG CITY OF SALEM BOARD OF HEALTH STANDARDS:SPC-Less Than 50,000/g -y;� •'Y ' Coliform-Less Than 10/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Daii Products, 16th Edition,American Public Health Association, 1992 fi96L ( IMPURTAW MESSAGE ) FOR / ►° DATF !/�� 2 3r 6 Z TIME /. �30 P.M. M OF PHONE AREA CODE NUMBER EXTENSION ❑ FAX ❑ MOB11 r AREA CODE / NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU I I RUSH RETURNED YOUR CALL I WILL FAX TO YOU MES AGE �ticti SIGNED � 1ops MADR IN4 S A Wi _ _= i , , �, � � .� � , �, � � � , G � : '. o � 1 JI�- ( IMPORTANT MESSAGE ) FOR l J ` DATE �� /�' G-3 TIME/ , -�P.M. M OF PHONE AREA MME NUMBER EXTENSION ❑ FAX ❑ MOBII F AREA CODE / UIUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU I WILL CALL AGAIN WANTS TO SEE YOU 'I RUSH RETURNED YOUR CALL II WILL FAX TO YOU MESSAGE IGNED FORM 4009 MADE IN U.S.A. t 1 uj r 0 j I J TRS COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM Address: 120 Washington Street, 4th Floor BOARD OF HEALTH Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel: (978) 741-1800 Fax: (978) 745-0343 Name / / //� � %�� Date j!`' fOperation(s) T f n i n _ V 01� (.�� Food Service Routine Address 7 c -� // • /� yt�c Risk ❑ Retail ❑ Re-inspection LevelM El Residential Kitchen Previous Inspection Telephone Q5C"� L/,'/, /'i// ❑ Mobile Date: Owner //�,,�,,/ /�/X- �-,1 /n 7 Z r��o1 HACCP Y/N ❑ Temporary ❑ Pre-operation 4 /yIi)� �/( �� ❑ Caterer ❑ Suspect Illness Person in Charge PIC) p/� ` S Time ElBed&Breakfast ElGeneral Complaint InEl HACCP Inspect �{�,ni /��-�/'(//1Out: Permit No. ❑ Other Each violation'checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. "', Local Law ❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/ Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/)Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) El 16. Cooking Temperatures El 5. Receiving/Condition El6. Tags/ Records/Accuracy of Ingredient Statements El 17. Reheating El7. Conformance with Approved Procedures/ HACCP Plans El 18. Cooling El 19. Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20. Time as a Public Health Control [:18. Separation/Segregation/ Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9. Food Contact Surfaces Cleaning and Sanitizing El[1 10. Proper Adequate Handwashing 21. Food and Food Preparation for HSP CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related ❑ Items) Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions v immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. - 590.000/Federal Food Code.This report, when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2)(590.003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing.Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: r �r Inspector's Signature: i Print: PIC's Signature: � Print: , y _ I Pag�of�-7 Pages FORM 734A HOBBS&WARREN - BOSTON Violations Related to Foodborne Illness I Interventions and Risk Factors (Red Items 1-22) PROTECTION FROM CONTAMINATION 8 Cross-contamination FOOD PROTECTION MANAGEMENT 3-302.11(A)(1) Raw Animal Foods Separated from 1 590.003(A) Assignment of Responsibility* Cooked and RTE Foods* 590.003(B) Demonstration of Knowledge* Contamination from Raw Ingredients 2-103.11 Person in Charge-Duties 3-302.11(A)(2) Raw Animal Foods Separated from Each Other* EMPLOYEE HEALTH Contamination from the Environment 2 590.003(C) Responsibility of the Person in Charge to 3-302.11(A) Food Protection* require reporting by Food Employees and 3-302.15 Washing Fruits and Vegetables Applicants* 3.304.11 Food Contact with Equipment and 590.003(F) Responsibility of a Food Employee or an Utensils* Applicant to Report to the Person in Charge* Contamination from the Consumer 13-306.14(A)(B)I Returned Food and Reservice of Food* 590.003(G) Reporting by Person in Charge* Disposition of Adulterated or Contaminated 3 590.003(D) Exclusions and Restrictions* Food 590.003(E) Removal of Exclusions and Restrictions 3-701.11 Discarding or Reconditioning Unsafe Food* FOOD FROM APPROVED SOURCE 9 Food Contact Surfaces 4 I Food and Water From Regulated Sources 4-501.111 Manual Warewashing-Hot Water 590.004(A-B) Compliance with Food Law* Sanitization Temperatures* 3-201.12 Food in a Hermetically Sealed Container* 4-501.112 Mechanical Warewashing-Hot Water 3-201.13 Fluid Milk and Milk Products* Samtization Temperatures* 3-202.13 Shell Eggs* 4-501.114 Chemical Sanitization-tem H, 3-202.14 Eggs and Milk Products, Pasteurized* p,P gg Concentration and Hardness* 3-202.16 Ice Made from Potable Drinking Water* 4-601.11(A) Equipment Food Contact Surfaces and 5-101.11 Drinking Water from an Approved System* Utensils Clean* 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Equipment Food- 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces and Utensils* Shellfish and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils and 3.201.14 Fish and Recreationally caught Molluscan Food Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization- Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved by 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 2-301.12 Cleaning Procedure* 3.202.18 Shellstock Identification Present* 2-301.14 When to Wash* I 590.004(C) Wild Mushrooms* 11 Good Hygienic Practices 3-201.17 Game Animals* 2-401.11 Eating,Drinking or Using Tobacco* 5 Receiving/Condition 2-401.12 Discharges From the Eyes,Nose and 3-202.11 PHFs Received at Proper Temperatures* Mouth* 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from 3-202.18 Shellstock Identification* Employees* 3-203.12 Shellstock Identification Maintained* 13 Handwash Facilities Tags/Records: Fish Products Conveniently Located and Accessible 3-402.11 Parasite Destruction* 5-203.11 Numbers and Capacities* 3-402.12 Records,Creation and Retention* 5-204.11 Location and Placement* 590.004(1) Labeling of Ingredients* 5-205.11 Accessibility,Operation and Maintenance 7 I Conformance with Approved Procedures Supplied with Soap and Hand Drying /HACCP Plans Devices 3-502.11 Specialized Processing Methods* 6-301.11 Hevices hing Cleanser,Availability 3-502.12 Reduced Oxygen Packaging,Criteria* 6-301.12 Hand Drying Provision 8-103.12 Conformance with Approved Procedures* •Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. CITY OF SALEM BOARD OF HEALTH Establishment Name: V/ylle �j Date: �� U Page: of Item Code C-Critical Item r /!DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY r- cr \Q �I_s 1 1 C - 1 I Discussion With Person in Charge: Corrective Action Required: I ❑ No I ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ inspection, to observe all conditions as described, and to Exclusion violations before the next ins P ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that 4 oncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure our food permit. ❑ Voluntary Disposal ❑ Other: .r I . ? Cl Wit PHPr:Rccc;ved at Temperalares Violations Related to Foodborne Illness Interventions and Hisk According,to Lvov Ccmlui to Factors(items 1-22) (Cont) 41'F/4J F'Within 4 Homs. PROTECTION FROM CHEMICALS j 3-5u1 13 Gwliue M diods for PIiF> j 14 Food or Color Additives 19 PHF Hot and Cold Holding ( 3-501 16(]37 Cold PHFs Maintained al .;r below 3-202.12 Additive,,, ( 590.004(1,) 41'/45"F: 3-302,W Protection from I Inappiovrd Addititen' ( I 3-501.16(A) lint Pl-1Fs Maintained at(-! above 15 Poisonous or Toxic Substances 7-161.11 kientd"pnein(orotahnn-Original 50116(A) (2:,asr,He Connuners„ id at or.rbovc i 30'R 7-W2,11 Cotnmon Narne-Working Containers" 21) Time as a Public Health Control j 3-501 14 Time a,a Public '-Iealth C onlrol" 7-'OI.I l Sepal a[ion--Sinragc j 7-202.11 Restriction--Presence and Ilse" j 19i1 iA74(}i. 4,u tons+P.equireracnt 7-702.12 Condrtionc of U%,11 ! 7-20 3 11 Toxic Containers-Prohibitions.. REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-7-04.11 Sanitizers.Critaia-ChenocidsT ( POPULATIONS IONS (HSP) 7-204 12 Chemicals for R'ashing Produce. Criteria^ ( 21 3-80L1 I(.4) Unpasteurized Pre-pacF aget{ tutees and 1 - 204.14 D:ring Agents.Cine:ia` 1 Be%erageewith WantingLibek* j 7-205.11 Incidental Fax(Contact,Lubricants- ( 3-W 1.11(B± � Use of Pasteurized Eggs:° 206.11 Restricted Use Pesueiden.Criteria 3-801.11(DI Raw er Pulially Cuoked Animal Ford and 7-206. Rodent Baits Pesus" ( Raw-Secd Spr,•aus Not Scty:c!. I7-206.1? liackir Puwdcrs.Pest Control and ( 3-80f.I1(G (lnnpened Food Package No: Re-sawed. •` Momton:tg" CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer:Advisor,Posted for Consumption of Arovwi F:xrds That are Raw, t'ndcrcvoked of 1 fi I Proper Cooking Temperatures for I Not Oils rwke Proses:ed to E:uninate PHFs 3-401.11A(1)(2) Eggs- 1557 15 Sec Pathogens.: " Eggs-Immediate Service 145"F15sect 3.302.!3 Pasbam'rred Eoo>Substitute for Raw Shell 3-401.11(A)(2) Comminuted fish, Meals R.Game Animals- 13J"F 15:,ec. 401.11(6)(1 ( 3- ) 2} Pork and P.cri Roast - 130'1, i21 min' SPECIAL REQUIREMENTS 1-401 l)-(0) '•,,T r590.009(A)-(D) t 3-�:Ol.l1(A)(2) Rattles,Injected Meat,, - I S5'F 1 i iolatiaa o. Section ..� n sec - I catering, mobile triode ternporar} and 3-401.1l(A)(3) Poutlry, Wild Game.Stuffed PHFs. residential kitchen operations should be Stuffing Contaunn2 Fish,Meat. debited tinder the appropriate sections P-mlttr or Ratite>-165`1, 15 sec " above :"related to foodbi ne.it ncss 3-101 11(0)(3) Whole-muscle, Intact Beef Steak:, interventions and risk factors. Other 145`F 590.0(}4 violations relating to goal retail 3-401.12 I Raw Animal Fovds COOked in aI practices should he debited under,#20 - Microwave 165`F* Special Requirements. 1-401.11(Aulab) All Other PHFs-- 145'715 sec. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.1 I(A)K(D) PHFs 165'F 15 sac 1: dTterns 23-30! 3-403.11(13) Microwave- 165°F 2 Inmate Standing Crim al and nor-crilicul Yiolunons, whist(do not r'ehue to the Trine°° ,/oorlhornc dhtcsy int crrtntitrua ,rind ri e4 Jsclur's Gsted above, can be ! 3-403.1 1(C) Commercially Proce;sed RTE Food- found in the(,.-Poring ser tion.+tJ ilte Fool Co,k unit 105 CdM 140'F"` 590.000. 3-40'.11(E) Retnainine Unsliced Portions r•f Beer (tem I Good Retail Practices ! FC 590.000 23. Management anal Personnel FC-2 .003 Roasts*, ( __ ]g Proper Cooling of PHFs ( 12a Food and Feed Protection I FC--3 .004 25 Equipment and Utensils FC-4 005 3-501.14(A) Cooling Cooked PHFs front 140-1,10 ' 26 Water, Plumbing and Waste FC-6 .006 I 70''F Within 2 Horn's art,[Frani 70`1, 27 PhVs real Facility FC--6 .007 to 41^F/45 T P,ithtn 4 Hours, a. 2E ' P D!sorouc or Trxic Mot enats FC-7 .005 3-501.14(6) Cooling PFIFs Marie From Antbtent29 Special Requirements 009 j Temperature ingre<hcnts l0 41"1,/45-T 30. Other Within 4 Hours' ''D mow,critical ntnt in rhe relief al I'M,)I and Cwh•U, 1O CNIOr 5Of;,O;'d). COU CITATION NO. ✓e e'd CITY OF SALEM3 1 , � _ 1 VIOLATION NOTICE. PD T 16 4 NAME!/LAST,FIRST,.!IITIAL) U��Q� STREETA RESS CITY/TOWN ESTATE ZIP ,.,u��o.Si'/v C3! LICENS NO. LIC.EXP.DATE DATE OF BIRTH OWNERS NAME(LAST,FIRST,INITIAL) STgEEyTADDRE55 CITY/TOWN STA ZIP /Oa wa,& &flrCl N2- REGISTRATION NO. STATE EXP.DATE AKERYPE EAR COLOR DATE OF VIOLATION TIf�7E OAM PM /DATE�CITATION 3Tf NS U ❑NOS L�V ON OF VIOL�JO� FORCING DEPT diOFFENSE lz; /fit.•,Ve ^ A . SECT. FRES � X Qsa W/Gtr B ur90,dGp C OFFIICEER/� ) I D.NO. TOTALFINE $ �U Y' O'YJ/.tS;{zP/T/S DUE /DO 7OFFICER CERTIFIES COPY GIVEN TO VIOLATOR X DO OT�C S ONLY BY POSTAL NOTE,MONEY MAID ORDER OR BY CHECK MADE PAYABLE TO: CITY CLERK CITY HALL 93 WASHINGTON STREET SALEM,MA 01970 TEL.(508)745-9595 X 251 1 HEREBY ELECT TO EXERCISE THE FIRST OPTION AS STATED ON REVERSE,CONFESS TO THE OFFENSE CHARGED,AND ENCLOSE PAYMENT IN THE AMOUNT OF $ CASE# SIGNATURE SEE OTHER SIDE FOR FURTHER INFORMATION ENCLOSE PAYMENT IN THIS ENVELOPE,PEEL AND SEAL I p.=URT DOCKET NO ��j✓t PY CITATION NO CITY OF SALEM PD q C p a oH o y ' ' VIOLATION NOTICE .L V 4 (p D m NAME(LAST,FIRST,INITIAL) p STREETADbRESS CITY/TOWN STATE ZIP d W LICENSE NO / LIQ EXP DATE DATE OF BIRTH O i} LTI y :- 7 !l S7 O N Lp OWNER'S NAME(LAST,FIRST,INITIAL) >= N-10 tic irdi\, ' /�J ^� p m� OZ �] 32 �' 32 STREETADORESS CITU WT7111•"�2IP'� G� oz 'o >Z W I�'jki'+'rYs IF,LL /E%� of<_ .h. /k^::r%/i/�. �'"c< s REGISTRATION NO STATE EXP DATE MAKE/TYPE 1 YEAR(COLOR m �? I II` O Z A DATE OF VIOIATION TIME DATE CITATION WRITTEN PEFll OFL wue LI YE r `� "' A h/-63 ❑PM l T- J-C 3 LI r t" ILO 3TION OF VIOLATION�, ENFORCING DEPT �tltl kkq //��/ p ^ \ s9 eshk o%,Choc rl r / OFFENSE r�Lr�k�e I�'l3 y>Q��y CHAP. SEDT IDES W c- i yam/ SxNiYrt r C, nv ,/ r,r r ! B r C O OFFI'CEER�//� ID NO TOTAL DUE $ /O(rA ((( OFFICER CERTIFIES COPY GIVEN TO VIOLATOR Iv 4 I AND X /i CL.L.(�./S'-:'G'ti,�_ BV MAIL DO NOT Ov A1L CASH-PAY ONLY BY POSTAL NOTE,MONEY ORDER OR BY CHECK MADE PAYABLE TO: I CITY CLERK CITY HALL 93 WASHINGTON STREET _ p SALEM,MA 01970 - y TEL.(500)745-9595 X 251 R I HEREBY ELECT TO EXERCISE THE FIRST OPTION AS STATED ON REVERSE,CONFESS TO THE OFFENSE CHARGED,AND ENCLOSE I _ PAYMENT IN THE AMOUNT OF $ CASE X jSIGNATURE ^ Y SEE OTHER SIDE FOR FURTHER INFORMATION ENCLOSE PAYMENT IN THIS ENVELOPE,PEEL AND SEAL U) v CID w 00 I Burger King #3564 MORRELL ASSOCIATES Hawthrone Square Mail/ Rte 107 Al I g s P.O. Box 268 Marshfield, MA 02050 259 Highland Ave (781)837-1395 www.morrell-associates.com Salem, MA Current Date: 7/17/2014 Date Sample Taken: 7/1/2014 Customer#: FB13-10 BACTERIA COUNT \ Sample Standard Plate Count/q Coliform/q Vanilla Ice Cream ��gg �q'�4 C 28,000 EPAC < 1 EPCC RECEl f!e® AUG 012014 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC<50,000/g;Coliform<50/g Other: SPC<50,000/g;Coliform<20/g LAB ANALYST /� LLLIL METHOD REFERENCE.Standard Methods For The Examination of Dairy Board of Health (/ Products, 17th Edition,American Public Health Association,2004 COURT DOCKET NO S I CITATION NO. O V19L IO S NOTICE VIOLATION NOTICE PD 1164 NAME(LAST,FIRST,INITIAL) STREETADORESS CITY/TOWN STATE ZIP i LICENSE NO / LIC EXP.DATE DATE OF BIRTH OWNER'S NAME(LAST,FIRST,INITIAL) \ STREET/ADDRESS CITV/TOWN ZIP REGISTRATION NO STATE EXP DATE A�STATE A YEAR(COLOR DATE OF VIOLATION ME DATE CITATION WRITTEN vERSRorvu' ❑, ❑PM 3 [-]NO LOCATIONgO^V�IOLnALI/ON / E�N7FO�RCING DEPT OFFENSE /ro'4c xe CHAP SECT I FINES /ryrfly SoAlye { /r va r/.Il (r fe B urTG,d'Cr9 � } C OFFICCEER LD NO TOTAL $FINE DUE I OFFICER CERTIFIES COPY GIVEN TO VIOLATOR fj J� r��„ ❑ I HAND X -f �f X!'-/-t'.t�9 Ge+k,.�-r?_ VY MAIL DO NOT MAIL CASH-PAY ONLY BY POSTAL NOTE,MONEY ORDER OR BY CHECK MADE PAYABLE TO: CITY CLERK CITY HALL 93 WASHINGTON STREET SALEM,MA 01970 TEL.(508)745-9595 X 251 1 HEREBY ELECT TO EXERCISE THE FIRST OPTION AS STATED ON REVERSE, CONFESS TO THE OFFENSE CHARGED,AND ENCLOSE PAYMENT IN THE AMOUNT OF $ CASE# SIGNATURE SEE OTHER SIDE FOR FURTHER INFORMATION ENCLOSE PAYMENT IN THIS ENVELOPE,PEEL AND SEAL -- -T - -- - - LOURT DOCKET NO. Cj./P�' CITATION NO CITY OF SALEM P� q q., a I o,D ! VIOLATION NOTICE l °F mm mm NAME(LAST,FIRST,INITIAL) to a /Ut�ic, 1�2z5 STREET ADDRE{SSS/. ClTY/TOWN STATE ZIP \ I OC / f' LICENSE NO LI(x EXP.DATE DATE OF BIRTH N O i 1/--5raswn 14Z-7r-;Z% O n p I OWNER'S 14AME(LAST,FIRST.INITIAL) J 'l s O I -j m -5 oz o� �7 >Z �2 ' 1STREET ADDRESS CI N SlA7E" -0 > k 3p m� c l F r 6d of q3 o s p O W k I./O ,grL.L .y 0m REGISTRATION NO, I STATE I EXP,DATE MAKE/T1'PE (YEAR(COLOR "> (-q a iil ill I f _ < az 1 • O Z A+ DATE OF VIOLATION 11ME DATE CITATION WRITTEN FEBSOrva: k ( C7 Iwuav Or "' A I /-/-63 I OEM /T)/''' 3 ONG r T y L TI pFVIO �, {ENFORCING DEPT. - OFFENSE/t4VA'e 47 �d/Zv CHAP. SECT QWES 133 r4yIw smniYc�we d(, ,� � A B 9,01 { I r �) C �OFFICER S FINE /,� ID.NO. TOTAL 07 y Y• B'K/:iS•,<C(,•1'lS DUE s le, n ( OFFICER CERTIFIES COPY GIVEN TO VIOLATOR I AND BY MAIL 7 - DO NOT MAIL CASH-PAY ONLY BY POSTAL NOTE,MONEY ORDER OR BY CHECK MADE PAYABLE TO: (� CITY CLERK o CRY HALL �.„y. 93 WASHINGTON STREET .. p - SALEM,MA)7p79 - > _ TEL(SOSj 745.95959 5 X 251 � n -1 HEREBY ELECT TO EXERCISE THE FIRST OPTION AS STATED ON -i 'REVERSE,CONFESS TO THE OFFENSE CHARGED,AND ENCLOSE PAYMENT IN THE AMOUNT OF I -$ CASE a' : 'SIGNATURE SEE OTHER SIDE FOR FURTHER INFORMATION ENCLOSE PAYMENT IN THIS ENVELOPE,PEEL AND SEAL F ^ i D co 3� w / MORRELL ASSOCIATES Current Date: 7/21/2011 P.O. BOX 268 Marshfield, MA 02050 Date Samples Taken: 7/6/2011 (781)837-1395 www.morrell-associates.com Customer#: FB13-10 v 0O11ttt •SSOLu SES C LBK LLC L Burger King#3564' L 9/16 00 Hawthrone-Square Mall/Rte 107 I A 259 Highland Ave �) N � Salem, MA T 0 N BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Milk Shake Mix <250 EPAC < 1 EPCC (9/21/11) '77CENe VED AUG 'i '1011 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS Machine: SPC!r.50,000/g; Coliform s 50/g Other: SPC..5 50,000/g;Coliforms 20/g METHOD REFERENCE: Standard Methods For The Examination of Dairy LAB ANALYST G Products, 17th Edition, American Public Health Association, 2004 �1 :a�E:f c-¢ tiwc,lrr, ' MORRELL ASSOCIATES CURRENTDATE: 2/24/2003 P.O. BOX 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 2/12/2003 14 )781) 837.1395 www.morrell•associates.com wstomer #: F89-18 C L Rc stor Wyman C Burger King #3564 E lc;& A Highland Ave. / Rte 107 N T T N Salem. MA BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Chorr.late Milk Sha::e p < 250 EPAC C i EPGC - MAR 4 7.2003 CITY OF SAI"EM BOARD OF HEAITH STANDARDS:SPC-Less Than 50,000/g / Collform-Less Than 10/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dalry Products, 16th Edition,American Public Health Association, 1992 c-rgvi� i - MORRELL ASSOCIATES CURRENT DATE: 1/28/2093 1I2AJ2t)f13 P.O. Box 288 Marshfield, MA 02050 DATE SAMPLES TAKEN: y (781) 837.1395 www.morrell-associates.com Customer #: FB9-13 Com: L I 1 Bo-torr-Wyman 0 Burger king #3564 II N 12/2c T Highland Ave. / Rte 107 T I 0 Salem, MA N BACTERIACOUNT \ Sample Standard Plate Count/g Coliform/g Van,lla Mi14- Shake 28,o00 EPAC 7 1B. U 4 ZUU3 C1TY OF SALEM BOARD OF HEALTH STANDARDS:SPC.Less Then 50,000/g Collform•Less Then 10/9 LAB ANALYST METHOD REFERENCE:Standard Methods For The Egmination of Dalry Product @, 16th Edition,American Public Health Association, 1992 MORRELL ASSOCIATES CURRENTDATE: 3/17/21=03 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN: 3/10/2003 (781) 837.1395 www.morrell•assoclates.com ustgoer #a FR4-13 Br.� t•,n-Wyman o Burger Kinn #3564 N 12?22 T Highland Ave./ Rte 107, T 1 N Salem, MA i BACTERIA COUNT � Sample Standard Plate Count/g Coliform/g f S* awLerry Milt Shake 450 1 APRCITIYOFS BOARD OF HEA TH 1 -STANDARDS:SPC-Less Than 50,000/9 f Coliform-Less Than 10/g LAB ANALYST .9t_ METHOD REFERENCE:Standard Methods For The Examination of Dair_v Products, 16th Edition,American Public Health Association, 1992 58678 MORRELL ASSOCIATES CURRENTDATE 9'17/003 = P.O. BOX 288 Marshfield, MA 02050 DATE SAMPLES TAKEN. (781) 837.1395 www.morrell-associates.com Customer . r139-113 Boston•Wyman o Burger King #3564 E 12!22 A Highland Ave. / Rte 107 N T T D Salem, MA BACTERIA COUNT 1 I Sample Standard Plate CounUg Coliform/g Straeoterry Mill,. Shake <. 250 EPAC 1 EPCCC OCT 2 -2069 CITY OF SALEM BOARD OF HEALTH .,,STANDARDS:SPC-Less Than 50,000/g Coliform-Less Than 10/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dair_v Products, 16th Edition,American Public Health Association, 1992 h369% MORRELL ASSOCIATES CURRENT DATE x119./2003 % P.O. Box 268 +Marshfield, MA 02050 DATE SAMPLES TAKEN: aj l 1/2003 (781) 837.1395 www.morrell-associates.com Customer : E89-i3 4ww' C L Bestor:--tdyman o Burger Kinn, #3564 N 12/22 T Highland Ave./ Rte 107 T N Salem, MA BACTERIACOUNT Sample Standard Plate COunt/q Coliform/g Cnecolate Milk Shake 5 250 EPAC { 1 ENCC jD I SEP 3 -;2003 C TY OF SALEM 7RD OF HEALTH STANDARDS:SPC-Less Than 50,000/g Coliform-Less Than 10/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dair_v Products, 16th Edition,American Public Health Association, 1992 62906 i, MORRELL ASSOCIATESCURRENTDATE. 7/25/2003 P.O. Box 288 Marshfield, MA 02050 DATE SAMPLES TAKEN: '7/21/2003' .; (781) 837.1395 www.morrell-associates.com Customer C: FB9-13 C L Bton -Wyalan C �� : Burger King #3564 N 12/22 T Highland Ave./ Fite 107 T I N Salem, MA BACTERIA COUNT Sample Standard Plate Count/g Coliform/g +ran i l l- Milk Shaf:e 280 5 Irl AUG 0 4 2003 CITY OF SALEM BOARD OF HEA LTH STANDARDS:SPC-Less Than 50,000/g Coliform-Less Than 10/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 n A iLC i r FMORRELL ASSOCIATES CURRENTDATE: 6/27/2002 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN 6/20/2003 (781) 837.1395 www.morrell-associates.com Customer #: FB9-13 C L WymanHurgFr fAng #3564 E 12122 A Highland Ave./ Rte 107 N T T N Salefn, MA ' BACTERIACOUNT Sample Standard Plate Count/g Coliform/g l'e.nilla M:i6 Shake 46,000 EPNC S JUL C 8 2003 r CITY OF SALEM BOARD OF HEALTH STANDARDS:SPC-Less Than 50,000/g �.. Coliform-Less Than 10/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 s r � d - �- MORRELL ASSOCIATES CURRENTDATE: 5/30i2003 P.O. Box 288 Marshfield, MA 02050 DATE SAMPLES TAKEN: 5120/2003 i w (781) 837.1395 www.morrell•associates.com Custowr 1 : F139-13 t C L s L P.,ston,._a':,atan o Bw 'get- King #3566 N '.2122 T Highland Ave./ Rte 107 T Salen, MA BACTERIA COUNT Sample Standard Plate Count/g Coliform/g nt11a Milp shaF= 690 1 SPCC ta JUN 3 .• 2003 f GITY OF ;iALER/ BOARD OF HEALTH STANDARDS:SPC-Less Than 50,000/g Coliform-Less Than 10/g LAB ANALYST _ METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 f MORRELL ASSOCIATES CURRENTDATE: 4/24/2003 SAMPLES 4/21 /200;3 TAKEN: P.O.'Box 288 Marshfield, MA 02050 DATE (781) 837.1395 www.morrell-associates.com, Customer it: FR9-13 C ; L Jo-�tur, Wyman Burger King #3564 N 12/22 T Highland Ave./ Rte 107 T I N Salem, MA BACTERIA COUNT Sample Standard Plate Count/g Coliform/g Vanilla Mill Shake Nix (6/29/03) 250 E:PHC 1 EPCC r � MAY 5 -„ 2003 t;{ i✓ ,) SALEM BOARD OF HEALTH STANDARDS:SPC-Less Than 50,000/g Coliform-Less Than 10/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 16th Edition,American Public Health Association, 1992 D9769 Burger King#3564 - MORRELL ASSOCIATES Hawthrone Square Mali/ Rte 107 g P.O. Box 268 Marshfield, MA 02050 259 Highland Ave (781)837-1395 www.morrell-associates.com Salem, MA Current Date: 6/23/2014 Date Sample Taken: 6/17/2014 Customer#: FB13-10 BACTERIA COUNT \ Sample Standard Plate Count/q Coliform/q Vanilla Ice Cream *.Cp II 17,000 < 1 EPEC " a �� JUL ^3Z014 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS: Machine: SPC<50,000/g;Coliform<50/g Other: SPC<50,000/g;Coliform<20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dalry Products, 17th Edition,American Public Health Association,2004 Board of Health MORRELL ASSOCIATES CET12/15/20oa 1 P.O. BOX 268 Marshfield, MA 02050 DATE SAMPLMPLESSTAKEN: : 12/912043 (781) 837.1395 www.morrell-associates-com Customer #a FB9-13 C L Boston -Wyman 0 Burger K ing #351,4 E 12122 A Highland Ave./ Rte 107 N T T 1 N Salem, MA BACTERIACOUNT Sample Standard Plate Count/g Coliform/g Strawberty MU Shake ! 250 EPAC 1 SPCC JAN G 5 U"';4 NEW Cul ifor:, Standard: 30/q for BOARD f`.' HE WH Saft Solve, 20/q for Hard IC STANDARDS:SPC-Less Than 50,000/g Coliform-Less Than 10/g LAB ANALYST CM 1r/�'t - METHOD REFERENCE:Standard Methods For The Examination of Dairy V Products, 16th Edition,American Public Health Association, 1992 6a4o9 MORRELL ASSOCIATES CURRENT DATE 1 174/2004 P.O. Box 268 Marshfield, MA 02050 DATE SAMPLES TAKEN. 1112 2004 k (781) 837-1395 www.morrell-associates.com Customer #: FB9-13 C L 48aston Nyman o Eurgef fang #354 N T Highland Av2./ !, a 107 T N Salem, KA ' BACTERIA COUt4��_J Sample Standard Plate Count/g Coliform/g Vanilla Nilk Shake % 250 A fPAC s EF-CC b FEB 2;-2004 NEW Ct,liform Standard: < 50/g for CITYOF- SALEM Soft Serve, 20,'g for Hard iC BOADD OF HEALTH STANDARDS:SPC-Less Than 50,000/gS Coliform-Less Than 10/g LAB ANALYST Z?--4 METHOD REFERENCE:Standard Methods For The Examination of Dairy i Products, 16th Edition,American Public Health Association, 1992 ' a724i f s MORRELL ASSOCIATES Burger King #3564 P.O. Box 268 Marshfield, MA 02050 Hawthrone Square Mall/ Rte 107 - (781)837-1395 www.morrell-associates.com 259 Highland Ave Salem, MA Current Date: 5/13/2014 Date Sample Taken: 5/1/2014 Customer#: FB13-10 BACTERIA COUNT Sample Standard Plate Count/q Coliform/q Vanilla Ice Cream 1,500 5 ° C jrj �® JUN 0 4 Z014 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS STANDARDS- Machine: SPC<50,000/g;Coliform<50/g Other: SPC<50,000/g;Coliform<20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy �77� Products, 17th Edition,American Public Health Association,2004 Board of Health s A MORRELL ASSOCIATES Burger King #3564 _ ff P.O. Box 268 Marshfield, MA 02050 Hawthrone Square Mall/ Rte 107 (781)837-1395 www.morrell-associates.com 259 Highland Ave Salem, MA Current Date 4/14/2014 Date Sample Taken: 4/1/2014 Customer#: FB13-10 BACTERIA COUNT Sample Standard Plate Count/q Coliform/q Vanilla Ice Cream 30,000 EPAC < 1 EPCC prECEI GD Mg 012014 SALEM oJARO OF HEALTH MASSACHUSETTS STANDARDS. Machine: SPC<50,000/g,Coliform<50/g Other: SPC<50,000/g;Coliform<20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 17th Edition,American Public Health Association,2004 Board of Health MORRELL ASSOCIATES Burger King #3564 � P.O. Box 268 Marshfield, MA 02050 259 Hi one Square Mail/ Rte 107 --- (781)837-1395 www.morrell-associates.COM 259 Highland Ave Salem, MA Current Date: 12/10/2013 Date Sample Taken: 2/2/2013 Customer#: FB13-10 BACTERIA COUNT Sample Standard Plate Count/q Coliform/q Vanilla Ice Cream � W® 4,300 < 1 EPCC N �62p14 Jr,N� Jrc�V MASSACHUSETTS STANDARDS: Machine: SPC<50,000/g;Coliform<50/g Other: SPC<50,000/g;Coliform<20/g LAB ANALYST �I METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 17th Edition,American Public Health Association,2004 Board of Health t MORRELL ASSOCIATES Burger King#3564 P.O. Box 268 Marshfield, MA 02050 (781)837-1395 www.morrell-associates.com Hawthrone Square Mall/ Rte 107 259 Highland Ave Salem, MA 01970 Current Date: 9/15/2014 Date Sample Taken: 9/2/2014 Customer#' FR13_1n BACTERIA COUNT Sample Standard Plate Count/q Coliform/q Vanilla Ice Cream RZ 26,000 EPAC < 1 EPCC Cje/V OCT X014 BOARDOF SALEM OF HEALTH MASSACHUSETTS STANDARDS: Machine SPC<50,000/g;Coliform<50/g Other: SPC<50,000/g;Coliform<20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 17th Edition,American Public Health Association,2004 Board of Health �/ MORRELL ASSOCIATES Burger King #3564 _ P.O. Box 268 Marshfield, MA 02050 --- (781)837-1395 www.morrell-associates.com 259 Hi one Square Mail/ Rte 107 259 HiAve Salem, MA Current Date: 8/14/2014 Date Sample Taken: 8/1/2014 Customer#: FB13-10 BACTERIA COUNT Sample Standard Plate Count/q Coliform/o Vanilla Ice Cream 42,000 EPAC < 1 EPCC RECEIVED 0 4 2014 80 00F N~P H MASSACHUSETTS STANDARDS: Machine: SPC<50,000/g;Coliform<50/g Other: SPC<50,000/g;Coliform<20/g LAB ANALYST METHOD REFERENCE:Standard Methods For The Examination of Dairy Products, 17th Edition,American Public Health Association,2004 Rn-4rd of Heal+h