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201 FORT AVENUE - BUILDING INSPECTION 201.Fort Avenue UPC 103I Nom �4p HASTINGS. UN ' - a, l THE COMMONWEALTH OF MASSACHUSETTS f C�-"��iTr,V.�,/�J`"7���J� � CITY ALEM HEALTH DEPARTMENT - 9 NORTH STREET, SALEM, MASS. 0197 FOOD ESTABLISHMENT INSPECTION REPORT l o'c3 Establishment Name S�h� L04v �T Date Address a0 F Uc Time: In Out Telephone 7Y� L2 Type of Establishment: Purpose: Owner's Name Food Service Routine Retail Food v Residential Kitchen Follow-up Person in Charge Mobile Unit Complaint L" Temporary Food Service Investigation Inspector's Name Catering Othe, Based on an inspection today, the items checked below indicate the violated provisions of 105 CMR 590.000. Each item is followed by the applicable section of the Massachusetts regulation. Non-critical violations are marked under column"N"and critical violations are marked under column "C". Descriptions of each item appear on the back of this form. Each violation checked requires an explanation on the narrative page(s). This report serves as official notice of violated provisions and official notice to correct said violations. Food € NCI Sanitary Facilities N C 1, F.F,Ogd Supply .002 29. Water Source .015 2 Food Containe�rts .0021-- 002 30. Sewage 016 c, u 31 Cross Connections 017 �Fgs�1 d ProtectiMoon --_lIIIIIIIII32. Toilets/HandwashIng .018 8 019 L3 P.T F Temperaturjes .004 7 Insects/Rodents .021 - 4_ b1cilitie� Hotc$:Qold Storage -004 Plumbing Ot 7 5. :P_}iF Re-s�rvice� .006 5 Toilet Rooms .018 6 ESpoiled/Dt mageo Foods .003 36. Handwashing Areas .019 Food Protmcted� .003 37. Garbage/Refuse .020 B. Food Thermometers .004 ,3�8_ Outside Disposal .020 9. Cross Contamination .005 L 9 Outer Openings 021 10. PHF's thawed, cooked 8 cooled .005 Pesticide/Rodenticide Application .021 1 i. Food Handling .005 12. Dispensing Utensils .006 Pical Facilities 41. 1 Floors .022 Personnel Walls. Ceiling .022 13. Employee Infections .008 1 3 Lighting .023 14. Employee Hygiene .009 .J 44. Ventilation .024 15. Employee Clothing .010 45. Dressing Rooms .025 Equipment 8 Utensils - Other P1��� Equipment/Utensil Clean 8 Sanitized .013 46 Toxics .026 7 Food Contact Surfaces .013 47 Premises 027 18. Non-Food Contact Surfaces .013 48. Living Areas .027 Food Contact Surfaces Clean .013 49. Linen 027 Non-Food Contact Surfaces Clean .013 50 Pets 027 Wiping Cloths .013 Vl Bulk Foods .031 2 Dish/Warewashing Facilities .013 52 Salad Bars 032 23. Pre-Scraped, Soaked .013 24 Wash/Rinse Water .013 1 No of 13 Critical Items Violated 25 Therrnomelers/Test Kits 013 _ These nems require immediate allenlion Equipment/Utensil Storage 014 27 Single Service Articles 014 Received th ' i, apes ed12 28 Single Service Re Use 1ORM 734A HOB©S d WARREN_INC 1965 THE COMMONWEALTH GF MASSACHUSETTS CITY OF SALEM HEALTH DEPARTMENT - 9 NORTH STREET, SALEM, MASS. 01970 Establishment Name Date Address dPage-lof 3 ��A �o.e7' �//c'NUt✓ Item No. In the space below describe all violations checked on front page. E eze�/ 7�is Sc�✓So..�C ,�ooi,/ .0 � lirr eST.v6G, i s c ,o,✓ keit 5r� z a m Z m m m Om I n o —�1_ _ yu` c�'(r air la/(N�� k S✓/l,�,e C.�.vr/�,ir/e� � __!a<_.— - Com_.../�f:_•✓�•S_fc_�-i.'fC "�� � � / — _ c�_L�, [r�%� MS C- c>.. lJ A .11 -b � C'.� T/.1✓T L/l.. e a� �- F �__. - ND S, n ./✓/-L1L/�.��a>H/•ro�,�TL"mot- m- n, Discussion with Management THE COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM HEALTH DEPARTMENT - 9 NORTH STREET, SALEM, MASS. 01970 Establishment Name /SDate Address aO/A Page Sof 3 Item No. In the space below describe all violations checked on front page. ••�� l o;- / - Dill � • ,r/ .�{.> T.1/ /�O�-�/c C.?/J-. v i z - _ ..� /",'_6��Tec�!✓ltKfie..0 �ice�.S TD/4e s�l��,��Tc�l F--cdc./ . .,v_ w /N i cal�/(t > S lJ•K. l-rz t� Cu� 7,90LzQRe ¢ T 3 --- »�.(tee.. /�llSo;g(j!•'-- T / / a - �o�d /JniF.-,.:�2«/ /_.✓ {_�, rc//e.•/ .C2:c .c .z... .`,.--. 0 O -_. _-_-- __—n_�N_1Ti Z�_ /hU.(� _ -fie a✓in r���, ZboX _ tiaT c•a7/tii c_G/ _ _ ' /feSTA�7 tiGG�f /4 �• G e.riSW E.rTt'�Gm.•..�7¢-? l ..q S,S — / Y 70 /vole � l� A.�v ot...veA ern-Dle ry oi[ 0:7k/! P�oSn,f. ,E'�FriSGS i> Discussion with Management - T �ti• xo-, _— COl)P T --�r_L_�2llL' <.�lJa.� cl �ti� C. 0/r_„SP i2�P_�;T m.�' o:7e%'_��✓,,5 .'c..� IMPORTANT MESSAGE FOR A.M. DATE I TIME P.M. M OF I R l Fo,-,-r /�y2 PHONE/ (\-1 g , -1 Lt S-- O G Z<FS CELL TELEPHONED PLEASE CALL CAMETOSEEYOU WILLCALLAGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL SPECIAL ATTENTION MESSAGE 7 Gr-\'t-j T!-Iln1 'P V T- ON N SF-c-(,oyllD PC7(L L i Q t Iy G:n S D fa Ct= HO('JQS IkAS L-IV 6N CA S,p f1Gly POS' 1�(1� Z tLSZIr >v SIGNED l k c{