IL BOCCA ITALIANA RESTAURANT INC - ESTABLISHMENTS IL BOCCA ITALIANA
RESTAURANT INC.
140 WASHINGTON STREET
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0140 Washington Street IL Bocca Italiana Rest. Inc.
City of Salem
FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection
HACCP: ❑
Item Status Violation Critical Urgency
Telephone: Violations Related to Good Retail Practices (Blue Items)
978-744-7333 Physical Facility FAIL Non-Critical BLUE
Owner Comment: There are many stained and damaged ceiling. Repair any leaks and replace all stained and damaged ceiling tiles.
':Patrice Desa0
PIC v Clean all ceiling vents.
Patrice Desa The bottom of the wall near the plate area is chipping/peeling. Repaint wall and provide a molding at the bottom.
Inspector
David Greenbaum here is a hole in the wall near plate area. Repair the hole.
Date Inspected: Correct By:' The back screen door has a gap at the side. Repair door to seal gap.
12/2/2005 The back stairs need to be repainted.
Risk Level:
GENERAL COMMENTS:
Permit Number:, 391:
BHP-2005-0236: •.
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®2005 Des Lauriers.Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Dec 05,2005 ) Page 1 oft
Item Status Violation Critical Urgency
RED:
Violations Related to
Foodborne Illness Interventions
and Risk Factors (Require
immediate corrective action)
� D
City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800
GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Dec 05,2005 ) Page 2 of
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CITY OF SALEM9 MASSA-`..;�✓ !CHUSETTS.
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: IL Bocca Italiana Rest. Inc.
Address of Establishment: 140 Washington Street
Owner's Name: Patrice Desa
Restrictions:
Application Date: 12/3/2004
Permit for Food Establishment 163-05
Frozen Desserts/Ice Cream
Permit for the Sale of Tobacco Products
These Permits Expire December 312005
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.
AL GENT
CITY OF SALEM9 MASSACHUSE l L I II
BOARD OF HEALTH f
• - c 120 WASHINGTONSALEM, MA 0197pTH FLOOR 01.� Z004
.� TEL. 978-741-1800 1. V
FAX 978-745-0343 CITY OF SALEM
STANLEY U. USOVICZ, UR. .JOANNE SCOTT, MPH, RS, CHO BOARD OF HEALTH
MAYOR HEALTH AGENT
2005 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT
�
NAME OF ESTABLISH MENTOQO, 11(''t�� Cuf1C< TEL# "/,11Tt'Z44-13763
W
ADDRESS OF ESTABLISHMENT WU if)I Ucno
MAILING ADDRESS (if different) SafVI\Q C
OWNER'S NAME �A1Jl2rrfCr, 11i\)A Xc u- �eJA TEL# 5( (4b2 �3c16 j6
ADDRESS 2I KJrli ibU 5T•
CITY • STog . STATE tiJA zip_ azli2a
CERTIFIED FOOD MANAGER'S NAME(S) _OEbN CERTIFICATE#(s) E130661S4669
(required in an establishment where potentially
1 hazardous food is prepared.)
1U
EMERGENCY RESPONSE PERSON RT Wkt HOME TEL#'I'1I S3S ��OS
gpA-pPM 11:38pµ- it.ao
HOURS OF OPERATION: Mon. * Tue. Xiol!Ned. 1Thu. Ili Fri."' WSat.4_IQ4_,Sun. 2A-001 .
TYPE OF ESTABLISHMENT FEE check only
RETAIL STORE YES NO 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 0
BED/BREAKFAST YES NO $100
ADDITIONAL PERMITS
MAKE (not just serve) ICE CREAM, YOGURT, SOFT SERVE YES NO $5
TOBACCO VENDOR YES N $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.
P�rsuan to M ter 62C, Section 49A, I certify under the pains and penalties of perjury that I, to my
best knowle e elief, have filed all state tax returns and paid all state taxes required under the law.
� l \ 1130.04 �r 03HOG-0595
Signature Date #ISocial Security or Federal Identification Number
---- - ------- el
Revised 11/03/03 FOODAP2.adm Check#&Date y��� 114, pg_ j�
L66
r� r.
0140 Washington Street IL Bocca Italiana Rest. Inc.
City of Salem
FOOD SERVICE ESTABLISHMENT - FOOD SERVICE REINSPECTION Inspection
HACCP: ❑
Telephone: Item Status Violation Critical Urgency Nature of problem or correction
978-744-7333 Non-compliance with: Done
Owner: Anti-Choking PASS ❑
Patrice Desa Tobacco PASS ❑
PIC: `
FOOD PROTECTION MANAGEMENT Done
Patrice PIC Assigned/Knowledgeable/Duties PASS ❑� RED
Inspector:
;,
David GreenbaumEMPLOYEE HEALTH Done
Date Inspected: Correct-By: Reporting of Diseases by Food Employee and PIC PASS RED
5/5/2005 - Personnel with Infections Restricted/Excluded PASS ❑d RED
Risk Level:
FOOD FROM APPROVED SOURCE Done
Permit Number: Food and Water from Approved Source PASS ❑d RED
.BHP-2005-0236 Receiving/Condition PASS RED
Status: Tags/Records/Accuracy of Ingredient Statements PASS RED
SIGNED OFF Conformance with Approved Procedures/HACCP PASS ❑J RED
# of Critical Violations:;__ plans
x, PROTECTION FROM CONTAMINATION Done
Time IN: Time OUT: Separation/Segregation/Protection PASS 0 RED
Notes. , - = Food Contact Surfaces Cleaning and Sanitizing PASS RED
131: Proper Adequate Handwashing PASS 0 RED
Urgency}Description(s): Good Hygienic Practices PASS ❑d RED
BLUE: + - " Prevention of Contamination from Hands PASS RED
Violations Related to Good
Retail Practices (Critical ry Handwash Facilities PASS ❑d RED
violations must be corrected
immediately or within 10, k
days)(Non-critical violations
GeoTMSO 2005 Des Lauriers Municipal Solutions, Inc. ( Rev. May 06,2005 ) Page I of
0140 Washington Street IL Bocca Italiana Rest. Inc.
must be corrected immediately PROTECTION FROM CHEMICALS Done
or within 90 days) Approved Food or Color Additives PASS ❑Q 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 ❑d RED
Cooling PASS RED
Hot and Cold Holding PASS ❑d RED
Time As a Public Health Control PASS ❑d RED
REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PO Done
Food and Food Preparation for HSP PASS RED
CONSUMER ADVISORY Done
Posting of Consumer Advisories PASS 0 RED
Violations Related to Good Retail Practices (Blue Done
Management and Personnel PASS ❑ BLUE
Food and Food Protection PASS ❑ BLUE
Equipment and Utensils PASS ❑ BLUE
Water, Plumbing and Waste PASS ❑ BLUE
Physical Facility PASS ❑ BLUE _
Poisonous or Toxic Materials PASS ❑ BLUE
Special Requirements PASS ❑ BLUE
Other-See Notes PASS ❑ BLUE Owner must seal all openings around back
screen door.
Owner will fax the extermination contract
with Freedom Pest Control to the Board of
Health upon receipt.
' All other violations cited in 4/28/05
inspection report have been corrected.
GeOTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. May 06,2005 ) Page 2 of
0140 Washington Street IL Bocca Italiana Rest. Inc.
GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. May 06,2005 ) Page 3 of 3
0140 Washington Street IL Bocca Italiana Rest. Inc.
City of Salem
FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection
HACCP: ❑
Telephone:. Item Status Violation Critical Urgency Nature of problem or correction
978-744-7333 Non-compliance with: Not Done
.Owner: - Anti-Choking PASS ❑
Patrice Desa` Tobacco PASS ❑
PIC:
Patrice Desa FOOD PROTECTION MANAGEMENT Not Done
Inspector'. PIC Assigned/Knowledgeable/Duties PASS ❑d RED
David Greenbaum EMPLOYEE HEALTH Not Done
Date Inspected: COrreCt By: Reporting of Diseases by Food Employee and PIC PASS ❑d RED
4/28/2005 Personnel with Infections Restricted/Excluded PASS ❑Q RED
Risk Level:'
FOOD FROM APPROVED SOURCE Not Done
Permit Number: Food and Water from Approved Source PASS ❑Q RED
Receiving/Condition/Condition PASS ❑Q RED
BHP-2005-0236 g
Status: '" Tags/Records/Accuracy of Ingredient Statements PASS ❑d RED
VIOLATION Conformance with Approved Procedures/HACCP PASS ❑d RED
#of Critical,Vlolations. Plans
3 - PROTECTION FROM CONTAMINATION Not Done
Time IN: Time OUT n— Separation/Segregation/Protection PASS ❑d RED
Notes: Food Contact Surfaces Cleaning and Sanitizing FAIL (Critical ❑d RED Diswasher di�reach the mandated
.117:. - \ rinse ted�perature of'180°F. Repair
'+ +� dishes er to to samhze with a final rinse
err perature of 180'F
Urgency Description(s): x 't Proper Adequate Handwashing PASS .I❑ RED
BLUE. t
Violations Related to Good t Good Hygienic Practices PASS ❑Q RED
Retail Practices (Critical, Prevention of Contamination from Hands PASS ❑Q RED
violations must be corrected
immediately or within 10 Vr ° ° Handwash Facilities FAIL Critical RED ` Provide disposable paper at the kitchen
days)(Non-critical violations andwash sink at all times.
GeOTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Apr 28,2005 ) Paze 1 of
4
0140 Washington Street IL Bocca Italiana Rest. Inc.
must be corrected immediately PROTECTION FROM CHEMICALS Not Done
or within 90 days) Approved Food or Color Additives PASS RED
RED:
Violations Related to Toxic chemicals PASS ❑D RED
Foodborne Illness Interventions TIMEITEMPERATURE CONTROLS(Potentially Haz Not Done
and Risk Factors (Require Cooking Temperatures PASS ❑d RED
immediate corrective action)
Reheating PASS ❑J RED
Cooling PASS RED
Hot and Cold Holding FAIL Critical ❑d RED Super" cooling unit had a temperature of
50 Repair unit.to maintain a
emperature of�F or below.
Time As a Public Health Control PASSd❑ RED
REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PO Not Done
Food and Food Preparation for HSP PASS �/❑ RED
CONSUMER ADVISORY Not Done
Posting of Consumer Advisories PASS RED
Violations Related to Good Retail Practices (Blue Not Done
Management and Personnel PASS ❑ BLUE
Food and Food Protection PASS ❑ BLUE
Equipment and Utensils FAIL Non-Critical ❑ BLUE Zaxyerator/freezer and the
eed visible, accurate
the meters.
he microwave needs a thorough cleaning.
Th snopener needs a thorough scouring.
Water, Plumbing and Waste PASS ❑ BLUE
Physical Facility FAIL Critical ❑ BLUE The back must have a tight fitting screen
Ooor if the back door is to be left in the
10
pen position.
Poisonous or Toxic Materials PASS [:1 BLUE
Special Requirements FAIL Non-Critical ❑ BLUE Owner must employ the services of a
licensed pest control operator and have
monthly extermination performed in this
establishment.
Other-See Notes PASS ❑ BLUE
GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Apr 28,2005 ) Page 2 of
0140 Washington Street IL Bocca Italiana Rest. Inc.
GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Apr 28,2005 ) Page 3 of
Antipasto Wsto
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ANTIPASTO SMALL $41.95 LARGE :9.95
MUSSELS CHABLIS $8.95
F..A N....1•S.p1J.i.l On...G..O.-1 CLyNI T u .....
Spy W/11.Wiw S.... L
HOUSE GARLIC BREAD 15.75 , +,
L..bu.7wa 0....•.OO..OO C11-1-w.1y u1 F...1 AJ +��
INSALATA CAPRESE 10.95 �D f''N.N -R=�tE.,N_U
F.A M.,.ydl.Will SO..,T.uw..ArlAl.b..9...t.a
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SALMON CARPACCIO
W..RAW WRL a....Fr...•.,...04..M.11.4 04.1 T"..N P!5 e!
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PAN SEARED SCALLOPS 13.95
S.mIO...C...qui.u..s....Win Mo.l a.......1 a..ul Fm,• GOLDEN SNAPPER sis.95
P•. 5•161.41 R.4 Swq... WOL PIal.tuw Clot T...41 Witt
FRIED CALAMARI AND ZUCCHINI $7.95 SL.II.t Lt«., WLlt. Wl.. B.tt., Sae. S...J W1tL MI..J
S.nJ.itL Fill.l•DI R..J.,e Sae.. V.I.f.U.a
CRAB CAKES 85.95 PAN SEARED SALMON FILLET 115.95
O•,H.uu4 F.A C.aL.A..A.S•wJ WIIL 1,116.4 T.PJ Wilt S..II SL11.1 1. A. A1tIdeL. L.«..S•e..
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O.F..L GAIIJ Pi...rrl.•M•.f•S...•
SILVER GOAT CHEESE AL FORNO $7.95 PAN SEARED SEA BASS $IS.9s
3.6J Cly..G..Nt....S.-.J W.M H...,GIu.J T.P•J Wltl R.uNa T...feo. BI•.L A.J G.... 0111•..
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Zupp! Polio
CHOICE. OF THE DAY CUP sass BOWL $3.95 CteJ•. Of GarJ., Sala) 01$U• Of Put•
LOBSTER BISOUE CUP sass BOWL 19.94
CHICKEN PARMIGIANO sil.95
Pasta
Suet Witt Ga,J.. 9.1.4 CHICKEN MARSALA $11.95
Brunt Of Ctl.l•. S.•f.•J Witt F..L M..&... AJ
FETTUCINI VEGATALI 111.95 M.,..?. W4. T.,tJ Wltl M...ardl. CIO...
S.st•J L.Aa. H.ntr..«.. 2e•.Li,i, FuL T..tsu, an..dt.
DIN. Oil A.J G.J:. S....4 Or•,655 AJ S,4.4 i.u..twl CHICKEN VERDICCHIO $12.95
B...1... GL{.t.. S..bJ Iw Witt. Wt..Wttt Mobe.1.
PHNNE WITH CHICKEN $12.95 Re.•tJ F..... •J Ani.lA• Murl•
Aet.J CUA.,Witt 0.1....SlibL. Mulu•.1. L«at.0 0111,
Oil. G•,R. Ty..J WIIL F.•.L SL..J P..«yt•..Clue. CHICKEN MARGHHRITA
TORTELLINI AL FORNO $12.95 CLIA.. 5uut L47ltly D4PJ 1. Ell 6.111.. A.J Sut..J
B.L•J T,fdli.i SldfJ Will P..i.i AJ SlOt.4i, Mntw..a Awa WitL A,u.L./.., M.•L,...a 1.A Wlit. Wi.. S,... T..•J
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Pa.«tllu.CLuu Witt A T..I Of Ful T..Mu TIIJ Witt 6OCCA ITALIANA'S SPECIAL $13.95
M.uuJl.
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SPAGHETTI WITH MEATBALLS $,9.95 CH.a. 8..•..U. P.1s4y AJ B.aO. Ty.J Will, L.....Cal.,
Sa.... S...44 Win MI.J VgdaLlu 6.4 Blatt Ftabu
SPAGHETTI WITH MARINARA SAUCE 1 9.95 POLLO VEGETALE st1.95
RAVIOLI WITH MARINARA SAUCE $Io.9S SL.f..J M.JLIII... Of CLI.L.. WIIL P....... 0.1...,
Z.-L1.1 B.....l B. Rut T•.•b•a . WUt. WI., AJ 01q..e
LOBSTER AND, CRABMEAT RAVIOLI sn,75
T...•J WIn S.d..J SL,I., AJ S.01.,. I.Cru., L.L.t., S.... Carty!
LINGUINE DEL GOLFO $12.95 CL.I..Of G•,J..SOW O. 10,01.RI Fl1.0.DI v...J...s•...
U.ldu W1tl S..ta.a M.... 361.p S.allq..S..IR•..,
Ful T.-&t...Witt Gall. A.J Oil CHICKEN PARMAGIANO
PRIMAVERA 'TUTTO OI MARE" $11.95 VEAL PARMIGIANO $13.95
F..l stn...S-11... A./ C,.&-..t Win s..t. a.....It, i
Z..AI.I. C.rr•t•.S.,J,I.a T.aOu Sort Oe..TLI. VEAL MARSALA $14.95
SplLdtl 1.A C..,., R...t.S.... S..IIglwi Of Vul S•.t.J WRL Fut M.A,...• A.J
SHRIMP AND SCALLOPS $15.95 M..•.I.Wt.. T.".J Will M......11. Cl....
S..NJ St,l.l A.a S.all.n Witt Gall. Sealhe.. VEAL FRANCESE Issm
C...0..JR...1.4 P..... 1. A FruL T...t.S..... V.al Lll Ltll DIII.J I. Ell Batt.. A.J S..b•J W11L
S....a WitL fill Fitt-1.1 AJ T..I.J NO. 6,..a A.ta.Ld•a A.a Cal..a 1. A Lu.. Sal• 3a•.. 3owa
LINGUINI AND CLAMS $14.95 Wi1tL MA..a V•l.f.Ll.• a./ R.ut.J Ft•t...
Lllll• 14.4 C6., 0... L4pLi. Yes,CLA.1 d VEAL CHOP 116.95
4-1;. A.J 0:1 O, M..bo. S....
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FRA DIAVOLO 11,.95 T•.P.J WIIL A P•,f WI.. 3.... A.J S.-.4 WRL Ml,..
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FILET MIGNON $17,95
SHRIMP SCAMPI $15.95 6r111.4 FN.t MiS..w TPP•) Witt Sa.t..J F.A CL...Ill.
S..nJ Sbip.Ctoy T.161.11.,0.1...A.J P ..1 0.1.... S.alli... AJ Tel Of Balu.i. VL.y,
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MARI 14ONDO 115.95 PLEASE ASK TO SEE OUR DESSERT AND CAFE MENU
3b1..,5•.141.. M.uda AJ Cl... S•.tI.J Iw A Bn Ja
A.J Glop Tut.5.... O,WLII. Wl.• 5.... Sort
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I ALL PASTA PREPARED AL DENTE
LUN 3ENU
I Antipasto Misto Pollo Magnifico!
I "OUSE GARLIC DREAD WITH CHEESE $1.96 S....4 Witt Rsl•t..1 F1611.m P-J...
L«•bu,S.•.1 0.;....A.d.f.CR..t»,ON,.Oil A.J Fwal S•.J
Tg9J Witt Maannlla C41". CHICKS" PARMIGIAHO 86.95
FRIED CALAMARI AND ZUCCHINI 1695 VERDICCHIO $7.95
C.LM FI.J GI•ua.i S..r•J WAIL F11d1.DI P.•J.e DI99ty Saw• 5..Ju.CLidr..Bua•t S•.1HJ Ful M•d....s,R..•t.J P•9fo
A.J A.ttal.Lit 1.A V•rJ:••li.Wt.• Sa..•Witt A Lul Of Lt...
PAN SEARED SCALLOPS $7.95
$vJ Oar A Cuarf Cilawtr.Saw•Witt MbJ Guos A.J MARSALA 51.95
R...t•J N"... a...1..•CU.&.. B....t S..f•.J Witt F...I Mw.l.r..• A.J M...•I•
DOCCA ITALIANAS CRAB CAKES 14.11; WI..T.p44 Witt 14... ,.It,Chiu
M..sa.44s Fust Gal Gin.Str 4 Will Mb44 Gnos a.J A Cl•iu if PiORENTINA t1.v5
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I MUSSELS CHABLIS $7.95 L.N.0 Witt A S91.4 Of Witt.WI..Lff.J WIN Sfl.•ol.C•,...
F",%Minds Sut.N Witt 0.1os.6a.li•A4 CMpfJ AJ F.H.a Clan•
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B...a Ilap•wi•F..L Vy.bLl.AwHpd..P..p.d Day SAUSAGE TORE t1Jf
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SOCCA ITALIANA SPECIALTY {1.95 pasta
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Mal...... Ca.lifbr•.,CL.•q b.•bu,Foo 14......If., 3....A Witt G. SaJ
Ef711a.t. P.....IN.D• P.r.. O••r M1•.J G.••.s T..44 Witt PETTUCINI V966TALI 11.9f
Wa•. $16.4 F110 Mll... Fral Sa.tuJ 0..a•It.Sfba•l.CL.rq Galas,Z... :.l.
PASTA SALAD WITH GAMSERIh.fe b9a..ys.Sw.q•... G...b.S..J.I•J To.abu 1.A Galt. A.J 011
Pnil" P..b T...J Will Mi..J G....., M•Ilwat•J EfiflawL Sao. SouJ Witt Elf A.J S+laad Fdfv.1.1 L9+J Witt SbrsJ
A,1114.to. Rras11J Pppu. M.d...w, A..J Pr.d•J$.all P••«tft...Cl....
SLA.,T.9f•J WIN Salsario Viwapat• A.J G.r9....1,CL.... PRIMAVERA TUTTO D' MARE $8.95
CRADMEAT SALAD 51.95 Ful SMi.p Swllga AJ C.a&..•t Will S..taJ Sa...It.Z.-M.1
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GRILLED SCALLOPS B SALAD 1895 SHRIMP GIARDINERA WITH LINGUINE 18.95
Grlll•J A.J Ma.iw.NJ S.aMfa Sow44 Or.. Mb•J G..ana W;/& S..t,S&A.,Will Bondi,Cl orf L.at.u. Ode. 1.a G.46
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Frul M•su.dla CL••s•. MUSSELS WITH SPAGHETTI
CHICKEN PE3TO SALAD $7.95 C.IIt..t.J M....1. Sa.s..J 1.A F.at T....t.S...r O.4a.bJ 1.
0.11144 Qlstu B••ast 7Lsst,l Wilt to.a "ahawi.Snap P•str Ga•16.O".. Oil AJ P .. S....J 0...S9yld11
4.4 Po.. Pasta.SoaJ Oao MbsJ Go.s.s. Last.J AI...Js. POLLO PRIMAVERA WITH PENNE 11.95
Tuu1,.•.A.J R•atJ P ..tr. Sa.t.Curb.Witt 6...•.11.3... Pit..M a ..C....U A.J
OUR SOUP Of TL. DAY C., $a.#$ B..1 $8.9s ClgptJ T..al... 1. A Ca•.f R.et.Su.•Lf9•J Will Sl•wJ
Pa..ifi•..Clew
P RAVIOLI DELLA CASA $6.95
P..I.. Sa+•J Wlll PaN
Phil, IuJ . 0, C.f Of $•.f Foul M..•.J•Chis• 86•141 Sa.t.•J Witt Owl..•. Pits.
DOCCA ITALIANA'S SPECIALTY 14.95 Mnbars Will B•Lpm Su.•
Roast Port. Har. F•..tina CN•... R.a6144 Petra. Wit& BAKED PASTA licts
$fl.f Maf•wwatst Pil.t•a P•.b B•L.J Witt Fi1.tt.Di P.«.J..•T.9f•J Witt SH..J
THE GRILLED VEGETABLE $6,95 Mot&alls A.J MdH4 M..n.dla Chis.
P....... 0.1.... M.al...r., T..at.u. Z...Lt.&. BAKED TORTOLLINI IN CREAM SAUCE $6.95
Efflla.t A.4 Pout M...a.dla
T..nIU.t Pill•J WIN Ri..ih,Cl.... Ad SoJriJ T.uha Lffd
OUR OTTIMO STEAK $1.9s Witt P:•.it Of Pos••itl•A.J G•.fo..14 Cl•it• Sa..•
G.i11N F:IJ Mil... T.9t.J Will $.wf••J' 0.1..%, SPAGHETTI BOLOGNESE 1695
Pet fin. Mnt.ors.Cl•..f T•.afa. A.J • ... of
Bdsa.I• VI..l., SL76tt1 Tq•J Witt O., N.uwaJ. Bdy.u.
THE CLASSIC ITALIAN $7.95 BAKED EGGPLANT PARMIGIANA $1.95
M.•la J.l la, P.....fit. D• Par.•. R...tit Pg9o.. St.ff.J Witt P.....IR.. F.wtba C&..s. Pat.A.J R...td 9.....
Litt.., $ala.i, T...t..s Aw4 F•wliw. CL.... T.ff•J Witt M......01. A.J R.ast J Moslaos IAI..A.a1.Ll.
Mittlud. fa1.4 Witt $W 044•.Of 01,10-1 Witt Pil.1t.Di
CHICKEN PESTO 16.15 P.r.J..o S....
G.nI.J CLI./.. Brut 14.11.2,11414 Witt Pill. A.J
Rut Not• A.4 T.l+d Witt. T.ub. L.tt..• A.4 All Pal• ..... At Dal•
G.III.J R.4 0.1...
PLEASE ASK TO SEE OUR DESSERT AND CAFE MENU -
MONEY MUSTARD CHICKEN 16.9s
0.III.4 toast Witt ......a. "..p M•.iaN Su.•
T.fpJ Witt P....l... Cl.•.•,LraL it. Lift... A.J ,r •� ` ,
CRAB PARING WIT" SHRIMP SALAD 11.95 B U O N A
F...L R..I Ga& Saint T.9+.4 Witt Sall Slri.9 A.4 Cj. ' O R N O
MI.NJ G.0uu
.s. S•..•J O. O.• Fol Bot. ,
ROAST TURKEY PANINO $6.95 t
D.•.a Ibliawa'• R.ast4J T.ot•f. T...*4 Wit& t
A.U•l.la, T.«•boa, BI..L 061.... Mb.J G.•.w. A.J D I V E R T I R S I ! ! !
M.1t.4 F..#1.. Clear
' CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
_ 120 WASHINGTON STREET, 4TH FLOOR
)d SALEM, MA O 1970 _
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: IL Bocca Italiana Rest. Inc.
Address of Establishment: 140 Washington Street
Owner's Name: Patrice Desa
Restrictions:
Application Date: 3/12/2004
Permit for Food Establishment 280-04
Frozen Desserts/Ice Cream
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,
Sanitary Code before an renovations
In accordance with the State S ry y ,
improvements, or equipment changes are made, all plans for such must be
submitted to and approved by the Salem Board of Health.
HEALTH AGENT
s
CITY OF SALEM, MASSACHUSETTS
r"t BOARD OF HEALTH
• 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
2004 APPLICATION FOR
t�PERMIT
TTOO OPERATE A FOOD ESTABLISHMENT
NAME OF ESTABLISHMENT IL yOCCC� ``1To�cnc��s1 IeK,TEL# NiA
ADDRESS OF ESTABLISHMENT SA LC )'t VAIN-
MAILING
AIN-MAILING ADDRESS (if different)
OWNER'S NAME 1hh�RICA b6SA TEL# 611 -S(o 1-023`7
ADDRESS
CELttlS[�9,- f�2 301%0CITY EAS-T oi'J • STATEM ZIP 021 '28
CERTIFIED FOOD MANAGER'S NAME(S)�-1121CF 11 CSA_ERTIFICATE#(s) jk3 IS9609
(required in an establishment where potentially hazardous
food is prepared.)
EMERGENCY RESPONSE PERSON �AVd,f Oe JAV HOME TEL#()11 -X561- 0`LD
i1= n' u:3o it=3c' Ito C6lL k�tl- 6"777 UUa
HOURS OF OPERATION: Mon.0 Tue. Wed.�o Thu.�Fri. Sat."" oSun. 12�
P^'
TYPE OF ESTABLISHMENT FEE check only
RETAIL STORE YES O less than 1000sq.ft. =$50
1000-10,000sq.ft. =$100
more than I0,000sq.ft. =$250
RESTAURANT NO less than 25 seats =$100
25-99 seats =$150
more than 99 seats =$200
BED/BREAKFAST YES NO $100
ADDITIONAL PERMITS
MAKE(not just serve) ICE CREAM, YOGURT, SOFT SERVE YES NO $5
TOBACCO VENDOR YES $50
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
est o leddeaii-cl-be lief, have filed all state t tate taxes required under the law.
J C, ` 10-y3b62 110
Signature Date Social Security or Federal Identification Number
---------------------------------------------------------------- ---------------------�--�,--/----------------------------------------
Revised 11/03/03 FOODAP2.adm Check#8 Date T8 3 3/:; �yL-
Massachusetts Department of Public Health Salem Board of Health
120 Washington Street,41h Floor
Division of Food and Drugs Salem, MA 01970-3523
FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343
Name Date /� Typ of Operation(s) Tyne of Inspection
IL e_ /a/ Food Service ❑ utine
AddressRisk ❑ Retail Re-inspection
ILId �'� �- Level ElResidential Kitchen Previous Inspection
Telephone t S` 02.77 m ❑ Mobile Date:
Owner HACCP YM ❑ Temporary ❑ Pre-operation
P ❑ Caterer ❑ Suspect Illness
Person in Charge(PIC) 5 j_ Time ❑ Bed&Breakfast ❑ General Complaint
In: El
Inspector Out: Permit No. ElO herr-
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 And-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
El 3. Personnel with Infections Restricted/Excluded El
FOOD FROM SOURCE
❑ 15.Toxic Chemicals
' "" - ' '""
❑ 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 [:117. 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
[_1 9. Food Contact Surfaces Cleaning and Sanitizing . REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)
El 10. Proper Adequate Handwashing E]21. Food and Food Preparation for HSP
ElCONSUMER: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
ofC Health. 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
4. 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
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
/ 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,5M�,nFo„ 14dm�
Inspector's Signature: Print:
PIC's Signature: \}� Print: '-� l �A PageA 0f Pages
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* 3-302.11(A)(I) Raw Animal Foots Separated from
590A03(B) Demonstration of Knowledge* Cooked and RTE Foods*
2-103,11 r Person in charge-duties Contamination from Raw ingredients
3-302.1 1(A)(2) Raw Animal Foods Separated from Each
EMPLOYEE HEALTH Other`
2 590.003(C) Responsibility of the person in charge to Contamination from the Environment
require reporting by food employees and 3-30211(A) Food Protection'
applicants' 3-30115 Washing Fruits and Vc,,etables
590.003(F) Responsibility Of AFood Employee Or An 3-304.11 Food Contact with Equipment and
Applicant To Report To The Person Tn Utensils*
Charge" , Contamination from the Consumer
590.003(G) Reporting by Person in Char e* 3-306.14(A)(1i) Redu and Fax]and Reservice of Food-
3 590.003(D) Exclusions and Restrictions'( Disposition of Adulterated or Contaminated
590.003(h) Removal of Exclusions and Restrictions Food
3-701.11 I Discarding or Reconditioning Unsafe
FOOD FROM APPROVED SOURCE Food*
4 Food and Water From Regulated Sources 9 Food Contact Surfaces
590.004(A-B) Conteh mec with Food Law'" 4-501-111 Manual Warewashing-[lot Water
3-201.12 Food in a Hermetictll} Sealed Container' Sanitization Pen.crannies*
3-201.13 Fluid Milk and Milk Products* 4-501.1.12 Mechanical Warewashing-Hut Water
3-202.13 Shelf&»s* Sanitization Tem eramres*
3-202.14 E es and Milk Products.Pxstetuizeci* 4-501.114 Chemical Sanitization-temp.,PH,
concentration and hardness
3-202.16 lee Made From Potable Drinking Water
5-1.01-11 Drinkin,, Water from an Approved System* 4-60tll(A) Equipment Food Contact Snrfaczs and
590.006(A) Bottled Drinking Water* Utensils Clean*
54 4-602.11 Cleaning Frequency of Equipment Foad-
0.006(B) Water hands Standards in CMR 220` Contact Surfaces and Utensils*
Shellfish and Fish From an Approved
oved Source 4-70211 frequency of Sanitization of Uten0s and
3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of Equi men(*
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
Re Mato Author' 2-301.11. Clean Condition-Hands and Anes"
3-202.18 Shellstock Identification Present" 2-301.12 Cleaning Procedure*
590 004(C) Wild Mushrooms* 2-301-14 When to Wash"
3-201-17 Game Animals' 11 Good Hygienic Practices
S Receiving/Condition 2-401.11 F..atina,Drinking or Using,Tobacco*
3-20211. PHFs Received at Pro ter Tent eraau.es* 2-401.12 Discharges'From the Eyes.Nose and
3-202-15 Packaee Into nit "
Month*
3-101.11 Food Safe and Unadulterated* 3-301.12 PreventineContamination When Tastin=*
6 Tags/Records:Shellstock 12 Prevention of Contamination from Hands
3-202.13 Shellstock Identification* 590.004(E) Preventing Contamination from
3-203.12 Shellstock Identification Maintained' Ent(]ovens*
Tags/Records:Fish Products 13 Handwash Facilities
3=102.11 Parasite Destruction, Conveniently Located and Accessible
3-402.12 Records.Creation and Retention* 5-303.1.1 Numbers and Ca acities*
590-004(1) Labeling of Ingredients' 1 5-204.11 Location and Placement*
7 Conformance with Approved Procedures
5-205-11 Accessibility,O ration and Maintenance
IHACCP PlansSupplied mth Soap and Nand Drying
3-50211 Specialized Processing Methods* Devices
3-50212 Reduced oxvaen packaging,criteria'' 6-301.11 Ilandwashing,Cleanser.Avarlab8ity
8-103.12 Conformance with Approved Pnxxdores*. 6-301.12 Hand Drvin,.Prorision
"Dcnoter critical reran in the tellers] 1999 Food Code or 105 CMR 590.000.
CITY OF SALEM
BOARD OF HEALTH
Establishment Name: �G CG/� /rifu Ar/4 d /'3 d"r Page: Z of Z
Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Vete
;f No. Reference R—Red item Verifietl
--PLEASE PRINT CLEARLY
X11 C (�Qc,�r Sca.csbY.r mea .�s/' rSs ,tc,i-off PU c.�r d' .aro smF ht,. K.�
r &n t /uz0+001 i s eiP�fJ N vi c e ��SPdC3"re/✓
!�II�7N /hf'J2f N /t�C.e�iCl2�
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 twg ty�fi..ve dollars'o pen, sion/revocation of ❑ Embargo ❑ Emergency Closure
your food permit. Ll Disposal L3Other:
3-561.14(C) PHFs Received at Temperatures
Violations Related to Foodborne Illness Interventions and Risk According to Law Cooled to
Factors(items 1-22) (Cont.) 41°F/45T Within 4 Hours.
PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs
14 Food or Color Additives 19 PHF Hot and Cold Holding
3-501.16(21) Cold Plus Mairatened at or below
3-202.]2 Additives* 590.004(F) 41"/45"'F*
3-302.14 Protection from Unapproved Additives* 't-501.16(A) Hot PHFs Maintained at or above
I$ Poisonous or Toxic Substances -
40"F
7-101.1 I Identifying Information-Original 3-501.1.6(A) Roasts Held at or above 1300F.
G>ntainers*
Control
7-102.11 Common Nat -Working*Containers* 20 Time as a Public Health
7-20t.11 Separation-Storages` 3-507.19 Time as a Public Health Contrnt*
7-202.11 Restriction-Presence and Use* 590,004(H) Variance Re nirement
7-202.12 Conditions of Use*
7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
POPULATIONS(HSP)
7-204.1 l Sarntizers,Criteria-Chemicals'"
7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.1 1(A) Unpasteurized Pre-packaged Juices and
Beverages with Warning Labeds�
7-204.74 Drina Agents.Criteria* 3-801.11(B) Use of Pasteurized Egos*
7-205.11 Incidental Food Contact. .Criteria* 3-801.11(D) Raw or Partially Cooked Arinnal Ford and
7-206.11 Restricted Use Pesticides.Criteria* Raw Seed Sprouts Not Served. *
n
Rodent Bait Stations"` 3-go1.11(C) Ra toned Faxi Packs=e Not Rn-served. "
Tracking Powders,Pest Control and
Mmutorin�*
CONSUMER ADVISORY
TIMEfrEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
16 Proper Cooking Temperatures for Animal Foods'Phat are Raw. Undercooked or
PHFs Not Otherwise Processed to Eliminate
3-401.L1A(ll(2) Eggs- 1.55°F 15 Sec.
Pathonens,*e'hxooa rrosom
Ergs-Immediate Service 145",Fl 5sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
3-401.11.(A)(2) Comminuted Fish, Meals&Game E gs*
Animals- 155°F 15 sec. ,r'
3-401.11(11)(1)(2) Pork and Beef Roast- 13WF Ll min* SPECIAL REQUIREMENTS
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 fool, temporary and
3-40t.11(.A)(3) Poultry, Wild Came,Stuffed PHPs, residential kitchen operations should be
Staffing Containing Fish,Meat, debited under the appropriate sections
Foultr or Ratites-165`1 15 sec. * above if related to foodborne illness
3-401.11(C)(3) Whole-muscle,Intact Beef Steaks interventions and tisk 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 sec.
f7 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-403.11(A)&(D) PHFs 165°F 15 sec. * (Items 23-30)
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}'actors listed above, can be
3-403.11(C) Commercially Processed RTE Fond- found in the following sections of the Food Code and 105 CMI?
_
140"F* 590.000.
3-403.11((3) Remaining Unsliced Portions of Beef Item Good Retail Practices. FC 580000
Roasts" ( 23. Mang ement and Personnel___..._ FCC
IS Proper Cooling of PHFs 24. Food and Food Protection FC- 3 .004
25 Equipment and utensils __FC 4 _ A05
3-501.14(A) Cooling Cooked PHFs from 140°F to _____ _M. _ Water, Plumbing and Waste FC-5 .006_____
70"F Within 2 Hours grid From 70°F 27. Ph sisal Facility_ FC-6 .007
to 41°F/45"F Within 4 Hours. * 28. Poisonous or Toxic Materials FC-7 .008
3-501.'14(B) Cooling PFIFs Made From Ambient 29. S ecial Rs uirements _ _ .009
Temperature Ingredients to 411V45°F 30,__ Other _-�
Within 4 Hours'" ssunmantt+.e zm„
Denotes critical item in the federal 1999 poral Code or 105 CMP 590.000.
Massachusetts Department of Public Health Salem Board SHealth
120 Washington Street,0 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 Ooeretion(s) T�ytg�", f tnsaection
L 4/ A 1; 610th a'FgO Service ('Routine
Address Risk ❑ Retail ❑ Re-inspection
Level ❑ Residential Kitchen Previous Inspection
Telephone7- L - 3 (+!� ❑ Mobile Date:
Owner HACCP Y!N ❑ Temporary ❑ Pre-operation
{j�� E El Caterer El Suspect Illness
Person in Charge(PIC) x+ Time ❑ Bed& Breakfast ❑General Complaint
7� In: ❑HACCP
Inspector / out: Permit No. ❑Other_._
A-VoEach 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 590.005(E) ❑ 590.009(F) ❑
action as determined by the Board of Health.
47,.FOOD PROTECTION MANAGEMENT o-"`, , ❑ 13/Prevention of Contamination from Hands
❑ 1. PIC Assigned/Knowledgeable/Duties 13. Handwash Facilities
❑ 2.OReportinLof Diseases b Food Employee a
PROTECTION FROM CHEMICALS
Reporting y „andPlC ..w.
[114,Approved Food or Color Additives
❑ 3. Personnel with Infections Restricted/Excluded
❑ 15.Toxic Chemicals
FOOD FROM APPROVED SOURCE ...a , . 1--- ...- fTIMEnEMPERATURE CONTROLS(Potannaily Hazar-dous Foods}
E] 4. Food and Water from Approved Source -_, A
❑ S. 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 tREQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)'„ -=.
❑21, Food and Food Preparation for HSP
❑ 10. Proper Adequate Handwashing
❑ 11. Good Hygienic Practices a 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- Y' 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
26. 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: fO
Sa9pinscecrForms-id0oc l l
Inspector's Signature: Print:
PIC'sSignature: Print:,,N r1 (� �RLe.�lp �M1 FPPagee�offl Pages
f ' S
Violations Related to Foodborne Illness
Interventions and Risk Factors(items 1-22)
PROTECTION FROM CONTAMINATION
FOOD PROTECTION MANAGEMENT 8 '', Cross-contamination
1 x90A03f.k) Assignment of Responsibility* 3-302.ll(A1 Raw Animalm
Foods Separated fro
590 003(B,_ Demonsh.ation of Knowledge* Cooked and RTP Foods*
2-103.11 Person in charge --(little s Contamination from Raw Ingredients
3-302.1I(A)(2) Raw Animal Foods Separated from Each
EMPLOYEE HEALTH Other*
590,003(C) Responsibility of the person in charge to Contamination from the Environment
L21 require reporting by foot employees and 3-302.11(A) Food Protection*
a �licants" _ 3:302.15 FY ashin-Fcults and Vegetables
590.003(1-) Responsibility Of food Employee Or An 3-304.11 Food Contact with Equipment and
Applicant To Report To The Person In Utensils*
Charge' Contamination from the Consumer
590.003(0) 3-306.14(A)(B) Returned Food and Rescrvicc of Food"
3 590.OWiD) Exclusions and Restrictions" Disposition of Adulterated or Contaminated
590.003(,1-) Remooat of Exclusions and Restrictions Food
3-701.11 Discarding or Reconditioning Unsafe
FOOD FROM APPROVED SOURCE Food*
4 Food and Viater From Regulated Sources 9 Food Contact Surfaces
590.004(A-Bl Comphan e wifh Foal law* 4-501_111 Manual Warewashing- Hot Water
3-201.12 Foots in a Hermetically Scaled Container* S uunzation tem teratures*
3-201_t3 Fluid Milk and Milk Products* 4-501.112 Mechanical WarewashinHot Water
3-202.13 Shalt Eggs* Sanitization Tem eratures*
3-202.14 ER is and Milk Products.Pasteurized`
4-501.114 Chemical Sanitization-temp.,pH,
3-202.16 Ice Made Froin Potable Drinking Water"
concentration and hardness.*
5-101.1.1 Drinkin Water front an A roved System* 4-601.J I(A) Equipment Food Contact Surfaces and
Utensils Clean*
590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency ofHquipment Food-
590,006(B) Water Meets Standards in 310 CMR 22.0" Contact'Surfaces and Utensils*
Sneilllsh and Fish From an Approved Source4_702.11 Frequency of Sanitization of Utensils and
3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces_oPE
Shellfish* 4-703.11 Methods of Sanitization-Hot Water and
3-207.15 Molluscan Shellfish from NSSP Listed Chemical*
Sources* 1p Proper,Adequate Handwashing
Game and Wild Mushrooms Approved by 2-301.11 Clean Condition-Hands and Arms*
Re u(ato Authorit
3-202.18 Shellstock Identification Presents' 2-301.12 Cleaning Procedure*
590.004(0) Wild Mushrooms* 2-301.14 When to Wash*
3-201.17 _ Game Animals* ll Good Hygienic Practices
5 Receiving/Condition 2-401.I I Eating,Drinkin or Using Tobacco*
3-202.11 PHFs Received at Pto er Temperatures* 2�OL i 2 Discharges From the Eyes,Nose and
3-202.1.5 Package Ince rit * Mouth*
3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When Tasting*
L6 TagsiRecords:Shellstock 12 Prevention of Contamination from Hands
3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from
Ell3-203.12 Shellstock Identification Maintained* Ha tondwash Facilities
Tags/Records:Fish Products 13
Conveniently Located and Accesslbte
3-402.11 ParasiteDcntnuaion*
3-402.12 Records.Creation and Retention* 5-203.11 Numbers and Ca gonias*
590.004('1) Labeling of ingredients' 5-204.11. Location and Placement*
7 Conformance with Approved Procedures 5-205.11 Accessibility.O aeration and Maintenance
/HACCP Plans Supplied with Soap and Hand Drying
3-502.11 S ecializxd Proeessine Methafs* Devices
6-301.11 Handwashin
3-502.12 Reduced os gen tackang,criteria" Cteansec,Avaitabilit-
8-103.12 Conformance with Ai rt,xed I o edures* 6-301.12 Hand Drng Provision
"Denotes critical item in the Cameral 1990 food Code or 105 Ch1R 590.000.
CITY OF SALEM
BOARD OF HEALTH
Establishment Name: IL rge /f AclM1A Date:��-/ Page: Z of
Item Code C-critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date
No. Reference R-Red Item Verified
PLEASE PRINT CLEARLY
?A1 Aj, 05A-Coo(! aCl,[ DaCS' 6F Y 4c. 1<errAkP4 Frt6A# o&n^. Ali_ "I d-s
4s>: [£dr` o Murf F Sb, rJ CA_d5' t .
tJ C P AS UNItlNlS mitiotr mtnr ,gz A" rHPkEVijdr
f'� C Qu+�s►t TiNR D s'r A& 10Ati9K P"orufcs. eVr ,t' Ar Pew�t�
►tF£R6ttot�ts a t,6A riotte Ar Att_ yimirr.
r'3 e t criarN H 1t- 0d9 WE uMsri r/NR 6'31' & Cas
r (/iLay1W A-LL- N63_
G b LA41r 1 C0 vo If./ AaAfor
•r
M�s>r f.6'�it268
ST7 N e elnl 0&f- 61 rnr"M !' /eA N Mr o Ole r LV10
+_f ?moikie t aeL Ccs IPI6
x-
r7f, N C S r s .eec r+mtAilart o f ae 0 GK brei T 0 Mef!
.ra4 Awa rmdrn m ower Mit
t
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. p
❑ VoluntaryDisposal ❑ Other:
I
3-501.14(0:) PRFs Received at Temperatures
Violations Related to Foodborne fitness Interventions and Risk According:to Iaw Cooled to
Factors(items 1.22) (Cont.) 4I°F/45".E WiChrn 4 Hours. *
PROTECTION FROM CHEMICALS 3-501.15 Coolina Methods for PHFs
14 Footl or Color Additives 19 PHF Hot and Cold Holding
3-50 L I6(B) Cold PI11's Mammined at or below
3-202.12 Additives" 590.004(F) 41 V45°F*
3-302.14 Protection from.Una> roved Additives*
3-501.16(A) Hot PHFs Afaintained at or above
1=515 Poisonous or Toxic Substances
140"F "
7-101.11 identifying Information-Original 3-501.16(A) Roasts Held at or above 130°F.
Containers*
7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control
7-201.11 Separation-Storage" 3-501.19 Timc as a Public Hcawh Control*
7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement
7-202.12 Conditions of Use" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-203.11 Toxic Containers-Prohibitions" pOPULATIONS(HSp
7-204.1'1. Sanitizers,Criteria-Chemicals*
7-204.1.2 Chemicals for Washiq Produce,Criterias21 3-80'1.1l(A) Unpasteurized Pre-packaged Juices and
Beverages with Warning i abels*
7-204.14 Drvin tuts,Criteria" 3-801.11(B) Use of Pasteurized Ecga*
7-205.11 Incidental Food Contact.Lubricants' 3-801.11(D) Rau or Partially Cooked Amma7 Food and
7-206.1 t Restricted Use Pesticides.Criteria*
Raw Seed S xouts Not Served.'t
7-206.12 Rodent Bart Stations* 3-g01.11(C1 Uno aped Fcwd Parka>e NotRe-served.
7-206.13 Tracking Powders.Pest Control and
Monitoring*
CONSUMER ADVISORY
TIMEITEMPERATURE 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 Eliatinate
Pathe ens
3-401.I1A(1)(2) Eggs- 1.55 T 1.5 Sec.
�r Te.-E,rxooi
E w,s-immedi ate Service 145°F15sec- 3-302.13 1 Pasteurized Eggs Substitute for Raw Shell
3-401.11(A)(2) Comminuted Fish,Meats Xz Game
E gs*
Animals- 155`•"F 15 sec. "
3-401.1 l(B)(1)(2) Pork and Beef Roast - 130`''F 121 rain* SPECIAL REQUIREMENTS
3-401.11.(A)(2) Ratites,Injected Meats-155`F 15 590.009(A)-(D) Violations of Section 590.009(A)-(D)in
sea * catering,mobile food, temporary and
3-401.1.1(,)(3) Poultry,Wild Game,Stuffed PHFs, residential kitchen operations should be
Sniffing Containing Fish,Meat, debited wider the appropriate sections
Poaltr or Ratites-165°.F IS sec. ,, above if related to foodborne illness
3-401.1 l(C)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other
145°P* _ 590.009 violations relating to good retail
3-401.12 Raw Animal Foods Cooked irr a practices should be debited under #29
- Microwave 165F* Special Requirements.
3-401.11(A)(I)(b) All Other PHFs-145°F 15 sec. * -
/7 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-403.11(A)&(D) PHFs 1650F 15 sec. " (Items 23-30)
3-403.11(H) Microwave-165°F 2 Minute Standing Critired and non-critical violations. which do not relate to the
Time" foodborne illness once ventions and risk factors listed above, can be
3-403.11(C) Commercially Processed RTE Food- found in a the following,sections of the Food Code and 105 CtYIR
140"F* .590.0.06.
q . Good Retail Practices F 590.000---
Item_ 403.11(E)� Remautina„tinsliced Portions of Beef
Roasts` 23. Mana in ent and Personnel _ FC-2 .003
1g Proper Cooling of PHFs 24 Foodand Food Protection _.__ FC-3 .004
25. __ Equipment and Utensils FC -4 __ 005
3-501.14(A) Cooling Cooked PHFs from 140°F to 26. Water,Plu_mbinq and Waste FG 5 006
70"F Within 2 Hour and From 70°F 27. Physicai Facility FC-6 I .OD7
_o_______ FC-7 .008
to 41'F145 F Within 4 Hours. 28. Poisonous or Toxic Materials „__--_--_
3-501.14(B) Cooling PHFs Made From Ambient 29. 5 e iiaq Ra uirements 1 .009
Temperature ingredients to 41TF/450F 30. Other
Within 4 Hours'# Is'-)Re.*xe ami
"Denotes caitical item in thx taleral 1999 Pood Cade or 105 CMR 590.000.
l
i
CITY OF SALEM
BOARD OF HEALTH
Establishment Name: IL PnecA (TALfA-NiA Date: /dAb+/ Page: of
Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Data
No. Reference R-Red Item J - Verified
PLEASE PRINT CLEARLY
S eAlf r,R. ps t*- opt+r c1OsAA40MS rUit._ 0-6 liff 0d A 0CT
i
S ii%l7tNi - SoLvftdlM NVr a tmoage r D S . XA14 i rit_t S7atrnel�
,tit v sr 114, .awl to Al- &-jo A k s A-V_ 4.
i
drfel�Aurt 1111FAITAIf- cs�r-
N wA9/ i
X ,tMi
o®a
I
& Roo S
i
I
I
I
I
Discussion With Person in Charge: Corrective Action Required:- El No Ll Yes
have read this report, have had the opportunity to ask questions and agree to correct all c3P
Voluntary Compliance ❑ Employee Restriction/
violations before the next inspection, to observe all conditions as described, and to Exclusion
P Ll Re-inspection Scheduled LI 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
3-501,14(0) PHFs;Received at"Tenrincratures
Violations Related to Foodborne fitness Interventions and Risk According to Law Cooled to
Factors(items 1-22) (Cont) 4 I'F/45'F Within 4 Hours.
3-501.15 Cooling Methods for I1HFs
PROTECTION FROM CHEMICALS 11
r_.. - �,__9 PHF Hot and Cold Holding
L_L4 Food or Color Additives 3-501,16(E) Cold PRFs Maintained at or below
3-202.12 Additives* 590.004(F) 41'45" F'
3-302.14 Protection fromLInall2rn1,A Additives, 3-501 16(A) Hot PlIFs Maintained at or above
Poisonous or Toxic Substances 140'17. *
7-101.11 identifying Infiannation-Original 3-501,16(A) flexists Held at or above 130'F,
containers-
7-102,11 Common Name-Working Containers' LN - Time as a Public Health Control
7-201.11 1 Separation-Stora_ 3-501.19 Tinic ass Public,Health Control*,
590.004(Fi) Variance Requirement
7-202.11 Restriction-Presence and Use"
7-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-203-11 Toxic Containers-Prohibitions"
7-204.11. Sarfitjzers.Criteria-Chemicals* POPULATIONS(HSP)
21 3-80 1.11(X) Unpasteurized Pre-packaged Juice�and
7-20-1.12 Chemicals for Washing Produce,Criteria,
-7-204_14 -prVinig I Bever ages%vifb Warning.1-abbelv
3-90I11(B). ol'Pasteurized Egp*
4
7-205.11 Incidental Food Contact, Labricannc' ( 3-$0,1.1.1 k�17- or Partially Cooked Animal Food and
7-206 1 Restricted Use Pesticides.Criteria*
Raw Seed Stwouts Not Served.
7-206.12 1 Rodent Bail Stations" 3-801.11(C) Unopened Food Package Not Re-served,
7-200 13Tracking, Powders,Pest Control and
'Morritoripo CONSUMER ADVISORY
TIMEITEMPERATUPE CONTROLS 22 3-603
" Coroanner Advisory Posted for Consumption Of
16 Proper Cooking Temperatures for Annual Foals That are Raw.1-Tradlacooked(it
PHFs Not Otherwise Processed to E'liminate
'at
1-401.1 LI A(1)(2) Eggs- 155`0 15 See. ___1_
_ hO ins r,ecs,cr jai
11gs-hancedrale Service l4_50FI_5sec* 302 J3 Pasteurised Eggs Substitute'for saw Shell
40 E I I(A)(2) Comminuted Fish,Meats&Game Eggs'
Animals- 155°F 15 sec.
3 Pork and Beef Roast- 1'0+ 121 590-t)09(,k)-(D) Violations of Section 590.009(A)-(D) in
3401 1 l(B)l,)(2) SPECIAL REQUIREMENTS
3-401.11(A)(2) Raritts, Injected Means-155F 15
se'. - entering, mobile food,temporary and
3-401.11(A)(3) Poultry,Wild Game, Stuffed PHFs, residential kitchen operations should be
Stuffing Containing Fish,Meat, dchircd under the appropriate sections
Poultry(a�Ratitcs_J()VF 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* 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)(1)) All Wier PHFs 145'F 1.5 sec. *
LE7 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-403.11(A)8(I)) PHFs 165°F 15 sec. "I (Items 23-30)
3-403.11(B) Microwave- 1650 F", Minnie Standing Critical and non-critical violations, which ds)we relate to the
Time" foodborne illness interventions and risk factors listed above, can be
3-403.11(C) Commercially Processed RTE Food firlo'd in.the fallowing sections of the Food Code and 10.5 CMR
14WF- 590.000.
3-403.11(E) Remaining Unsl!ced portions of Beef Item T Good Retail Practices FC b80 000
Roasts* 23. Maralperrent and Personnel FC-2 .003
Cooling of PHFs Protection --- FC-3 F.004
- Proper Cc 24. -Food and Food tection
mbin and Waste FC 5
25. Equipment and Utensils FC-4 .005
3-501,14(A) Cooling Cooked PI IFs from 1,10'F to
26. �Alaler Pill
60
10"FWithin 2 Hours and Fron170'1� ZTP�,sialFacll� FC-6 007
to 4 PF1451-T Within 4 Hours. 28, Poisonous or foxic MaterialsFC FC-7 .008
---- ------- --
3-501.14(13) Cooling PHFs Made From Ambient .009
Temperature Ingredients to 41'17145"F _30 ... Other
Within 41 lours*
"Denotes c7aical item in the loderal 1999 Food Code or 105 C[,Ili 590.000.
CITY OF SALEM
BOARD OF HEALTH
Establishment Name: /L prrsl I, r ,,4,*4 Date: 3�� ��..r Page: r of 4
Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date
3 No. Reference R—Red Item Verified
PLEASE PRINT CLEARLY
r
feqr
> d
5
r �
v
x
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
t comply with all mandates of the Mass/Federal Food Code. I understand that
noncompliance may result in daily fines of twenty-five dollars r suspension/revocation of ❑ Embargo ❑ Emergency Closure
your food permit.
Com- _ ❑ Voluntary Disposal ❑ Other:
3-501.14(C) PHFS Received at Temperatures
Violations Related to Foodborne illness Interventions and Risk According to Law('00led to
Factors(items 1-22) (Cont.) 41"F745'F Within 4 Hours.
PROTECTION FROM CHEMICALS 3-501.75 Cmfl ..A eMethodsforPHFs
14 Food or Color Additives 19 PHF Hot and Cold Holding
3-501.16(13) Cold PIMs Maintained at or below
3-202.12 Additives" 590,004(F) 41.'i45'F"
3-302.14 Protection from Unm.roved Additives'a 3-507.16017 Hot FHFs Maintained at or above
15 Poisonous or Toxic Substances
4 'F._v
7-107.11 Identifying fofonnafion-Or,ignal 3-501.16(A) Roasts Heid at or aboae 130-F.
Containers*
7-102.11 Corrnnon Name-'Working Containers* 20 Time as a Public Health Control
7.301.11 Se.oration-Stara e" 3-501.19 Time as a Public Health ControP`
7-2021t Restriction-Presence and Use" 590.004(1-1) Variance Recuiretnent
7-102.12 Conditions of Use"
7-203.11 Toxic Container%-Prohibitions" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7?04.11 Saoidzeis.Criteria-Chemicals* POPULATIONSH( SP)
7-204.13 Chemicals for W"ashur>Produce.Criteria" 21 3-801.11(A) Unpastcurized Pre-packaged.Juices and
Beverages with Warning Labels'
7-204.14 Dmiag Agents. Criteria* 3-801.11(B) Use of Pasteurized Eggs*
7?05.11 Incidental Food Contact,Lubricants*
3-301 11(D) Raw or Partially Cooked Animal Food and
7-206.11 Restricted Use Pesticides,Criteria' Raw Seed Sprouts Not Served.,x
7-206.12 1 Rodent Bait Stations" 3-801.t 1(C) LJno xned Pocxt Pucka re Not'Re-served.
7-206.13 Tracking Powders,Pest Control and
Monitoring* CONSUMER ADVISORY
TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
Animal Foods That are Raw, Undercooked or
16 Proper Cooking Temperatures for Not Otherwise Processed to Eliminate
PHFS PatlioaenS e' ^" izoor
3-401.11 A(1)(2) 6erz 155°F 15 Sec. 1-302.1 Pasteurized Ffge Substitute for Raw Shell
F gs- Immediate Service 115 1 15sec*_
3-401.11(A)(2) Comminuted Fish.Meats&Came
Animals- 155'F 15 sec. "
3-401.1l(B)(1)(2) Pork and Beef Roast-'130T 121 tubi, SPECIAL REQUIREMENTS
3401.11(A)(2) Ratites,Injected Meats- 155F 1.5 590 009(1_%)_(U} Violations of Section 590.009(A)-(D)in
sec. * catering,mobile food, temporary and
3-401.11(A)(3) Poultry,Wild Came.Stuffed PHF+, residential kitchen operations should be
Stuffing,Containing Fish,Meat, debited under the appropriate sections
POltltry or Ratites-165'F 15 sec. * above if related to foodborne illness
3-401.1 1(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 PRFs- '145'F 15 sec.
17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-40111(A)&(D) PEIFs 165'F 15 sec. * (Items 23-30)
3-403.11(13) Microwave-165'F 2 Minute Standing Criticed and non-critical riolatione, which do not relate to the
Time* foodborne illness interventions and risk factors listed abate, cart be
3-103.'1l(C) Commercially Processed RTE Foat- fauna in the following ve(th o of the Food Code and 105 CMR
140'F' 590.000. _
3403.11(E) Retraining Unsliced Portions of Beef Item I Good Retail Practices FC 590.000 i
Roasts"` F23_ 1j danagement and Personnel FC-2 ,om
Ig Proper Cooling of PHFS 24 Food and Foo Protection FC 3 .004
__-_ _ _n
tt . . .005
3-501.14(A) Cooling Cooked PHFS from 140'F to 25 Equipment and Utensils FC-4 _ _
26. Water.Plum _
bin and Waste FC 5 .006
70'F Within 2 Hours arc(Front 70'F L28,_:
Ph s1cal FacilityFG-6 .007
to 41'F145'F Within 4 Hours. * Poisonous or Toxic MaterialsFC-7 .008
3-501.14(13) Cooling PHFs Made From Ambient S eP eial Requirements009
Temperature Ingredients to 41'Fl45'F Othsr (__ ............ ..
Within 4 Hotu's- s.o xo.nasx:.z o��
*Denotes critical item in thetederat 1999 Food Code or 105 CMR 590.006,
CITY OF SALEM
BOARD OF HEALTH
Establishment Name: LL A(/r/ /,r to Li ANIS Date: 3 -/n- 0 Page: / of
Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date
i No. Reference R—Red Item Verified
- PLEASE PRINT CLEARLY
S;.
t LYS it Z / 2 /f /J ii e
✓ l Poi/C �t i �� di s m 19A,1L / )
q i
� s l"�s i� � c� � � Ps lid" ✓/ /�Ge- .f!C9/,.¢.
's 42�
n
u� Zfe "rPGL" n e 4221-cl
4IZ� S P ) tis �r ';�� 4_A1 �,es v-ash �
1e Fd-�-P 14e, N .v 117
(�4ldles / 4c rn /eke ywrsh e cL NeeC15G° P�'QI tiP
Peri ✓ f 9z /GUO Pc f C'A , v ,,O vC /d& cd✓e,k
J Jff�S ry C P P L1 9- PCG of L/ �I S 7n L/
4
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/
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
i noncompliance may result in daily fines of twenty--f+ve dollars-osuspensl n/revocation of Li Embargo Ll Emergency Closure
your food permit. �i > �� \
"-"-��-- 0 Voluntary Disposal ❑ Other:
3-501.14((') PHFs Received at Temperatures
Violations Related to Foodborne Illness Interventions and Risk According to l.aw Cooled to
Factors(items 1-22) (Cont.) _ 4VF/45"F Within 4 Hours.="
PROTECTION FROM CHEMICALS 3-501.15 Ca lhtglle8rods for PHFs
Food or Color Additives 19 PHF Hot and Cold Holtling .
3-501.16(6) Cold PHFs Maintained at or below
1-
20212 Additives" 590.004(F) 41"145°F-
3-30114 Protection froth Unaplrrtn•ed .lddrtives` 3-501,16(A) Ihrt PHFs Maintained A or above
Lis Poisonous or Toxic Substances
140"F''. ="
7-101.11 Identifying Information-Original
3-501.16(A) Roasts Held at or above 130'F.
Containers
7-102.11 Common Name I-Working Conatiners* 20 Time as a Public Health Control
7?01.11 Se arttion-SEorage"'
3-501.19 Time as a Public Health Control's
7-20211 Restriction-Presence and Use* 590.004(H) Variance Requirement
7-202.12 Conditions of Use* _
7-203.11Toxic Containers REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-204.11 Sanitturs.Criteria-Chemicals* POPULATIONS(HSP)
7-204.12 Chemicals forWashin*Produce, Criteria 2'l. 3-80 L 11(A) Unpasteurized Prep Aaged.Juices and
Beverages with WarnmglatbeWl
7-204.14 Drying Agents.Cuteric" 3-801.11(B) Use of Pasteurized Epp-
7-'?05.11 Incidental;Food Cont let,Lubricants*
7-206.11 Restricted Use Pesticides,Criteria
3-801.1.1(D) Raw or Partially Cooked Animal Food and
Rau Sccd S trouts Not Served
7-206.1.2 Rodent Bait StationO 3-801.11(C) Unopened Food Package Not Re-served.
7-206.13 Tracking Powders, Pest Control and
Monitorine'
CONSUMER ADVISORY
TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer.Advisory Posted for Consumption of
Animal Fools native Raw. Undercooked or
1G Proper Cooking Temperatures for
PHFs Not Otherwise Processed to Eliminate
r nvcr 2oar
3=101.I1A(1)(2) Eggs- 155'F h Sec. Patho,cre
Lugs-immediate Service 145`1715sec' 3-302 13 Pasteurized Eggs Substitute for Raw Shell
3401.11{A)(2) Comminuted Fish.Meats&Game Egg'*
Animals- 155'F 15 sec.
SPECIAL REQUIREMENTS _
3-401.11(6)(1)(2) Pork and Beed Roast- 130'F 12'1 nun" ;90.00 Violations of Section 590,009(A) (D)in
3-401.11(A)(2) Rattles,Ljected Meats- 155'F 15
sec * catering,mobile food, temporary and
3 401.11(A)(3) Poultry,Wild Game.Stuffed PHFs, residential kitchen operations should be
Stuffing;Containing Fish,Meat. debited ander 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 r` 590.009 violations relating to`fiord retail
3-401.12 Raw Animal Foals Cooked in a practices should be debited under #29-
Microwave 163'F* Special Requircmenis.
3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.
17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-403.1.1(A)&(D) PHFs 165'F 15 sec. # (Items 23-30)
3 403.11(B) Microwave-165'F 2 Minute Standinze Critical'and non-critical violations, which do not relate to the
Tine* foodhorne illness iarervcruians and tisk factors listed above, can he
3-403.11(C) Commercially Processed RTE Food- found in the following sections of the Food Code and 105 CAIR
140'F'" 590.000. _
3403,11(E) Remaining Unslieed Portions of Beef Item Good Retail Practices FC 590.000
Roasts' i 23 Management and Personnel FC-2 .003
1g Proper Cooling of PHFs P4. Food and Food Protection__ FC-3 .004
--
25. E m ns
meet and Uteils _FC 4 005 _
3-501.14(A) Cooling Cooked P1IFs from 140'F to 26. Water.Plu_mbinp and Waste FC 5 .006
70`F Within 21tours and From 70'F _ al
i 27. Ph sical Facility FC_6 .007
35()114(6 Icmicriil�ur�lnMr gdicntsourt * _28 iPoesia Regrrerne Matenals ` FC 7 008
to41'F/4i°F Within4H
) € m Ambient 29 $Qecial Requirements 009
1 b to 41"F1450F 30 . Other
Within 4 Hours* s.^,oionnn,a„az ao�
Denotes critical item in the federal 1999 Food Code or 105 C94R 590-000.
IMPORTANT MESSAGE
9
FOR
DATE TIME ,//,�?P.M.
M //s' ,2
OF e 3h444!7
PHONE6?'�flL��U—X1.3 0'3
AR CODE NUMBER EXTENSION
D FAX
D MOBILE
AREA CODE NUMBER TIME TO CALL
TELEPHONED PLEASE CALL
CAME TO SEE YOU WILL CALL AGAIN
WANTS TO SEE YOU [RUSH
RETURNED YOUR CALL WILL FAX TO YOU
MESSAGE
4 oaee
SIGNED
V� FORM 4009
YYYY���O MAOE IN UJ S.A.
NOTES
oci6)
CITY OF SALEM, MASSACHUSETTS
LICENSING BOARD
120 WASHINGTON STREET
978-745-9595 ext.421
NOTIFICATION FORM
IF YOUR APPLICATION INCLUDES THE SERVING OF FOOD YOU MUST HAVE THIS
FORM SIGNED BY THE HEALTH DEPARTMENT PRIOR TO SUBMITTING YOUR
APPLICATION TO THE LICENSING BOARD.
(this form MUST be signed and returned with your application).
NAME OF BUSINESS
Corporate name: Il Bucca Italiana Restaurant, Inc.
d/b/a:
LOCATION: 140 Washington Street, Salem, MA 01970
TELE. # 978-745-9100
TYPE OF LICENSE Restaurant
APPLICANTS INFORMATION
Name: Patrice M. DeSa
Home address: 21 Whitby Street
Cit,; E. Boston State: MA Zip: 02128
Home tele. # 617-567-0237
HEALTH AGENT/INSPECTOR'S COMMENTS:
Hqgh Agent
notification fam
r:
CITY OF SALEM
BOARD OF HEALTH
Establishment Name: -r/ 13OCC a ria / a n a Date: /A - a - O 3 Page: of ;Z_
Rem Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTIONDate
No.. Reference R-Red Item Verified
" .. .PLEASE PRINT CLEARLY
A. 04 o t 4 Vohder esr~ horJ.P /se,f lPd / %'/oz.s and
w
AMU rye ew o >
n e t v 4F 4 S4,14 e 0 d axle .
- -rhzeo, w Nl kae, Sl/ bi
tR
� Ik J
l� � /P� r.Xtq �/IL Q,KGJ dllSLrWGS�d� GU/ �i Q tavOSI��, GU//I
5caw 4tu, he, ,a- e..94/--Aod. Puse time /HW eer/y
U
eQv Iced d ✓o d d ,til &V;7 /o 34P +-tc4e 4r
4 Wdt nol be,
IJP %t tLv rlitw /Jpr c� o-/ Aeo l/
C H A u es /u ro u P aaE�T ST.�v�7U/C� /6,06rv 5
a° e v/ ..od eke. /ISD aF /-�E9-cTl �,uD f.�� �o✓E/�
ale /ar u/fi�eJ• f�twel� �o��s
r
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/
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
noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure
your food permit.
- ❑ Voluntary Disposal ❑ Other:
1
t
3-501.14(C) PHFs Received at Temperalures
Violations Related to Foodborne fitness Interventions and Risk According to Law Cooled to
Factors(items 1-22) (Cont) 41°F145°F Within 4 Hours.
19 CooPHF Hot .
PROTECTION FROM CHEMICALS �-501.10 Cooling Methods for PHFs
14 Food or Color Additives
and Cold Holding
_ 3-501.16(13) Co1dPAFs Maintained at or below3-202.12 Additives* 590.004(F) 41^/45°F*
3-30214 Protection from lTnat.Waved Aglditives't 3-SOl.tfi(A) Her PHFs n4aintained at or above
15 Poisonous or Toxic Substances
140°F. *
7-101.11 Identifyiatglnformation-Original 3_501.16(A) Roasts Held at or above 130'F.
Containers"
1-102.11 Conunon9anre-Workin Containers''
20 Time as a Public Health Control
7-201.1.1 Se.aranon-Stot 7gc"' 3-501 19 Ttr_ne as a Public Health Control*
7-20211 Restriction-Presence and Use* 590.004(H) Variance Req uh-ement
7-202.12 Conditions of Use*
7-203.11 TOXie Containers-Prohibi ons* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-204.11 Sanitizers.Criteria-Chemicals*
POPULATIONS HSP)
7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged.luices and
7-204.14 Drying A eats.Criteria* Beverages with Wanare Labels*
7-205.11 Lrcidental Fwd Contact,Lubricants* 3-801.11(B) Use of Pasteurized F,,-s*
3-801.11(D) Raw or Pao ally Cooked Animal Food and
7-206.12 Restricted Use Stations*
C6teria* Raw Seed S)routs Not Served."'
7-206.1.2 Rodent Halt Stations* 3-801.11(C) Unopened Food Package Not Rc-served.
7-206.13 Trading Powders,Pest Control and
Monitoring" CONSUMER ADVISORY
TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
Animal Fo ods`fhat are Raw, Undercooked or
16 Proper Cooking Temperatures for Not Otherwise Processed to'Eliminate
PHFs moon""014
3-4(}1.11 A(1}(2) Eggs- 155'7 15 Sec.
Patbotc.ns
f t;Rs-Immediate Service.1450FISsec:* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
3-401.11(A)(2) Comminuted Fish.Meats&Game Eggs*
Animals- l55°F 15 sec.
3-401.11B)(1)(2) Porl and Beet Roast- 130°F 121.milO SPECIAL REQUIREMENTS _
590.009(A)-
3-401.11(A)(2) Ratites, Injected Meats--155°F 15 @I Violations of Section 590009(A}(D)in
Se,, * catering, mobile food, temporary and
3-401.11(A)(3) Poultry,Wild Game.Started PHFs- residential kitchen operations should be
Stuffing Containing Fish,Meat. debited tinder 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* 590.009 violations relating to good retail
3-401.12 Raw Animal Foods Cooked in a practices should be debited under ll29-
Microwave 165`F* Special Requirements.
3-401.11(A)(1)(b) All Other PHFs- 145°F15 sea *
17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-403.11(A)&(D) PHFs 165°F 15 sec. * (Items 23-30)
3-403.11(13) Microwave-165'F 2_Minute Standing Critical and non-critical violations, which do not relate to the
Time" jitodborne tiluess interventions and risk factars tested abave, can he
3-40311(C) Commercially Processed RTE Food- ,found in the follrmzng sections of the Food Code and 105 CMR
14017* .590.000.
3-403.1i(E) Remaining Unsliced Portions of Beef ` Item Good Retail Practices k FC 590.000
Rr,a7sts* 23 Management and Personnel
FC-2 .003
1 24 Fd d Food Protection FC-3 .004
Ig Proper Cooling of PHFs Food an ----- +-
25. E uiment and UtensilsFC 4 005 _
3-501.14(A) Cooling Cooked PHFs from 140'F to 126. Water.Plumbin and Waste FC-5 .006
70'F Within 2 Hours and Front 70'T 27. Ph sisal Facilli -QFC-6 .007
to 41°F(45°F Within 4 Hours. * L 28 Poisonous or Toxic Materials FC-7 .008
3-501.,14(B) Gmliug PHFs Made F'ronn Ambient 1 29. S ecial Regglrements _ _009
Temperature Ingredients to 4P'F/45`F 30. Other _._ _._
----
--�
'Denotes critical item in t 6e federal 4999 Food Code or 105 CMR 590.000.
CITY OF SALEM
't BOARD OF HEALTH
i{ r�
Establishment Name: Date: / y �l - 63 Page: of
Rem Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION pate
No. Reference. R—Red Item Verified
y PLEASE PRINT CLEARLY
'T C,
S✓ a
ca t n fm
_ l • a ledl06 0 _/'Z2
l
i U k_J � - - e - _ wc
k
11 (+ Sr �<
E g7titvdorJs .�/d7
In PP,
Zg
u
w f
�8 -
t
U--1
av At
,,.
1
tqaaz. t P y
1.
elll
n Discussion With Person in Charge: Corrective Action equired: Lf 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
3 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. / / A I
4 ❑ Voluntary Disposal ❑ Other:
s �
3-501.14(C) PHFs Received at Temperatures
Violations Related to Foodborne Illness Interventions and Risk Aceoidint;to Law Cooled to
Factors(Items 1-22) (Cont,) 41.°1-/45°F Within 4 Hours.
PROTECTION_FROM CHEMICALS 3-501.15 Cooling Methods for PHFs
Food or Color Additives 19 PHF Hot and Cold Holding
14 3-501.16(B) Cold PIIF,s Maintained at or below
3-202.12 _Addnncs'r 590.004(F) 41°145°F*
3-302.14 protection from Unapproved AddfGve 'w 3.50[ 16(A) Hot PHFs Maintained at or above
15 1 Poisonous or Toxic Substances
140°F.*
7-101.11 Identifying Information-Original 3-501.16(A) Roasts Held at or above 130`"F.
Contarners
t59�0(.�004(H)
Time as a Public Health Control
7-102.11 C parati 'Vatne-Workitt*Containers* Time as a Public Health Control7-261.11 Se.oration-Storage"7-202.11 Restnction-Presence and Cine" VarianceRe'cuiretnent
7-202.12 Conditions of Use REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-203.11 Toxic Containers-Prohibitions' POPULATIONS(HSP)
7-204.11 Sanitizers.Criteria-Chemicals* ----
7-204.12 Chemicals for Washing Produce.Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and
7-204.14 Drira, Agents.Cotena* Beverages with Warning Labels*
'7-265.11 Incidental Food Cont tet,Lztbrieants" 3-801.11(B) Use of P isteurired Hens`
7-206.11 Restricted Use Pesticides,Criteria* 3-501 1 I(D) Raw at Partially(,calked Animal Food and
Raw Seed Souls Not Seised.
7-206.12 Rodent Bait Stations* 3-801.1.1(C) Unopened Food Parka�e Not Re-served.
7-206.13 Tracking Powders, Pest Control and �`" --
Monitorine'
CONSUMER ADVISORY
TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
Animal Foods 9'hat are Raw, Undercooked or
16 Proper Cooking Temperatures for Not Otherwise Processed to Eliminate
PHFs Ee.omx r �wi
3-401.11 A 1O(2) Elms- Pathogens
155'F 15 Sec.
Lc s-Immediate Service 145°FL5sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
T467.11(A)(2) Comminuted Fish.Meats&Game Eggs'
Animals- USF U see. 4' SPECIAL REQUIREMENTS
3-401.11.(A)(2) Ratiics, Injected Meats'- t55°F 15
3-401.11(B)(1)(2) Polk and Beef Roast- 1.30°F 121 min* 590.009590.009(A)-(D)(A)-(D) Violations of Section nn
aU -
sec. * catering, mobile food, temporary and
3-401.11(A)(3) Poultry,Wild Game.Stuffed PHFs, residential kitchen operations should be
Stuffing Containing Fish,Meat, 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-T 4` 590.009 violations relating to good retail
3-401.12 Raw Aminal Foods Cooked in a practices should be debited under#29 -
Miciowave 165°F* Special Requirements.
3-40 1.11(A)(1)(b) All Other PHFs-145°F'15 sec. *
17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
103.'11(A)&(D) PI IFs 165°F 15 sea * (Items 23-30)
3-46311(13) Microwave- 165'F 2 Minute Standing, Critical and non-critical violations, which do not relate to the
Time* foodborne illness inten,entions and risk factors listed above can be
3-403.1.l(C) Commercially Processed RTE Food- lutrnd in the following sections of the Food Code and 105 CMR
146°F` 590.000.
31103.1.1(B) Remaining Unsliced Portions of,Beef ? It Good Retail Practices i FC 590,000
Roasts'` 23. Management and PersonnelFC-2 .003
_
24 Food and Food Pra2ection FC-3 .004
1g Proper Cooling of PHFs - ---- -- -,
25. EgwpmPnt and utensiis FC 4 .005
3-501.14(A) Cooling Calked PHFs from 14W to -_-" - --" --" -"- '0 --
a 26. Water.Plumbing and Waste FC 5 .006
76 F Within 2 Hours and From 70"F 27. Physical Facile �FC-6 .067
to 41°Ft4s"F Within 4 Hours.* j_28 Poisonous or Toxic_Materials FC-7 .008
3-5(11.14(B) Cooling PHFs Made From Ambient 20 Special Requirements 009
Temperature Ingredients to 41°FI45"F 30. Other _ ----- _
Within 4 Hours* s-'Y:,f n11C..4
*D noir,critical!rem in the federal 1999 Foal Cale of 105 Chin 590.000.
New Italian restaurant set
to open early next year
SALEM—A new Italianrestau- holic Beverages Control Commis-
rant may open in the downtown sion for approval.
where Troisi's is now located. The new owners,Vander and
On Monday night,the Licensing Patrice DeSa of East Boston,said
Board approved the transfer of a they hope to start the new restau-
seasonal beer and wine license from rant early neat year.
Troisi's Italian Cuisine, 140 Wash- Troisi's,which remains open for
to Il Bucca Italiana.The business,opened in 2002.
the state Alco- –Tom Dalton
r R � 7
ernment yesterday raised the na-
tional threat level to orange,indi-
i eating a high risk of terrorist at-
e . 'A,- tack,and said threat indicators are
*&P, 'perhaps greater now than at any
point"since Sept, 11,2001,with
?,I strikes possible during the holi-
days.
Americans were promised"ex-
tensive and considerable
protec-tions"around the country and told
s to stick to their travel plans de-
spite intelligence indicating the al-
Qaida terrorist network is seeking
KIRA HORVATH/Staff photo again to use planes a—
an
ders dealt with a lagging econo- and exploit susr'
U.S.aviatio
Som
e .