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MAJOR MAGLEASHES PUB - ESTABLISHMENTS JI major MmYl'Ohtl Put 26Y wgfkitffip Ittid- ftNNERSAL® UNV-12110 MADE IN USA SUSTAINMLE ,p�ypgl FORES t�"NfENf 1096 INIMPVE 1� POSTzlem CoMed Fibm SmrttlPY w e Pmmem Pry Yr�n'.m i Commonwealth of Massachusetts ` r City of Salem Board of Health Kimberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 01/06/2011 ESTABLISHMENT NAME: Major Magleashe's Pub File Number:BHF-2004-000064 268 Washington Street Salem MA 01970 LOCATED AT: 0268 WASHINGTON STREET SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes FOOD SERVICE BHP-2011-0252 Jan 1,2011 Dec 31,2011 $280.00 ESTABLISHMENT Total Fees: $280.00 PERMIT EXPIRES IDecember3l, 2011 Board of Health '`n \J 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 • a BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KINIBERLEY DRISCOLL FAS(978) 745-0343 MAYOR DGIIE1P.NnAUIo OSALETNI.CONI DAVID GREENBAUNI,RS ACTING HEALTH AGENT 2011 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT NPC-( 0 1� d` A6L—r-A5 i6 5 Pv Q TEL# ADDRESS OF ESTABLISHMENT 2OR CJA 5/71A16T p,( 59-, FAX# MAILING ADDRESS(if different) EMAIL-Business': Website: MRTR 17AGL/ Ii Sit£S a COM OWNER'SNAME PNIL149 R. SH&A TEL# 2g4Y ADDRESS 73 G3Cr—Lg-t-( 2D. SA Lr%r� /I4 01 " o STREET CITY STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S) Prl"-I P & CERTIFICATE#(S) (Required in an establishment where potentially/hazardous food is prepared) EMERGENCY RESPONSE PERSON PA-L)L- FL N /L!y HOME TEL# 117 1';DAYS'OFOPERAT,ION_;?,i:`-=-Monday:,'=l :' ';Tuesday'.*:"-�r,Wednesday=s,;l??'ThursdayF'>,_ Sunday HOURS OF OPERATION 1 11 id A nt 1 11,130A),` //100 A1 M Please write in time of day. I (For example 11 am-11 pm) — 1 :60 pN1 - j;oa y-M! � I:ac +.g ' � y"'J�� 1 _/:00 TYPE OF ESTABLISHMENT FEE (check only) RETAIL STORE YESN0 less than 1000scift =$70 1000-10,000sq.ft. =$280 more than 10,000sq.ft. =$420 RESTAURANTYES NO less than 25 seats $140 (Outdoor Stationary Food Cart$21 25-99 seats =$280 more than 99 seats =$420 --------------------------------------------------------- ------ BED/BREAKFAST/ YES NO $100 CHILDCARE SERVICES/NURSING HOME ADDITIONAL PERMITS MAKE (notjust serve) ICE CREAM, YOGURT/SOFT SERVE YES $25 TOBACCO VENDOR YES NO $135 ALL NON-PROFIT(such as church kitchens) YES $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 Chapte 2C,Section 49A, I certify under the pains and penalties of perjury that I,to my best knowledge and belief,have filed all state tax retgrris d aid all state ax r ed under the law. � /&lz � zor� OY - 7,636000 Signature Date Social Security or Federal Identification Number Revised 10/7/11 FOODAP2011.adm Check#&Date .t . .- .' _ F _ TI^s.w;yn.vi Y.rt : ,.A s. : , 4r wf•,wt..nn •.f,.pF" oro,y,lrrt•.,M.I„�..r?,�"«M'�. .ilrvlrvt�l�r."'.'a';-.J'M•+Yti<• Massachusetts Department of Public Health Salem Board of Health Division of Food and Drugs 120 Washington Street,4th Floor 9 Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax(978) 745-0343 Namen Date Tyge of Ooeration(sl, Type of Inspection Y y� A- Ald) . ANULI t Q0A_�.+ `- i >JT - I Good Service x❑ Routine Address / Risk E] Retail Re-inspection a �<n a,4n-^f` 11nn', 1/fin 0 _ Level ❑ Residential Kitchen Previous Inspection Telephone, El Mobile Date: ( (()) C pp -� HACCP YIN El Temporary El Pre-operation Owner pOP. D Gin On ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) Time ❑ Bed&Breakfast ElGeneral Complaint Of inn Dn n J In: '�/ + ` ❑ HACCP Inspector f a}a (�µp 0� Out: Permit No. ❑ Other Each violation checked requires a��,explanation on the narrative pagd(s) and a citation of specific provision(s) violated. l) 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) O action as determined by the Board of Health. / kOOD PROTECTION MANAGEMENT (( ❑ 12. Prevention of Contamination from Hands Ix 1. PIC Assigned/Knowledgeable/Duties p L=i ❑ 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 IIV 1 (v 5.Toxic Chemicals FOOD FROM APPROVED SOURCE ` TIMEITEMPERATURE CONTROLS Potentiall•Hazardous Foods ❑ 4. Food and Water from Approved Source ( Y ) _❑ 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 ADVISORY " �U m 11. Good Hygienic Practices CONSUMER r - - -• ❑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 Factots(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) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(95990.0 0 0o4) 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 OFRE-IINN}S"P�E�CTTION: \ n311_cR x.-09 S ssoinapecrFomasa em Inspector's Signature: Print: V PIC'sSignature: ( /�^Q� Print: ;4,-/ I'Ll/ Page of-2,Pages 1 - w i Violations Related to Foodborne illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT ( 8 Cross-contamination { 1 500.003(A) Assignment of Responsibility* ( 3-302.11(Au I) Raw Animal Foods Separated from 590.003(3) Demonstration of Knowledge* I Cooked and RTE Foods* 2-103.11 Person in charge-duties I Contamination from,4aw Ingredients 3-302.11(A)(2) Raw Ainirial F�xxls Separated from Each EMPLOYEE HEALTH I Other' 2 590.003(C) Responsibility of the person in charge to I Contamination from the Environment requoe reporting by food employees and 13-302.11(A) Food Protection' { applicants* 3-302 15 Washing Fruits and Vegetables { 590.003(F) Resprumbility,Of A Plod Employee Or An 1 ( 3-304.11 Food Contact with Equipment and Applicant To Report To The Person In ( I I Utensils-* Charge* I I Contamination from the Consumer { 590.003(G) Reporting by Person in Charge* { 3-306.14(A)(B) Returned Food and Reservice of Food" 13 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590 003(E) Removal of Exclusions and Restrictions I I I Food 3-701.11 Discardirg or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 4 Food and Wafer From Regulated Sources I 19 Food Contact Surfaces 590.004(A-B) Compliance with Food Law" j 4-501.111 Manual W:uruashine-Rot Water { 3-20 .12 Foci in a Hermetically Scaled Container" i Sanitization Temperatures` { 3-201 13 Fluid Mill-and Milk Products* ( 4-501.112 Mechanical Warewashinn Rot Water Sanitization Temperatures* 13-202.13 I Shell Eggs* I 14 5)1114 � Chemical Sanitization-temp.,pH, 3-20114 Eggs and Milk Products.Pasteurized* I 3-202.16 I lee Made From Potable Drinking Water" { Equipment concentration and hardness. 5-101.11 I Drinking Water from an Approved System* ( 4-60i.11(Ai Etensment an- Contact Surfaces and Utensils Clean" 1590.006(A) { Bottled Drinking lAlater* I 4-602.1 1 Cleaning Frequency of Equipment Food- 590 006(B) Water Meets Standards in 310 CMR 22.04 I Contact Surfaces and Utensils* Shellfish and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils and 3-201.1.1 Fish and Recreationally Caught Molluscan I I Rxd Contact Surfaces of Eutimment* Shclliish' 14-703.11 I Methods of Sanitization--Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical'" Sources* I tp I I Proper,Adequate Handwashing Game and Wild Mushrooms Approved by Requ/atory Authority 2-301.11 Clean Condition-Hands and Aims'' 3-1.02.18 Shellstock identification Present" I 1-301.12 Cleanm,2 Pres;cdure* { 590.004(C} Wild Mushrooms' 12-301.11 When to Wash* { 3-201.17 Game Animals* I I it { Good Hygienic Practices g Receiving/Condition I 12401.11 Eating,Drinking or L'shm Tobacco* 3-202.11 ( PHFs Received at Proper Temperatures* I I 2-401.12 ( Discharges From the Eyes, Nose and Mouth° 3-202.t5 I Package Integrity' * z-3t)1 12 Preventing Contamination When Tasting* I 3-101.11 I Food Safe and Unadulterated i 16 Tags/Records:Shellstock ( 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification * 590.004(M Preventing Contamination from 13-203.12 Shellstock Identification Mmntained" ( andwash Tags/Records:Fish Products { 113 Handsh Facilities 3402.11 Parasite Destruction" I Conveniently Located and Accessible 1 3-402.12 Records.Creation and Retention* I 15-203.11 Numbers and Capacities* 590.004(1) Labeling of ingredients' ( 15-204.11 Location and Placement* 7 Conformance with Approved Procedures I ( 5-205.11 Accessibility, Operation and Maintenance I /HACCP Plans I Supplied with Soap and hand Drying 3-502.11 Specialized Processing Methods* ( Devices _ 6-301.11 Handwashing Cleanser,Avaitabilitv { 3-502.12 Reduced oxygen packaging.criteria* I 8-103.12 Conformance with Approved Procedures* I 16-301.12 Hand Drying Provision *Denoted critical item in the federal 1999 rood Code in 105 0010 590.000. CITY OF SALEM BOARD OF HEALTH Establishment Name �.i,,Jl Q%1C _ Iti S �« Date: I Q— x_01 Page: Z of `Z! Item Code c-critical Iterrij DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date f No. Reference R-Red Item -T- ,Verified PLEASE PRINT CLEARLY (�.S �-Y A, o K IV, r,,.,JA,1 370 1 .smi L l '.3° 10-(q-0 61-61-oy NM r-UAJ qa" ( I_ 1(gAtj,1-- C ° I � C."o1-f LG °4 o x( pcL� t,VI r V o)aut�1 3?�° U U --- ._ •IY I l l� 0 AA A2 A&,-V a?'CIYh-A•/1 0M 1 O AA_(� �_,PM — cp f v_/.t/L/�Ail.r.1X, I in - 171 a "If I )aQ,2... 11190° `! )A4 o_P � ( TVI PA, A, , 17r\s to S" <A r' � ,,SOA, k - "1�0 �. u e P1v I-V A R �1 .c.aa,Q _V�Z�zQ 'J(\ P fir,A,, ,- A'1)A � ki10 - a.Uv ,O\rnM —C�rnnnQ P��r, �� y1 .� rA , i Discussion With Person in Charge: I Corrective Action Required: I ❑ No a� Yes , r 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 ❑ 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 twe toy five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. o� ❑ Voluntary Disposal ❑ Other: , l 3-501 14((') PRFs Received at Temperatures Violations Related to Foodborne fitness Interventions and Risk According to Lau Cooled to Factors(ItetHs 1-22) (Cont) 41'F/45`F W idiin 4 Hours. PROTECTION FROM CHEMICALS 3-501.19 Cooling Method~for PHFs � 19 PHF Hot and Cold Holding 14 i Food or Cola Additives _I z"5(11 16(B) Cold PHFs Mainwinetl at or below 3-202.12 I Additives" ( 590 0041T 41`(45°P^ f 3-302.14 ( Protconnfrom tlnapproredAdditives` I Z.jtJLihr:1) ( 11otI'HFsttaintaiuetl.tturabove 15 I j Poisonous or Toxic Substances 140 1 . k - 7 IOi.il I Idcntif}'rn, lnfiamatum tA't;;,nxl I , j t entainers, I i->01,1F(Ai I Ro.++t,Heid a:or above 130'1•. 7 102 11 ; Common tiame - W,trk❑,c i nnuunerr., ; _'ii Time as a Public Health Control -� +fiU 1-'-----`--(' 'Pica•as a Public health Control, ! 7-2U l.li Srpauuun-SL»a2;." —_� '--+— ---} ")U,rt{tii}tT 1':rar;r Requirement l 7-202.11 Rcatrktlon-Yrc,caoc and t..r' 7-202.12 C'rmdnion:of Us , 1 7-103 11 Toxic C'owamco -Prolnb: ionrREOUIREMENTS FOR HIGHLY SUSCEPTIBLE � i 2(}4.11 Junitian.i'nterix-lhrnziads' POPULATIONS(HSP) 7-20-4.12 Chrnuvals fol 5k;cht�zt,P:odut_Cti;c,;z' 21 "t.5n1 114 , liopnacurvcd Pre-pad:naed Jmrca wid .-- --- -- j I Bw ertzes t}itb Warning I..bcls` i 7204,14 Dr in .A::ente.('nar`{ 5 ? 1 Ui3)- �_.� 1.:c of Pa>tem Lied bnaa` I '05.1t _ ( htcidrntal F:��l r'S:nrait�lx,hrt.: - a-SULI I?.i z) ! F:.,w ur Partall}C,vt},rcLlaimal Frxw and I j 77-2()6.11 . ` `c 7 206.1? ttiht:-., $.ni 1:an,•m. _ �r 'UR 'AV ` —, in _CO_N_SUMER ADVISORY ,i T! oa,Wnt! '�i;t?p01 {9Y.,,.;' , ('•i:i.i _1 TIL@EffEM; P RATURE CONTROLS I 1"v*3, ;"itai .ne ':.i�. l4;aetar•n[d Ternpe,atures for i 101 5} r. l5 -_ - Pt• hninudmic. i<:'1,I; I r', ,r:II1P• F: 4.d,:,.,'r.:', ta '.iatv.SL: I },h}1.1ttI+)(2' l-::rpCv;:;nCQfiip, ST^:✓tS. .,.,p:," i _.J...._.""_- REQUIREMENTS F 5 4UL(13), 1;'2) i "n:, arj Kcal R<z.:�t !'(r rNTS ' SPECIAL R EPuf - ,... ,.a• : '. "...:ra.. Far^ :.. .. ?::, �- { t i .I,ztrm: ':? S.. ,s::: ., :;},:Kpat a,-(;t. . . j I � � i I t'�•ii!'i i1,7,. ;u ,V,1}: tik`S:. iCI1 t{?:,:�d: : 4't? . A;._—_ d.ifr .�.� ;-1 lj i (.`... it;tit: i.':C!i.>;i '- .ai::i(ms tttvdl., � .,..( ;,•'i":al;,i:. .. � 1 .. ..., -, c'11.P" rrnrLC�: _ ;hy". ' .. titr: t'.' :,'ii,a'.;L�:fii:' '• $iy„ , ! tr "at'eaur:',iiotii_Y. r,.ss3,r.c3 i ;'10 L AFIONSREiAP'E 'It7� )OV E'F'AiiPPA '.;tt.s_. 1'HI 'a?7't- !; ':Ct. ' I i:Ieots2r.30) , ,103.11,bj Gl,truv -v,- it:9'1 ;. t;iuu::titandv*x', I (,'wwo, v,d l,on ,Im.a! r:,.:;rt:..a,. .n:rr:(.;r•rn: '':Ast• i . ;:n,(%it I'll, t'6„•c• ul„F,,•,ttrr�y.t ,rrru t:'l J•tt tort i'"�./ar:, r r;,.t t --:T)3—I J,(.) Crnanelcw3h Pto,e..c,' 12"i li l•wni ”-� f,•,:rd in, :hr ;t�'•n,-:n,4 '!,.: 't:: o;:h, Foodtbdecr,J Pyi t d54; ii(ty Remamin^ L r,>i wed Pr to,t�ol'k3:x•: 1 Nenr�' Good•Retad Practices " - _-- '^FC _-- •_$9t7 COG ' R'inoagPmrnt and Per:'onnr--! FC ! 00_, i :ra :------ --Fc.xi:,nd F o-:xt Prot-tion- FC s rd:.: Ig I ( Proper Cooling of PHFs -" - - -- r r (IUii)rrird;t rtMi Ute,sill f <. � t ' � ;',edine C:xffi�dYHl=s 1'vny fat tu h - I F -, � •_>'- -.-Fhifer.PI:,m4iny-irr!_,N_'�e- -____-;-FC_ yj,7 _ W"+tion _' 1Liu:<.,^[ rrom ,') 1 FPa,.,?itp• _ -'~— '- -- _ E ia.i?"e/t. Pgitlan tiger,'- 12' cos rr.aus of Tnxu tata+e,w; '-- --T FC,-- =00, --- ' r _Oi.( rt6l (Chit,1HF: :vl;tdc I t.rtn Amhicot j ,. °_-_Lai n(:�a!R ornr•,?mtii!_,__ _ - y -- i > I Tomb:r.anre !nFrrd,cru,tr•.-i'F/15 F 'pn,a.,.... .... '.n:.q if:r?a.:'i.i 1...�:.i1.o:': ?e.: IL' t '..•, .' r•,r{I .r�. . " 4g,u_ `-+4 tP S.{- �r?S. .:t..r..• .,.. «4'.e^'u"'i'ta/� ' '". ... . :.r^^...,,.«..o...;n.z�r.-...�«r.+..�xYv^t.t+6t.•`°.�+iq�,�,.'"�/',, Massachusetts Department of Public Health Salem Board of Health Division of Food and Drugs 120 Washington Street,4'"Floor g Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name/�A Date L oe of Ooeratlon(sl T e of Inspection -t 111 f) ll.a� �I V I t Q 0 O 1�Aq` /V P I Y_r _,�-aah-( Y Food Service Routine Address,'" 11,, /`` cI Risk Retail ❑ Re-inspection a fn5k l 1 D�;�rt.fl l �7.a.t X In Level ❑ Residential Kitchen Previous Inspection Telephone T plc/ 1 , f�}1_ ? 1 �/ �❑ Mobile Date: Owner �1 y1/ 'J) ((�l HACCP YM ❑ Temporary ❑ Pre-operation �� p1t I ❑ Caterer F-1 Suspect Illness Person in Ch'age(PIC) / J Time ElBed& Breakfast ElGeneral Complaint In�2: «ir' ElHACCP Inspector � LA e © �/ Out: u Permit No. El Other Each violation checked requires an ekplanation 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)N 590.009(F) p� action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands- V 1. PIC Assigned/Knowledgeable/Duties vllf El13. Handwash Facilities EMPLOYEE HEALTH .. .. PROTECTION FROM CHEMICALS /1 El 2. Reporting of Diseases by Food Employee and PIC - / v ❑ 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 i ,�(� ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ' ✓f ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/. ACCP 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) El21. Food and Food Preparation for HSP El 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 FN 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)(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: 0P pall) A ; 0 � se��l�i1�1 Inspector's Signature: /�rle o ��f k Al Print: ( �� 0- Cr � v 1 PIC's Signatur � �'-- Print: Page `of". fr Violations Related to Foodborne Illness Interventions and Risk Factors(items 9-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT ( 8 Cross-contaminaton 1 590.003(A) Assignment of Responsibility* 3-302.11(A)(1) Raw Animal Foods Separated from 590.003($) Demonstration of Knowledge* I Cooked and RTE Fooc 2-103.11 Person in charge-duties I Contamination from Raw Ingredients 3-302.11(A)(2) Raw Animal Focxis Separated from Each EMPLOYEE HEALTH ( I Other' 2 590.003(C) Responsibility of the person to charge to I Contamination from the Environment require reporting by foot]employees and 3-302.11(A) Food Protection- I applicants* 3-302.15 Washing Fruits and Veeetables _ 590.003(F) Responsibility Of A Fax] Employee Or An I 13-304.1! Food Contact with Equipment and Applicant To Report To The Person In Utensils* Charge* I Contamination from the Consumer 590.003((;) Reporting by Person in Charge* 1 3-306.141A)(R) ( Returned Food and Resen ice of Food' 3 590,003(0) Exclusions and Restrictions* I Disposition of Adulterated or Contaminated 590.003(1-,) Retaus-al of Exclusions and Restrictions ( ( Food 13-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Frwd* 4I Food and Water From Regulated Sources 19 ( Food Contact Surfaces I 590.00d(A-B 1 Gimpli;mce with Food L:rw* d 501.1 al W' i I Manual -Hot Water ---- 13-201.13 Food in a Hermetically Scaled Container* ( Sanitization"Fe tiperatures* 3-2201.13 Fluid Milk and Milk Products* 14-501.i i2 Mcclumical Warewashing-Hot Water 3-202.13 Shell Eg.gs* I Sanitization Temporariness 3-202.t4 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Siu-titization-temp.,pH, 3-202.16 lee Made From Potable Drinking Water- I concentration and hardness. 5-101 11 Drinking Water from an Approved System* I 4-601'1 I(A) Equipment Foal Contact Swtaces and 590.006(A) Bottled Drinking Waterx I _ _ Utensils Clean- 4-602 lean- 11 4-602.11 Clearing Frequency of Equipment Food- 590 006(B) Water Meets Standards in 310 CMR 22.0'' ( Contact Surfaces and Ut nsis* Shellfish and Fish From an Approved Source ( ( 4-702.11 Frequency of Sanitization of Utensils and 3201.14 Fish and Recreationally Caught Molluscan I Foal Contact Surfaces of Equipment- Shellfish, 14-703,11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed I Chemical* Sources* ( 10 I Proper,Adequate Handwashing Game and Wild Mushrooms Approved by Regulatory Authority ,x,-301.11 Clean Condition-Hands and Anns* 13-202.18 Shellstock Identification Present* 2-30112. CleaningPrx;edurc* I 590.004(C} I Wild Mushrooms` I '_-:501.1.1 When to Wdsh* 3-201.17 1 Came Animals* 11 f Good Hygienic Practices g ( Receivinq/Condition ( 2-401.11 Eating,Drinking or Using Tobacco* 13-202.11 PHFs Received at Proper Temperatures* I ( 401.12 Discharges From the Eyes, Nose and 3-202,15 Package Integrity' I I Mouth* 3-101.11 Food Safe and Unadulterated* 3-30LA2 Preventing Contamination When Tasting* b Tags/Records:Shellstock 112 Prevention of Contamination from Hands J 3-202.18 Shellstock Identification* 590.0(14(F) Preventing Contamination from 13-203.12 Shellstock Identification Maintained* Emplovecst Tags/Records:Fish Products I 113 ( Handwash Facilities j ( 3402.11 Parasite Destruction* Conveniently Located and Accessible� - - 3-402.12 Records.Creation and Retention* 15-203.11 I Numbers and Capacities* 590.004(1) I Labeling of Ingredients* 15-204.11 I Di ation and Placement* 15-205.11 A essibilit ,Operation and Maintenance Conformance with Approved Procedures ( Su'plied y pDrying /HACCP Plans pp'ed with Soap and fiend 3-502.11 Specialized Processing Methods* Devices _ _ I .� 6-301.11 Handwashing Clean ser, Availability 3-502.12 Reduced oxygen packaging,criteria 18-103.12 Conformance with Approved Procedures* I 16-301.12 Hand Drying provision Denotes critical nem in the Wet al 1999 Fo:xl Cole m 105 C:1-IR 590.0011. F QX PD 0.11'� pp BOARD OF HEALTH Establishment Name:i6 n �!J ? ,'Nkl r,Q�A ALW 1'i t Xr� Date: —n�_(F/— �f Page: of 7 Item Code C-Critical Item,j } _ DESCRIPTION OF VIOLATION f PLAN OF CORRECTION ` Date j No. Reference R—Red Item PLEASE PRINT CLEARLY Verified ` ! K t�11/'✓Vl l�i�l� L�19 Kul i/�,LJ -i� \ r� �C�-('� L�i1l\ P/I/G.� /t YfJC.f�. F I I �( 5� t . a'LL r(1 0 .0n (Iit (1, /I1 A-ell 1 .0i n , IJ -(24 iAQ, ,Q I C'T lC Discussion With Person in Charge: / Correct Action Required: I ❑No ( ❑mss Q Joluntary Compliance ❑ Employee Restriction/ Exclusion y ❑ Reinspection Scheduled ❑ Emergency Suspension t E ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other FORM 7348 (REV. 7/2000) HOBBS &WARREN, - BOSTON This Form Approved by the Department of Public Health dr Violations Related to Foodborne Illness Interventions and Risk 3-501.14(C) PHFs Received at Temperatures Factors(Red Items 1-22) (Cont) According to Law Cooled to 41°F/45°F Within 4 Hours.* PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14 I Food or Color Additives 119 PHF Hot and Cold Holding 3-202.12 Additives* 3-501.16(6) Cold PHFs Maintained at or below 3-202.14 Protection from Unapproved Additives* 590.004(F) 41°F/45'F* 15 Poisonous or Toxic Substances I 3-501.16(A) Hot PHFs Maintained at or above 7-101.11 Identifying Information-Original 140'F.* Containers* 3-501.16(A) Roasts Held at or above 130°E* 7-102.11 I Common Name-Working Containers* 120 I Time as a Public Health Control 7-201.11 Separation-Storage* 3-501.19 Time as a Public Health 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) 17-204.11 Sanitizers,Criteria-Chemicals* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals for Washing Produce,Criteria* Beverages with Warning Labels* 11 7-204.14 Drying Agents.Criteria* 3-801.11(B) Use of Pasteurized Eggs* 7-205.11 Incidental Food Contact,Lubricants* _ 3-801.1 I(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria* I Raw Seed Sprouts Not Served.* 7-206.12 Rodent Bait Stations* I 3-801.11(C) I Unopened Food Package Not Re-served.* 7-206.13 Tracking Powders,Pest Control and Monitoring* CONSUMER ADVISORY 22 3-603.11 Consumer Advisory Posted for Consumption of TIME/TEMPERATURE CONTROLS Animal Foods that are Raw,Undercooked or 16 Proper Cooking Temperatures for not Otherwise Processed to Eliminate PHFs Pathogens.* Eoec"11112111 3-401.11A(1)(2) Eggs- 155°F 15 Sec. 3-302 13 1 Pasteurized Eggs Substitute for Raw Shell Eggs* Eggs-Immediate Service 145°F 15 Sec.* 3-401.11(A)(2) Comminuted Fish,Meats&Game SPECIAL REQUIREMENTS Animals- 155°F Sec.* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 3-401.11(6)(1)(2) Pork and Beef Roast- 130°F 121 Min.*I catering,mobile food,temporary and 3-401.1l(A)(2) Ratites,Injected Meats- 155°F 15 Sec.*I residential kitchen operations should be 3-401.1 l(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections Stuffing Containing Fish,Meat, above if related to foodborne illness Poultry or Ratites- 165°F 15 Sec.* interventions and risk factors. Other 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail 145°F* practices should be debited under#29- 3-401.12 Raw Animal Foods Cooked in a Special Requirements. Microwave 165°F* 3-401.11(A)(I)(b) All Other PHFs- 145°F 15 Sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 17 I Reheating for Hot Holding (Blue Items 23-30) 3-403.11(A)&(D) PHFs 165°F 15 Sec.* Critical and non-critical violations, which do not relate to the 3-403.11(B) Microwave- 165°F 2 Minute Standing foodborne illness interventions and riskfactors listed above, can be Time* found in the following sections of the Food Code and 105 CMR 3-403.11(C) Commercially Processed RTE Food- 590.00. 140°F* Item Good Retail Practices FC 590.00 3-403.11(E) Remaining Unsliced Portions of Beef 23. Management and Personnel FC-2 .003 Roasts* 24. Food and Food Protection FC-3 004 118 I Proper Cooling of PHFs 25. Equipment and Utensils FC-4 .005 3-501.14(A) Cooling Cooked PHFs from 140°F to 26. Water, Plumbing and Waste FC-5 .006 70°F Within 2 Hours and from 70°F 27. Physical Facility FC-6 .007 to 41°F/45°F Within 4 Hours.* 28. I Poisonous or Toxic Materials FC-7 .008 I 3-501.14(B) Cooling PHFs Made From Ambient 29. I Special Requirements .009 Temperature Ingredients to 41°F/45°F 30. Other Within 4 Hours* *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 97,Pr �M BOARD OF HEALTH Establishment Name` s t� LIZ r VY�fC ��v1 PSS C t�XT �' Date: —� �D—CLQ! Page: l of 4-1 Rem Code C—Critical Item t DESCRIPTION OF VIOLATION ! PLAN OF CORRECTION Date No. Reference R—Red Item PLEASE PRINT CLEARLY Verified i ,V/� ` t I��X Pn A/)A Inivx--AA -'AA 0 I I I T ` a� '�"l ,) P� FTC I I I I I I I Discussion With Person in Charge: Corrective Action Required: I ❑No I ❑Yes ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure r ❑ Voluntary Disposal ❑ Other • FORM 7348 (REV. 7/2000) HOBBS &WARREN, - BOSTON This Form Approved by the Department of Public Health Violations Related to Foodborne Illness Interventions and Risk 3-501.14(C) PHFs Received at Temperatures [o Factors(Red Items 1-22) (Cont.) According to Law Cooled41°F/45*F Within 4 Hours.* PROTECTION FROM CHEMICALS 13-501.15 I Cooling Methods for PHFs 14 Food or Color Additives I 19 I PHF Hot and Cold Holding 3-202.12 Additives* 3-501.16(6) Cold PHFs Maintained at or below 3-202.14 Protection from Unapproved Additives* 590.004(F) 41°F/45°F* 15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above 7-101.11 Identifying Information-Original 140°F* Containers* 13-501.16(A) I Roasts Held at or above 130°F.* I 7-102.11 Common Name-Working Containers* I 120 Time as a Public Health Control 7-201.11 Separation-Storage* 13-501.19 Time as a Public Health Control* 7-202.11 Restriction-Presence and Use* I 590.004(H) Variance Requirement 17-202.12 Conditions of Use* _ REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions* POPULATIONS (HSP) 7-204.11 Sanitizers.Criteria-Chemicals* 21 13-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals for Washing Produce,Criteria* 1 Beverages with Warning Labels* 7-204.14 Drying Agents,Criteria* 3-801.1](B) Use of Pasteurized Eggs* 7-205.11 Incidental Food Contact,Lubricants* 3-801.11(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria* Raw Seed Sprouts Not 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* CONSUMER ADVISORY 22 3-603.11 Consumer Advisory Posted for Consumption of TIME/TEMPERATURE CONTROLS Animal Foods that are Raw,Undercooked or 16 Proper Cooking Temperatures for not Otherwise Processed to Eliminate PHFs Pathogens.* Eecnve 11112001 3-401.1IA(1)(2) Eggs- 155°F 15 Sec. I 3-302.13 I Pasteurized Eggs Substitute for Raw Shell Eggs* Eggs-Immediate Service 145*F 15 Sec.* --- 3-401.11(A)(2) Comminuted Fish,Meats&Game SPECIAL REQUIREMENTS Animals- 155*F Sec.*I I I 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 13-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 Min.*I catering,mobile food,temporary and 3-401.11(A)(2) Ratites,Injected Meats- 155°F 15 Sec.*I residential kitchen operations should be 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections Stuffing Containing Fish,Meat, above if related to foodbome illness Poultry or Ratites- 165°F 15 Sec.* interventions and risk factors.Other 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail 145°F* practices should be debited under#29- 3-401.12 Raw Animal Foods Cooked in a Special Requirements. Microwave 165°F* 3-401.11(A)(1)(b) All Other PHFs- 145°F 15 Sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 117 Reheating for Hot Holding (Blue Items 23-30) 3-403.11(A)&(D) PHFs 165°F 15 Sec.* Critical and non-critical violations, which do not relate to the 3-403.11(B) Microwave- 165°F 2 Minute Standing foodborne illness interventions and risk factors listed above, can be Time* found in the following sections of the Food Code and 105 CMR 3-403.11(C) Commercially Processed RTE Food- 590.00. 140°F* Item Good Retail Practices FC 590.00 3-403.11(E) Remaining Unsliced Portions of Beef 23. Management and Personnel FC-2 .003 Roasts* 24. Food and Food Protection FC-3 .004 18 Proper Cooling of PHFs 25. I Equipment and Utensils FC-4 .005 I 3-501.14(A) Cooling Cooked PHFs from 140°F to 26. Water, Plumbing and Waste FC-5 .006 I 70°F Within 2 Hours and from 70°F 27. Physical Facility FC-6 I .007 I to 41°F/45*F Within 4 Hours.* 28. Poisonous or Toxic Materials FC-7 .008 I 3-501.14(B) Cooling PHFs Made From Ambient 129. Special Requirements .009 Temperature Ingredients to 41°F/45°F 130. Other Within 4 Hours* *Denotes critical item in the federal 1999 Food Cale or 105 CMR 590.000. w i Commonwealth of Massachusetts City of Salem Board of Health IGmberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Foo"etail Establishment Permit DATE PRINTED: 01/08/2008 ESTABLISHMENT NAME: Major Magleashe's Pub File Number:BHF-2004-000064 268 Washington Street Salem MA 01970 LOCATED AT: 0268 WASHINGTON STREET SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes FOOD SERVICE BHP-2008-0275 Jan 7,2008 Dec 31,2008 $280.00 ESTABLISHMENT TOBACCO VENDOR BHP-2008-0278 Jan 7,2008 Dec 31,2008 $135.00 Total Fees: $415.00 PERMIT EXPIRES IDecember3l, 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 1 of 3 CITY OF SALEM, MASSACHUSETTS I� I` BOARD OF HEALTH oacyy 120 WASHINGTON STREET,4T FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978)745-0343 MAYOR TSCOITt'rt)SALEM.COM JOANNE SCOTT, HEALTH AGENT 2008 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT �A d�� M AireSH� S p�t3 TEL# ADDRESS OF ESTABLISHMENT z6� (t)Rstiy �ron( 5� FAX# MAILING ADDRESS (if different) EMAIL-Business': Website: /� OWNER'S NAME V NIt-If R- SNC/ PAL)L- FtAHEikT�/ TEL# �� - 71/ - zyc7y ADDRESS 2-3 6 L LL-F-Al-1 Rt>. Sf}LF-,r"1 O/ 9'70 STREET SOV I D PXk0 S7— CITY STATE /b-1 Z ca 6 OF CERTIFIED FOOD MANAGER'S NAME(S) PH I L I{' SH15,4 CERTIFICATE#(S) 7-7 2- (Required (Required in an establishment where potentially hazardous food is prepared) EMERGENCY RESPONSE PERSON PPtt)L FLAT&(Z T 5, HOME TEL# 979- "/Y - k5-30 DAYS OF OPERATION Monday Tuesday Wednesday Thursday Friday Saturday Sunday HOURS OF OPERATION ly:3o��1 /i po �M /)'3oA`1 7/ 30 ()r1 /l.,,o Am 9,01 Izr/ooN l Please write in time of day (For example t lam-11 pm) rco n1,1 - !`MA(l - 1%600 /:oo F+M - I:00 /)1"1 _ 1 ',JOA111 _ I.wA^l TYPE OF ESTABLISHMENT FEE (check only), RETAIL STORE YES NO less than 1000sq.ft. =$70 1000-10,000sq.ft. =$280 more than I0,000sq.ft. =$420 RESTAURANT YES NO less than 25 seats =$140 (Outdoor Stationary Food Cart$21 25-99 seats =5280 more than 99 seats =$420 '----'--'------...--'--. ------------------------------- --- BED/BREAKFAST/ YES NO $100 CHILDCARE SERVICES-__. ADDITIONAL PERMITS MAKE (notjust serve) ICE CREAM, YOGURT/SOFT SERVE YES NO $25 TOBACCO VENDOR ES 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 fled all state tax re d paid all state t s r fired under the law ,7 1lL/5/07 2-636Oo0 Signature Date Social Security or Federal Identification Number Revised 4/24/07 FOODAP2008 adm Check#&Date Commonwealth of Massachusetts « City of Salem Board of Health rumberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 12/30/2008 ESTABLISHMENT NAME: Major Magleashe's Pub File Numbs:BHF-2004-OOOW 268 Washington Street Salem MA 01970 LOCATED AT: 0268 WASHINGTON STREET SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions!Notes FOOD SERVICE BHP-2009.0325 Dec 30,2008 Dec 31,2009 $280.00 ESTABLISHMENT TOBACCO VENDOR BHP-2009.0328 Dec 30,2008 Dec 31,2009 $135.00 Total Fees: $415.00 PERMIT EXPIRES (December 31,2009 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 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR IDIONNEnaSALEM.COM JANET DIONNE, ACTING HEALTH AGENT 2009 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT MAToR /008 TEL# 97?- ?`iY-- Z3 14 ADDRESS OF ESTABLISHMENT 2*g �JASN/�/g7Bv( S'V'- FAX# MAILING ADDRESS(if different) EMAIL- Business': p Website: OWNER'S NAME / hyNOp S"`( 1 �pl��L ��NFRTY TEL# 9�� 7`f� Z�� ADDRESS 2-3 s4l"EM /r7rq- 0 / 9-2V STREET CITY STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S) PY1-i fI $HF- -- CERTIFICATE#(S) 7l 1 16 2- (Required in an establishment where potentially hazardous food is prepared) EMERGENCY RESPONSE PERSON 1 pruL FLAKF-Rry HOME TEL# 9-7 71,1Y` K3 -DAYS OF OPERATION I . Monday. Tuesday' Wednesday a`j `'Thursday Friday Saturday- Sunday I HOURS OF OPERATION 3D An— //; I o AM 30 ft^)- t(:)d AM; 1(9d P M -i /0;00 AM ' I7-Noo N — Please write in time of day. DO�'M 0o F1 -ao /d'M e /'j PI •00 t (Forexampletram-ttpm) 1500 hN"1. 1'' l= m! r �' o �� (;oa A-(`(l TYPE OF ESTABLISHMENT FEE (check only) RETAIL STORE YES NO less than 1000sq.ft. =$70 1000-10,000sq.ft. =$280 more than 10,000sq.ft. =$420 ----------------------------------------------- --------- ------------------------------------------------------ ----------------------------------- RESTAURANT YE NO less than 25 seats (Outdoor Stationary Food Cart$21 25-99 seats =$280 more than 99 seats =$420 BED/BREAKFAST/--------------------YS------416----------------------------------------------------------------------------------$1-0-0------- CHILDCARE ----CHILDCARE SERVICES ADDITIONAL PERMITS MAKE(not just serve) ICE CREAM, YOGURT/SOFT SERVE YES NO TOBACCO VENDOR ES NO $135 ALL NON-PROFIT(such as church kitchens) 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 retu7 aid all state tars e ed under the law. /LOO Q u — ('�> /a 0 e ! 2z36000 Signature v Date qq Social Security or Federal Identification Number Revised 424/07 FOODAP2008.adm Chmkff&Date $ l i 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 Name f Date Ty a of Ooeration(s). Tvpe of Insoection M0 �� or Q�e< f t j 1a* Food Service ®Routine Address IIPP �t Risk Retail [0 Re-inspection k� lOtYA n��vn who-z Level ❑ Residential Kitchen Previous Inaction Telephone -%4,-6-3 I i1 1�a3 t ❑ Mobile Date:4(1-7a y Owner ��I ' l/ HACCP Y/N ❑ Temporary ❑ Pre-operation h,� ': Nr+ NII,1/ CJAnrhr ❑ Caterer ❑ Suspect Illness Person in`Charge(PIC) i TimeElBed&Breakfast ElGeneral Complaint Inspector �� IKrX.XO I Out:3 j7L� 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 EMPLOYEE HEALTH -`......, ' El 13. Handwash Facilities PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded _ El 15.Toxic Chemicals FOOD FROM APPROVED SOURCE - .-"- TIME/rEMPERATURE CONTROLS Poterdfall i -. � � ) _ ❑ 4. Food and Water from Approved Source ( y 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 El11. Good Hygienic Practices -CONSUMER ADVISORY; \ ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices, � VL��imber of Violated Provisions Related Critical (C) violations marked must be corrected �` ` , 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)(590.003) 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) 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 SMnVp Wor 14 da Inspector's Signature-, 1 /\ Print: PIC's Signature: ` >"�' ,] A Print. pH I`r �Y N'Pi�crc I Page of Pages li 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--02.11(A)(1) Raw Am malFoudsSeparatzdfrom 590.003(B) Demonstration of Knowledge" Cooked and RTE Fotids* _ 2-103.11 Person in charge--duties I I Contamination from Raw Ingredients 3-302.11(AA2) Raw Aninwl Foods Separated from Each EMPLOYEE HEALTH I I Other* 2 590.003(0 Responsibility of the person in charge to I I Contamination from the Environment require reporting by food employees and 13-302.11(A) Food Protection^ apyticants* 3-302,15 Washing Fruits and Vegetables _ 590.003(F) Responsibility Of A Food Employee Or An 1 3-304.11 Food Contact with Equipment and Applicant To Report To The Person In I Utensils* Charge* I Contamination from the Consumer 590.003(0) Reporting by Person in Charge'' I 3-306.14(A)(B) ( Returned Food and Reservice of Food* _ 3 1590.003(D) Exclusions and Restrictions* I Disposition of Adulterated or Contaminated 590.003(E) Removal of Exclusions and Restrictions Food 3-701.11 Discarding or Reconditioning Unsafe l FOOD FROM APPROVED SOURCE Fixed* i 4 Food and Water From Regulated Sources 19 Food Contact Surfaces _ I I 4-501 111 ( Manual Warewashing-Hot Water :S90A04(A-Bj Food in Compliance with Food Law I Sanitization Temperatures'" 13 01.12 Fluid in i Hermetically Sealed Contuner* ( 4-501.112 I Mechanical Warewashing-Hot Water 3-201.13 I Fluid Milk and Milk Prcxlurt,* 1 3-202.13 Shell Eggs` I Sanitization Temperatures* 3-202.!4 Ergs and Milk Products.Pasteurized* I 14-501.114 Chenfical Sanitization-temp., PH, concentration and hardness. " 3-202.16 lee Made From Potable Drinking Water'" 5 4-601.11(A) Equipment Food Contact Surfaces and .101.1 l Drinking Water from an Approved System" Utensils Clean` 590.006(A) Bottled Drinking Water* " 14-602.11 Cleaning Frequency of Equipment Food- 590 006(B) Water Meets Standards in 310 CMR.....0 Contact Surfaces and Utensils* I Shelfiish and Fish From an Approved Source I 4-702.11 1 Frequency of Sanitization of Utensils and 3201 14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of Equipment* Sheilio.h- I 14-703A! Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources" 11p I Proper,Adequate Handwashing Game and Wild Mushrooms Approved by ( Regulatory Authority 2.301.11 Clean Condition-Hands and Arens* 3-202.18 Shellstock Identification Present* 12-301 12 Cleaning Procedure* 590.004(0) Wild Mushrooms* I 2-301.14 When to Wash* 3-101.17 Oamc Animals* I ( tl Good Hygienic Practices g Receiving/Condition I 12-401.31 Eating,Drinking or Using Tobacco" 3-202.1 t PHFs Received at Proper Temperatures" 2-401.12 Discharges From the Eyes. Nose and 13-202 t5 I Package Integrity' I Mouth` 3-101.11 I Food Safe and Unadulterated* I 3-301.12 I Preventing Contamination Wlien Tasting"' 6 I Tags/Records:Shellstock 112 I Prevention of Contamination from Hands 3-202.18 Shellstock Identification* I 590090 Preventing Contamination from 3-203.12 Shellstock Identification Maintained* I Employees* TagslRecords:Fish Products I ( 13 I Handwash Facilities 3402.11 Parasite Destruction` I I Conveniently Located and Accessible 13-402.12 Records,Creation and Retention* 15-203.11 Numbers and Capacities* i Labeling of Ingredients* 15-2!)4.11 I I.,ocation and Placement* 5)0.004(J} 9 9 15-205.11 i Aoeessibilit Operation and Maintenance I ( T Conformance with Approved Procedures I ) /HACCP Plans I ( Suppled with Soap and Hand Drying 3-502.12 Specialized Processing Methods* Devices I 3-502.1_ Reduced oxygen packaging;criteria" 6-301.11 Handwashing Cleanser,Availability 8-103.12 Conformance with Approved Procedures* I 16-301.t2 Hand Drying Provision - *Denotes critical item in the federal 1999 Food Cale of 105 CMR 590.000. r � R _ CITY OF SALEM f BOARD OF HEALTH Establishment Name: 10(j f i /"i c C I/'r, 4AC` t �, ,� Date: J?qJd c� Page: of �• Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION I Date 1 }� No. Reference R-Red item PLEASE PRINT CLEARLY Verified ! � ) a=�-�.•a �2 �.-V�,. v. ,,, hlll c�� ,'f- I'xar- rlJ�lnc�-, Cion r. n,,,.)- -h6 � ;/tfC7 11 r'/ �i , �0� � Jf �r a}- fn�r2l. �✓1 t�7J(Si_ --�, ,�.�r . I �va/�= 1 ✓� / �u�� .�7�,,njs.I �7�- (��'O�� -><—[„T7��=rp �' '' 17.J',!.�`-_ Al Ate- I ` 1,( n /r.JV On ( / �DLn ✓JC I ' I ✓l ..�z r,n, t the r: ) . t' iI � r )-V^))Aj 4. oZ ,Y I 1 Discussion With Person in Charge: Corrective Action Required: I ❑ No tis I have read this report, have had the opportunity to ask questions and agree to correct all �p 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. _ / ) (�� - 1 ❑ Voluntary Disposal ❑ Other: „ r MANns MAW Q Foodbamp.6lir esil, ruld Rise: AtworJiGg Cnmed l„ Factor,-(derng Y-0) 'Cofit; i 1 PROTFMON FROM Cl FMICALGTd I I MW Hot and Cold HOW109 Food or Coiw Mmdve� 'A 501 AMA Chid I'M MuMnshan lebw WU 919t 1 41QAj W i WIN I Proicciial 00M i Z.p"Wq A&WOM, 3 5%INA) I iol PHI`, onisenoti-,of TLXic stibstiov"s IMAI W"M War Wd.4 tc ntovr 00 V 20 Time as a Pubk Hoaqh C.l:ndev: I= 19 rime a a Rom mil cuouvi 7 21A.I! 7-202 t1 '-202A2 An 11 RE.01,11REMENTS FOR HIGHLY SUSCEP71BLE 7-204.1! POPULATIONS jHSP,1 SMAIM Qp"nunmd M la:,aetd hnc�, nd 7-204A4 Dn,,ilw of Pa,vanzed 7 ZMAI Lad: MI F00 WIS 1 11P.OUN, 110LIl D RAw or FMAI,WNW Anami F.J nd ATKA I lk:;�ric"J qema z I P;o%r St"d �j,roal,i Noi Saved, -i---06.!2 K;:I,�"v 1"!•i 3 SUI I W? I fjn,,p-ncd FaO Pat:kay., Nol Re-.kr%ol CONSUMER ADVISORY TZMEnEIAPERATUPE CONTROLS 1 22 3AU5 11 Clownicr AMvinq WON Q Wwwry1m�f 16 Cqoklng Tmnlc,�iSziren ParAvoimi to 34M ;IV!Q 5 K i -!!�iu iol "<a%v s'h.11 W hmnInn%nut 1011 Q, hm,. SPECIAL REOUIRMENTS 1 Pxh .6 Iiczf 130t F I i 1 will I KATO wabnlug. n101,11 00CL ,Mlporavv and AWANAO) Rawy VON Gmx. Woe,11M ld!;lI Wchl;n ope!iltion'�hovid 1%. debilld undo dw lijipio-, z;Xc :eknons 'q.s,.'n3.1-ic} ', ;5,t. . ' jlovc if fQwtcj 1l'fx-x1born"llhlei%; 340LINCpQ so, nwcl Bait S*xal'i faclkr� Ozln.t IWO 590.0,00 vlolliiion"roiaci'.g to poo'l 2'eirkh 1 MOW Rqvv Awrtlal 11M C aled in 3 und�- 165^1 klnpirr,irwnt3 AM MACKA? Ai Olhri III],:- b4i 11= 17 E Pcivadriq for 1-10i Holding WOU IMAM RFL ATEO TO GOOD RETAIL PRACTICES L403 I I(varivil n1u., (hems 2300) TAM!00 WalW614.5 WauW1 W*av"M Maw w T'° %Uqw-e UWA In"i icnfiop,*✓n0okjae tars 1:,!,:d r,m Lr. RIV saki - Annid in M;'"A .ty so Qw,of=1l:rood(0drin,'?ji)� ';Ilp Mom Z401140 ROMM Am L W hoe,r"'(qcn'of 11:,A Pon) Good Retail practi-el; 23 'Mana, rr asd Pey��;nnel 24 Fo:)d�md focicJ Prclp�Vor. r-ropet Cooling ol PHN, 'A- Egapnwnt and W(,17113 Fc-4 i'c� i 501 IT'S n 2, 2VA3t.."LL x1bvi 27 facility fzC.— '+'t07 • A v I-M,F"Awn 4 Wnu. Malmiw; `(,—.7— 219B COAQ PHP MO& Wm imbba 36W low I R"A-3 I M.W1 Wo e nM :j Sq'i r CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978.745.0343 Kimberley Driscoll WNrWSALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT This Farm will be collected during your next Board of Health inspection. QUESTIOfNV}AIRE- GREASE TRAPS 2408 1. NAME OF ESTABLISHMENT: l ' d p6 �5�� S 2. ADDRESS OF ESTABLISHMENT: _ (� g 01951.11A(G7eAJ S P 3. DOES YOUR ESTABLISHMENT HAVE A GREASE TRAP? r e"�9 4. WHAT SIZE GREASE TRAP DOES YOUR ESTABLISHMENT HAVE? CAPACITY IN GALLONS 36 5. HOW IS_THE-GREASE_TRAP-MAINTAINED? ON A DAILY BASIS? BY AN IN-HOUSE PERSON OR BY AN(OUTSiDE CLEANING SERVICE? 6. WHAT IS THE FREQUENCY THAT THE GREASE IS REMOVED FROM THE TRAP? 2- PC 2 'f G/J/Z 7. WHAT IS THE NAME OF THE FIRM WHO REMOVES AND/OR PICKS UP THE GREASE FROM YOUR ESTABLISHMENT? SERv(c.r Pwgp �&- 4-- I) RPIN 8. WHAT IS THE DATE OF YOUR LAST INVOICE FROM THE REMOVAL FIRM? Massachusetts,Department of Public Health Salem Board of Health Division of Food and Drugs 120 Washington Street,4'" Floor 9 Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name ) ,!t 1 Date 1 Type of Ooeration(s). Type of Insoection 11U �r �� -S r 51/4 f ,,�? ��!of v ❑� Food Service El Routine Address ' ^I / Risk El Retail [2Re-inspection _ Level [I Residential Kitchen Previous Inspection Telephone ` ' ❑ Mobile Date: ` l �" t HACCP Y/N.. [I Temporary ElPre-operationOwner ()r E] Caterer ❑ Suspect Illness Person'in Charge(PIC) y I Time ❑ Bed&Breakfast El General Complaint ILI "� �{ A In: ❑ HACCP Inspector -�'� ! ,ate` I Out: (.?, f Permit No. ❑Other Each violation checked rdquires an explanation on the narrative pages) 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) El 590.009(F) [_1action as determined by the Board of Health. V i, cn _ _ FOOD PROTECTION MANAGEMENT El 12. Prevention of Contamination from Hands ('!�c/'�� ❑ 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 El 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 ❑ 1 B. 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, when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-z) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-8)(5590..090.0 054))) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (Fc-5)(550.005) 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 59JlnspectFam614 tloc /} ' IInspector's Signature: I Print: I .1 .n . �(_, LK.A-�� /-t�� 1, din. �_, / PIC's Signature: / ' /r) 4�.1,f� Print:P�//I / /`, S-y�-� Page�of I Pages Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT I $ ' Cross-contamination I 1 590.003(A) Assignment of Responsibility" I � 3-302.11(A)(1) Raw Animal Fnods Separated from 590.003(B) Demonstration of Knowledge" I Cooked and RTE Fowds* l 2-103.11 Person in charge--duties I ( Contamination from Raw Ingredients 3-302,i 1(A)(2) Raw.Aninnal Foods Separated from Each EMPLOYEE HEALTH I I Other` J 2 590.003(C) Responsibility of the person in charge to I Contamination from the Environment require repotting by food employees and I 3-302.1 1(A) Food Protec+ion' applicants* 13-302 13 Washing Fruits and Vegetables 590.003(F) Responsibility Of A Food Employee Or An ( 3.30¢,11 Food Contact with Equipment and Applicant To Report To The Person In I Utensils* Charge* I ( Contamination from the Consumer 590.003(1;) Reporting by Person in Charee* I 13-31)6.14(A)(B) I Returned Food and Reservice of Foal" I 590.003(D) Exclusions andResariclions* ( I Dispos.7ionotAdulferatedorContaminated 590.o03(E) Removal of Exclusions and Restrictions ( Food 701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Fund* 41 Food and Water From Regulated Sources 1 ( 9 Food Contact Surfaces 590.004(A-B) Compliance with Food Laws 4-501 111 Manual Warewashing-Hot Water 3-201.12 Food in it Hermetically Scaled Container*, Sanitization Temperatures' 4-501.112 Mechanical Warewashing-Hot Water 3.201 13 Fluid Milk and Milk Products* Sanitization Tem eratures* 3-202.13 Shell Eggs* I p' 13-202.14 Eggs and Milk Products.Pasteurized' I 14-501.114 I Chenucal Sanitization-temp.,pH, 3-202.16 lee Made From Potable Drinking Water* I concentration and hadif " 5401.11 Drinking Water from an Approved System' 4-601 1 t(.A) I Equipment Food Contact Surfaces and 590.006(A) Bottled Drinking Water* I Utensils Clean- 590.006(B) Water Meets Standards in 310 CMR 22.0" f 4-602.11 Cleaning Frequency of Equipment Fead- Contact Surfaces and Utensils' Shellfish and Fish Froman Approved Source I 14-702.11 Frequency of Sanitization of Utensils and 13.201.14 Fish and Recreationally Caught Molluscan I Food Contact Surfaces of Equipment Shellfish' 14-703-11 I Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical:' I Sources* 10 I Proper,Adequate Handwashing Game and Wild Mushrooms Approved by Regulatory Authority I 2-301.11 Clean Condition-Hands and.Anus" 3-202.18 Shellstock Identification Present`" I ( 2-301.1? Cleaning Procedure* 1590.004(C) Wild Mushrooms- 2-301.14 When to Wash` 3-201.17 Came Animals* I 111 Good Hygienic Practices g I Receiving/Condition 2-401.11 Eating.Drinking or Using,Tobacco* 3-202.11 PIfFs Received at Proper Temperatures* I I 2-401.i 2 ( Discharges From the Eyes, Nose and 3-202.15 Package Integrity" I Mouth* 3-101.11 Food Safe and Unadulterated* 3-30(.12 Preventing Contamination When Tasting* 6 Tags/Records:Shellstock 112 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* I ( 590.004(E) Preventing Contamination from 3-203.12 Shellstnek Identification Maintained* ( Empiny,es* l Tags/Records: Fish Products ( 113 I Hardwash Facilities 1 3-902.11 Parasite Destruction Conveniently Located and Accessible` I � I 3-402.12 Records.Creation and Retention* I 1j-203.11 ( Numbers and Capacities* 540.0040) I Labeling of Ingredients" 5-204.11 Location and Piacerncmt 7 I Conformance with Approved Procedures ( 5-205.11 Accessibility,Operation and Maintenance /HACCP Plans I I Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* I Devices 3-502.12 Reduced oxygen packaging.criteria" 6-301.11 I Handwashiug Cleanser, Availability 18-103.12 Conformance with Approved Procedures* ( 6307.12 Hand Drying Provision Denotes,critical nem in the federal 1991)F(xxl Code of 105 CMR 590.000. - y A Massachusetts Department bf Public Health Salem Board of Health Division of Food and Drugs 120 Washington Street,4'"Floor 9 Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name Datg Tvpe of Ooeration(s), Type of Inspection MG Ike m �.�4�n c -t 7f' hi74 704 L)7 Food Service Routine Address r�.�► J Risk/ ❑ Retail Re-inspection ev IA l,AG I A �a ` � )rw�� Level ❑ Residential Kitchen Previous Inspection Telephone � �-2 ❑ Mobile Date: Owner - f HACCP Y/N El Temporary ElPre-operation � FGuL Iz iaher_�/ I ❑ Caterer ❑ Suspect Illness Person Chart a(PIC) ' ❑ Bed&Breakfast El General Complaint In: 12 ��,IAD Time ^ ❑ HACCP ,- Inspector )►O Stit�n ��^ Out:/ � Permit No. ElOther Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s) violated. t 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 590.00e(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 s 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 -w ❑ 4. Food and Water from Approved Source TIMEITEMPERATURE CONTROLS(Poteritlalty 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 El 20.Time As a Public Health Control �Ld 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) l� ❑21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices O.1L .4.091 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 I 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)(590 003) 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-a)(Sso.00s) ;-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 -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: {� l �/Grl FYie S 5801nspecfFom510 n Inspector's Signature: Le 1/,&� Print: \� ��^ �/✓ �C PIC's Signature: /; Print: �7 N I L ' /-� � Page fof �l'ages X✓�� c Violations Related to Foodborne illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT__ _ _ _ 18 I Cross-contamination I 1 590.003(A) Assignment of Responsibility* I 3-302.11(A)(]) Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge* I ( Cooked and RTE Fcvxls* l 2-103.11 Person in charge -duties I I I Contamination from Raw ingredents a-302.1 I(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH I I Other` 2 590.003(C) Responsibility of the person in charge to I Contamination from the Environment require reporting by food employees and 13-302.11(A) Food Protection- applicants* 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility Of A Food Employee Or An 3-304.11 ( Food Contact with Equipment and Applicant To Report To The Person In Utensds* Charge* I Contamination from the Consumer 590.003(G) Reporting by Person in Charge* 13-306.14(A)(B) I Returned Food and Reservice of Food* 3 590.003(D) Exclusions and Restrictions* I I Disposition of Adulterated or Contaminated 590.003(F.) Removal of Exclusions and Restrictions I Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 4 Food and Water From Regulated Sources I 19 Food Contact Surfaces - 590.004(A-B) Compliance with Food Law* i 4-501 111 Manual Waewashing -Hot Water 13-201.12 Food ins Hermetically Scaled Container" I Sanitization'fentpe.ratures* 3-201.13 Fluid Milk and Milk Products* I 4-501.112 Mechanical Warewashing-Ilot Water 3-202.13 Shell Eggs* ! Sanitization Temperatures* 3-202.14 Eggs and Milk Products.Pasteurized* � 14-501.114 I Chemical Sanitization-temp.,pH, concentration and hardness. 3-202.16 lee Made From Potable Drinking Water- 5401. ater" I q-60i.1 I{A) Equipment Food Contact Surfaces and 5-101.11 Drinking Water from an Approved System" Utensils Clean" 590.006(Bm) Bottled Drinking Water* 4-607 1 1 Cleaning Frequency of Equipment Food- 59(I 006(}3) Water Meets Standards 310 CMR 22.0* i Shellfish and Fish From an Approved Source I ( Contact Surfaces and Utensils* 3-201.14 Fish and Recreationally Caught Molluscan 4-702.11 Frequency of Sanitization of Utensils and ( Food Contact Surfaces of Equinment* Shellfish ( a_703.11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* 10 I Proper,Adequate Handwashing Game and Wild Mushrooms Approved by Regulatory Authority 2-301,11 Clean Condition-Hands and Arnts"` 3-202.18 Shellstu k Identification Present" ( 2-301.12 Cleaning Procedure' ------- -- - 590.004(C) Wild Mushrooms* 12-301.14 I When to Wash` 1-201.17 Game Animals* I I it Good Hygienic Practices 5 Receiving/Condition 2-401.1 l 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 Package Integrity, Mouth` 3-101.11 Food Safe and Unadulterated* ( 3-301.12 Preventing Contamination When Tasting* I 6 Tags/Records:Sheiistock I 112 Prevention of Contamination from Hands 3-202.18 Shellstock Identification * 590.004(13) Preventing Contamination from 13-203.12 Shellstock Identification Maintained* I I Emplovees' Tags/Records:Fish Products 113 Handwash Facilities 3-402.11 I Parasite Destruction" ( I Ccnvenientty Located and Accessible 3-402.12 I Records,Creation and Retention* 15-203.11 Numbers and Capacities* 590.004(7) I Labeling of Ingredients' 15-204.11 Location and Placement* -- 7 Conformance with Approved Procedures 15-20.5.11 Accessibility,Operation and Maintenance 1HACCP Plans Supplied with Slap and Hand Drying Devices 3-502.11 Specialized Processing MetMethods* ( 3-502.12 Reduced oxygen packaging,criteria* I I 6-301.11 Handwashing Cleanser,Availability 18-103.12 Conformance with Approved Procedures" ( 16-301.12 Hand Drying Provision 'Deaoic<critical hent in the federal 1999 pond Code or 105 CNIR 590.000, i CITY OF SALEM ` 1 BOARD OF HEALTH Establishment Name: M re I ltq Date: A4-- / 5- A Page: of { Item Code C-Critical IteM V DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date t - No. Reference R-Red Item Verified i t PLEASE PRINT CLEARLY. 46 .�i✓I {` �Q- i ^�2 U f- � 1/�f r�,�nj/J ac�Gor,is� �tcrn . � �r.c� ��/' C �c�� tro/- r�0 ,..� � 7 /Y/.S!»„ C:• Ire t . I Y(n �t�1c.t ICL h : V�_ �v Si. Y1 IJQ�iVn tea. `Vio t1c -- I 0 l hOr�lz / I,, T/ J r(/� l� —_ �L�lor U,, �r.�a�I' r ✓t G l e_i CS r n-f I .14 reei ✓c_c , <lPi,n i o'�s , un fPr 1 M _Il l v i 'iAr._Un.,n� tIAC , c��r,J / oma= 1 r+_ _4.� ao lot n /' 4- I Si - - -_ K / p j"I � r� �i-� //](� 1��D1'. I�/n l/t't/� �0..-I /�Ll.el 1_n t�,r-i f-' iiw.�.l -✓hn r lie a ✓.I.a /n�I }{ I YO/�r}}�,ffnCI �nPlIle.,) 1A 1• /- fec�c.��J4LFS�. C7O�/ I/1 4A,Ur,,'Vn: YO �_.��n/' Ir A, S-. .4;9 )OD 'L I '9 F-4(rr. .�,/j � �ir� v� �v-2Ar ln_ � I A h6A-Pjx�/I�A�vO !n ��vi" r/Ocil ,s� ` I I ✓ I G.��. I,r,� r✓ t� 2r� �. 'Pr ufn r-/./J'�� ✓ �.n,�..rtnA �1.1:5 ori 1 1 } I - I Discussion With Person in Charge: Corrective Action Required: ❑ No r❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ I. 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 ty1five dolla s or suspension/revocation of ❑ Embargo ❑ Emergency Closure f your food permit. IIII o Voluntary Disposal ❑ Other. 1 Violations Related to Ferldbolov,Illness and Risk LQ, lq Factors(Items 1-22) ;Cont.? Gii'lk! Mrthnd, fig ,TitsPROTECTION FROM CHEMICALS Food or 40�16r Addtkives 19 tPHF Hal and Cold Holdmri 14 1 C'iild PHF,, Mainfamedat(w belcit, I 5t)l!0(14(f) 11/4�°F, 3-30214 1,1 6,A', I-i'll llliv� Mairinuied at ,, 31,ove Pol3onous of Taxi:Sgorfances 1,10 l" 17.102,1 1 (orni'loll Nwvo Work:,I.,0'lit amtr;�� Time as a Public Health Control ftblit,I li�,;Liffi C,trivol _202A 1 Rc,tiif,voli -P;eft l'ix aial U 7_201.12 Coifdilwyt: ,it i ls�v, I I REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7 �03 H Toxii,('Xjlltlfllfct�� -Pathlbi".ri, POPULATIONS(HSP) 7-204.11 21 1 -INtIlAi(A) �1-204.12 tt,t Au.'Nv:., Pwullcc, 7-204.14 flecrlv�es'kill) Warllifl�, Crikena, I lill) Uw of_Pwtc:lnzej F"gl o ImNl",aw" Z5()I.Il(f)) RX% n10 7-206,!1CotLOa- Rav 7-206.12 pvs!`,�w Boil Satiric' f iioprrttd Fxxi ltackxniv N,,i Rsened 7-106.13 1,1:1cilill,4'oedefz. P ,mj ckstu�,l and CONSUMER ADVISORY 22 31,t}3. I AWItpi y Pw�t„d for Coi TIMErrEMPERATURE CONTROLS22 focd,11w are R;w, vi 16 Proper Cookirig Tomparallues for PlIFs .ol I ahcf v,Isi, llr(*:v,twfj if)Hillimitte ?till 11 A(I €'ct::._ !35'F is S"'c. -J 11wixk,af: 4wr:zCv I'l'r14:c'. '..3(r7.1 i P'afhog�mi suhzuip..for K.w ShOl 3-40 1.11(Att comwimll'-d Nf.a:�& 6,11% 3-401.1 J(By),�Qf Polk anc, Uvvi koi=,t 12! nm,` SPECIAL REQUIREMENTS -Ill) 3-4")1.11(A), 15.�+ t? 5",00Q(A)-fD) violutlow�w socti('11 ") eito.rtng. mohill: fx:d, t,niptraty aflo reNid,,nti.d kitOien ojvraiiofia hovid he 11w appropriwe its Katmk, 165'F 15 iWyc if rvhtitA to RK),lbimp" Mir,'� '.i-40LINCII 3) Wh,,le „wf:lf: tnt,:o Bo4 inlclventirfnv and risl: fachir" Ofl)cr 5W009 viola"Juliq rehpint to 20k.] (Ottil 3-4w.;2 lla:k,Awlizil Ff,,dn !it a iploctice's �huuL' I-V Wtited utIdt-f #-,9 i05 F I 3=401.i1tP.tt3 tht 11 .1t!Od_-s llfll-. t 17 4 Retreating for litit Hdidirvg VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3_103.1 1 A),!t- I)) PRI.: W, 1' 1. ,v_ ^ i (Items 23-30) 1..403.11(13) M i cvo.,%at f _, M i f,u i,:Sul ficting Ciinoo wo non-e iih:al vtoiviwtii. do t1f); ,3,47, 0 Itu- ruile, friodhortie baeri,enji,twaici li,tedabov(, ton b,, 3-403.1!i Cl commowlally R'[E Ji,,,j- fiiawl in the fi,i 1,tis mii f eci i.,m, qj the Pond i odc mil I r)<Cl I R Item Cood Retail Practices 3403A I(Fi T'v;namiiiI,L iisi,�i,fj ,Z llf,<f zf�,d Personnel.... Fix-id;ind Food Proieceri,. ........ 18 Proper Cooling of PHFs k25 Equiorrient and Utensils F c:5 1-501,J UA) If, 26 WaIM Plumt�q incl Waste FC-5 r," PHI,: fi,,im 1,4fF _q_ ...... 701, W,Ihm 2 flxw�;!nd Frorrf'19�I-, FC-G t W7 41 'F/45'F N;ftjjin 41 jj,Ut, 26 rot,,,onous or TOW kkkhals_ -F"= 1002 3 501.141 ti) CoAiug Pfftiroiu -funbicia Rt:1Wrmnfwivq 00u Tempzz-cLklfc j!'FA_- Wlfillp.4 0268 Washington Street Major Magleashe's Pub City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: PROTECTION FROM CONTAMINATION 744-2328 j Handwash Facilities FAIL Critical RED Owner: Comment: Hand wash sink had celery in it. Sink to be used for hand washing only. Philip R. Shea $ Paul Flaher i Violations Related to Good Retail Practices (Blue Items) PIC: Food and Food Protection FAIL BLUE Phil Shea Inspector: Comment: Food stored directly on floor in walk in. Food to be 6-6 inches off of the floor. John Gehan Equipment and Utensils FAIL BLUE Date Inspected:Correct By: Comment:Walk in floor requires general cleaning. 7/19/2007 White freezer downstairs has no visible thermometer. Provide visible and accurate thermometer. Risk Level: Permit Number: BHP-2007-0192 Status: SIGNED OFF #of Critical Violations: 1 j 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. Jul 19,2007 ) 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. Jul 19,2007 ) Page 2 of t . t CITY OF SALEM, MASSACHUSETTS i' BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAx 978.745-0343 Kimberley Driscoll WWW.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT 2007 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT NSI^ Jk 117AGL1545NO45 P06 TEL# 9-79'-N��23 ADDRESS OF ESTABLISHMENTFAX# MAILING ADDRESS(if different) EMAIL--Business': Owner's. OWNER'S NAMETEL# 978-° 't�"�Z.y</�• ADDRESS Z3 6r- L-LFA4k Ab S,4 I- -, STREET CITY STATE ZIP /J CERTIFIED FOOD MANAGER'S NAME(S) + H144P fi' S-tll r�1 CERTIFICATE#(S) -7 2 16 Z- DI A✓/D fYK-052., / d"] Z$6 6 (Required in an establishment where potentially hazardous food is prepared) EMERGENCY RESPONSE PERSON / �/ HOME TEL# Cl 7 ` 7y� 5r3 j DAYSOFOPERATION Monday Tuesday Wednesday Thursday Friday Saturday Sunday HOURS Of OPERATION (/_ 30 A)A) /{:3o A47 . t I:3J AA4 ._%(.3d A''7 //. 30 AT1 9'zo A'`1 I2.Noaxl I i Please write in time of day. (for examplellam-11om1 f:00 �'^7 -I.eo 10 - /,Co 0,`?' .- /^r)0 Aa7 _ / '00 A,\1 - r :60 ilM I;0a .R TYPE OF ESTABLISHMENT,,, FEE (check only) RETAIL STORE YES NO less than 1000sq.ft. =$ 50 1000-10,000sq.ft. =$100 more than 10,000sq.ft. =$250 ---- --- : ..............------ -- - - ._..... - � RESTAURANT ES NO less than-2� seats $100 seats -x$15_0= more than 99 seats =$200 BED/BREAKFAST YES NO $100 ---------- _. ----- ----- . -----.._. ---- -- -- ..... ..... ----- - .....-.......................... ADDITIONAL PERMITS MAKE{not just serve} ICE CREAM, YOGURT, SOFT SERVF Y= NO TOBACCO VENDOR 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 62Q, Section 49A, I certify under the pains and penalties;of perjury that I, to my best knowledge and belief, ha q,1I state tax el paidallstate taxes requ,red under the law Signature G Date Social Security or Federal Identification Number - - -- -- Re vi s ed 11!13/OF POODAP 2007 ad �(".heck!!&Date /2--ii /O _.. pj�(j s _',!. 1��=VAM" IN '�P� Cimnonweauniof massacmiscuar- M *spyYj I bale k RF'4�-, V� I W. % Y 7 SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 12/20/2006 ESTABLISHMENT NAME: Major Magleashe's Pub File Number:BHF-2004-000064 268 Washington Street Salem MA 01970 LOCATED AT: 0268 WASHINGTON STREET SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions Notes FOOD SERVICE BHP-2007-0192 Dec 20,2006 Dec 31,2007 $150.00 ESTABLISHMENT TOBACCO VENDOR BHP-2007-0203 Dec 20,2006 Dec 31,2007 $50.00 Total Fees: $200.00 PERMIT EXPIRES December 31, 2007 Board of Health w� V 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 12 of 18 0268 Washington Street Major Magleashe's Pub City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HAccP: ❑ Item Status Violation Critical Urgency Telephone: Violations Related to Good Retail Practices (Blue Items) 744-2328 Equipment and Utensils FAIL BLUE Owner: Comment:Walk in floor requires general cleaning. Philip R. Shea & Paul Flaher PIC: Both freezers downstairs requires general cleaning. Paul Flaherty Inspector: John Gehan Date Inspected:Correct By: 1/11/2007 Risk Level: Permit Number: BHP-2007-0192 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. Jan 11,2007 ) 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 GeoTMSO 2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jan 11,2007 ) Page 2 oft 0268 Washington Street Major Magleashe's Pub City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: FI Item Status Violation Critical Urgency Telephone:', FOOD PROTECTION MANAGEMENT 744-2328 PIC Assigned/Knowledgeable/Duties PASS [J; RED Owner: jj Noncompliance with: Philip R. Shea &Paul Fisher IPASS I Anti-Choking PIC: PASS Paul Flaherty Tobacco Inspector: ! John Gehan EMPLOYEE HEALTH Reporting of Diseases by Food Employee and PIC PASS U RED Date !Correct By: I86 Personnel with Infections Restricted/Excluded PASS [/_J RED Risk Level: FOOD FROM APPROVED SOURCE Permit Number Food and Water from Approved Source PASSE RED BHP-2006-0148 Receiving/Condition PASS EJ; RED ! Status: ��. — —� PASS [Vi RED SIGNED OFF Tags/Records/Accuracy of Ingredient Statements #of Critical Violations: Conformance with Approved Procedures/HACCP Plans PASS EJ RED 0 Time IN: I 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 94 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. Sep 07,2006 ) Page I of Item Status Violation Critical Urgency RED: PROTECTION FROM CONTAMINATION Violations Related to Separation/Segregation/Protection PASS RED Foodborne Illness Interventions and Risk Factors(Require Food Contact Surfaces Cleaning and Sanitizing PASS ❑d RED immediate corrective action) Proper Adequate Handwashing PASS RED Good Hygienic Practices PASS ❑J RED Prevention of Contamination from Hands PASS ❑d RED Handwash Facilities PASS ❑Q RED PROTECTION FROM CHEMICALS Approved Food or Color Additives PASS RED Toxic Chemirals PASSJ❑ RED TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) Cooking Temperatures PASS ❑J RED Reheating PASS ❑J RED Cooling PASS ❑d RED Hot and Cold Holding PASSd❑ RED Time As a Public Health Control PASS ❑d RED REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food and Food Preparation for HSP PASSd❑ RED CONSUMER ADVISORY Posting of Consumer Advisories PASSJ❑ RED 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. Sep 07,2006 ) Page 2 oJ3 • Item Status Violation Criticalr U gency Violations Related to Good Retail Practices (Blue Items) Food and Food Protection PASS BLUE Equipment and Utensils PASS BLUE Water,Plumbing and Waste PASS BLUE Physical Facility PASS BLUE Management and Personnel PASS BLUE Poisonous or Toxic Materials PASS BLUE Special Requirements PASS BLUE Other-See Notes PASS BLUE GENERAL COMMENTS: 741:AII violations have been corrected. 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. Sep 07,2006) Page 3 of T 1 0268 Washington Street Major Magleashe's Pub City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: FOOD PROTECTION MANAGEMENT 744-2328 PIC Assigned/Knowledgeable/Duties PASS ❑d RED Owner: Non-compliance with: Philip R. Shea& Paul Flaher Anti-Choking PASS PIC: Paul Flaherty Tobacco PASS Inspector: John Gehan EMPLOYEE HEALTH DateCorrect By: Reporting of Diseases by Food Employee and PIC PASS ❑.� RED 1m6i Personnel with Infections Restricted/Excluded PASS 0 RED Risk Level: . FOOD FROM APPROVED SOURCE Permit Number: Food and Water from Approved Source PASS RED BHP-2006-0148 Receiving/Condition PASS ❑d RED Status: Open Tags/Records/Accuracy of Ingredient Statements PASS ❑J RED #of Critical Violations: Conformance with Approved Procedures/HACCP Plans PASS ❑./ RED 3 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. Aug 25,2006) Page! of Item Status Violation Critical Urgency RED: PROTECTION FROM CONTAMINATION Violations Related t0 Separation/Segregation/Protection PASS RED Foodborne Illness Interventions and Risk Factors(Require Food Contact Surfaces Cleaning and Sanitizing FAIL ❑J RED immediate corrective action) omments:Sanitizing log not kept daily. Log to be maintained daily. Proper Adequate Handwashing PASS RED Good Hygienic Practices PASS 0 RED Prevention of Contamination from Hands PASS RED Handwash Facilities PASS RED PROTECTION FROM CHEMICALS Approved Food or Color Additives PASS W/ RED Toxic Chemicals PASS RED TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) Cooking Temperatures PASS 0 RED Reheating PASSd❑ RED Cooling PASS 0 RED Hot and Cold Holding PASS ❑J RED Time As a Public Health Control PASS RED REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food and Food Preparation for HSP PASS RED CONSUMER ADVISORY Posting of Consumer Advisories PASS RED 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. Aug 25,2006) Page 2 of Item Status Violation Critical Urgency Violations Related to Good Retail Practices (Blue Items) Food and Food Protection FAIL Critical BLUE Comments: Raw Poultry stored on top shelves in walk in. Potentially hazardous foods to be stored on proper shelves according to state code. Equipment an tensils FAIL Critical BLUE omments:franklin chef refrigerators require general cleaning. 41 mall beverage afire refrigerator(sandwich shop)requires general cleaning. / Minachine in kitchen reading at 162°F. temperature to reach 780°F as mandated. B✓ ar ware ash machine has temperature of 174°F. Temperature to reach 180°F as mandated. all freezer in basement requires visible and accurate thermometer. Water, Plumbing and Waste PASS BLUE Physical Facility PASS BLUE Management and Personnel PASS BLUE Poisonous or Toxic Materials PASS BLUE Special Requirements PASS BLUE Other-See Notes PASS BLUE GFMERAL COMMENTS: f 7:last three months of extermination reports to be seen at reinspection. 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. Aug 25,2006) Page 3 of v 0268 Washwtua Street Maier Mao%ache's Pub City Of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Item Status Violation Type Urgency PROTECTION FROM CONTAMINATION Address: 0268 Washington Street Food Contact Surfaces Cleaning and Sanitizing FAIL RED COMMENTS: Sanitizing log not kept daily. Log to be maintained daily. Telephone: 7442328 Violations Related to Good Retail Practices Owner: Philip R. Shea &Paul Flaherty (Blue Items) PIC: Paul Flaherty Food and Food Protection FAIL Critical BLUE Inspector: John Gehan COMMENTS: Raw Poultry stored on top shelves in walk in. Potentially hazardous foods to be stored on proper shelves according to state code. Date: 8/24/06 Equipment and Utensils FAIL Critical BLUE Risk Level: COMMENTS: franklin chef refrigerators require general cleaning. HACCP: No Correct By: 9/7/06 Small beverage afire refrigerator(sandwich shop) requires general cleaning. Permit Number: BHP-2006-0148 Ware wash machine in kitchen reading at 1620F. temperature to reach 180OF as Status: NEW mandated. # of Critical Violations: 3 Bar warewash machine has temperature of 174*F. Temperature to reach 180uF as mandated. Time IN: OUT: Samll freezer in basement requires visible and accurate thermometer. Urgency Description(s): GENERAL COMMENTS: Last three months of extermination reports to be seen at reinspection. BLUE: Violations Related to Good Retail Practices (Critical violations must be corrected immediately or within 10 days)(Non-critical violations must be City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970 (978)741-1800 Geo7MS02005 Des Lauriers Municipal Solutions,Inc. COMMONWEALTH OF MASSACHUSETTS Pagel 0268 Washinoton Strieet �jainr Mai/eashe's Pub City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Item Status Violation Type Urgency corrected immediately or within 90 days) RED: Violations Related to Foodborne Illness Interventions and Risk Factors (Require immediate corrective action) Inspector Signature n rc city of Salem Board of Health 120 Washington Street,4th Floor SALEM I4A 01970 (978)741-1800 GecTMS&2005 oes Leaders Municipal soludons,Inc. COMMONWEALTH 6i MASSACHUSETTS Page 2 0268 Washington Street Major Magleashe's Pub City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: FOOD PROTECTION MANAGEMENT 744-2328 PIC Assigned/Knowledgeable/Duties PASS RED Owner: Non-compliance with: Philip R. Shea & Paul Flatter Anti-Choking PASS PIC: Paul Flaherty Tobacco PASS Inspector: John Gehan EMPLOYEE HEALTH Date Inspected: Correct By Reporting of Diseases by Food Employee and PIC PASS 0 RED 3/1/2006 Personnel with Infections Restricted/Excluded PASS RED Risk Level: FOOD FROM APPROVED SOURCE Permit Number: Food and Water from Approved Source PASS RED BHP-2006-0148 Receiving/Condition PASS RED Status: I - Open Tags/Records/Accuracy of Ingredient Statements PASS RED #of Critical Violations: Conformance with Approved Procedures/HACCP Plans PASS RED 2 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 GeoTMSO 2006 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Mar 02,2006 ) Page I of Item Status Violation Critical Urgency RED: PROTECTION FROM CONTAMINATION Violations Related to Separation/Segregation/Protection FAIL Critical RED Foodborne Illness Interventions and Risk Factors (Require Comments: Raw poultry above raw meats and beverages in downstairs walkin. store raw poultry below raw meat to prevent cross immediate corrective action) contamination and rlocate beverages to prevent cross contamination. Food Contact Surfaces Cleaning and Sanitizing PASS RED Proper Adequate Handwashing PASS RED Good Hygienic Practices PASS RED Prevention of Contamination from Hands PASS Q RED Handwash Facilities FAIL Critical RED i�omments: Handwash sink at cookline had onions, gloves and plastic bag in it at time of inspection. Sink to be used for hand washing only. dme handwash sink requires"handwashing only"sign. PROTECTION FROM CHEMICALS Approved Food or Color Additives PASS ❑J RED Toxic Chemicals PASS ❑d RED TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) Cooking Temperatures PASS RED Reheating PASS RED Cooling PASS RED Hot and Cold Holding PASS RED Time As a Public Health Control PASS RED REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food and Food Preparation for HSP PASS RED CONSUMER ADVISORY Posting of Consumer Advisories PASS 0 RED 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 Mar 02,2006 ) Page 2 of ' Item Status Violation Critical Urgency Violations Related to Good Retail Practices (Blue Items) Food and Food Protection PASS BLUE Equipment and Utensils FAIL BLUE 4/mments: Microwave requires general cleaning. nives on food line had accumulation of food debris. Properly clean and sanitize knives. reezer beneath coffe maker at 22'F at time of inspection. Freezer must be at 0°F or below as mandated. Water, Plumbing and Waste PASS BLUE Physical Facility PASS BLUE Comments: Ceiling tile above fryolator missing. Replace missing tile. Management and Personnel PASS BLUE Poisonous or Toxic Materials PASS BLUE Special Requirements PASS BLUE Other-See Notes PASS BLUE GENERAL COMMENTS: 505: 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. Mar 02,2006 ) Page 3 of 0268 Washington Street Major Magleashe's Pub City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: PROTECTION FROM CONTAMINATION 744-2328 Separation/Segregation/Protection PASS ❑d RED Owner: - Comments: Philip R. Shea & Paul Flaher Handwash Facilities PASS RED PIC: Comments: Inspector: Violations Related to Good Retail Practices (Blue Items) John Gehan Equipment and Utensils PASS BLUE Date Inspected: Correct By: comments: 3/1/2006 GENERAL COMMENTS: Risk Level: 530:Owner to call Board of Health upon ceiling tile completion. All violations cited on 3/1/06 have been corrected. Permit Number' BHP-2006-0148 Status: Open #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®2006 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Mar 13,2006 ) Page 1 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®2006 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Mar 13,2006 ) Page 2 of Commonwealth of Massachusetts isCity of Salem Board of Health SM 120 Washington Street,4th Floor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 01/03/2006 WHO'S PLACE OF BUSINESS IS: Major Magleashe's Pub File Number.BHF-2004-0064 268 Washington Street Salem MA 01970 LOCATED AT: 0268 WASHINGTON STREET SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes FOOD SERVICE BHP-2006-0148 Jan 3,2006 Dec 31,2006 $150.00 ESTABLISHMENT TOBACCO VENDOR BHP-2006-0149 Jan 3,2006 Dec 31,2006 $5000 Total Fees: $200.00 PERMIT EXPIRES December 31, 2006 Board of Health This Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code,beofre any revonations, improvements,or equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Page 5 of 12 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH �I'11f_�l (f;:4� ll�jJJ�O s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 STANLEY J. LJSOVICZ, JR. FAx 978-745-0343 MAYOR WWW.SALEM.COM CITY (_JF SALEM JOANNE SCOTT, MPH, RS, CHO BOARD OF HEALTH HEALTH AGENT 2006 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT �ark 4�)f��G\ 5H/�S TEL# 97� 7y 23 ADDRESS OF ESTABLISHMENT MAILING ADDRESS (if different) // OWNER'S NAME /"H/L-i P R SH5,4 INr,~ )t- FL14HFWT /TEL# 97�-15`�-2`f 9Y ADDRESS 2-3 fjELL-F-44Z CITY STATE MA-, ZIP O/970 CERTIFIED FOOD MANAGER'S NAME(S) PHILIP Sf1F/Q CERTIFICATE#(s) -77 2. 1 6 2 _Pr4✓1D Yy'kaS2. 1072-8616. (required in an establishment where potentially hazardous flood is prepared.) EMERGENCY RESPONSE PERSON P/7ly�L HOME TEL# .&.'`HOURS.QF;OPERATIONrMiihT.uer W..eda? Thu: . .=1• , Fri. SaY:S. Sun.. .;'7•'j>' `pJr i .ti Y" x so x c 4 4 »b F T'• _ xnnu. .'r,. ytfr4�h5. , ;,v- ny.t a: a �/ � w ,`�)`. af/ .�,i r�"7 ..e�•�'KAV .. /!"" Af . t TYPE OF ESTABLISHMENT FEE'(check onlvl' RETAIL STORE YES NO less than 1000sq.ft. =$ 50 1000-10,000sq.ft. =$100 more than 10,000sq.ft. =$250 ............. ------------------------------------------------------- ----------------------------------_----------.........--- GRESTAURANT� ES NO less than 25 seats $100 /50 -OG 5-99 seat C -150 m an 99 seats =$200 _..-----....-------------------------------------------------------------------------------------------- BED/BREAKFAST YES NO $100 ADDITIONAL PERMITS ----------------------------------------------------------------------------------------------------------------------- MAKE_(not just serve) ICE CREAM, YO-"(�T,�gte�r, SERVE �� iJ0 $5 TOBACCO VENDOR) ksl"U ILEI 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 keg ge and belief, v ed all state tax returns and paid all state taxes required under the law. oo 19 Signature 0 Date Social Security or Federal Identification Number ------------------------------------------------------------------------------------------------------------------------------------- Revised11/03/05 FOODAP2.adm Check#&Date /2�/ $`dC�o pee / 1 I. ' �.� • � s On March 3, 2005 during a routine inspection Sr. Sanitarian Janet M. Dionne and Sanitarian David J. Greenbaum were finishing up printing out the inspection report when Ms. Dionne noticed the door to the back room open. She observed an ice machine and went to inspect what was in the back room. Upon entering the back room area Ms. Dionne was encountered by a patron of this establishment that asked if she was the health inspector, she replied that she was t and at that time the patron lit up a cigarette. Upon further inspection, Ms. Dionne noted that the back room had a small shelf that ran along three of the walls to the left of the door,bar stools, magazines and ashtrays. Ms. Dionne then informed sanitarian David J. Greenbaum of her findings and he to went into the back room to observe and to further inspect the area. Ms. Dionne and Mr. Greenbaum then discussed their findings with Paul Flaherty the Certified Food Manager, and reminded him that they are there to enforce the no smoking ban and state (_ regulations. Mr. Flaherty stated, "that room was built for smoking and that they will continue smoking there." r l� / Jane�on ; Sr. Sanitarian David J. Greenbaum Sanitarian r �g p'D NOV s CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH g) 120 WASHINGTON STREET, 4TH FLOOR Y SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 _ STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT April 11, 2005 Philip R. Shea, Owner Major Magleashe's Pub 268 Washington Street Salem, MA 01970 Dear Mr. Shea: On March 3, 2005 at approximately 2:30 PM, in response to a complaint, personnel from the Salem Board of Health conducted a compliance check to determine if your establishment was in compliance with Salem Board of Health Regulation #22 concerning the Workplace Smoking Ban including restaurants a njLgr At that time approximately three people were observed smoking COQ"- Yn the bar and dining areas. Ashtrays were provided and the presence anq/ odor of smoke were also observed in your establishmenE� Documentation is on rile at the Board of Health regarding this vIo ation. You are in violation of Section D(1) and D(2) of Salem Board of Health Regulation #22. According to this section, it is unlawful for any employer or other person having control of the premises upon which smoking is prohibited by this regulation, or the business agent or designee of such person, to permit a violation of this regulation. Section G of this regulation states, "Any employer, or his or her business agent, who violates any provision of this regulation, the violation of which is subject to a specific penalty, may be penalized by the non- criminal method of disposition as provided in Massachusetts General Laws, Chapter 40, Section 21 D or by filing a criminal complaint at the appropriate venue. It shall be the responsibility of the employer, or his or her business agent, to ensure compliance with all sections of this regulation. Violators shall receive a fine of $100 for a first violation, $200 for a second violation, and $300 for each additional fine within 24 months Therefore, you are ordered to pay a fine of $200 for the violation stated above since this is your first violation within 24 months. A check or money order payable to the City of Salem must be at the Board of Health office, 120 Washington Street within ten days of receipt of this notice. Should you be aggrieved by this Order, you have the right to request a hearing before the Board of Health. A request for such a hearing must be received in writing in this office of the Board of Health within seven (7) days of receipt of this Order. At said hearing, you will be given the opportunity to be heard and to present witness and documentary evidence as to why this Order should be modified or withdrawn. An attorney may represent you. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection or investigation reports, orders, and other documentary information in the possession of this Board, and that any adverse party has the right to be present at the hearing. If you have any questions regarding this notification please call me at 978-741- 1800. Sincerely yours, 2eann SScott alth Agent Cc: Christina Harrington, Board of Health Chairman James Gilbert, City Solicitor Joyce Redford, Director, North Shore Tobacco Control Program ld l n 9L- _ - fit,. woo -h-) �n)n�c��s_l� asha,La _ 'YYJAJWt 1�1 �10 A n9 I d _ �Na.s Suy-p—�sec COu11�1�c�►� c� lYt _ 7-D 1 u 4 0 VU-� [lO M 9- �Vl s rJA n r fro rl, l i (SU--� _ RIF " 'I d c � _lo-s u� t wl, Win77 ch —dAU ono�v U)LQ-. � a_ IcQ�C�vr�cg -gvow- I _ I � � : II II it _ II -_ II _ I _ III III �_ I II ill �_ II �_ II _ III II II II SII 11 11 _ l ,,, .r y 1 0268 Washington Street Major Magleashe's Pub City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Telephone: Item Status Violation Critical Urgency Nature of problem or correction 744-2328 Non-compliance with: Not Done Owner. Anti-Choking PASS ❑ Totie's One and Two, Inc. Tobacco PASS ❑ PIC: Phil Shea FOOD PROTECTION MANAGEMENT Not Done Inspector: PIC Assigned/Knowledgeable/Duties PASS d❑ RED Janet Dionne EMPLOYEE HEALTH Not 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 Not Done Permit Number. Food and Water from Approved Source PASS RED BHP-2005-0300 Receiving/Condition PASS RED Status: Tags/Records/Accuracy of Ingredient Statements PASS 0 RED 'PARTIAL COMPLY #Of Critical Violations' """ Conformance with Approved Procedures/HACCP PASS RED Plans 1 Time IN Time OUT Notes: 7 Urgency Description(s): BLUE Violations Related to Good Retail Practices (Critical violations must be corrected immediately or within 10 days)(Non-critical violations GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 04,2005 ) Page I of 0268 Washington Street Major Magleashe's Pub must be corrected immediately PROTECTION FROM CONTAMINATION Not Done or within 90 days) Separation/Segregation/Protection PASSd❑ RED RED. Violations Related t0 Food Contact Surfaces Cleaning and Sanitizing FAIL Criticald❑ RED Dishwasher rinse temp 1601.final rinse to reach minimum of 180'f. Service Foodborne Illness Interventions dishwasher immediately and Risk Factors (Require immediate corrective action) tXe scoop stored incorrectly.store handleside up in ice, or in cleaned& sanitized container labeled"ICE SCOOP ONLY" knives to be stored in appropriate rack .,butting board stained&scored-resurface or replace Proper Adequate Handwashing PASSJ❑ RED Good Hygienic Practices PASS •/❑ RED Prevention of Contamination from Hands PASS •/❑ RED Handwash Facilities PASS RED PROTECTION FROM CHEMICALS Not Done Approved Food or Color Additives PASS ❑ RED Toxic Chemicals PASS V RED TIME/TEMPERATURE CONTROLS(Potentially Haz Not Done Cooking Temperatures PASS W] RED Reheating PASS d❑ RED Cooling PASSd❑ RED Hot and Cold Holding PASSd❑ RED Time As a Public Health Control PASSd❑ RED REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PO Not Done Food and Food Preparation for HSP PASSJ❑ RED CONSUMER ADVISORY Not Done Posting of Consumer Advisories PASS Q RED GeoTMS®2005 Des Lauriers Municipal Solutions, Inc ( Rev. Mar 04,2005 ) Page 2 of 0268 Washington Street Major Magleashe's Pub Violations Related to Good Retail Practices (Blue Not Done Management and Personnel PASS ❑ BLUE Food and Food Protection PASS ❑ BLUE Equipment and Utensils FAIL Critical ❑ BLUE ,S'p-cnges being used for dishwashing Sponges breed bacteria. Use only washable cloths only. 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 GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 04,2005 ) Page 3 of 0268 Washington Street Major Magleashe's Pub City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Telephone. Item Status Violation Critical Urgency Nature of problem or correction 744-2328 Non-compliance with: Done Owner: Anti-Choking PASS ❑ Totie's One and Two, Inc. Tobacco PASS ❑ PIC: Phil Shea FOOD PROTECTION MANAGEMENT Done InspectorPIC Assigned/Knowledgeable/Duties PASS ❑d RED Janet Dionne EMPLOYEE HEALTH Done Date Inspected: Correct By: Reporting of Diseases by Food Employee and PIC PASS ❑d RED 311512005 Personnel with Infections Restricted/Excluded PASS MJ RED Risk Level: FOOD FROM APPROVED SOURCE Done Permit Number: Food and Water from Approved Source PASS ❑d RED BHP-2005-0300 Receiving/Condition PASS ❑d RED Status: Tags/Records/Accuracy of Ingredient Statements PASS ❑d RED Closed Conformance with Approved Procedures/HACCP PASS RED At of Critical Violations: Plans PROTECTION FROM CONTAMINATION Done Time IN: Time OUT: Separation/Segregation/Protection PASS ❑d RED Notes: Food Contact Surfaces Cleaning and Sanitizing PASS Q RED 25. Proper Adequate Handwashing PASS RED Urgency Description(s): Good Hygienic Practices PASS RED BLUE: Violations Related to Good Prevention of Contamination from Hands PASS ❑/ RED Retail Practices (Critical Handwash Facilities PASS ❑d RED violations must be corrected immediately or within 10 days)(Non-critical violations GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 17,2005 ) Paze 1 of 0268 Washington Street Major Magleashe's Pub 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 ❑D RED Foodborne Illness Interventions TIME/TEMPERATURE CONTROLS(Potentially Haz Done and Risk Factors (Require Cooking Temperatures PASS ❑o RED immediate corrective action) Reheating PASS ❑d RED Cooling PASS ❑Q RED Hot and Cold Holding PASS ❑d RED Time As a Public Health Control PASS RED REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PO Done Food and Food Preparation for HSP PASS ❑d RED CONSUMER ADVISORY Done Posting of Consumer Advisories PASS ❑d 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 GeOTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 17,2005 ) Page 2 o!2 0268 Washington Street Major Magieashe's Pub City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Telephone: Item Status Violation Critical Urgency Nature of problem or correction 7"-2328 Non-compliance with: Done Owner: Anti-Choking PASS ❑ Totie's One and Two, Inc. Tobacco PASS ❑ PIC: Phil Shea 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 3/10/2005 Personnel with Infections Restricted/Excluded PASS RED Risk Level: FOOD FROM APPROVED SOURCE Done Permit Number: Food and Water from Approved Source PASS ❑o RED BHP-2005-0300 Receiving/Condition PASS /❑ RED Status: Tags/Records/Accuracy of Ingredient Statements PASS ❑d RED PARTIAL COMPLY Conformance with Approved Procedures/HACCP PASS RED #of Critical Violations: Plans 1 Time IN Time OUT Notes: 16:inspector to re-inspect on friday 3-11-05 to check status of dishwasher Urgency Description(s): . BLUE: Violations Related to Good Retail Practices (Critical violations must be corrected GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 15,2005 ) Page I of 0268 Washington Street Major Magleashe's Pub immediately or within 10 PROTECTION FROM CONTAMINATION Done days)(Non-critical violations Separation/Segregation/Protection PASS ❑/ RED must be corrected immediately or within 90 days) Food Contact Surfaces Cleaning and Sanitizing FAIL Critical ❑d REDDishwasher only reaches final rinse temp RED: of 165°f. Final rinse to reach minimum of Violations Related to 180°f or must have chemically fed sanitizer in final rinse. service immediately. all Foodborne Illness Interventions untensils to be handwashed until and Risk Factors (Require dishwasher reaches temp of 180°f immediate corrective action) Proper Adequate Handwashing PASSd❑ RED Good Hygienic Practices PASS RED Prevention of Contamination from Hands PASS ❑/ RED Handwash Facilities PASS ❑/ RED PROTECTION FROM CHEMICALS Done Approved Food or Color Additives PASS RED Toxic Chemicals PASS ❑./ RED TIMEITEMPERATURE CONTROLS(Potentially Haz Done Cooking Temperatures PASSd❑ RED Reheating PASS RED Cooling PASS ❑J RED Hot and Cold Holding PASS ❑// RED Time As a Public Health Control PASS ❑d RED REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PO Done Food and Food Preparation for HSP PASS ❑J RED CONSUMER ADVISORY Done Posting of Consumer Advisories PASS ❑ RED GeoTMS(D 2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 15,2005 ) Paze 2 of f 0268 Washington Street Major Magleashe's Pub 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 GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 15,2005 ) Page 3 of SORT NT MESSAGE ) FOR A.M. DATE � TIME ISS P.M. M OF PHOT\ F AREA CODE NUMBER EXTENSION ❑ FAX U MOBN F AREA CODE NUMBER TIME TO CALL TELEPHONED I PLEASE CALL CAMETOSEEYOU WILL CALL AGAIN WANTS TO SEE YOU I RUSH RETURNED YOUR CALLI II WILL FAX TO YOU M ESSA E ,_, C� ` SIGNED �C--�_ �iQ�-1^�I✓�t/U�rj�_�Q� �IYrH FORM 4009 MAGE IN U S A i N UTES _ k f • + ( IMPORTANT MESSAGE ) FOR A.M. DATE: TIME �' /-s P.M. M OF �o PeiJ STS PHONE AREA CODE NUMBER EMENSION ❑ FAX ❑ MOBII F AREA CODE /NUMBER TIMETO CALL/ , TELEPHONED / PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU I RUSH RETURNED YOU/R�CALL ( WILL FAX TO YOU � ,a/) . h� ti —A a t � SIGNED FORM 4009 . MADE IN U S A ORTANT MESSAGE ` FOR i DATE <LZG-a� TIME Mu�-t�J M. OF PHONE AREA CODE NUMBER EXTENSION ❑ FAX CI MOEIII F AREA CODE ' / NUMBER TIME TO CALL TELEPHONED y /PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN ' WANTS TO SEE YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE . dj-CiJJ /L a-7 _ � U SIGNED , FORM 4009 � ------ �.Yr�7 MACE IN U S A �i UTE c,-3 E — r - I i 1 s�o ►cn, -fv �I h�,l,�x=P S�,c, ',uJ wn�urt CiJ IBD ° otVtA C s u ° t i f �i }F �I I� t i r I �, !� F. ', fI}I I i4 �r _W 0268 Washington Street Major Magleashe's Pub City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Telephone: Item Status Violation Critical Urgency Nature of problem or correction 744-2328 Non-compliance with: Done Owner: Anti-Choking PASS ❑ Totie's One and Two, Inc. Tobacco PASS ❑ PIC: Phil Shea FOOD PROTECTION MANAGEMENT Done Inspector: PIC Assigned/Knowledgeable/Duties PASS ❑d RED Janet Dionne EMPLOYEE HEALTH Done Date Inspected: Correct By Reporting of Diseases by Food Employee and PIC PASS 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-2005-0300 Receiving/Condition PASS ❑/ RED Status: Tags/Records/Accuracy of Ingredient Statements PASS RED PARTIAL COMPLY #of Critical Violations: Conformance with Approved Procedures/HACCP PASS ❑J RED Plans 1 Time IN: Time OUT - Notes: a 16:Inspector to re-inspect on friday 3-11-05 to check status of dishwasher. Urgency Description(s): BLUE: Violations Related to Good Retail Practices (Critical violations must be corrected GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 11,2005 ) Page 1 o%3 l `0268 Washington Street Major Magleashe's Pub Immediately or within 10 PROTECTION FROM CONTAMINATION Done days)(Non-critical violations Separation/Segregation/Protection PASSd❑ RED must be corrected immediately or within 90 days) Food Contact Surfaces Cleaning and Sanitizing FAIL Critical RED Dishwasher only reaches final rinse temp RED: of 165°f Final rinse to reach minimum of 180°f or must have chemically fed sanitizer Violations Related to in final rinse.service immediately. all Foodborne Illness Interventions untensils to be handwashed until and Risk Factors (Require dishwasher reaches temp of 180°f. Immediate corrective action) Proper Adequate Handwashing PASS RED Good Hygienic Practices PASS ❑d RED Prevention of Contamination from Hands PASS ❑/ RED Handwash Facilities PASS ❑/ RED PROTECTION FROM CHEMICALS Done Approved Food or Color Additives PASS RED Toxic Chemicals PASS ❑J RED TIMEITEMPERATURE CONTROLS(Potentially Haz Done Cooking Temperatures PASS RED Reheating PASS ❑d RED Cooling PASS RED Hot and Cold Holding PASS 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 Q RED GeOTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 11,2005 ) Page 2 of J "0268 Washington Street Major Magleashe's Pub 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 9�q'dl GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Mar 11,2005 ) Page 3 of �1 t� f 1 +I 1 i 1 ( IMPORTANT MESSAGE ) FORi�f n-P - `� U OATF `� �� TIME -�S P.M. ' M . OF �J PHONE AREA CODE NUMBER EXTENSION j 0 FAX 0 MORA F AREA CODE N BER TIME TO CALL TELEPHONED , PLEASE CALL CAME TO SEE YOU l I WILL CALL AGAIN WANTS TO SEE YOU I RUSH RETURNEE)YOUR CALL I II WILL FAX TO YOU ME�SSAGE SIGNED f400 MAGE W A. r � NOTES i 1 I �" o CITY OF SALEM, MASSACHUSETTS 'S BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR a\ �o SALEM, MA 01970 = TEL. 978-741-1800FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT Facsimile Transmittal To: 1 regia 1i��, Fax # 53a - &ia3 RE: P)k Date : 3- 9- o� Page(s): including this cover# 02 Message: Xs U Board of Health News ----------------------------------------------------------------For Your Information Office Hours: Effective September 12, 2003 Monday, Tuesday, Wednesday 8:00 AM to 4:00 PM Thursday 8:00 AM to 7:00 PM Friday 8:00 AM to 12:00 NOON Do Salem Residents Know ? — The Board of Health meetings are held the second Tuesday of the Month. Major Magleasbe's Pub 268 Washington Street Salem, Massachusetts 01970 978-744-2328 December 28, 2004 MEMORANDUM C� TO. ALL PERSONNEL JAN - 3 2005 FROM: PHIL SHEA, PAUL FLAHERTY, OWNERS RE: TREATMENT OF HEALTH DEPT. REPRESENTATIVES CITY OF SALEM BOARD OF HEALTH Dear Staff, On April 1, 2001 the Salem Board of Health's regulation prohibiting smoking in restaurants and bars went into effect. The purpose'of the regulation is to protect both customers and you, as employees, from the hazards related to second-hand smoke and to recognize the benefits of breathing smoke-free air. Until July 5, 2004, it was possible for our patrons to travel to other communities in order to smoke in a bar. As of that date all restaurants and bars became smoke-free on a statewide basis. Other than private clubs. we are now on a level playing field with all surrounding cities and towns. We must enforce the law. Representatives of, or members of the Salem Board of Health and/or representatives of the North Shore Tobacco Collaborative are entitled to inspect our establishment for compliance to the law during any routine inspection at any time of the business day. The inspectors will not be denied access to our restaurant and they will be treated with the same courtesy and respect that we would bestow on our own customers. We will, at all times, allow them to do their job and will not get in any type of debate over compliance to or enforcement of the law. Any staflfmember who does not adhere strictly to this policy may be subject to suspension or termination. Ifany customer interferes with inspectors or mistreats them in am way. it should be reported to management immediately. We need to work together to make sure that our policy regarding this issue is strictly enforced. 'Thank you all for your attention to this matter. fours truly. Phil and Paul I 1 MR NO STATUS CODE FOR PHARMACY USE ONLY AFFIX COMPUTER LABEL HERE DATE WRITTEN DEA NO PROVIDER# PATIENT'S LAST NAME FIRST NAME MIDDLE INITIAL 19236642 INGRAHAM 2010 DOB SEX DRUG NAME STRENGTH. M CD OuarvnTv (' 1 ADDRESS SIG DRUG ALLERGIES Z OTY. AMT PAID REPRESENTSA l7 COUNSELING ❑YES ❑REFUSED ❑Y SHANGE❑NO /M REFILL(circle one) n aeaz-D i,oreal N c NSC SIGNATURE M.D. N D I z B a s Peabody 2 Essex Center Drive t Yr PRINT OR TYPE Medical Associates Peabody,MA 01960 WORKER'S COMP./ (978)532-6111 MVA Interchange Is mandated unless the practitioner wrh6s YES ❑NO the words"NO SUBSTRIITION"In this space. HP Fax Series 900 Fax History Report for Plain Paper Fax/Copier Joanne Scott Salem BOH 978 745 0343 Mar 09200- 12:22pm Last Fax Date Time 'Fyne ldentifrcation Duration " Mar 9 12:22pm Sent 919785326123 0:38 2 OK Result: OK - black and white fax CITY OF SALEM l BOARD OF HEALTH Establishment Name: Date: 3- 9 9 5 Page: / of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified PLEASE PRINT CLEARLY Phi/ 5- �' a� a O�/ /s/ Ps�a tilrsh.�va L ^ a r�f�Pa2rP d a� Gcl I I ;k^ yt-P�- , -!� �,y� n-� 6(0� /�, �'� �.ro-.•s r1yO�.�c� I I / Sl,e,� upas alae,-, a a6aa! of -Ike- Ad44i-ti,>4a /u/e 1 50Ln[ 4, ode. Ygfoo dl_l I ��L 51W a fAAf s /n Co-incd� Y Gc.4 4,4_" Iry� In&10/6 //s trc-5u 1 C�4// i� nl- 4-40. y-Oi�ed L-loo i.G 5A"Ak0-77 ups OLsrdu�!_ i� �-l�Gv_ l�S�.co�s� /� ��e. >rao_ .vi�rL,��. ✓L>�� i Discussion With Person in Charge: Corrective Action Required: t(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 that noncompliance may result in daily fines cf twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: 3-501.14((;) PHFs Received at Temperatures Violations Related to Foodborne.Illness Interventions add Rish According to Iaw Cooled to Factors(items 1-22) (Cont.) 41`F/45`F Within 4 Hours. .` PROTECTION FROM CHEMICALS j 3-501.15 Cooling Methods for PHFs' j 14 I Food or Color Additives j 14 PHF Hot and Cold Holding j 3-501.!6(5) Cold PIIFsMaintained atoibelow 3-202.12 Additiwa" 590A04(F) 11'J45" F` 3-302.14 Procclion from Unapproved Additves' I 3-501.4(F) Hot PHFs Maintained at or abcne IS Poisonous or Toxic Substances j floc P 7-101.11 Conttvfng lnfora::na;n Origins( 3-SOI 16(A) Roasts Held at orabove 130T. j Containers" 7-102 11 Common Name-Working Containers" I j 24) j Time as a Public Health Control 7-201.11 5enaration -Canag,,; 1 1 3-501 it) Time as a Public Health Control* j 7-202 11 Restriction-Pres.encv and Use 590.004(H) Variance Requirement 7-202.12 Conditions of Use" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7?03 1 I Toxic Containers-Prohibitions' POPULATIONS(HSP) 7-204.1 ' S.util+zet s,Criterut-Chc:ni ids" i-''_{)4 12 C'hcmicals Cortina-C Produce,Cn:cria"' 121 3-801.11(A) ( Unpasteurized Pra-pa&aged Juices and Reventces with Warning Iahel.s'. 7-204.1.1 Drying Agents.CritetiaF 3-801.11(ft) I Use of Pastemizecl Fees" 7-205.11 Incidental Food Contact. Lubnearts' 3-801,11(t)) Raw or Pmtially Cooked,4nim:d Fond and 7-206,11 Restricted Use Ferrcicies.Ctitena* 7-20x,.12 Rodent B-:it Stations^ Raw Seed Sprouts Not Served. 'A I j ;-801.11(C) j Unopened F,xxi Package Not Re-served. 7-206.13 'Pricking Prncder:,Pest Conte+:! end " j Monitoring' CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumet Advisory Posted for Consumption of Animal Foods'lliat are Raw.Undercooked or 16 Proper Cooking Temperatures for Not Otherwise Processed to Eliminate PIiFS Errecev�r;t,nv 3 401 11A(I)(-') F,ggs- 155''F 19 Se, Pathogens.' E}'e,- into?ediate S;rvice 145"1715see, I 3-302.13 ` Pasteurized Fagg:Substitute for Raw 9d1e1! 3-401.11iA)(2) C'omminutcd Fish,Meats&Came I Eggs'" Animals- 155''F !5 sec. m 3-401.11(5)(I){21 Pork and Beef Roast- )30'P 121 mink SPECIAL REQUIREMENTS 3-401.1 I(A)2) Ratn?s, Irl MeatS- 155'F 15 590.009(A)-(D) Violations of Section 590.009(A)-(D) in eL, ,: caterine,, mobile food, temporary and 3-401.11(A)(3) Poultry,W"d Game, Slotted PHPs, ! 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 lixxlbornc illness 3-301.11(((3) Whole-rmsaie,hltact Beef Steaks ( interventions and risk factors. Other 1 451F r 590.009 violations relating to good retail 3-30'.12 Rasx A tir.:al Foods Conked in a practices should be debited under #29 - Mic:'o%v;ve 165'-F* 1 Special RequilementS. 3-401,111(A)(10) All Other PFIF;.- I35'F15sec. * 17 1 Reheating for Hot Holding VIOLATIONS R FLATED TO GOOD RETAIL PRACTICES 3-403.11(A)&t D) I'HFs 1650P 15 sec. " ( (Items 23-30) 3-403.1 PB) Mmow'ave- 165( F 2 Minute Standinx{ Ctitical and run-critir.al violations, which do not relate In Nrc 'I)me" ( faodhorne d/ner.e intrroentions mrd riskfbcun-.c listed,vtxmc eon be 3-403.11(C) Commercialty Processed RTL Food- I found in the following sections of the Food Code and/05 CRR ;40� * j .590.000. 3-403.11(E) Remaining Ujuticed Portions of Beed' item Good Retail Practices FC 590800 ft,rn+; 23. I Management and Personnel FC-2 ,003 18 Proper Cooling of PHFs 1 24 ( Food and Food Protection FC-3 .004 _25. Equipment and Utensils FC-4 005 3-501.14(:) Coolhtg Cooked PHFs from I 10"F to 26. ----_ Water,Plumbinq and Waste FC- 5 .006 70`F Within 2 Hours and Horn Aff ( 27 PhVsical FacifitV FC-6 007 I to 41`F/45"F Within 4 Hum::. . I ( 29. Poisonous or Toxic Materials FC-7 008 3-501 14(B) Cooling PRFs Made From Ambient 29, Special Requirements 1009 Temperature Ingredients to 41"F/45'P 30, Other Within 4 I-dours'' I`)f"r'b',d 6-2,1„ ' Denotes olecA ilen,uuhe('deal 1909 Pond Code o.105 CNIR 590 OW, �t r * �C#Kd' r;aRriNh➢.Pi�'MI �R.W!`in':M% ��3^ d p t?' ^�yY: -• _ a w 'e"' .f.�+µ�u,dN"+7^.'-' < . A -,fr ..-4 ;CITY OF SALEM;`MASSACHUSETTS`- BOARDbFHEALTH 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: Major Magleashe's Pub Address of Establishment: 268 Washington Street Owner's Name: Philip R. Shea Restrictions: Application Date: 12/7/2004 Permit for Food Establishment 201-05 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products 45-05 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. CITY OF SALEM, MASSACHUSDTF(a BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOG3 2004 SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 OF SALEM STANLEY ,J. LISOVICZ, JR. .JOANNE SCOTT, MPH, RS, CHO BOARD OA OF HEALTH MAYOR HEALTH AGENT 2005 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT I919J-0 ,,AS``�/ti.`5 TEL# cJ'7� 7 2-3 ZS' ADDRESS OF ESTABLISHMENT 2 CO g l�J MAILING ADDRESS (if different) OWNER'SNAME PHILIP /T - TEL# 972 7`NS .2-ffcly ADDRESS 2-3 A p. CITY SA LFA? STA'"E J")4 - ZIP D `� U CERTIFIED FOOD MANAGER'S NAME(S) ONILI)A SHrz',9- CERTIFICATE#(s) -772- 1 (0 L Pet-VtQ PYK6Sz 10-7 '2- (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON R)t)L HOME TEL I ZNoc1rJ HOURS OF OPERATION: Mon. ✓ Tue. /Wed. v Thu. ✓ Fri. ✓ Sat. v Sun. ✓ _ I A-pl 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 YES NO �D ! less than 25 seats =$100 25-99 seats ✓ =$150 more than 99 seats 00 BED/BREAKFAST YES NO $100 ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGURT, SOFT SERVE YES NO $5 TOBACCO VENDORLI _ ES NO ✓ 50 , LL NON-PROFIT(such as church kitrhensl l� �� 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 state taxes required under the law. Sign tt Date JI 3p Social Security or Federal Identification Number ------ a`f ---------- --4 -------- Revised 11/03/03 FO AP2.adm Check#&Date .: div I r' II 1' jl -- -- -------- - I _ j{1 I' I' , i v' III I i ;il i �I I - ..�. ..� �.: I: �1! ii i :i l+ {� iii ry� I! it F f _�-__�. __ r, _�__ �� if 'ii <il _ ��+ � � - �l.� _ :%� `,,�i - k� f{ IMPO7RTA-NTn MESSAGE ) FOR DATE % 'a`OV�` TIME M OF RHONF AREA CODE NUMBER EXTENSION O FAX O MOBII F AREA CODE j UMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU ' WILL CALL AGAIN WANTS TO SEE YOU ( RUSH RETURNED YOUR CALL I WILL FAX TD YOU MESSAGE AJY.P�I� Q�lGla� SIGhD �iW FOORMN4000 NOTES ( IMPORTANT MESSAGE ) FOR Q L _ DATE 1� �� `d TIMEa' M 9G�?GCLNif/� OF /_ d��LGd �I/ �./!IXl--/ ?/ ,// PHONE( A CI�,� 7� ER 7' v \AREA CODE NUMBER EXTENSION Q FAX Q MOBIL F AREA CODE NUMBER TIME TO CALL TELEPHONED I[ PLEASE CALL CAME TO SEE YOU �- 77�'' WILL CALL AGAIN WANTS TO SEE YOU I' RUSH RETURNED YOUR CALL I WILL FAX TO YOU MESSAGE +. d- w �iL 4�'-� .r�,c. �iza.✓ II Irl/ �o �/1. Gam✓ SIGNEOD ��fy� Wro1s MADE FORM NX SA NOTES -- III ( IMPORTANT MESSAGE ) FOR DATE TI o<4' TIME ` P M. M bc-ml &A 0 I awL OF PHONE AREA CODE NUMBER EXTENSION O FAX ❑ MOSII F AREA CODE NUMBER TIME TO CALL TELEPHONED J PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOURCALLI WILL FAX TO YOU y„ MESSAGE £,AP,Q,k- INH'�/1 S(NN2� Gi�Lli"� �intil(,�vW La`�`rS th ScUk,m� I U SIGNED i OC FORM 4009 ��.YY��iiii MADE IN U 5 A i NOTES - -er I I I 1 I I 1 I I I I 1 I I I I I 1 1 I I I � I - _ � _ , . I �. 1 I Massachusetts Department of Public Health Salem Board of Health 120 Washington Street, 4" Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ES•TAB!_fSHMENT'INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 NameDate / TTLvpp of Ooeration(s), Type of Insoection ma lug MdQIIOA sh es Ppb �1 S IV I Ly'Food Service ❑ Routine Address ryh_ O /i 1� )_ L� c�i ,�e� Risk/ ❑ Retail 94e-inspection a(P 0, (/V �K1/U yY Level ❑ Residential Kitchen Previous Inspection Telephone ❑ Mobile Date: �� -a3a� m ?•a3 'o� Owner HACCP YM El Temporary ElPre-operation p�,f,�( ,p n S ,p2 h ❑ Caterer El Suspect Illness Person in Charge(DTIC) Time ❑ Bed&Breakfast ❑ General Complaint In: El HACCP Inspector !�, (�I VI1YiP. 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 ❑ 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 r_1 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 ;❑ Separation/Segregation/Protection / \ El 20.Time As a Public Health Control . Food Contact Surfaces Cleaning and Sanitizing L'1J REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑21. Food and Food Preparation for HSP El 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices CONSUMER ADVISORY ❑ 22. Posting of Consumer Advisories i 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): Ci 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. cN 590.000/federal Food Code. This rep g ort, when signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an _ . Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 5. Equipment and Utensils (FC-a)(sso.00s) cited in this report may result in suspension or revocation of 25. 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)(510.001) 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 5001n,dFom -14O Inlsp' 'ott,�'s ggrgnaM. Print: PIC' Signature' �/. �, �- Print:��!//_/ J- !'SY1r S Z Page 1 of ages (� 0 Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PRO1'ECTION'FROM CONTAMINtt;;'iON- FOOL! PROTECTION MANAGEMENT � 8 i Gross-conte:mrraton � ( 59u.UC3(A; Assignment of Responsibility` �_z02.i lt.}.)t.l e:aw;iuinxd i'v.xir S-I)z,ated from 54U.00323) Demonstration of R:wwledge" COuiced and RTP foods* 2-103.t I Person in Charge -duhzs j Ccnh,, im if-or irem R?'w ingredients 3 36% 11(A)i7) Raw A;;i;rxrl Foods Sepuratrd ironFach EMPLO"EE HEALTH Other' 2 ! 540,003;C) Reepcnsibility of the person in cha;gr to Goraminadon fr_,m rhe Envkonmenr regoire reporting br foal employes and 3-30?.l l:?.) Pom! 'r'rk:x cL•rn" applicants" 3:3021°. Wash;naFruitsw'dvc--tabic 190 003(f) Responsibility Of A!-cid Employee Or An � 3-304,11 Food Contact er:h 'Ecluipment and .applicant to Report To The Person in Utensri Charger j j ^omaminatior,from d`+e 0-:n-,sumer 540 001(6) Reportina btiPrrsoo in C•h.trae' ! 3-3010.1:(AI(h) Returned Fo:,J mid P.ese;-tace of Food* I 3 590.003!D) Exclusions and Restrieaiore,* Di;prsLlcn of,VJYSc,Bad or Comarrohatad RemovA of Exclusions and R.ettrictions 1 Poc'd i i3 101.i i tAacanling o; Reconwbor:rr' :;nsole FOOD FROM APPROVED SOURCE { 4 Food and Water Frnm Regulated Sources 9 Food Canfart Surfaces 59U.004(A-5) Compliance with Food Law' n-501.1 I1 Afanu.;i l4arewa;hmg-Hot'r4'nt j J-2UL12 Pooa m a Herntcii--ally Sealul C{;inane.'" j S:mitivt6,n Ten ncratur-_s" � 3-'OLI'. Fluid Milk and h2lk f3oducts^ H-50!.112 ZtT.rch:anal l�'.:'cwas!,inn lint Water 3-202.13 Shell Las* Sanitizadon Temp rsrcret ! , 14-50ll i = Ch.n:.cal Sancti ::,on-temp..plc, 3-2.,0_,, l 14 Eg's and Mill:Products. a:u urized* 3-202.10 Ice Made From Potable Drinking Water- concentration and hwrdn_ss, 4-(;0:.1 i(.;) �.;a::)::rent : aed C,nit-'O Surfaces ,and i .5 1Ul.l t finn}:ina Water Froman Anpruved System' Cten;ih Cleat' 540.000(A) Bottled Drinkine Watcr" 4-0O2.1 C'lean::: i?eyumtcy e Er ui n»ent Food- .5')()oon(B) Water Meets Standards in 310 CMR 22.0" I I •.outaa S:,rta.es and Utensiisk SftetNish and Fish From an Approved Socnrr, i 1 7ti' i i+re0 aenc.t s, 32'11.14 Fish and Recreati+orally Cau(>.h: Mollusczn ! ;�nit;z�ttion of Utensils and p'or•u Coetact SlWaces of Equipment," Shellfish" 4-7t:_ 1 1 Menlo,u of SanitmAion-{lot Water and 3-20L15 MolhlsrmSheilfishLomNSSPI strd ! Che,ural' Sources* Game and Wild hlushrcoms Approvcu by tfr Proper,Adequate handwash;ng Renutatory Authorrt4' 2- ;1.i; Clean Condition-H;:udsond Armsl 3-202.18 Shellst,>k Identification Present" --301.12 ;aeanrrr P- edure'' 590.001+,C'} Wild Mushrooms* 2-301.1.1 When to Wash 3 'Ot.17 (cam: Animals* 11 Good Hygienic Practices ! g ReceivingfCondition 2401.11 Eating.Drinking or U,.ine'E,baccut � ,_207 11 PIIFs F�ce,ved at Ptope;Tenircrahtres't I -'•401 12 Dise,haptc,From Vile Eget.; \os:and -,-2.w 15 Package Integrity" i Nfooth` 3-:01.11 Paod Safe and t'nadulterr:ed 3-30 !, ? Pretentim,( ontaminatiotI Winen'1?v,tinq:, h TagsfRecords:Sheilstock 12. Preve-:T:ah o;Contamination from elands 4-202.18 Snellst<xk Identification ib 540.011-41,) Canta:3r intron from -3 _03.12 Sheiista'k Identification Maintained` Employees' Togs/Records;Fish Products I 13 I tfandwa;h Faril'ttic< Garven!rnt'•r Located and accessible 3-?021! Recortc Dreati tion' `t?03 11 Nunikis and Capalhirs* Rrcords.Creation and Retention* ! ! j !; r , 59U.U04U) Labeling of Ingredients' 5-204.11 :.ro_ation snit P it,: .lent' 5-205.:i ! Ac:es;rbihty.Operation and Maintenance 1 7 Conformance with Approved Procedure= i SuppneJ wap Soau and Harrd[,lying I i7HACCP Plans -502 11 Specialized Pfocessine?vleiho&n ( Cr1 3-502.1' Reduced oxylleu packaging,criteria" ( (t-3OLl I Handwd'aa:ping C!+:an.�cr,At^xdaMliry d-103.12 Conformance with Approved Procedure;` ( 6-301.1:: Htatd Drying Provi<;,,t Dcuv,es,.r Kcal nim in ti,e tMers,i ,'+'19 pastel C,aie rn 103 Cti1R 540601; CITY OF SALEM Ma �/J B/OARD OF HEALTH / Establishment Name: / 1/Q/<J� / OI�� IPC/S/SPS 1'Ub Date: B,yIU `7 Page: a of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date l No. Reference R-Red Item Verified 11 PLEASE PRINT CLEARLY - �/t��l�(ik/J)t, o� - Ohl nln�r2 hen l�l�nsi /l�S /-61e �tked� // Dl�Pf1Cf1c�3 7�7J / r�Pad, /2ronPfTa/i/ �ifr�idrr �slJ%( Gbe rQi' litdY &1WV ap « ir-e- eve ¢rem/�i;2e 0/r t-5nlu " 1V { N C Y l h a `�ent0 z)r F 2 hello I /1S- MCll1 Cr&/r(. I }4i1 rrfhv� i�/,�/ad s 0,16p7 7a ��Z {fin /Drr�tq� i . hpmx _)�Al 1 r incl R !o o � I � I - 1 t Discussion With Person in Charge: ��' Corrective Action Required: I ❑ No I ❑ tea C \ ❑ Voluntary Compliance ❑ Employee Restriction/ s 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 ❑ 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-five,do_rs or suspension/revocation-of ❑ Embargo ❑ Emergency Closure F your food permit. FKa - - Ll Voluntary Disposal L3 Other: ". i / 1 5-50i id,C! PI Fs Received at Temperatures Violations Related to Foodtunre Wrests Uae;ventions and Risk Accor,img to I.tw Coiled to Factors(items 1-22) {Cort) 41"F/45'F Within 4 Hour. PROTECTION FROM CHEMICALS � 3-501 15 Coolm9:Methods for PHFs I ii9 PHF Hot and Cold Holding 14 ( Food or Calor 4dditives 3 501.16(D) Cold PIIFs Maintaincd at of below 3-` 0_.12 Additive>' 590.(304(F! 410115"F"` 3-3U% t1 Pnaertion tPan! ihtapproved Additives 3 501.16(A) Hot PIIF>Maintained at or abuv, 15 Poisonous or Toxic Substances 14O F ,e 17-101.11 Idcatihvng Information 0,1611a! 3-501.16(A) Roasts Held at or above 330"F. Containers 20 Time as a Public Health Control 7-102.11 Comtuon Nmnc-W„rkin_Coma,vers "01.11 S.-; 3-501.19 Timc as a Public Heailh Con[ro;" _ ',aranuit--Stcragc'. j 7-202.11 I2estri.:>nn: -P.enence and tjse" 5%.004(H) Variance R.quiretnrnt 7-202.'.2 Condrti[)n'•of Usa" 7-203 11 Te tic(.'m-ainers--Plehibi!i"110 j REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sa iii,rrs Craz:,.; . Chemicals* POPULATIONS(HSP) j7-2.04.12 C emird�_ t h j 121 3-801.1)(At ( Unpasteurized Pre-packaged Juices and h. �. Marhing i rn_iucc,Cn:cri0t j 7-2U�1.14 Dryuq,Rgcnte.Cn+ar:n'" j Beverages with Warning I abcl.i^ i 7-205.11 :116dental F,:od Contac*,Lubricants3-801.1I(B) ?Jae ot'Pasteurized Egos^ 3-801 11(D) I Raw or Partiallv Cooked Annual Food and ( '7-206.1 t Rc:l cit B U:.e li stiritlea.Guena' Raw Seed Sprouts Not Served. 7-206.i 2 Tnxckji waif ders.ns" 3-801.1](C) Unopened Food Package Not Reserved. 7-:'.06.13 Tr:ckmg Powders,t est l'unirpi and Monitorial- CONSUMER ADVISORY TiMEITEMPERATURE CONTROLS 12 3-603.11 Consmner Advisory Posted for Consumption of 16 I Proper Cookinq'femperstures for Annual Foods lbar we Raw. Undercooked or i PHFS ( Not Otherwise Processed to Hinunate 3-401.11A(1)(2) Eggs15i° 15 Sec. Pathogens * `0k"ava nr;aonr Ea)s hunted:ate Seni,:e 145`Fl Sse, j 3-302.13 Pasteurized Egg::Substitute for Raw Shell 3-401.1 l(1)(2) Comminuted Pis::, M14cat.:=F.Game Egos* ,Animals- ;55`F 1 i sr_. 3-401.118)(! P, k 3:1d frc:Roast- 1_l�F 1 ot nt;tx SPECIAL REQUIREMENTS 009fA)-(D _3-401.1 t(A)(2) Rante ! :Jccted?deats- 155^F 15 590. ) Violations of Section 590.009(A)-(D) in catering, mobile food, temporary and 3-401.11(A0) Poultry, Wild Game,Stuffed PHfis, residential kitchen operations should be Stufiine Contaittine Fish,Meat, debited under fbe appropriate sections Poultry of Roar ,A65°F 15 see. ' I above if related to foodborne illness 3-401.11((7)(3) Whole-muscle,Intact Deaf Steaks ( interventions and rink lactors. Other 145°17 j 590.009 violations relating to good retail 3.101,12 Raw Animal Foods Cl,xtkcd in a practices should be debited under #29 Mlcruwave 165"F" Special Requirements. 3-401 il(Ar(1)!b1 All Othui P}{Fs - 145'F 15 17 ( Reheating for Hat Holding VIOLATIONS RGLATED TO GOOD RETAIL PRACTICES 3 4"3.11(A)&fD) PI,Fs 165-F 15 sec. (ltemc 23-30) i 3-403.1 I(H) Ylicrow,ve- 165' F 2 Minute Standing I Critical and nun-critical viaLnrrms, which do not relate to the Tauc" foodborne illness nitervcnitrma mrd risk)i+ctors 1i.cted abore, can be 3403.I](C) I Commercially Pox eased RTE Ftxtd - Comm!in the folium-ing sectiori.t qJ the Faoct Cade and 105 CUR i401FI 590.0oo. 3-103.1 !(F) R'131ainina L'nshced Portions of Beer ?tem Good Retail Practices FC 590.000 I2.+;Ists 23. Manaqement and Personnel FC-2 .003 f$ Prapet Caa!ing of PiiFs i 24. Food and Food Protection FC- 3 .004 J 25.___ Equipment and Utensils FC-4 .005 3-501.14(A) Cooling Cont?d PHI:, from 1=0`P to 26. Water. Plumbinq and Waste FC-5 .006 /0-F Within 2 Houn,and From 70"F 27. Physical Facility FC-6 007 nu i l"F/45`F N':ilii n 4 Hours. 28. Poisonous or Toxic Materials FC - 7 .008 3-501 14F,) Cooling PFIrs Matic Front Ambientj 29, Sa-clal Reear.rernerts ( .0o9 Te:nuet.o❑re ingrcdients 1o41"F/45`P 30 Other - 1 Within 4lfr+urs* ` ^ Den-.ries crin',;iicm m IU:f2drm! !t+'14 Foot.Gude or 10?CMP 590,)00. CITY OF SALEM /� /BOARD OF HEALTH � Establishment Name: IIIA I nO O �n o'-'I ao chO s 0_1 Date: g I6 Y Page: of Item Code C-Critical Item W f DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY 0/)Y-4, fr��Hlh_ ._s i��'' S'"'Areboard e- l � ISP.. li� nll�/t l�r� 'P 11/4 6 /,/Wye- J/( r ka/2 Irli�{�o�i�ms C'� �l m , y 6 e "I sago_7z 1 1 1 , 1 � Glnu-PS Yvtus� � l�orh t,u�loh ��as7�J, �- Gvi� hJ 1 I re 010 In 4457TA . I I - - Discussion With Person in Charge: Corrective Action Required: I ❑ No I ❑ !es 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 tweqlty/-�ive dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. / (/gyp G? _❑_ Voluntary Disposal ❑ Other: i n . J1 .4�C) PHFs Rey,ivzd at'lempernures Violations Related to Foodborne Wness)mer ventions and Risk According to Lew Cooled to Factors(ltems t-22) ;Cont.) 41'F/45'F Within 4 Hours. '' 1 PROTECTION FROPII CHEMICALS 3 501.15 Cooling Methods for PHFs j 19 PHF Hot and Cold Holding hi Food rtt Color Additives 3-5 0 1.1 603) Cold PIII-s Maintained at or below 1 3-202.1'2 Additive-;* j 590.004(F) -41'145° F- 3 302.14 Protector, {Four I hiapnnned Addlthees" 15 Poisonous or-i oxic Substances 3-SOl.lfi{A) Hot FIIFe Maintained at or above t40'F. * 7-IO1.tI telemit}'mg "-t;xmenou --(n-i_^mti 3-50I.ICitA) Roasts Held ut or above 130'F Cmdeurcr:' 7-102.1 3 Common^:amu-Works m�Comrdners" ( � 2}i Time as a Public Health Control j 3-501.19 Time as a Public Health Control' 7-201.11 Separation-Shvage* " 1 -7-202.11 Restriction-- Presen•:r and 11se" 5`J(%004(H) Variance Requirement j 7-202.!2 Cond:tioasuttis.= 203 i I fails Contvinz6m rs-Pruiuon:;; i REQUIREMENTS FOR HIGHLY SUSCEPTIBLE ri 7-204.a .,anitirers. ,.Cntzru, --t hnuicals POPULATIONS(HSP) 1-120-4 12 Chemicals for Wa:aunc Prodwe,Criteria" 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204 14 Drying Agents.Ct::arin" Beverages with Warning I.abelc* j 7205.11 Incidental Foal Contact.Lahr:cants^ 3-80i.:I(P) Use ofPastalrizedLets" f 3-801,11(D) Raw or Partially Cooked Aninml Food and 7-206,11 Regrictcd Cse Pesticides.Criteria„ 7 206 12 RaiC n?Bait Snat,nns` j Raw Seed Sprouts Nor Served. " I 7-206.13 T-i,knig Purrders,Ptst Cordrol and 3-SOLI 1((:) Unopened Pcx�d Package Not R.e-szreed ,Mor.itorin„' j CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-603 11 Consumer Advisory Posted 1'or Consumption of Arterial Foals That are Raw. Undercooked or 16 Proper Cooking Ternpera`ures for I PHFs Nnt Otherwise Processed to Eliminate i 7-401.1 IAOV1 L22:: 155`>'15 5ca Pathogens.* E're.:m r-+,vain Eggs-linniedimc Servos 1 45-F 1 5src 1 =02.13 Pasteur ird Eggs Substitute for Raw Shell 3-b)LIVA)(2) Com:muutedMA, Meats:&G:unc I Eggs:;. A.nimalk:- I55"F 15 se:.. SPECIAL REQUIREMENTS -401.11iB)t I)(2t Pork:md Bec`Rumt '.30"'F 121 niie* i 590.009(A)-(D) Violations of Section 590.t)09(A)-(D) in 3-40L11(A)(2) Ratites, Inlccted Meats-"155'F 15 sec I catering, mobile food, temporary and 3-401.1 PA)(3) Poullrt,Wild Game. S:ubcd PHFs, residential kitchen operations should be Stuffing:".onhrining Fish. B4ear, debited under die appropriate scalars Poultry or Ratiio< 165cF 15 sec. " I above if retated to loodborne illness 3401.1 (C1,(3) Whole-musele,Intact Beef Str:ks interventions and risk factor. Other 1=45°F 590.009 violations relating to good retail 3401,12 'taw .Animal Food,Cooked in:: ( practices should be debited under #29-- Miuvuave 1(5'F x Special Requirements. 3-401.11(A)(I!;b) All OtherPliFs-- 145°F IS sea * 17 Reheating tot Hot Holding VIOLATIONS ReLATED TO GOOD RETAIL PRACTICES 3-403.11(.A)8:(1)) PFIP:. Ii.3"F i5 sec. (Items 23-30) .i-40;.11(B) Microwme- 165'F 2 Minute Standing Cmren(and nun-rnlical violatruwr, which do not relare!a ties I Tiniev foodborne illness intraventirm.> and riekJhctars listed above, can be, 3-403.1'(C) Coni nerctalk Proce>szd RTF F-xsrl- found in tire following sections of the Fimd Code and 16 CJltf 1-t("F' j 590.000. 3403.1 i(E) Remaoi; l Unsliced Portions of Beef I Item Good Retail Practices FC 500.000 j Roasts` ' 23. Manailemem and Personnel FC-2 003 j Proper Cooling of PHFo j 24. Food and Food Protection FC-3 004 25 Equipment and Utensils FC-4 .005 _ 3-5(11i4(A; C ooling Cooked ( 26, Water,Plumbingand Waste FC-5 .006 -- 70"17 Wilhni 2 hours and From 7U'F ( 27. Physical Facility FC -6 007 to 4!^FR5"F Within 4 Hours. " j l 28, Poisonous or Toxic Materials FC--7 008 3-501.141 H 1 Cooling PRFs blade Prom Ambreut29. Special Requirement^, 009 T engrrrauue htgreCienh,to 41"17/45`F' 30. ( Other Withi:r 4 Hour-, "nm..n:ae.-z moo 'ieMUS C MC1l i1CIN m dn0 fed:raI 1')'e9 FO-d Cude or 105 CP4k 5;'0 OCU, l 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 i Name / /1 Date ITyae of Operation(s) TyRe of Insoection N- X5= Food Service ZrRoutine Address Risk Cl Retail ❑ Re-inspection Level ❑ Residential Kitchen Previous Inspection Telephone ❑ Mobile Date:/- 3 O -0 9 El Temporary ElPre-operationOwner I HACCP V/N ❑ Caterer (�p EI Suspect Illness Person in Charge(PIC) Time ❑ Bed&Breakfast ❑ General Complaint G r,'imQ I In: ❑ HACCP Inspector,i��Gri 1 beam �l/ 3Y,'� .,,.r�i out: Permit No. ❑ Other Each violation checked requirefs an explanafion 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 TIMEffEMPERATURE CONTROLS(Potentially Hazardous Fo"'ods) ❑ 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 Separation/Segregation/Protection ❑20.Time As a Public Health Control . ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) El 10. Proper Adequate Handwashing [121. Food and Food Preparation for HSP ❑ 11. Good Hygienic Practices CONSUMER ADVISORY [122. 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 9 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`th 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)(590.008) 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 5901nVedFom -14do nsp to ' S aturhl.. e - i Print: I PIC's Signature: D n�� ,' ,"S(J Print �,�I ) S/-�� Page of 4ages Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT ( 8 Cro,s-cortamlrahon t 59n.U0(Fi) 1 A-<;tgmnent of Responsibility" 4,0 1) Rate .Animal Pends S;parated hom 540.003(8) Demonstration of Knowledge* i Caked and VI'F F,nv1r' j 2-1 G3.1 1 Person in charge--duties ( j COWM nation trorr,Raw lngrepienrs 3-3)0111 2) Raw Animal Fcvods SeparatoJ !rom Each EMPLOYEE HEALTH t7th:r' 2 590,003(C) Responsibility of dee person in charge to ( Ccntan,naton/rom cne Environment require reporting by focal employees and 3-302.1!(A) F.jod Prnteetton` applicants' 3-302.35 Wu>hriwFru!l+and Ve;=etablcs 990,(103(F) Rcspunstbiluy OFA Food Employee Or An 3-304.11 Fuad Contact with Eei Equipment:m Applicant To Report To The Person In Utensils# Charee" ! Gontamination from the Consumer 590.003(6) Reporting by Person in Chiroc* 3-306AVA1(H) Relumcd Fond and Re nricc of F<wct- e 5% )(-g(D) Exclusions and Restrictions" Dr'sposition of Aduke,ated or Contaminated ;90.003(L) Removal of Exclusions and Rcstric•tion� Food 3-iii 1.11 Disc,rding or Reconditioning Unsafe FOOD F90M APPROVED SOURCE Fr"`dt 4 Food and Water From Rrgurated Sources Food Contact Surfaces :)90 0h34(rl-R) Compliance with Fond Law" 4-501 111 Manual Warcwastnm,-Hct Water 3-201.12 Fcxx{in a Hermetically Seated Comainer,' San itizunrn"I'errperautres" 1.3 Fluid Milk and Milk Products* dSft1 11 trtec0ania;i W'are•s,a�ltin Flu(Nater 1 ' S-mii:z:rion Temprr;uuies"` 3-22.13 Slrcli Eggs'F 4-501 114 Ch"mcal Sanitization-temp.,pl-I, j 3-20_..i 4 Eggs and bulk Pna,ucts. Pasteurized' ctr.:crrttration anti it.rcdness + , 3 3021 Ci Ice Made From Potable Drinking Rater' ( .!_6111 11(A) Equipment Find Contact Surfaces and 5-101 11 Drinking,-ter from an Apptovzd Sstem'" Uten;.ilsClean' 500 006(A) P.nttledDrinking\Fater"" ' i 4-602.1i CleanincFrctleencycdEquipment Foud- 540.(106(8) Water Mets Standards in 310 CMR 22.0" Contact Surtaeee and UtvncilsY Shellfish and Fisn From an Approved Source 4-7112 11 Preyuency of Sanitization of Utenaria and 3201.14 Fr:h and Recrea tionallp Laugh; tviolluscan Fax!Contact Surfaces of Equmment� I Shellfish" i 1-103.1; Methexis of Samtrzation--Piot Water and 13-20L15 Molluscan Shellfish from NSSP t,isled ( Chemical'. Souri.es 111 Proper;Adequate Handwashing Game arta Wrfd Mushrooms Approved by 1 2?01.1! Clean CondAivn- Hands and Arm+': Requkntpn Auihoriry 2-2()' 18 Shellstock Idendfictuiun Present" '2-301.32 Cleanim„Plcxedmr* 540I)04(C) Wild btushrcwirns^ 2 301.14 When to'A ask" ?-201.17 Genre Prumalm* '. 'i Good Hygienic Practices, 5 Receiving/Condition 1-01.11 F;ning,Drinking or UgmsH Tobacco' 3-202.1: PRFs Received at Proper Temperatures;' i 2-401.12 Discharges From the Fye,.Nos;and Mouth" 3-202.?5 P,rekage (ntepity" ( 3-101.11 Final Safe end unadulterated" 3-301.12Present urs�ConC::nmatiott When Tasting* 6 Tags/Records:Shellstock 1 12 Prevention of Contamination from Hands 3-202.16 Shellaock identification I 590.004(6) Preventing Contamination from 1 3-203.12 Shellstock Identification Maintained" Pntpfu}ees 13 Handwash Facilities Tags/Records: Fish sh Products 3-402.1! Parasite Destruction*c Conveniently L ocated.;nd Accessible ',-103.i t Numbers aad Capacitie<r 1 3-402.12 Records.Creation and Retention" ( 5-204.11 Liwauon w;d PLtcenr-nl* 590.0040! Labeling of Ingredients* 7 Conformance with Approved Procedures ( ( >2105 11 Accessibility,Operauon and M�intcuance /HACCP Plans , Suppt"ed vnth Soap anal t-!aad Dry;ng 3-502.1! Specialized Prcces�mg Mebods' 1 Cavrcas j 3-50.'..:2 Reduced oxygen packaging,criteria' 6 '01.1 1 Hendwa<hing C!,,ame!.A�ailabihiv 3-[03.12 Cun!orr rince with Approved Prc;redtires- (*301.12 Fiarr.I Dr}�ine Pcorision „Donnie,crane!item,n the L;deml 1999 Fort C ode,l 105 CNIR Sn1.nnU. CITY OF SALEM BOARD OF HEALTH Establishment Name:A,f��'Dp— M/gGLc�nsrl'e_S Date: 21 qa Page: 2. of ,s Item Code C-critical nem DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY "z '7 N/c.. 'C4000 A,«s As- psis!' Lln " w,p,ti/(r- C--e-0-MS ry OE: rL14r1,1')Wre'1!CO srr 2 RVG,e&TS vnr25- r .'..,�(3ti�-,f� "(L.k� /a�-n,wt` ,-- oaq r �n/r.-•/' �f i/4 L u�l�Y�!L cfY3s`_ci;�1 e 3vjlKrK 12-it ft-' 99;G o T i-t 451 XXL J-3- r,f divc.k-a- r s Q erweLA�i✓ t ct'L P, f I � � I I ��.AnrF\t�rvt raf i rr� I i�Y! ,L�>�✓�r , N-- Al 1 of AA ivq-ffi ttr f f Z t Rs 0- ,Ad-_T irl a h S". J 1 v"(2 J-10 t�, ' TO Srtr' F-0 00 S' -��.5 J JY fit✓ G rlA�.� . I i � I Discussion With Person in Charge: Corrective Action Required: I ❑ No I ❑ Yes f I have read this report, have had the opportunity to ask questions and agree to correct all C1 Voluntary Compliance LI Employee Restriction/ violations before the ext inspection, to observe all conditions as described, and to Exclusion nrn ` p 13 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 /j��_ ❑ Voluntary Disposal ❑ Other: i v } 3.J01.14(0 PH F.Receivedtit Temperatures Violailons Rented to Foodborne 1Nna.,;s Interventions and Risk Nccordill`g to Ian•Ccolcd to Factors(Iterns t-22) (Coni) 41'F/45"F Withrn 4 HOlii$, PROTECTION FROM CHEMICALS I 3-5U1.t5 Cooling Methods for PITFs j 19 PHF Hot and Cold Holding 19 Food or Color Additives I 1-;01 16(B) Cold 11111s Mainain ted at or below 3-2(1.'.12 Additi'cs^ 590.004(17) 41"/45"F`: 3-;02 1-t Prounion I:vm Una> ro, A }p- d :.dditi von 3-5UL16(A) Hot PHFs Maintained at of atime I ES I Poisonous or Toxic Substances I 7 101 11 ltienntg:r.g inii;nnabon-Ongiu,;tl 140'F. ' ;_501.101:11 I2oau,Held at of above 130'17 Container'' , Time as a Public Health Control 7-102.11 Common N;uno-Working Cvntaine:s` ( 2{, 1 7-201,11 Separation-Stotagc" 3-501.19 Time as a Public Health Contr&' I 7-20e 11 P.c>tri..bon-Presence and t-'s.'' 590.004(li) Vm'nmce Requircnent 7-202.12 Condt-•ions of Use' 7-203 It T,ts cC:,r!:moi^ec;-Pmhibitioln"* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7.204.11 Sanit;reis.Criteria -Chemicals^ POPULATIONS(HSP) 7-204 12 Cli-nicals lot Cvashme Produce,Criteria* i 21 1 3-80!.11(A) Unpasteurizxd Pre-packaged.Juices and Beverages with Warning T_ab.1s" 7-2f:4.11 ineide t l'eix,Criteria' 3-801.11(B) Use of Pasteuri'zecl Egg-" ( 7-105 11 i ?nrident:a F:xul Co*deo,L=-:Sri.ants` � ' 3-801 111 1) Raw or Partially Conked Animal Fo oll and I 7-2(?6.11 iiestr;,1ed 1Ise Pc�tieides, Crifut'ia" Raw Seed Sprouts No, Served. I '-20n 1? Rodent Bou Station,' 13-30!.1 llCl I Inopened Food Package Not Rc-served. ` 7-20(i.t3 � Tracking Pmvdcrz, Hest Coutr�a; .uul ' Mo.t:,.,rnr- CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer A dvisory Posted for Consumption of Animal Foods That are Rare. Tlndercnoked or l6 Proper Cooking i'etr:Peratures for Not Other�ise Processed to Eliminate i PIiFs r.?oc i 3-401.11A(4)12) Eggs. 1-53 F15Se- Pathogens."' Egss-':n raedtate Scrvi:e ?45°F 1 Ssec` me 3g' -302.13 Pasteurized Egg, Substitute for Raw Shell 3-401,1!(A)(2) Cc)imninutcd Fish.Al-alt;&Gams E-, Animals- I>5 F l:i r.ec. * ( SPECIAL REQUIREMENTS 3-40L11(Btil)131 Pork iriecefRo:st- 130'F1221min'` 3-401.1 1(A)f21 Ratites,Inject"'Meats- i 5i"F 15 I 590.004(A)-(D) Violations of Section 590.009(A)-(D) in ser. catering, mobile food, temporary and 3-401 11(A)(3) Potdtty, Wild Gyne.Snuffed PHhs, residential kitchen operations should he Stufttn ing*Cont:mFi,lu.Meat, debited under the appropriate sections Fouttr,or Ratites-u:5'17 45 ce. ` above if related to foodborne illness 3-401.11(C'1(3) Whole-mus.le.Intact Beet Sterns interventions and risk factor's. Other 145`17"' 590.009 violations relating to ito od retail 3-401.12 Rau'Atmaal Fo ds Cooked in a practices should be debited under#29- Micmowave 1650'' Special Requirements. 3-401.ll(Af(iNbl Ail Other PHFs- 14SY15sec. " I 17 I I Reheating for Hot Holding I VIOLATIONS R ELATED TO GOOD RETAIL PRACTICES I3-40.311(A)&t D) PI17- 165`F15sec. " I (Items 23-30) i-403.11(E?) Micmwa,e- 165` C^ Minute Jtmmding Critical and non-cnncal violations, trh¢'h do not relate to the TTntr:` I .fondhonme illness interventions and ask,faclom listed above, carr he 3-410! 11((') ComtnerJaIN Pieces;d RTP Food- jump/in rhe folloning ser'tiom afdre Food Code and 105 CT4R 140°F' 590.000. "402 l 1(8) item.:irtimt Unahced Portions of Beef Item Good Retail Practices FC 590.000 Rtr:ste' 23. Management and Personnel FC-2 _003_ 18 Proper Cooling of PHFs 24 Food and Food Protection FC-3 .004 ; 25 Equipment and Utensils FC-4 005 3-iOl-W4 A) Gx,ilnc Ccwlied Pl-TFs from 1400F to 25. Water. Plmnbinq and Waste FC--5 .006 1W Within 2l lours and From 70'F ! 27 Physical Facilitv FC-C 007 to 41`17,'45'17 U`ith!n 4 Hours * 28. Poisonous or Toxic Materials FC-7 _.008_ 3-501.14(B) Cooling PHFs Ma<ie i-'romn Ambient 29. Special Requirements A09 I enuperat ore incredients at 41'FY}>'p 30. Other _- Witlun t Hours: .111:':2'°11-11- D oras,--, -11 'Dano,,,<riti,it;it,. in the mnderal ,49r1 ri CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH _ 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 Wig TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT October 19, 2004 Philip R. Shea, Owner Major Magleashe's Pub 268 Washington Street Salem, MA 01970 Dear Mr. Shea: On September 15, 2004 at approximately 11:30 PM, in response to a complaint, personnel from the Tobacco Control Program conducted a compliance check to determine if your establishment was in compliance with Salem Board of Health Regulation #22 concerning the Workplace Smoking Ban including restaurants and bars. At that time approximately three people were observed smoking in the bar and dining areas. Ashtrays were provided and the presence and odor of smoke were also observed in your establishment. Documentation is on file at the Board of Health regarding this violation. You are in violation of Section D(1) and D(2) of Salem Board of Health Regulation #22. According to this section, it is unlawful for any employer or other person having control of the premises upon which smoking is prohibited by this regulation, or the business agent or designee of such person, to permit a violation of this regulation. Section G of this regulation states, "Any employer, or his or her business agent, who violates any provision of this regulation, the violation of which is subject to a specific penalty, may be penalized by the non- criminal method of disposition as provided in Massachusetts General Laws, Chapter 40, Section 21 D or by filing a criminal complaint at the appropriate venue. It shall be the responsibility of the employer, or his or her business agent, to ensure compliance with all sections of this regulation. Violators shall receive a fine of $100 for a first violation, $200 for a second violation, and $300 for each additional fine within 24 months. Therefore, you are ordered to pay a fine of $100 for the violation stated above since this is your first violation within 24 months. A check or money order payable to the City of Salem must be at the Board of Health office, 120 Washington Street within ten days of receipt of this notice. r Should you be aggrieved by this Order, you have the right to request a hearing before the Board of Health. A request for such a hearing must be received in writing in this office of the Board of Health within seven (7) days of receipt of this Order. At said hearing, you will be given the opportunity to be heard and to present witness and documentary evidence as to why this Order should be modified or withdrawn. An attorney may represent you. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection or investigation reports, orders, and other documentary information in the possession of this Board, and that any adverse party has the right to be present at the hearing. If you have any questions regarding this notification please call me at 978-741- 1800. Sincerely yours, J_ (., �.�.z�e anne Scott Health Agent Cc: Christina Harrington, Board of Health Chairman James Gilbert, City Solicitor Joyce Redford, Director, North Shore Tobacco Control Program certified mail 70033110000519920434 o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR `a SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVIC7, 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: Owner' s Name : Philip R. Shea Name of Establishment : Major Magleashe ' s Pub Address of Establishment : 268 Washington Street Type of Establishment : FOOD SERVICE Application Date : 12/24/2002 Restrictions: Permit for Food Establishment 152-03 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products 37-03 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 ��'. . f I.3..'i lw y.,:S R,. `�:.1.. ..Y' S.. „ • .„ k.' y'y. .t.. 1 h� SF: .,;y.` if �.1i{ •;� � 3 � � "x" Y y fid L CITY OF SALEM,- r' MASSACHUSETTS �g BOARD OF HEALTH M., 120 WASHINGTON STREET. 4TH FLOOR SALEM, MA 01970 ,Jr➢ TFL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR, ^. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGF'NT 2003 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT TEL# 7`f ADDRESS OF ESTABLISHMENT jStPy �TD� MAILING ADDRESS (ifdifferent) OWNER'S NAME / NIL// - SlLi} TEL# ADDRESS Z3 %LLr{ /Qa„ CITY STATE mA - ZIP 0 /9'70 CERTIFIED FOOD MANAGER'S NAME(S) PtYiL rP 47ey,9 t- CERTIFICATE#(s) — 7 Z t!o 2 4)A-✓ZJ> fYN-oSz. 1072. P(oL (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON A901.- HOME TEL# HOURS OF OPERATION: Mon. '-rTue.%Wed. '" Thu. `/ Fri. `/ Sat. Sun. ✓ Neow— t`004,t7 TYPE OF ESTABLISHMENT �� FEE check only RETAIL STORE, YES L:/ less than 1000sq.ft. =$ 50 Iia r0 1000-10,000sq,ft. =$100 more than 10.000sq.ft. =$250 RESTAURANT ES NO le n 25 seats =$100 25-99 seats =$150 ore than 99 seats =$200 BED/BREAKFAST YES NO $100 ADDITIONAL PERMITS MAKE ICE CREAM, YOGURT, SOFT SERVE ,YS $5 TOBACCO VENDOR �' �� $50 ALL NON-PROFIT(such as rhurch kitchons) 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. Signatu �'Q p � Date1 ,-/26 zSocial Security or Federal Identification Number Revised 11/25/0.022 F09DD'A"`P"'22..adm Check#&Date_//L "7 z.(�3 6 00 0 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 / / Date TVe of Oneration(,sl Type of Inspection 4ye?6?/41- -- /C�G�ffi S �GI(7 / p��j Foodservice f/�Fioutine Address / Risk 1:1 Retail ElRe-inspection A/0 ff /LtJi/s/11,9�_/i,-, .��rt Level L1 Residential Kitchen Previous Inspection Telephone �./ j/f> ❑ Mobile Date: Owner HACCP Y/N ❑ Temporary ❑ Pre-operation ❑ Caterer ElSuspect Illness Person in Charg (PIC) // ii Time ❑ Bed&Breakfast ❑ General Complaint In: ❑ HACCP InspectoL /454E- U� 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 (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 ®163. 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 ❑ 8. Separation/Segregation/ Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ElEl 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 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 i 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: Inspector's Signature: / / / i�L Print: // PIC's Signature: Print: PageL04--Pages v FORM 734A HOBBS&WARREN - BOSTON r, Violations Related to Foodborne Illness Y 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 1590.003(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* I 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 3-306.14(A)(B)l Returned Food and Reservlce 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 l590.004(A-B) Compliance with Food Law* Sanitization Temperatures* 3-201.12 Food in a Hermetically Sealed Container* 4-501.112 Mechanical Warewashmg-Hot Water 3-201.13 Fluid Milk and Milk Products* I 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- Ho[Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* - 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved by Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 2-301.12 Cleaning Procedure* 3.202.18 Shellstock Identification Present* 2-301.14 When to Wash* 590.004(C) Wild Mushrooms* 3-201.17 Game Animals* 11 Good Hygienic Practices 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* -- 6 Tags/Records:Shellstock 12 Prevention of Contamination from Hands 590.004(E) Preventing Contamination from 3-202.18 Shellstock Identification* Employees* 3-203.12 Shellstock Identification Maintained* Tags/Records: Fish Products 13 ndwash Facilities 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(7) Labeling of Ingredients* 5-205.11 Accessibility,Operation and Maintenance 1 I Conformance with Approved Procedures HACCP Plans Supplied with Soap and Hand Drying Devices 3-502.11 Specialized Processing Methods* 16-301.11 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 CD1R 590.000. } CITY OF SALEM 'j BOARD OF HEALTH Establishment Name: sllylii�r /�rvii��ii_ffi e s 7�is 6 Date: /1a13 Page: �7- of Item Code C-Critical Item' DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date, No. Reference R—Red Item PLEASE PRINT CLEARLY Verified C' 1 /3 F 1 ,4 /7j0 n/ �. C r 1 x/'50 c'// � f I.ZS /✓��- �1/7/i S.�/iii �`/�c.�nT>/Jilj�C�f�'r /r� �iCCP�r aiJ�.J/i. ffi,.>r,r � 1 All I ✓ ��r�/.dri�i.. fC l TP_r�177i? 1 1 I I I i $ Discussion With Person in Charge: Corrective Action Required: ❑No I ❑Yes I I have read this report, have had the opportunity to ask questions and agree to correct all ❑ voluntary Compliance L11 Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to comply Exclusion i' with all mandates of the Mass/Federal Food Code. I understand that noncompliance may L11 Re-inspection Scheduled ❑ Emergency Suspension result in daily fines of twenty-five dollars or suspension/revocation of your food permit. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other FORM 7348 HOBBS &WARREN - BOSTON Violations Related to Foodborne Illness Interventions and Risk 3-501.14(C) PHFs Received at Temperatures Factors(Red Items 1-22) (Cont.) According to Law Cooled to 41'F/45*F Within 4 Hours.* PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14 I I Food or Color Additives I 119 PHF Hot and Cold Holding 3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below 3-202.14 I Protection from Unapproved Additives* 590.004(F) 41*F/45°F* 15 ( Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above 7-101.11 Identifying Information-Original 14WE* Containers* 3-501.16(A) Roasts Held at or above 130°F.* 7-102.11 Common Name-Working Containers* 120 I Time as a Public Health Control 7-201.11 Separation-Storage* 13-501.19 Time as a Public Health Control* 7-202.11 I Restriction-Presence and Use* I 590.004(H) Variance Requirement 17-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 I Toxic Containers-Prohibitions* POPULATIONS(HSP) 7-204.11 Samtizers,Criteria-Chemicals* _I 21 13-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals for Washing Produce,Criteria* I 1 Beverages with Warning Labels* 7-204.14 Drying Agents,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 7-205.11 Incidental Food Contact,Lubricants* _ _ 3-801.1 l(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Critena* Raw Seed Sprouts Not 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* CONSUMER ADVISORY 22 3-603.11 Consumer Advisory Posted for Consumption of TIME/TEMPERATURE CONTROLS Animal Foods that are Raw,Undercooked or 16 Proper Cooking Temperatures for not Otherwise Processed to Eliminate PHFs Pathogens.* Enecl-111,2101 3-401.11A(1)(2) Eggs- 155'F 15 Sec. 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* Eggs-Immediate Service 145*F 15 Sec.* 3-401.11(A)(2) Comminuted Fish,Meats&Game SPECIAL REQUIREMENTS Animals- 155*F Sec.* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 3-401.1413)(1)(2) Pork and Beef Roast- 130*F 121 Min.* catering,mobile food,temporary and 3-401.1](A)(2) I Ratites,Injected Meats- 155'F 15 Sec.* residential kitchen operations should be 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections Stuffing Containing Fish,Meat, above if related to foodborne illness Poultry or Ratites- 165'F 15 Sec.* interventions and risk factors. Other 3-401.1l(C)(3) Whole-muscle.Intact Beef Steaks 590.009 violations relating to good retail 145°F* practices should be debited under#29- 3-401.12 Raw Animal Foods Cooked in a Special Requirements. Microwave 165°F* 3-401.11(A)(1)(b) All Other PHFs- 145'F 15 Sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 17 Reheating for Hot Holding (Blue Items 23-30) 3-403.11(A)&(D) PHFs 165'F 15 Sec.* Critical and ton-critical violations, which do not relate to the 3-403.11(B) Microwave- 165'F 2 Minute Standing foodborne illness interventions and risk factors listed above, can be Time* found in rhe following sections of the Food Code and 105 CMR 3-403.11(C) Commercially Processed RTE Food- 590.00. 140°F* Item Good Retail Practices FC 590.00 3-403.1l(E) Remaining Unsliced Portions of Beef 23. Management and Personnel FC-2 .003 Roasts* 24. I Food and Food Protection FC-3 .004 18 Proper Cooling of PHFs 25. Equipment and Utensils FC-4 .005 3-501.14(A) Cooling Cooked PHFs from 140'F to 26. Water, Plumbing and Waste FC-5 .006 70'F Within 2 Hours and from 70*F 27. Physical 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 PHFs Made From Ambient 29. Special Requirements .009 Temperature Ingredients to 41*F/45*F 30. Other Within 4 Hours* *Denotes critical item in the federal 1999 Food Code or 105 CMR 590 000. � • CITY OF SALEM9 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: Major Magleashe's Pub Address of Establishment: 268 Washington Street Owner's Name: Philip R. Shea Restrictions: Application Date: 12/11/2003 Permit for Food Establishment 185-04 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products 42-04 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. HEALTeAGENT7e i CITY OF SALEM, MASSACHUSES_ BOARD OF HEALTH � ��`k \ L 120 WASHINGTON STREET, 4TH FLOOR` . SALEM, MA 01970 DEC 10 2003 TEL. 978-741-1800 FAx 978-745-0343 ' ry - $ y STANLEY USOVICZ, JR { vl� ✓� t'.'�tM� JOANNE SCOTT, MPH, RS, CHO BOARD OF HEALTH 5' MAYOR HEALTH AGENT w 2004 APPLICATION FOR PERMIT TO OPERATE A FOOD Ey T , 9LISHMENT, 'p• A1 .. ,- i1N 1411�"P�tg NAME OF ESTABLISHMENT fvt f��2 r` VBG G�/d SNS 'S TEL N# �y ADDRESS OF ESTABLISHMENT MAILING ADDRESS (if different) p OWNER'S NAME1 13H(L( 5 TEL# c7 ?�' 7f5 2-y 5Y ADDRESS 2-3 61Z&L-61. q /29' CITY M STATE n?/4 ZIP 019 ?6) CERTIFIED FOOD MANAGER'SNAME(S) VH11-it- SN/ CERTIFICATE#(s) 7"jZ66L (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON / 4 ()L- �LA�7�� HOME TEL# j7k'7y11— F06 HOURS OF OPERATION: Mon. ✓ Tue. -/ Wed. Thu. `Z Fri. Sat. v Sun. v Ix,TYPE OF ESTABLISHMENT . " r r ' " - , - iA FEE. �, RETAILISTOREn �,:yctieg"c::li o.nl.y_ $ M41YEStiyr T I '1 g� tf�r 1000-10,000sq.ft. =$100 O` more than 10,000sq.ft. =$250 RESTAURANT YE NO � r less than 25 seats 5�� 25-99 seats more than 99 seats =$200 BED/BREAKFAST YES NO $100 ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGURT, SOFT SERV YES NO $5 TOBACCO VENDOR 4.-2 ES 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 knowledge and belief, have filed all state tax returns and paid all state taxes required under the law. /fin. ori - u36060 Sign r /� Date tZ�L 03 Social Security or Federal Identification Number Vim` ' `'� ----------- -- -------------------------------------------------------------- Revised 11/03/03 FOO AP2.adm Check#&Date v � � . tt� Q � I Y t '4N{✓/�'JJV g U O � Y JAN -3 2005.- CITY OF SALEM BOARD OF HEALTH ' Major Magleashe's Pub 268 Washington Street Salem, Massachusetts 01970 978-744-2328 December 28, 2004 MEMORANDUM C TO: ALL PERSONNEL JAN e 3 2005 FROM: PHIL SHEA, PAUL FLAHERTY, OWNERS RE: TREATMENT OF HEALTH DEPT. REPRESENTATIVES CITY OF SALEM BOARD OF HEALTH Dear Staff, On April 1, 2001 the Salem Board of Health's regulation prohibiting smoking in restaurants and bars went into effect. The purpose of the regulation is to protect both customers and you, as employees, from the hazards related to second-hand smoke and to recognize the benefits of breathing smoke-free air. Until July 5, 2004, it was possible for our patrons to travel to other communities in order to smoke in a bar. As of that date all restaurants and bars became smoke-free on a statewide basis. Other than private clubs, we are now on a level playing field with all surrounding cities and towns. We must enforce the law. Representatives of, or members of the Salem Board of Health and/or representatives of the North Shore Tobacco Collaborative are entitled to inspect our establishment for compliance to the law during any routine inspection at any time of the business day. The inspectors will not be denied access to our restaurant and they will be treated with the same courtesy and respect that we would bestow`on our own customers. We will, at all times, allow them to do their job and will not get in any type of debate over compliance to or enforcement of the law. Any staff member who does not adhere strictly to this policy may be subject to suspension or termination. If any customer interferes with inspectors or mistreats them in any way, it should be reported to management immediately. We need to work together to make sure that our policy regarding this issue is strictly enforced. Thank you all for your attention to this matter. Yours truly, Phil and Paul +R, CITY OF SALEM, MASSACHUSETTS m2L BOARD OFHEALTH S 8 ' 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 November 4, 2004 Philip R. Shea, Owner Major Magleashe's Pub 268 Washington Street Salem, MA 01970 Dear Mr. Shea: The Salem Board of Health requests your presence at the next Board of Health meeting to discuss chronic violations of the Board of Health Smoking Regulation. The meeting will be held Tuesday, November 9, 2004 at City Hall Annex, 120 Washington Street 3rd floor conference room at 9:00 P.M. If you have any questions, contact me at 978-741-1800. Sincerely, or the Board of ealth << Joanne Scott, He Ith Agent JS/mp CC: Christina Harrington, Chairperson of the Board of Health and Members f r r �J�.e:V►7JlJl� ��?ill To: Joann Scott fa: 978-745-0343 From: Joyce Redford Data: 10/25104 Rs: Papoa: 2 includes cover CC: ❑urosrd ❑ForReviaw ❑ Plea"canmxd ❑Preew Ropy ❑Please Wcyck Joanne, We have received another complaint on Major Mag Leash's regarding smoking alfter 11:30 p.m.,this complaint was received and referencing a violation that would have occurred after our most recent inspection and violation,which of September 15,2004. This ongoing issue with Major's is of concern because as you know Salem has had a regulation in place since 2001 and the State Law since July 2004. It seems the Board may want to consider exercising its authority,6 further penalize this establishment due to their ongoing blatant disregard of the local regulation and the.Boards jurisdiction. I remember the Board having to do something like this when Rooseveti's was not willing to comply with the ETS regulation. Feels like we're moving backwards? . . . . . . . . . . . . . . . . . . . . . . . . . . . . TO 39t1d d91SN O999IVL8LG 8O:ZT VOOZ/9VOT -North Shore Area Boards of Health Collaborative Tobacco Control Program TOBACCO COMPLAINT FORM 'SWrm. MA 01970 (978)741-5646 w r (978)741-5650 FI /�ax BATE: D - .� lJL tMfTOWN OF: �S1TE: Ci aC Y�J 'ADDRESS: �COMPLAINTANT: A SVS TELEPHONE- �;da Oct. Zocy-( tune memhey' � �IVATURE OF COMPLAINT: o� �i oP a droop aslcea rbv' CA GShh2z © (Ippvox . S :ioopm LZJ s �olc� �1C4- 5rno� " is G11okZed "tr 1vw( n A� - W060PM W>V' V(, LAS tZ2 )0ro nA CO- @ �� CLtt,. Q pud- vn y,P kOtr E if @ ave,cin +,rA4, apPc 8 PERSON TAKING COMPLAINT: `. >' y ACTION TAKEN: r O W O - O _ a a O f O U O U - U d INSPECTOR: DANVERS • LYNN • MAR13LEHEAD • NAHANT• PEABODY• SALEM • SAUGUS • SWAMPSCOTT Z0 39Vd d31SN 0995T6LBL6 60:ZT b00ZISZlOT CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH p' 120 WASHINGTON STREET, 4TH FLOOR a SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT October 19, 2004 Philip R. Shea, Owner Major Magleashe's Pub 268 Washington Street Salem, MA 01970 Dear Mr. Shea: On September 15, 2004 at approximately 11:30 PM, in response to a complaint, personnel from the Tobacco Control Program conducted a compliance check to determine if your establishment was in compliance with Salem Board of Health Regulation #22 concerning the Workplace Smoking Ban including restaurants and bars. At that time approximately three people were observed smoking in the bar and dining areas. Ashtrays were provided and the presence and odor of smoke were also observed in your establishment. Documentation is on file at the Board of Health regarding this violation. You are in violation of Section D(1) and D(2) of Salem Board of Health Regulation #22. According to this section, it is unlawful for any employer or other person having control of the premises upon which smoking is prohibited by this regulation, or the business agent or designee of such person, to permit a violation of this regulation. Section G of this regulation states, "Any employer, or his or her business agent, who violates any provision of this regulation, the violation of which is subject to a specific penalty, may be penalized by the non- criminal method of disposition as provided in Massachusetts General Laws, Chapter 40, Section 21 D or by filing a criminal complaint at the appropriate venue. It shall be the responsibility of the employer, or his or her business agent, to ensure compliance with all sections of this regulation. Violators shall receive a fine of $100 for a first violation, $200 for a second violation, and $300 for each additional fine within 24 months. Therefore, you are ordered to pay a fine of$100 for the violation stated above since this is your first violation within 24 months. A check or money order payable to the City of Salem must be at the Board of Health office, 120 Washington Street within ten days of receipt of this notice. Should you be aggrieved by this Order, you have the right to request a hearing before the Board of Health. A request for such a hearing must be received in writing in this office of the Board of Health within seven (7) days of receipt of this Order. At said hearing, you will be given the opportunity to be heard and to present witness and documentary evidence as to why this Order should be modified or withdrawn. An attorney may represent you. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection or investigation reports, orders, and other documentary information in the possession of this Board, and that any adverse party has the right to be present at the hearing. If you have any questions regarding this notification please call me at 978-741- 1800. Sincerely yours, J�anne Scott Health Agent Cc: Christina Harrington, Board of Health Chairman James Gilbert, City Solicitor Joyce Redford, Director, North Shore Tobacco Control Program certified mail 70033110000519920434 09/24/2004 15:15 FAX 617 624 5921 TOBACCO CONTROL Q001 FAX COVER SHEET ♦ FAX COVER SHEET 4 FAX CO Il o MASSACHUSEr1rS TOBACCO CONTROL PROGRA I� L! o Massachusetts Department of Public Health SEP 2 7 2004 250 Washington Street, 4th Floor Boston, MA 02108-4619 CITY OF SALEM BOARD OF HEALTH Phone: (617) 624-5900 FAX: (617) 624-59?1 TO: r.-Sale-m e0 .H TO: 4/0rAS/norc _ 9/7a/-r& a(c l SPA 149 FAX#: T7-K--74yI 4� FAX# DATE: I DATE: # PAGES: PAGES: J 3 pages includinq cover 3 pages includinq cover ABOUT: Complaint—Smoke-free Workplace Law COMMENTS: Attached is a complaint that was received by the Massachusetts Department of Public Health. We request that you investigate this complaint and fax back the attached "complaint follow up form".We will send a letter and a Copy of the complaint to the workplace in approximately five days. If you have any questions about the content of this fax or the smoke-free workplace law, please contact Mark Boldt at 617-624-5923. NOTICE:The pages comprising ibis facsinule transmission contain confidential inforrnation from the Department of Public Health.This information is intended only for the use by the recipients listed above.If you arc not the intended mcipicat or the employee or agent of the intended recipient responsible for the delivery of this information,you are hereby notified that the disclosure,copying,use or distribution of ihis information is strictly probibikd.If you have received this transmission-in wo; please notify us immcdiarely by telephone ty arrange for the ream of the transmincd documents to us or b verify their destruction. 09/24/2004 15:16 FAX 017 924 5921 TOBACCO CONTROL 10002 Massachusetts Department of Public Health Massachusetts Tobacco Control Program Complaint follow-up form Attached is a complaint received by the Massachusetts Department of Public Health.After investigating the complaint,please complete this one page and fax it to 617-6245921. it%r-kh (S /,3 0 H Name of Municipality: .SC L r h , I 0 /� Complaint number:—LS� Name of Workplace: 'Ma 1'e5Y i ISA C S Date of Inspection: Time of Inspection: AM PM ❑ Violation observed ❑ No violation observed ❑ Location is exempt from law Indicators of a violation observed: ❑ Customer(s)smoking ❑ Employee(s)smoking ❑ Unknown person/people smoking ❑ Other: If a violation was observed,Inspector: ❑ issued ticket ❑referred violation to board of health for action ❑ Other: Comments: AM MR BROWN I V11141affim 7/29/04 l 09/24/2004 15:16 FAX 017 024 5921 TOBACCO CONTROL 0003 I COMPLAINT. REFERRAL Complaint Information Complaint Number 154 Complaint received via. Live Phone Call Date of call: 9/10/2004 Time of call: 3:00 PM Workplace Information Name of workplac Major Magieashes Street Address: 265 Washington Street City: Salem Zip: 01970 Incident Details Date of the incident: 9-904 Approximate time of incident: 11p1n Type of workplace: Bar/Nightclub Location of the incident within the workplace: Bar Comments about the location of incident; Entire Pub a Person seen smoking; Customer ® Employee Unknown El Other smoking indicators: ashtrays present © clg stubs present Additional Information: Friday,September 24,2004 Page 137 of 144 u--Va4/YIIIH aa:40 tAA oil 044 QVAA AUOA4W VMAKU4 WUUA FAX COVER SHEET♦ FAX COVER SHEET ♦ FAX CO �UIRR IV 4 n 'MASSACHUSEr1rS TOBACCO CONTROL PROGRA� 1'! V Massachusetts Department of Public Health SEP 2 7 2004 250 Washington Street, 4th Floor Boston, MA 02108-4619 CITY OF SALEM BOARD OF HEALTH Phone: (617) 624-5900 FAX: (617) 624-59;1 TO: t�GLlt!✓VI 600 TO: NOrASAorc 610rrLS o(:7 tPA 19 FAX M. q ?g -?4S1 0343 FAX# 791 -4-7-?-o4-90 f DATE: DATE: . # PAGES: # PAGES: 3 Daqes includim cover 3 pages including cover ABOUT: Complaint— Smoke-free Workplace Law COMMENTS: Attached is a complaint that was received by the Massachusetts Department of Public Health. We request that you investigate this complaint and fax back the attached "complaint follow up form". We will send a letter and a copy of the complaint to the workplace in approximately five days. If you have any questions about the content of this fax or the smoke-free workplace law, please contact Mark Boldt at 617-624-5923. NOTICE,The pages cornpnsmg dtus faLmnule transmission contain confidential mformation from the Department of Public Health This information is intended only for the use by the recipient listed above.If you are not the intended roelplcut or the employee o.agent of the intended recipient responsible for the delivery of flus information,you are hereby non6cd that the disclosure,copying,use or distribution of thu inforrwtioo is strictly prohibited.If you have received this tnins stun in error, plezce notify m irmncdiarely by telephone to arraogc for the return of transttuttcd documents to us or to vmfy then destruehou _ Massachusetts Department of Public Health . Massachusetts Tobacco Control Program Complaint follow-up-form Attached is a complaint received by the Massachusetts Department of Public Health.After investigatigg the complaint,please complete this one page and fax it to 617-6245921. A110 r-��+h CS hors 0 H V — Name of Municipality: o �� , 6 D tV Complaint number:_ Name of Workplace: G?, ( /► (24 t?Q C4 — Date of Inspection: Time of Inspection: AM PM i ❑ Violation observed ❑ No violation observed ❑ Location is exempt from law I indicators of a violation observed: r i ❑ Customer(s)smoking ❑ Employee(s) smoking ❑ Unknown person/people smoking ❑ Other: If a violation was observed,Inspector: ❑ issued ticket ❑referred violation to board of health for action ❑ Other: Comments• "i��'��$t�`�"t �#1�'t;'tiilli' • t 1 �'`� 7/29/04 _ 0;49 .r&& oil *14 1 I I W- 1 M PLAINT REF"SRIRCIRAL domplaint Information Complaint Number 154 lei tref Complaint received via. LW Phone Call Complaint a f c 11. Date of call: 911012004 Time of call: 3:00 PM Workplace Information - Name of workplac Major Magleashes Street Address: 268 Washington Street City: Salem Zip: 01970 Incident Details Date of the incident. 9-904 Approximate time of incident: 11Pfn Type of workplace; Bar/Nightclub Location of the incident within the workplace: Bar Comments about the location of incident: (Entire Pub Person seen smoking: Customer W Employee Unknown L-1 Other smoking Indicators: ashtrays present 02' clq Mubs present Additional Information: Friday,September 24,2004 Pago 137 of 744 L > emo 7ID BOARD OF HEALTH i Date: September 16,2004 To: Joanne Soott,Health Agent From: Joyce Redford,Program Director and Michelle Cremins,Compliance Inspector RE: Salem Tobacco Inspections On Wednesday evening, September 15,2004 Michelle Cremins and I conducted Environmental Tobacco Smoke(ETS) inspections at the following establishments following reported complaints. Compliant Saint Joseph's • An ETS inspection was conducted at 8:45pm following a complaint at the Saint Joseph's BINGO event,being held on 156 Federal Street. No violation was found at the time of the inspection. Non-Compliant Major Mac Leash's • An ETS inspection was conducted at 11:30pm following a complaint that smoking was being allowed in the establishment after 11:00pm. Upon entering the establishment at 11:30 pm,we immediately observed that ashtrays had been provided at the bar and on the tables. The ashtrays were dirty with extinguished cigarette butts in them. At the time of the inspection there were approximately 12 patrons in the bar and three were actively smoking. We identified ourselves and asked to speak with the manager;the bartender stated that he was the person in charge at that moment. We indicated that we were conducting an ETS inspection and that the dirty ashtrays on the bar as well as allowing and observing active smoking put them in violation of the ETS regulation. I told the bartender who identified himself as Fred that I was going to fill out a violation report and that the information would be forwarded to the Board of Health for further action. While the violation report was being completed another male, (possible an employee)who appeared to be in his late fifties early sixties years of age,wearing a green polo shirt(exactly like the bartender's)was telling the patrons who were actively smoking to put their cigarettes out. This man leaned against the bar(on the customer's side), and was looking over at both Michelle and I and was swearing calling us"assholes:' After the bartender was given the violation report he began debating the regulation,to which he was told we were not there to debate the regulation and we exited the establishment. (781)',40490 Fax 77-0432 Phone''` a (781)'477 + . T O 1 "? u k . •f..,, �.„ .<:;ks, www.nstcp.org 71 P"7 Ishment Ntune: N0. Address .. Owriers Name: Uo Person In Charge: Inspector: Date:" AM Time:; = M ' 0 T �: q7 \ Approximate Number of Patron(s)in Establishment .XItJ .. -'nc.'>.+��"A` rrarjp�tc:?yF'e't�•'.,1,:,: :4+:4: , r..ipy �.;.. {.. � „. • .. ... ..:- , ,ia i �Sm it a° o alem:" our a eh;+RRahon4 •r;1, �331$4i'�yy7'.. y� ;u'G� c .,te' .;F�„�":i .ry *tj1Ah:y: y.. �K .I W - ��' <i>m?g�a .,ea: Restroom.,~�OJher�. ...� ;,,s t- �" rtrY�•",``�!� �- ,� •i +b ,n ?+ay1� xN.u: 3�' ;k'�.gt -t, - `dxMf uT� ��3XiT °� }°�};1 '�i 5'+v ,"a 4y, U� + .. i°�'' ' t },%cej r� z..b'� , •,st+s'.,.-�t,'", ? 3\{' -e) '.'4Fe'Yd'-{a"' i=. d+,;y ;: n'uxtt>i .-,a y. �.'�Y%.' � i"•.:*.i:..s',f yi,;.t'.- .Y.Pj- ._;r.=:: mo_i,-.'�: �ir�' ry. � P •'3` ;w� �..y�¢,,fit 9..v' .,n. - yl'��'.- :� '.�._ .r*'..,. ,zAi'.': :� Si,� .,y.. y.�{`g,� 3;,.:�"w.r:; 3'y '�!>•"''T'N:' ;�:,.�ifu0l_�,�R�. -iiLy:� _ rr,_;4, .v+`' ...t;! 'fit k ❑` iolation.ofS'ror�o,skin;KIh: Area "Nof Ra ulate- d•SecionV Salem Board d oHeat�hRegulation E] Public allowed into-a private club"that holds an ❑ Public allowed into a room or hall of a private social .. Alcoholic Beverage License and smoking is present. function and smoking is present. #Person(s)Smoking #Person(s)Smoking ❑ Violation of Non Posting of Signs; Section VI Salem Board of Health Regulation , ❑ Entrance ❑Waiting Area ❑ Bar(Area) ❑Dining Area ❑Restroom ❑ Other ❑ Areas of Concern [Ashtrays Provided DOirty Ashtrays dor of Smoke rescnce of Smoke []Other ❑ Compliant and no areas of concern at time of Inspection Copy left at Establishment ❑ Copy Mailed to Establishment Date: Based on an inspection today, the items above indicate the status of compliance with the City of Salem's Board of Health Regulation#24 Information will be forwarded over to the Salem Board of Health and further action may follow. Board of Health-white/NSTCP Electronic/Establishment- Pink CITY OF SALEMt MASSACHUSETTS w BOARD OF HEALTH + •�¢{ 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA O 1970 v TEL. 978-741-1800 FAX 978-745-0343 _ ANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT October 19, 2004 Philip R. Shea, Owner Major Magleashe's Pub 268 Washington Street Salem, MA 01970 Dear Mr. Shea: On September 15, 2004 at approximately 11:30 PM, in response to a complaint, personnel from the Tobacco Control Program conducted a compliance check to determine if your establishment was in compliance with Salem Board of Health Regulation #22 concerning the Workplace Smoking Ban including restaurants and bars. At that time approximately three people were observed smoking in the bar and dining areas. Ashtrays were provided and the presence and odor of smoke were also observed in your establishment. Documentation is on file at the Board of Health regarding this violation You are in violation of Section D(1) and D(2) of Salem Board of Health Regulation #22. According to this section, it is unlawful for any employer or other person having control of the premises upon which smoking is prohibited by this regulation, or the business agent or designee of such person, to permit a violation of this regulation. Section G of this regulation states, "Any employer, or his or her business agent, who violates any provision of 'this regulation, the violation of which is subject to a specific penalty, may be penalized by the non- criminal method of disposition as provided in Massachusetts General Laws, Chapter 40, Section 21 D or by filing a criminal complaint at the appropriate venue. It shall be the responsibility of the employer, or his or her business agent, to ensure compliance with all sections of this regulation Violators shall receive a fine of $100 for a first violation, $200 for a second violation, and $300 for each additional fine within 24 months Therefore, you are ordered to pay a fine of $100 for the violation stated above since this is your first violation within 24 months. A check or money order payable to the City of Salem must be at the Board of Health office, 120 Washington Street within ten days of receipt of this notice. r • n , Should you be aggrieved by this Order, you have the right to request a hearing before the Board of Health. A request for such a hearing must be received in writing in this office of the Board oT Health within seven (7) days of receipt of this Order. At said hearing, you will be given the opportunity to be heard and to present witness and documentary evidence as to why this Order should be modified or withdrawn. An attorney may represent you. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection or _ investigation reports, orders, and other documentary information in the possession of this Board, and that any adverse party has the right to be present at the hearing. If you have any questions regarding this notification please call me at 978-741- 1800. Sincerely yours, 1 J.banne Scott Health Agent Cc: Christina Harrington, Board of Health Chairman James Gilbert, City Solicitor Joyce Redford, Director, North Shore Tobacco Control Program certified mail 70033110000519920434 i facsinide transmiW To: Jamim Scott fax: 978-745-0343 From: Joyce Redford Date: 10/25/04 Re; pow: 2 includes cover CC; ❑ur wd ❑For Review ❑ Memo Carward Cl Please Reply ❑PW"PACYCIS Joanne, We have received another complaint on Major Mag leash's regarding smoking after 11:30 p.m.,this complaint was received and referencing a violation that would have occurred after our most recent inspection and violation,which of September 15,2004. This ongoing issue with Majors is of concern because as you know Salem has had a regulation in place since 2001 and the State Law since July 2004. it seems the Board may want to consider exercising its authority,to further penalize this establishment due to their ongoing blatant disregard of the local regulation and the Boards jurisdiction. I remember the Board having to do something like this when Roosevett's was not willing to Comply with the ETS regutabon. Feels like we're moving backwards? : i'="r•, ._ ' _-,.r,�+, �"m`�'" 'qn...:ety4Yr^-'�a-..;Nr}+rr_.. . ., . . ,..'+y+,. ' .. - 'North Shore Area Boards of Health Collaborative Tobacco Control Program TOBACCO COMPLAINT FORM takm, IAA 01970 0 (978)741-5848 ��✓' (978)741-5850 Fax /�t BATE: (U - 1 V'-A CITYITOWN OF: SITE: ADDRESS: 1 nrrl 4n . COMPLAINTANT: rn nk)) TELEPHONF- NATURE OF COMPLAINT: ;r%1,&Lj, c)GA-• %r � z-c, - Dne m2rnhe� oP a Cy-oop aGtea rbe aA GShh2t.LA © OLWV'DX . :00Pm t�AS �otcl Cid 5rno1G%O %S Gt10 wa aper w.• Dom _ lr�.�€xr �rC dLA& U3eve kztbro rk 0kA- @ i�'r�� a0A poi- Vn �l-PisR. r c- -haws @ vn, Cpl¢ You rich, PERSON TAKINd COMPLAINT: a ACTION TAKEN: 0 C7 O a a 0 U O U U to INSPECTOR: DANVERS 9 LYNN • MARBLEHEAD • NAHANT • PEABODY • SALEM • SAUGUS • SWAMPSCOTT i SALEM BOARD OF HEALTH REGULATION#22 WORKPLACE SMOKING BAN (Replacing prior Regulation #22, "Concerning Prohibiting of Smoking in restaurants and Bars) A. Statement of Purpose: Whereas conclusive evidence exists that tobacco smoke causes cancer, respiratory and cardiac diseases, negative birth outcomes, irritations to the eyes, nose, and throat; and whereas the harmful effects of tobacco smoke are not confined to smokers but also cause severe discomfort and illness to nonsmokers; and whereas environmental tobacco smoke [hereinafter ETS], which includes both exhaled smoke and the side stream smoke from burning tobacco products, causes the death of 53,000 Americans each year(McGinnis JM, Foege W, "Actual Causes of Death in the United States", JAMA 1993 270:2207- 2212); and whereas in 2000, the Public Health Service's National Toxicology Program listed environmental tobacco smoke as a known human carcinogen (U.S. DHHS, 2000, citing Cal. EPA, 1997); now, therefore, the Board of Health of the City of Salem recognizes the right of those who wish to breathe smokefree air and establishes this regulation to protect and improve the public health and welfare by prohibiting smoking in workplaces. B. Authority: This regulation is promulgated under the authority granted to the Salem Board of Health under Massachusetts General Laws Chapter 111, Section 31 that "boards of health may make reasonable health regulations." C. Definitions: For the purposes of this regulation, the following words shall have the meanings respectively ascribed to them by this paragraph: Business Agent: An individual who has been designated by the owner or operator of any establishment to be the manager or otherwise in charge of said establishment. Board: The Board of Health of the City of Salem. City: The City of Salem. ■ Employee: Any person who performs services for an employer. Employer: A person, partnership, association, corporation, trust, or other organized ■ group of individuals, including the City of Salem or any agency thereof, which utilizes - the services of one (1 ) or more employees. i Enclosed: A space bounded by walls (with or without windows)continuous from the floor to the ceiling and enclosed by doors, including, but not limited to, offices, rooms and halls. Person: Any individual, firm, partnership, association, corporation, company or organization of any kind including, but not limited to an owner, operator, manager, proprietor or person in charge of any building, establishment,business, or restaurant or retail store, or the business agents or designees of any of the foregoing. Private Club: A non-profit establishment created and organized pursuant to M.G.L. Ch. 180 as a charitable corporation with a defined membership and in accordance with 204 CMR 10.02. If a private club holds an alcoholic beverage license, said license shall be a "club license" or a"war veterans club license" as defined in M.G.L. Ch. 138, section 12 and by the Massachusetts Alcohol Beverage Control Commission. Said license is subject to the terms set forth by the local licensing authority. Public place: Any building, facility or vehicle owned, leased, operated or occupied by the municipality, including school buildings or grounds; any enclosed area open to the general public including, but not limited to, retail stores, retail food stores, libraries, museums, theaters, banks, Laundromats, indoor sports arenas, auditoriums, inn/hoteUmotel lobbies, private and public educational facilities, shopping malls, common areas of residential buildings, public restrooms, lobbies, staircases, halls, exits, entrance ways, elevators accessible to the public and licensed child-care locations. Retail Food Store: Any establishment commonly known as a supermarket, grocery store, bakery or convenience store, or any other establishment that offers food items to the public for off-premises consumption. Retail Store: Any establishment whose primary purpose is to sell or offer for sale to consumers any goods, wares, merchandise, articles or other things. Retail Tobacco Store: An establishment that neither possesses nor is required to possess a retail food permit; whose primary purpose is to sell or offer for sale tobacco products and tobacco paraphernalia and for which the sale of other products is merely incidental; that maintains a valid permit for the sale of tobacco products issued by the Board of Health; and prohibits the entry of persons under the age of 18 at all times. Smoking: Inhaling, exhaling, burning or carrying any lighted cigar, cigarette, or other tobacco product in any fornn. Workplace: Any enclosed arca of a structure or portion thereof at which one (1 ) or more employees perform services for their employer. D. Smoking Prohibited: 1. Smoking is prohibited in all workplaces and public places except as allowed in Section F. of this regulation. 2. It shall be unlawful for any employer or other person having control of the premises upon which smoking is prohibited by this regulation, or the business agent or designee of such person, to permit a violation of this regulation. E. Posting notice of prohibition: Every person having control of premises upon which smoking is prohibited by and under the authority of this regulation shall conspicuously display upon the premises "No Smoking" signs provided by the Massachusetts Department of Public Health and available from the Salem Board of Health or the international "No Smoking" symbol (consisting of a pictorial representation of a burning cigarette enclosed in a red circle with a red bar across it) and comparable in size to the sign provided by the Massachusetts Department of Public Health and available from the Salem Board of Health. F. Exceptions: Notwithstanding the provisions of Paragraph D of this regulation, smoking may be permitted in the following places and/or circumstances: 1. Private residences except those portions used as a child care or health care office when operating as such. 2. Hotel and motel rooms rented to guests that are designated as "smoking rooms", provided that at least 75% of the rooms are smokefree at all times. A room so assigned shall have signs posted indicating that smoking is prohibited therein and shall have self-closing doors. No change in room designations shall take place without prior written approval of the Board of Health. 3. Private or semiprivate rooms of nursing homes and long term care facilities, which are separately ventilated, occupied by one (1) or more patients, and all of who are smokers who have requested in writing to be placed in rooms where smoking is pennitted. 4. Private clubs that have it cap on all types of memberships; where Ley access is required for entry; where all employees are members; provided that there shall be no smoking in any part of the building when any part of the building is being used for a function open to the public or when any part of the building is used for a private social function other than club functions and at members-only functions unless the followmg conditions arc met during such a function: .. . . a .. �: . .. i• '�'' a • Smoking occurs only in those area(s)that are members only • Such an area, or areas, is physically separated from the rest of the building by floor to ceiling walls and self-closing doors • Members only area is under negative pressure in comparison to function area • Such an area, or areas, has a separate working ventilation system • Such an area, or areas, has separate make-up air • All building code requirements must be met Private clubs established after the passage of this regulation shall not be considered an exception. 5. A Retail Tobacco Store separated from other establishments by a solid wall or self- closing door, all of whose entry doors bear a sign of dimensions at least 12 inches by 6 inches stating, "No one under the age of 18 is allowed." Retail Tobacco Stores established or sold after the passage of this regulation shall not be considered an exception. 6. Open-air outdoor or sidewalk seating,provided that a) said area is not artificially heated or cooled; b) said area is not enclosed, except for one side which may adjoin the building; c) the outdoor space and the indoor space are, where they adjoin, separated by a solid wall and self-closing doors such that smoke cannot enter the indoor space; and d) customers cavy their own food and/or drinks to the area and are not served in this area by wait staff. G. Violations: Any employer, or his or her business agent, who violates any provision of this regulation, the violation of which is subject to a specific penalty, may be penalized by the non-criminal method of disposition as provided in Massachusetts General Laws, Chapter 40, Section 21D or by filing a criminal complaint at the appropriate venue. It shall be the responsibility of the employer, or his or her business agent, to ensure compliance with all sections of this regulation. The violator shall receive: 1. In the case of a first violation, a fine of one hundred dollars ($100.00). 2. In the case of a second violation within 24 months of the date of the first violation, a fine of two hundred dollars ($200.00). 3. In the case of three or more violations within 24 months of the current violation, including the current violation, a fine of three hundred dollars ($300.00). H. Enforcement: The Board of Health and its designees shall enforce this regulation The Board of Hcalth and its designees may inspect an establishment Ibr compliance with this regulation during rouUne code enforcement inspections and/or during periodic, unannounced inspections of those establishments subject to this regulation. Any citizen who desires to register a complaint under this regulation may request that the Board of Health initiate an investigation. — 1. Severability: If any paragraph or provision of this regulation is found to be illegal or against public policy or unconstitutional, it shall not affect the legality of any remaining paragraphs or provisions. J. Conflict with Other Laws or Regulations: Notwithstanding the provisions of the foregoing Paragraph D of this regulation, nothing in this regulation shall be deemed to amend or repeal applicable fire, health or other regulations so as to permit smoking in areas where it is prohibited by such fire, health or other regulations. K. Effective Date: This regulation shall be effective as of January 1, 2044 As voted by the Board of health on Mayl3, 2003 with a vote of 3 in favor, I abstained, and the Chair abstained as is custom except to break a tie. Amended December 16, 2003 to allow smoking in private clubs with conditions; and in outdoor restaurant areas not served by wait staff with a vote of two in favor, one opposed, the Chair abstained as is custom except to break a tie. Christina Harrington, Chair Date This regulation shall take effect January I , 2004. City of Salem Board of Health 120 Washington Street Salem, MA 01970-3523 Joanne Scott, health Agent Christina Harrington, Chairperson Martin Pair Irving Ingraham, Mi) Mary Leary Mi.roslaw Kantorostnski Lucy Corchado Mary Madore Barbara A. Sir0is, t:J('rk of the Board A summary was published in the Salem Evening News January )3, 2004 1' I.A........ w . eA..a• R,h......... +.. .. "'rr^w w_!"' Mt--ti yti..w^...,. _ ..« ., ¢ f Public Health Salem Board of Health Massachusetts Department O 120 Washington Street,4°i Floor Divis!R,n of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978)741-1800 Fax (978)745-0343 Name i ` y� / Date f ) ( Type of Operation(s), TYoe of Inspection rdoalea;5he� h'uE i 7 /�7/dA 2 FoodService &�-Routine Address �p g / , lit-/V 31 .a� I Risk ❑ Retail ❑ Re-inspection Inspection wa IJ �1' Level ❑ Residential Kitchen Previous Inspection Telephone A ❑ Mobile Date: ❑ Temporary ❑ Pre-oporation Owned_ tri" rJ �1_�� HACCP YIN I ❑ Caterer ❑Suspect Illness Parson in Chargb(PIC} /� Time ) ❑ Bed&Breakfast ❑General Complaint I,-:. �],I_n: (( ❑ HACCP Inspector ,1 -Dm4 t j Lr+�Xt�J't�f) �£ L f? Alt 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 (lyf2.Prevention of Contamination from Hands El1. PIC Assigned/Knowledgeable/Duties �- 3.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 TIMEtTEMPERATUREcONTROLS(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. 6eparation/Segregation/Protection ❑20.Time As a Public Health Control 9/Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) [121. 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 �e 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 r 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 4. Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of 5. 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: I fj j S 5.40MIs 1F11 6 14 d. �/D ' pr' r tore• ,./ }/ / Print: f ! r r is V Signature r r I Print: {„�� ( ��.-�^1/ Pagel of Pages J Violations;?elated to Foodborne lliness interventions and Risk Factors(items 1-22) PRI"Tt-CTION 01 I#F CONTAMINATION FOOD PROTECTION MANAGEMENT g j C,°ss-con!_:::,naron 1 I >9t).003(A) Asvlgnmem ul'Respow ibik j j 1-302.; :(Ai(I, ! Raw Animal Foods Separated h'nm 596.003(H) D•_n'ons;r.uinn of Ermowledgrz' Co;,}:rc.xxl RTE h)o,z"' 2-1'.+' tI Frtaonincharge -duties ComamBtatrn,',D-Raw;^gredrents 3-Ni2A ItAY2) Raw An'rnal TOO ls. Sepsaedfrorn Each EMPLOYEE HEALTH I Other" 2 590.003(C) Responsibility of the person in ehal3{e to CrntamGaUicrr from Gia Ehvi+onment require iepoi"onry I)y foot}employees an 3-302 11 A) Pmu Ft oteOul'o" i tpl:.1icatu ' 3:30? 15 'Aasn:ng Fruits.,;id veg-_nasi^:: 590003(,F) Responsibility Of A Fooj EmnloYce Or Art lI 3-304.1 I Food C'sntct Equipment and Appiicaut to Rrpoil To The Prrnun I» ( Utew;ih,t Cha(ge' Contarnu,atron t.om the Consumer ` 590.00.;(0) Reporting by Person in Chane' 3-306.14; )(4) Rettuner i,-.oil and 12eacn•ice of Food- 11 ood^31 590 003(➢) Exclusions and Rcstrctirms" Ursp osrim otAduiterated orCon!a.minaf,,d 590 rC:#t 13) RentoNal of Exclusions and Rertnrh-ms + F0°d 3-7 0 1.11 U:;r•aril;np;:o'Recorditio.^,inf'linaafe FOOD F-IOM APPROVED SOURCE Lout" d Food and Water From Regukried Sources 9 Food Contact Surtaces 590.JiN7t A-Bl Cumpliune with Food Law-° 4-501 !! Manual Wt�rz.washme-Hoa Water ! 3-201.1'_ Good in a Heratctically Scaled Cuntannrr" Sanitisation Temporal Tres 3-201,13 Fond .Milk and Milk PrnducL'" `+01.112 Nlrfiao nii,d Warewashinblot Water S,,riHrati,m Tempennture::" She(; El-',W _ I ! 4-5(1!.11: {'heuural SaniIiIntroit- temp.,ptl, 3-202. 4 F1,,9.., and ;bail}:Products. Ystctt!izetC s::m'rotre!:.:n and ha,dues. ' 202.16 lee ',,bide Paan Ytdehle Prinking tie.aer" 4-661.1 t(A) Fonipmen' P"A Conoid sur;:,ce,and 5-lot.I I Drinking Water front au Apr) ,wod Systeo:^ ' ! !itensils Clear" 590.00b(A) !iuttled Drinking Water' 4-n(t2.1 I Cleaning r res ,.t cv of Equipment anent Food- ( g' r' - 9 I 590 006(F) Waren h gets Standards i, 310('A^.R Source Contact Surfa,es anal Utensiis* ,Shell/ish and Fish From an Approved Scurre a-7;;7 I I Frequent,of Sanitization o*L't-_nsils and 01.14 Fish and Recruationai!y C.mght Mollusc.ot ! I :{('o-'1m`:, :Surface,,, ,.rhr.es of&;m;: nrut^ .-201. -.• Shellh`'l`V Fo:*�t=703.`1 Afi.thods of sa:uuzatien-- FIoL Water x14 ! 3-201.15 A4ullusrtn Shel!tish from NSSP Listed ! t hennaed' Sources ( 10 j ! Proper,Adequate Handwashing Game and Wild Mushrooms Approved by ! , I Regu:atory Au!honry j --3u1 Is Clean Cuuunion--Hard!;rad Alms` 202.13 Shelktocl:Identification Presrnf` ( ( ?-301 12 Cleaairr P,%,velure" 5'40.004(0 Wild Mus-hntom;* I 2-;ill 11 When to Wasox 3-20!.17 Game Awmah,{ j it ( Good Hygiar+ic.Practices q ; Receiving/Condition i 2-d0i. I F:11; )>.DrmLilu ur usiag l'uod'"'o'' 3-702.1! Pffs Received at Proper Temperatures* j ?-401.`2 Oisshargr.,I i.,m the Eyes. Nurse and Mouth^ j 3- R.15 Pac}:age htteenty" i 1 12 Pieventrn,Gmtaminxtion Wher Tasurg't 3-201.11 Food Safe and Unadulterated Tags/Records:Sheilstock j 12 Prevention of Contnmina#Pon bout Hands j +202.18 Shellstrkk Identiticanon* ( 590.Wi(E) Pie;enmiiw Coni:: tinntien from 12 Shelistock Idcntific:aiortMaintaincth j E:npi(yes• ! ' 13 I rlandwash Facilities TogslRecords•Fish Products I Co m'enienny Located and Accessihls 3-102.11 Parasite Destruction` 3-402.12 Records.Creation and Retennon* j 5-203.11 Numbers and Capacitizs` I Lobelin of Ingredients' 5 204.?1 Location an(l P!ae'ement" 590.00-40) 9 9 5 _05 I i vcaessibii'ty. Operr.t:on and Mnmteuamce j 7 /HACCPtPlan with Approveri Procedures /HACCP Plans SurFheu'is^G`�3cac and rand Dr}a�-.,q Del ceL 3-50:!.11 _ _svc,ialized Frocmiel, Methods, i 2 , , , : o--0:.:: lhunbxushiaeCi:arsm Av iiabihty j 3-562.!'3 Reduced ax}•gen pacl:apiug,crueria" 6 30 L 12 Hall(] Dr 8-1(,3"12 Confili trance with Appruaed Procedure:" yi",1,Pf,:-iyoc' Du,„icz ui:icai uc:n] 71r. !zcie,ai I) PuuJ Codc nr 105CMR590:1(➢), r r ih CITY OF SALEM t vv11�� / / BOARD OF HEALTH ` Establishment Name: M)I'm /i/o C� lea's AR S pu d Date: 9 Page: 02 of 3 Item Code C-Critical item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY oc�lin� ln�no��finr � nbin� -Hw -,� /l/)io/iia ` — 2'J �rnn F �� ) n /,iho�� pr�i7�v� rawrl brl • lI c�fJPn rtx�s 7b PX XPi/) /;i? )I JAI- ISP. <'�el 1 a 4 Yurx nt)4 hoinq wove towrl h.avdl it ), C3 I C — l iP J l09Grp- h/ril10v ` I V�Jlt,c _ Cn�1nl� .' LLao 1)4 nlI — of I e - r, , i _ (n�int� �i�hP� f_STL(lVll/h/ I�an�rr0 /J�2 _�QSJ)Y r�r hod 50 OF . - rn rnvs4 GAP rnarrrfzr111 (24 4/ e dip � P I 4( Or holm ) as nllfida a . ' toh r nH 1-,1„- Luhoi-e n'cc/rzy t "11A o7n 0 4kS pnn r vim 0 0-4 'Z2 P 4/ F ov faolZ � C lMa oA(-f nnf ✓2� C' - otZ �Ilnc ti V'_e hNnQ In i('o- -A�P- cc2S47,rvLC1,1S dV?I) )C�; j KDC)+h I n9 +a kA--- si-?)Wd in i Ge. (:�3 r A6!a�rna v- C,(nSwYL P oh+nn nc' -}Topi . IPCEI, fi .Srzrlk 17 �P Iro .C'ripvD F ') rte P000 {1na1rl(i 'Qiff ' un /an YN ZI,? ( l�rn/7 a14Cr ` P(a �Q 2�1 .�/9h , fi vn� /nrt {ri /VlQ/1 �Qh(�o/�"lnn �nrrt,� T�ntV T- - i3 — +f�� hrf �rn� �� h�v hrrf n�� ca�r(� 072 0(2f)Pv47-)L ,P( (� -l0r1lnor fn Piro M rin �vn 0 + -Ivt [)0;, )( op t� n F Vl,l ns . e Discussion With Person in Charge: Corrective Action Required: I ❑ No I ❑ !es F_ 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 LI Re-inspection Scheduled ❑ Emergency Suspension ` comply with all mandates of the Mass/Federal Food Code. 1 understand that t noncompliance may result in daily fines o,twenty-five Ilars o sus ension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: �'a 3-5u1.14(C) PHFs Received at Temperatures Violations Related to Foodborne i0ness!iter venticns Rnd Risk According to Lnty Cooled to Factors(Items 1-=,% (Cont) 41'F745'F W(thin 4 Hca1 .' PROTECTION FROM CHEMN-GALS SO1.15 Cooling Methods fitr PHFs 14 Food G:t:O,Or QddlYi'J2S 19 PHF Mot and Cold Holding ( 3-501.16(B) G>Id BHF, Maintained at or btiow 3-702.12 Additives' J90.064(F)004(F) 11"745" F` 3-3ri7.11 Poison u 'roto Un Subs a AcdiUv:e'= 3-501.16(A) Hol F'HFs Maintained at or above 115 Poisonous G:Toxic Substances I 110"F * I 7-t0Ii.II Identifyinginfu:(edtunt 3-50116(.1) Roasts Held atorabove130'F. '" Containers' 7-102.1 ! Corroon N:+nt.. -Work:ur r'auta:nerc' I 241 Time as a Public Health Control 7-301J3 S-cat aoun--S:;,rage" 3-501.19 Tim:as a Public Health C)101 l'" Variance RaUnircate..: 17'' '_.11 Re-trio:o:: --Pre.enez and Use I 5y0,001f til (1 7-202.12 Conditions'If?Ise" 17.203.11 T1 Kic Con nines:-Prohibitions' REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 17-_04..: Sattitizers. ,:ricin:-::.hemicalr:" i POPULATIONS(HSP) 7-204.!2 Chemicals Inr Washer PrU(1ltCe.Cr'itaria" 121 3-X01.1 I(A) Unpasteurized Pre-packaged Juice:and Beverages with Warning Nabcls' 7-204.14 Dain;:,�geats.Criteria 13-901.1 I(B) Use of `Pasteurized E ,' 7 205 1? Incidental Food C'outac' . Luhrican's'- I I ked 3-8111 11(D) Raw(it Partially Cooked Animal Pond and j 7 106,1' Rearmed U,ae Pet.ik :s.Crnena" Raw Seed Sprouts Not Served. '. 7-2(16.:2 Roam( Dart Stations 7--305.!3 'I'ra.:king Poscderc.Test Cnntiol tied 13-901.�1(C) ( Unopened Food Package Not Re :served. Mon iwrin;r' CONSUMER ADVISORY TIMEiTEMPERATURE CONTROLS 22 3 603 1 I Consumer Advisory Posted for Consumption of Animal Foods'17tat are Raw. Undercooked or 16 Proper Cooking Temperatures far I PHFs Not Otherwise Processed to Eliminate 1 3-401.1 IA(1)(2) 5 ! -� r 15 Sec. - - Pathorrns.;. ,=uernve v,aoar `+ I 8I^=s-1111111al:ate Service 14?`P15&ec'r €€3-302.13 Pastenrited Fgg<Substitute for Raw Shell 13-401 II(A)i2) Commnmted Fisr: k1,-s&Game ( Eggs* I nirrwlc- 1',5"F I'+sec. " SPECIAL REQUIREMENTS 3-401.1liffy!l(2) Pork ant; ice]Rotnt- 130"F 121 unit" 3-401.11(Ap.2) Ratites. lejectedLFeats- 155°F 1.5 5900')Y(A)-(D) ViolalutnsofSection 590.009(A)-(D) in Six, ': catering, mobile food, temporary and 3-401.! 1(1)(3) Puuhry, W'ildCiante,Slulled PHFs, resicictltial kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Poul ry or Ratite<-165017I5.sic. :: I above if related to foodborne illness :3-401.11X)(3) 4vrnolo-:nas.ie,Intact Beef Steaks interventions and risk factors. Other i45-F 590.009 violations relating to goad re'ail 34M.i Z Raw Ar.anal P.,od- Couked in e practites should be debited under f{29 - Micirwave i 65`F ' I Special Requirements. 3-401.;ll:.1(1)tb) All Other PHFs-- I.0 F 15 see. * I 17 Reheating for Slot Holding VIOLATIONS R-LATED TO GOOD RETAIL PRACTICES ,403.11(,,k)&(0) PI IF: 165-'F 15 sec. (Items 23-3(1) 3-403.11(6) Micri ave- [65"F 2 Minute Standin;, Cinical and non-critical vwlahanv, which do nal relate to the Tina•'" foodborne dlnev.i inerverviass and risk rn tors lisird above, con he 3-40;3.i.(") Commercially Pcmensed 11TE FtK)d- found in theJollowing sections q/the Food Cade and 105 CAIR i40"F I _590.000. 3-4011 U,EI Ramainv-_@ Onsh,rtl Portions,of Beef ', Item Good Retail Practices FC 1590.000 Roasts"° 23. Management and PersennRi FC -2 .003 118 ( Proper Cooling of PHFs I __ Food and Food Proieetion FC-3 004 25 Equipment and Utensils FC-4 5105 3-501,[4(;1) Cooling Cooked FUN front 140"F to 26. Water,Plumbing and W este FC--S A06 70"F Within 2 Hones wid From 70"F 1 27 Physical Facility FC-6 007 to 41'F/45'F Within 4 flows. " 1 28. Poisonous o1 Tox:c Materials FC-7 .008 3 501,I-t(F) Cooling PHFs Made Front.Ambient 29. Special Requirements 009 i Ternpet-,inn: tngredicntsh,4!"F145'F 130, Other Within 4 Uoutyrr 'Deuae,=tical ie m 16 Federal 19 V Fore C-de or 105 C s!k Y 0 000. CITY OF SALEM y1I� BOARD OF HEALTH vin ' I Establishment Name: \ l Its On t r cAq on S Date: � Z� O� I Page: � of 3 Item Code C-Critical Ite DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date 1 No. Reference R—Red Item Verified PLEASE PRINT CLEARLY �S N%� i-YQn r hn rV) -�h0wo0rifQ l P►2 . }7�mvtcl� Vtsibl� Guy e -- .1. -) h o vt n 6at_sre(Z cm I n 1n ( n o of OW n -I fn cep O-C 4-F O-f2Gs Y 'v)rt.. A�'A� E 1 11 k I a-1ry��A >nsht•n� 1 Aery 57 of I` S rh rnn 1 I - 12 orlL- -6 1 47rr�cl I - I Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes Voluntary Compliance / Pliance ❑ Employee P Y ee Restriction I have read this report, have had the opportunity to ask questions and agree to correct all ❑ VoExclusion 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 finesy-five or sy�Trevoc/ ation of ❑ Embargo ❑ Emergency closure your food permit. / /(/Jf ❑ Voluntary Disposal ❑ Other: 3-511 14(C) PHFs Roso ivied at I'cwperamres Violations Related to Poodbotne tRnes3 m':,vendors and Risk .Accoidmg to Law Cooled to Factors(Items 1-221 (Cent; 41 FlAS"f Within d Hoot,;, ' PROTECTION FROM CHER??GALS 15 Coulin;Methods i'or PHFc -202.12 .'ufditi,es` 19 FHF Hot and Cold Holding 11 Food Color Additives3-501,16(R) Cold PHFs Maintained at or below 590.004(P} 41"'145°F- 3-3()2,11 Protection '1em (In-:ppru•:ed Ac+lu+v^,;- 1S Poisonous cr Tor.',c Substrates 3-501.16(A) Ilot PHFs Maintained at or above 4o°F Coutainers"nbfers14 n.:ahon -On I inai 3-501.16(A) Roasts Held atorabove 130`'17 ' 7 1`r2 if 1211 Time as a Public Health Contrd 3-501 19 Time as a Public Health Control" 7-2CiL11 Sepata[i::n-9,a'aee' 5940040-1) VarianceRe(Ltirernent ! 7-202 11 Re,trictnon-Pmneme and (ire' { 202.i2 1 Conemions of tJse" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203 11 'finis G.::nainetsmcr--- hemicvds'- POPULATIONS(HSP) 7-204.1! I Sanitizecs.C:n:er;, -Chemicnts�� 7-204.12 Cliemica;, 6)r WasFing Produce.Criteria" 121 3-SOL I I(A) Unpasteurized Pre-Packaged Juices and 7-204.14 D'eonia ' er.ts.Crirerria' fievemges with Warning lab 7-205.11 Incidental Food Contact. t_nln,rants^ I 3-8U1.11(LU Use of Pasteurized Eggs" 7-206 11 Rcaric.trd Use Pesrie:;iza.Giteua" " 3-80i.11(D) Raw or PartiallyCoked Anunal Food and ( C i Raw Seed Sprouts N�+t Served. m I 't-206J2 Rcxicni Rant Stations 1 206 13 'i':-:ckmg P,v.der., Pest Control ::ad 3-801.171 C) Unopened Food Package Not Re-served. A4rnio-.rin;;^ CONSUMER ADVISORY TIMEIfEMPERATURE CONTROLS 22 3"603.11 Consumer Advisory Posted for Consumption of 16 I Prayer Cooking Temperatures for Animal Foods That are Raw.Undercooked of PHFS Not Otherwise Processed to Eliminate Elrx[tlm r:rCJn 3--101.11A(L(2) i ,gs- 1"-F 15 Sec. ( Pathogens.' T'gas-hnmcdiatc Srrice 145°P;5.,ccr I . 302.13 Pasteurized Eggs Substitute for Raw Shelf 3-401.111A)(2) Conurvinned Fis^, Mears:`Genre Eggs,,' Animate-orgy _ Beef r 15 sec. SPECIAL REQUIREMENTS 3-441.11(BiC!)(.) Pand Beet Roast - 130'F ;21 nun* 3-all.l I(A)i'_; Ratrres. lnjc-:ted Nicals- 155'•F' 15 590 009(A)-(D) Violations of Section 59n.009(A)-(D)in sec. I catering, mobile food, temporary and 401.1 f(A)V) Pou;try, Wild Game,Stuffed I'FIP::, rucidential kitchen operations should be Stuitiuet Coin:oning Fish,Meat, debited under the appropriate sections Pointe= or Rt,T1Gs-;651' 15 se,:. '° above if related to foodborne iJlnecs 3101.1!(C)f t) Whole-nmsclr„ Intact Bret S+e:iks interventions and risk factors. Other 135°F ! 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Ccokcd in a p:a ticcs should be debited under h`29-- Nlicroa+av: 169 "F' Special Requirements. 3-40111(A.+;!)(bi A.11 Other PFtF3- i-f5`F 15 see. 17 Reheating for Hot Holding VIOLATIONS R°LATED TO GOOD RETAIL PRACTICES 3-403.11(A)&�(D) PHFs 165'F 15 sec. ' (hems 23-30) 3-403.11(B; Microwave- ;65' 1-2 Minute Standinn, Crilual and nun-critical violations, which do nu:relare to the Time* foodbri-ne dlnes.s intervenRuns and risk)actors listed above, can be ---403.1 :(C) Coiumercially Proc-;;sed RTE Food- found is rhe fi,pmving serlion.s of the Food Code and 105 011? 130'F° .590.0()0. 3-403 1 It L) Rc:;,wining Uns iced Pun;one of Beef Item Good Retail Practices FC 1 590.0(10 Roasts' � 23. Management and Personnel FC -2 ' .003 1g Proper Cooling of FHFs 24. Food and Food Protection FC--3 .004 ( 25 Equipmerd and Utensils FC-4 005 3-511.14(A) CoolJI n:g C'<a>}:cd PHP. from WO`P to I pg, Mater. Plumbing and Waste FC-5 (--006 70'P Within 2 llouc and From'70"1: 27. Physical Facnity FC-6 .007 j to=t 1`Fi45`F Within 4 Hours. s 28. Poisonous or Tox+c Materials FC-7 1 .008 ?--'SJ ' T,-r+peratute ruc;redientsjw 4(`14( 45-F 130, Soixaal Reoulrement� .003 Other Within 41,our;;: i 1 1:i,B) Cooling PH:,Made Fri 29 Denotes ef.....al item r.;ns 0y9 F,(,d t-ud,,•,) p+5 Cp-11:5901n1f). ■ Complete items 1,2,and 3.Also complete A. Sign item 4 if Restricted Delivery is desired. 0 Agent ■ Print your game and address on the reverse X 0 Addressee so that we can return the card to you. - B. R ed by.F�nred Na e) c.pate of Delivery ■ Attach this card to the back of the mailpiece, / e l S, e , //'1 9 n or on the front if space permits. 01 .v tV V !1" _ D. Is delivery address different from ffen)'l? 0 Yes 1. Article Addressed to: If YES,enter delivery address below: 0 No Philip R Shea Major Magleashe's Pub 268 Washubgton Street Salem, MA 01970 3. Service Type 0 Certified Mail 0 Express Mail { 0 Registered 0 Return Receipt for Merchandise 0 Insured Mail 0 C.O.D. dg 4. Restricted Delivery?(Extra Fee) 0 Yes 2. Article Number 1 7003 3110 0805 1992 0434 , (Transfer from service labs .. -1 .I PS Form 3811,August 2001 Domestic Return Receipt 102595-02-10-1540 UNITED STATES POSTAL SERVICE Fir6t-Class Mail UStae &Fees Paidg Pe No.G-10 • Sender: Please prme, address, and ZIP+4 in this box OF * OF HEALTH LEM, MA 01970 OpPP 11-1.11 M.1 U.S. Postal ServiceTIA m sCERTIFIED MAIL. RECEIPT (Domestic.Mail Only; 0 ru Ir FFICI L 'USE Ir rR Postage $ ul p Certified Fee C3 Retum ReclePt Fee POHstemre (Endorsement Required) C3Resbioted DelNery Fee rq (Endorsemem Required) r-1 m Total Po ,$ Postage&Fees m J p sent To IC3 I(`' Sir;iWMC(o___------------__________________________________________________________ or PO Box No. ....................................................................................... I C*Slere,nPW I iS]siu£tuS!__a QSu6I III 61 116111 1 d Ik..I:'aa Laumsa a L.a.uw_acsas Certified Mail Provides: (OWAO'y)y00a eunr'ooec==i ad ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminderg ■ Certified Mail may ONLY be combined with First-Class Mail&or Priority Mail&. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811?to the article and add applicable postage fo cover the fee.Endorse mailpiece'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS&postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agnt.Advise the clerk or mark the mailpiece with the endorsement"Restrictedelivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail I receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an Inquiry. Internet access to delivery information is not available on mall I addressed to APOs and FPOs. Memo IEP 2o2004 CITY OF SALEM BOARD OF HEALTH Date: September 16,2004 To: Joanne Soott, Health Agent From: Joyce Redford, Program Director and Michelle Cremins, Compliance Inspector RE: Salem Tobacco Inspections On Wednesday evening,September 15,2004 Michelle Cremins and I conducted Environmental Tobacco Smoke(ETS) inspections at the following establishments following reported complaints. Compliant Saint Joseph's • An ETS inspection was conducted at 8:45pm following a complaint at the Saint Joseph's BINGO event, being held on 156 Federal Street. No violation was found at the time of the inspection. Non-Compliant Major Mac Leash's • An ETS inspection was conducted at 11:30pm following a complaint that smoking was being allowed in the establishment after 11:00pm. Upon entering the establishment at 11:30 pm,we immediately observed that ashtrays had been provided at the bar and on the tables. The ashtrays were dirty with extinguished cigarette butts in them. At the time of the inspection there were approximately 12 patrons in the bar and three were actively smoking. We identified ourselves and asked to speak with the manager;the bartender stated that he was the person in charge at that moment. We indicated that we were conducting an ETS inspection and that the dirty ashtrays on the bar as well as allowing and observing active smoking put them in violation of the ETS regulation. I told the bartender who identified himself as Fred that I was going to fill out a violation report and that the information would be forwarded to the Board of Health for further action. While the violation report was being completed another male, (possible an employee)who appeared to be in his late fifties early sixties years of age,wearing a green polo shirt(exactly like the bartender's)was telling the patrons who were actively smoking to put their cigarettes out. This man leaned against the bar(on the customer's side),and was looking over at both Michelle and I and was swearing calling us"assholes:' After the bartender was given the violation report he began debating the regulation,to which he was told we were not there to debate the regulation and we exited the establishment. Il North Shore Area Boards of Health Collaborative Tobacco Control Program 85ExchangeStreet, Suite A7 (781)477-0432 Phone Lynn, MA 01901 INSPECTION REPORT www 477-0490 ns cp.o g Fax �( /'Establishment o Address: VTI -f t) ��`tf� (�rc y N0. Owners Name: Inspection Person In Charge: Routine ❑ Inspector: Date: Time: AM M Follow-up ❑ CIA �� : Complaint [w \ Approximate Number of Patron(s) in Establishment t-� Other [,violation of Smoking in a Prohibited Area; Section IV Salem Board of Health Regulation ❑Entrance ❑Waiting Area Ek ar(Area) [96ining Area ❑ Restroom . ❑ Other #Person(s) Smoking 21 ❑Violation of Smoking In An Area Not Regulated;SectionV Salem Board of Health Regulation ❑Public allowed into a private club that holds an ❑ Public allowed into a room or hall of a private social Alcoholic Beverage License and smoking is present. function and smoking is present. #Person(s)Smoking #Person(s) Smoking ❑ Violation of Non Posting of Signs; Section VI Salem Board of Health Regulation ❑ Entrance ❑Waiting Area ❑Bar(Area) ❑Dining Area ❑Restroom ❑ Other ❑ Areas of Concern Ashtrays Provided V irty Ashtrays Vdor of Smokeresence of Smoke ❑Other ❑ Compliant and no areas of concern at time of Inspection �I Copy left at Establishment El Mailed to Establishment Date: v+ - � Ile, � ' Based on an inspection today,the items above indicate the status of compliance with the City of Salem's Board of Health Regulation#24 Information will be forwarded over to the Salem Board of Health and further action may follow. Board of Health-white/NSTCP Electronic/Establishment-Pink CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH .. 120 WASHINGTON STREET, 4TH FLOOR c SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. .JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT October 19, 2004 Philip R. Shea, Owner Major Magleashe's Pub 268 Washington Street Salem, MA 01970 Dear Mr. Shea: On September 15, 2004 at approximately 11:30 PM, in response to a complaint, personnel from the Tobacco Control Program conducted a compliance check to determine if your establishment was in compliance with Salem Board of Health Regulation #22 concerning the Workplace Smoking Ban including restaurants and bars. At that time approximately three people were observed smoking in the bar and dining areas. Ashtrays were provided and the presence and odor of smoke were also observed in your establishment. Documentation is on file at the Board of Health regarding this violation. You are in violation of Section D(1) and D(2) of Salem Board of Health Regulation #22. According to this section, it is unlawful for any employer or other person having control of the premises upon which smoking is prohibited by this regulation, or the business agent or designee of such person, to permit a violation of this regulation. Section G of this regulation states, "Any employer, or his or her business agent, who violates any provision of this regulation, the violation of which is subject to a specific penalty, may be penalized by the non- criminal method of disposition as provided in Massachusetts General Laws, Chapter 40, Section 21 D or by filing a criminal complaint at the appropriate venue. It shall be the responsibility of the employer, or his or her business agent, to ensure compliance with all sections of this regulation. Violators shall receive a fine of $100 for a first violation, $200 for a second violation, and $300 for each additional fine within 24 months. Therefore, you are ordered to pay a fine of $100 for the violation stated above since this is your first violation within 24 months. A check or money order payable to the City of Salem must be at the Board of Health office, 120 Washington Street within ten days of receipt of this notice. Should you be aggrieved by this Order, you have the right to request a hearing before the Board of Health. A request for such a hearing must be received in writing in this office of the Board of Health within seven (7) days of receipt of this Order. At said hearing, you will be given the opportunity to be heard and to resent witness and documentary evidence as to why this Order should be P rY Y modified or withdrawn. An attorney may represent you. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection or investigation reports, orders, and other documentary information in the possession of this Board, and that any adverse party has the right to be present at the hearing. If you have any questions regarding this notification please call me at 978-741- 1800. Since rely yours, , J- anne Scott Health Agent Cc: Christina Harrington, Board of Health Chairman James Gilbert, City Solicitor Joyce Redford, Director, North Shore Tobacco Control Program certified mail 70033110000519920434