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MCSWIGGINS IRISH PUB AND RESTAURANT - ESTABLISHMENTS McSWIGGINS IRISH PUB Av PUB & RESTAURANT toD�k Q 121 ESSEX STREETS i a a I e tr ° w Sal Massachusetts Department of. Public Health 120 W Board SHealth Department 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 ( Date T e of O eration�) T e of Ins ction Food Service El Routine Address Risk 1 ❑ Retail Z Re-inspection 1 S _ Level ❑ Residential Kitchen Previous Inspection Telephone _ ❑ Mobile Date: Owner HACGP YIN ❑ Temporary 171Pre-operation r ❑ Caterer ❑Suspect Illness 0erso in Charge(PIC) I Time ❑ Bed&Breakfast ❑General Complaint In: Oa 171HACCP Inspector Permit No. ❑Other o Out. 3 Each violation checked requ res 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 ❑ 1 q.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 TIMEtTEMPERATURECQNTROLS.(Potentially hazardous Foods) ❑ ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION - ! ❑ 19.Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) _r El 21 Food and Food Preparation for HSP E31 0, Proper Adequate Handwashing+�r� "CONSUMER ADVISORY- Ll 11.Good Hygienic Practices . [122. Posting of Consumer Advisories Violations Related to Good Retail Pr 'umber of Violated Provisions Related Critical (C)violations marked must be corrected- o 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 by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2)(590.003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food 26.Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: s:s9pnspecrFo,ms.ra.eoc � i-^: '�Yjt]•U�'-- C Inspector's Sign3lur • ! Print: _ Page < 00-Pages PIC's Signatarer s Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 8 Cross-contamination 1 590.003h A) Assignment of Responvbility" 3-3,02.11(A)(1) Raw Animal Foods Separated from 590.003(B) Demonstration of Knoeledit, Cooked and R fE Foods* Person in charge--duties --� Contamination from Raw Ingredients 3-30211(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other* 2 590.003(C) Responsibi lity of the person in charge to Contamination from the Environment require reporting by food employees and 3-302A I(A) Food Protection* applicants* 3-302.15 Washinz Fruits and Ve,etables 590.003(F) Responsibility Of A Food Employee 01 An 3-3,04.11 Foal Contact with Equipment and Applicant To Report To Phe Person In Utensils* Charge* Contamination from the Consumer 590.003(G) Reporting by Person in Charge*- 3-306.14(A)(13) Returned Food and Reservice of Food- 3 590.003(D) Exclusions and Restrictions" Disposition of Adulterated or Contaminated 590.003(1„) Removal of Exclusions and Restrictions - Food 3-701.11 Disairding of,Reconditioning Lnsafe FOOD FROM APPROVED SOURCE Food's 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 590.004(0-B) Comptiance with Food Law* 4-501111 Manual Warewashing,-[lot Water 3-261.12 Food in a Hermetically Sealed Container* Sanitization T eramres* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechimical Warewasliino Hot Water 3-202,13 Shell Eggs* Sanitization Tem eramres* 3-202.14 F.:z s and Milk Prodocus.Pasteurized* 4-501.114 Chemical Sanitization-temp.,pit, concentration and hardness, 3-20216 Ice Made From Potable Drinking Watet't 4-601A 1(A) Equipment Food Contact Surfaces and 5-1.01.11 Drinking Water from an Approved System* Utensils Clean' 590.006(0) Binttled Drinking Water* 4-60211 Cleaning Frequency ofEquipment Food- 590.006(B) Water Meets Standards in 310 CMR 22.0`" Contact Surfaces mid Utensils* Shelifish and Fish From an Approved Sourc© 4-702.11 Frequency of Sanitization of Utensils and 3-201.14 Fish and Recreationally'Caught Molluscan Food Contact Surfaces of Ec ui meat' Shellfish* 4-703,11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Iasted Chemical* Sources" 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved by Regulatorya2gulatory Authority 301.11 Clean Condition-Hands and Arms'` 3-202.16 She➢stock Identification Present* 2-301-12 Cleaning Procedme* 590.004(0) Wild Mushrooms* 2-301.14 'When to Wash* 3-201.17 Game Animals" 11 Good Hygienic Practices Receiving/Condition 2-401.11 Eatins,Drinking or Using Tobacco^' 3-202.11 Pl1Fs Received at Proper Temnetatures'f 2-401.12 Discharges From the Eyes,Nose and 3-202-15 Paekage Jauntily* Month* 3-101.11. Food Safe and Unadulterated`" 3-301.12 Preventing Contamination When Tasting* 6 - Tags/Records:Shelistock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Cdendfieation590.004(E) Preventing Contamination from ° 3-203.12 She]Ntock Identification Maintained* Employees.Fish Products 13 Handwash Facilities 3-402.11 PaasiteDestruc on*' Conveniently Located and Accessible 5-203.11 Numbers and Ca acities* 3-402.12 Records.Creation and Retention"` 590.004(7) Labeling of Ingredients" 5-204.11 Location mid Placement* 7 Conformance with Approved Procedures n-20511 Accessibility, O eration and Mttintenaince iHACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-50212 Reduced oxygen packaging,criteria- 6-101.11 Ifanshin dwaz Cleanser.Availability 8-103.12 Conformance with A roved Procedures* 6-30112 liattd Dpvin>Provision "Denotes eriticvl item in the fuieral 1949 reod Code or 105 CNV 590,000. J CITY OF SALEM �j BOARD OF HEALTH s Establishment Name: L r1S 11trJtt '/LJ t Kai /un/ Date: " / m/o6 Page: oC of 7 Item Code C-critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date +f - No. Reference R—Red Item Verified r .. a PLEASE PR WT CLEARLY r 95 J 4 PS- G , 5,0 1. , 44 nn Ste 4,4 ir A. "r s t 4: . t 1 Discussion With Person in Charge: Corrective Action Required: ❑ No Yes ~t I have read this report, have had the opportunity to ask ues Idns and a ree to correct all volunta y Compliance ❑ Employee Restriction/ P PP n Y 9 Exclusion t violations before the next inspection, to observe all condition as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass /Fed er�l! Food Code. I nderstand tht J�noncompliance may result in daily fines of twenty-five dollars or suspensi n/r ocation of ❑ Embargo ❑ Emergency Closure your food permit. LlVoluntary Disposal El Other: t 3-501.14(C) PHFs Received at Temperatures Violations Related to Foodborne Illness Interventions and Risk According to L ov Cooled to -Factors(items 1-22) (Cont.) 41"Fi45'FWithin 4Hours. PROTECTION FROM CHEMICALS 3501.15 Conlin-Methods for PHFs 19 lq Food or Color Additives PHF Hot and Cold Holding 2.12 3-501.16(B) Cold PHFs Maintained at or below 3-33(Y 3- 0Additives"2.14 Protection from Una 590.004(F) 41°145'F*roved Additives" 3-501.16(A) I for PHFs Maintained at or above I5 Poisonous or Toxic Substances 140'3. 7-101.11 Identifying Information-Original 3-591.16(.A) Roasts Held at or above 130'17. Containers` 7-102.11 Common Name-Workmo Containers' 2g Time as a Public Health Control 7-201.1 1 Se raradon-Stora e^` 3-51)1.19 Time as a Public Health Control" 7-202.11 Restriction-Presence and Use* 590.004(11) Variance Re uirement 7-202.12 Conditions of Ilse* 7-203.11 Toxic Containers-Prohibitions" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Samtizers,Criteria-Chcmic.als� POPULATIONS(HSP) 7-20412 Clrenucals for washing Produce,Criteria" 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.14 Drvin= ants,C riteria* Beverages with NV ening Labels' 7-205.11 Incidental Food C ontam Lubricants* 3-801_11(B) Use of Pasteatt7ed Eg sM 7-206.11. Restricted Use Pesticides.Criteria` 3-801.11(D) Raw or Partially Cooked Animal Food and Raw Seed Sprouts Not Served. 7-206.12 1 Rodent Bait Stations* 3-801.I f(C7-r no erred Ford Package " 7-206.13 Tracking Powders,Pest Control and ) package Re-served. Monitoring" CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 7,6 Proper Cooking Temperatures for Animal Foods That are Raw. Undercooked or PHFs Not Otherwise Processed to Eliminate 3-401.11A(1)(2) Eggs- 155'F 1.5 Sec. Eggs-Inanediate Service 145'Fl5sec- 3-302.13 Pasteurized Eggs Subsritute for Raw Shell 3-40Comminutedm .(A)(2) Comminuted Fish,Mcafs&Gae -- fi zs'w Animals- 155'F 15 see. * - 3-401.11(13)(1)(2) Pork and Reef Roast-130'F 121 min" SPECIAL REQUIREMENTS 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 590.009(A)-(D) Violations of Section 590.009(A)-(D)in sec a catering. mobile food,temporary and 3-401.11(A)(3) Poultry, Wild Game,Stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Poultry or Ratites-165°.3 15 sec. �` - _ above if related to foodborne illness 3-401.11((7)(3) Whole-muscle, Intact Beef Steaks imterventions and risk factors. Other 145-F" A. 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Cooked in a practices should be debited under#29- Microwave 165°F* Special Requirements. 3-401.11(A)(1)(b) All Other PHFs- 145°F'15sec. * 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.11{A)&(D) PHFs 1650F 15 sec. * (Items 23-30) 3.403.11(B) Microwave-165°F 2 Minute Standing Critical and non-critical victorious, which do not relate to the Time* (aodhorne illness inter veniion.s and risk factors listed above, can he 3 03.11(C) CommercialN Processed RTE Foul- found in the following sections of the Food Code and 103 CMR 140°F* 590.000. 3-403.11(3..) RemafirinI Uns(iaed Portions of Beef Item Good Retail Practices FC 590.000 -- Roasts* 23. -Management and Personnel FC-2 .003 18 Proper Cooling of PHFs 24. _ Food and Food Protection _ FC--3 .004 25. E ui meat and Utensils FC__4 .005 3-501.14(A) Cooling Cooked PHFs from 140'F to 6, - - -- 28� _Water:Plumbin and Waste FC-5 .006 70'3 Within 2 Hours and From 70°F 27. Ph steal Facili FC-6 .007 - t - to 4 t'F(45'F Within 4 Hours. * 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(T,3) Cooling PHFs Made Froin Ambient 29. S ectal Re ulrements _ _ .009 Temperature Ingredients to 41°F450F 30 yOther _ Within 4 Hours ssvnrom,traszm "'Denotes e tical hent in the fuferal 1999 Foal Code or 105 CMR 590.000. r .. Massachusetts Department of Public_ Health Salem Board 120 Washington S Health Division of Food and Drugs Salem, MA 01970-35230 Floor FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax(978) 745-0343 Name r- ! I Datp I Type of Ooeration(s) Type of Insoection Il I br, .� m Food Service Routine Address ` C� RIN ❑ Retail Re-inspection Level El Residential Kitchen Previous I spection Telephone - ❑ Mobile Date: S (" S/&i,- Owner HACCP Y/N ❑ Temporary ElPre-o eration ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) Time ❑ Bed&Breakfast ❑ General Complaint In: E] HACCP Inspector �� ) OJ 3�/ Permit No. ❑Other Each violatioWcheck d requires aA 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„M„sy w„ „_d��„�,„�A- El12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13 Handwash Facilities i=EMPLOYEE HEALTH a : j J'PROTEdT1ON FROM CHEMICALS 5`"-"'�� s"•.»` �" n`� a" y ❑ 2. Reporting of Diseases by Food Employee and PIC a m , _� » •a< �•»» .. +-int= m,» .• El 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded w ❑ 15.Toxic Chemicals g,FOOD FROM APPROVED SOURCE ;,,,,..„� I TIMEITEMPERATURE CONTROLS(Potentially Hazardous F6adaj'7 '•fi ❑ 4. Food and Water from Approved Source a� ��-�m,a �:a ��,a�:��, �, I .a ❑ 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/Protecti' _ji El20.Time As a Public Health Control E] 9. Food Contact Surfaces Cleaning and-Sanitizing�� REOUIREMENTSFOR HIGHLYSOSCEPTIBLEPOPULATIONS(HSP),�g ❑21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices CONSI1MEF:ADVISORY 7;,®� Ys El 22. Posting of Consumer Advisories Violations Related to Good Retail Practice") Number of Violated Provisions'Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board -- and Risk Factors(Items 1-22): of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code. This report, when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (Fc-2)(550.003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (Fc-a)(sso.00s) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and-submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: 5:5901nspeIXFo•m614.tla Inspector's Signature: Print: _ PIC'sSignature•. {w // / ,�/ P '_t• ? �i '/ Pageof_2Pages f - - Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 8 Cross-contamination . 1I 59O.003(A) AssignmentofResponsibility* 3-302.11(A)(]) Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge" - - Cooked and RTE Foods* 2-103.11. Person in charge-duties Contamination from Raw ingredients 3-302.1I(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other" 2 590.003(C) Responsibility of,the person in charge to Contamination from the Environment require reporting by food employees and 3-302.11(A) Food Protection'" applicants* 3-30115 ..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 Utensils* Charge* Contamination from the Consumer 590.003(G) Reporting by Person in Charge* 3-306.14(A)(BL Returned Food and Resevice of Foal* 31 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003(F.) Removal of Exclusions and Restrictions - Food 3-701.1.1 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Fa>d* 4 Food and Water From Regulated Sources UL Food Contact Surfaces 590.004(A-B) Compliance with Food law* 4501.111 Manual Warewashing-Hot Water 3-201.12 Fax]in a Hermetically Sealed Container* - eratures* - 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Milk Products.Pasteurized* 4-501114 Chemical Sanitization-temp.,PH, 3-202.16 Ice Made From Potable Drinking Water* concentration and hardness. 5-101..1.I Drinking Water from an ApLioved System* \ 4-601.1 I(A) Equipment Food Contact 9urfacc;Land \\ Utensils Clean" 590.006(A) Battled Drinking Water* 4602.11 Cleaning Frequency of Equipment Food- 590,006(B) Water Meets Standards in 310 CMR 22.0 Contact Surfaces and Utensils'" She/lush and Fish From an Approved Source �\ 3-201.14 Fish and Recreationally Caught Molluscan 4-70211 Frequency of Sanitization of Utensils and i "," Food Contact Surfaces of Equipment" Shellfish* 4-703.11 - Methods ofSanitization-Hat Water and 3-201.15 Molluscan Shellfish from NSSP Listed E Chemical* Sources* 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved by Re a/oto Author" - 2-301.1 t Clean Condition-Hands and Arms" 3-20218 Shellstock Identification Present* 2-30112 Cleaning Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 Game Animals* it 'Good Hygienic Practices Receiving/Condition �', , , 2401..11 Eating,Drinking or Using Tobacco* 3-202.1.1. - PHFs Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and 3-202.15 Package Integrity* Mouth* 3-101.11. Food Safe and Unadulterated* 3-30112 Preventing,Contamination When Tastin 6 Tags/Records:Shellstock LE2 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590-004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* Employees* TagstRecords:Fish Products 13 Handwash Facilities 3.402.11 Parasite Destruction* Conveniently Located and Accessible - 3-402.12 Records,Creation and Retention* 5-203.11 Numbers and Capacities* 590.004(7) Labeling of Ingredients' 5-204.11 Location and Placement* - 9 Conformance with Approved Procedures 5-205.11 Accessibility,Operation and Maintenance /HACCP Pians Supplied with Soap and Nand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.1.2 Reduced oxygen packaging,criteria* 6-3011 t Handwashi ng Cleanser, Availability 8-103.12 Conformance with A roved Procedures* 6-301.1.2 Hand Drying Provision -Denotes critical item in the federal 1999 Foal Code or 10 CMR 590A00. - { CITY OF SALEM BQARD OF HEALTH Establishment Name: t •�1 P".$ / 11 �, Date: i Page: of 'R Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date '..� No. Reference R—Red Item Verified j. PLEASE aawr c7uv rt p c.is x - IF C �uil� f L .f b/ e re r ( 0� ` l g 4 I x o' G o Discussion With Person in Charge: _ Corrective Action Required: ❑ No Yes t ❑ Voluntary Compliance Z) 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. understand that k noricompliance may result in daily fines of tw ty-fiv doll s or.•`S D-nsion/r vocation of ❑ Embargo L3Emergency Closure E ayour food permit. LI Voluntary14/ Disposal ❑ Other: ' 3.50t.14(C) PHFs Received at"l'emperatures Violations Related to Foodborne Illness Interventions and Risk According to I-aw Cooled to Factors(items 1-22) (Cont.) 41'F/45'F Within 4 Hours. ` PROTECTION FROM CHEMICALS 3-501.!5 Coolinn Methods for PHFs 14 Food or Color Additives 19 PHP Hot and Cold Holding 3-501.16(B) Cald Pfirs Maintained at of below 3-202.12 Additives* 590.004(F) 41145°F* 3-302.14 Protection front Una proved Additives" 1y Poisonous or Toxic Substances 3-501.16(A) Hot PHFS Maintained at or above 40'7. * 7-18 L 1] Identifying Information-th'ightal 3-501.1.6(A) Roasts Held at or above 130'F. " Containers* 7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control 7-201.11 Separation-Storage; 3-501.19 Time as a Public Health Control* 7-202.'11 Restriction-Presence and Use" 590.004(H) Variance Re uirentent 7-202.12 Conditions of Use- 7-203,11 se* REOUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.L1 Toxic Containers-Prohibitions" 7-20,4.11 Satntizers,Criteria-Chemicals* POPULATIONS(HSP) _ 7-204.12 Chemicals fbi W tshine Ptnduce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and Be�emges with W•ursine Labels* 7-204.14 Dr•inn t grits,Criteria` 3-801.1I(B) Use of Pasteurized Bens* 7-205.11 Incidental Food(-outage.Lubricants* 3-801.11.(B) Raw or Partialty Cooked Animal Fund and 7-206,11 Restricted Use Pesticides. Criteria* 7-206.12 Rodent Bait StationsRaw Seed Sprouts Not Served. 'w w 3-801.11(C) Urso ened Food Package Not Re-served. 7-206.13 Tracking Powders,Pest Control and - Monitorinn CONSUMER ADVISORY TIMETTEMPERATURE CONTROLS ' 71-11311 Consumer Advisory Posted for Consumption of Anhnal Foods'Pkat are Kaw.Undercooked or 16 Proper Conking Temperatures for PHFs Not Otherwise Processed to Eliminate • rr,<oor 3-401.'L1A(1)(2) Eggs- ISS`F 15 Sec. 1a[hoe,ns_*Em rill F 4es-hmnedtate Sen•ice. 145°F15sec* 3-302.13 Pasteurised Fggs Substitute for Raw Shell 3-401.11(A)(2) Comminuted Fish,Meats&Game E gs* Animals-155°F 15 sec. .r SPECIAL REQUIREMENTS 3-401.11(B)(1)(2) Pork and Beef Roast- 130"F 121 min* 3-4101.1 UA)(2) Ratites, injected Meats 155'715 590,009(A)-(D) Violations of Section 590.009(A)-(D)in Sec t catering, mobile food,temporary and 3401.11(A)(3) Potdtty,Wild Game, Stuffed PHFs, - residential kitchen operations should be Stuffing Containing Fish, Meat, debited under the appropriate sections Poultry or Ratites-165°17 15 sec. *•, above if related to foodborne illness 3-401.11(C)(3) Whole-muscle,intact Beef Steaks interventions and risk factors. Other 145°F„ 590.009 violations relating to good retail 3401.12 Raw Anunal Foods Cooked in a practices should be debited under#29- Microwave 165'F* Special Requnements. 3-40 1.11(A)(1)(b) All OtherPHFs-- 145'17" 15 sec. * ' 1? Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.11(A)&(D) PHFs 165'F 15 sea * (hems 23-30) 3-403.11(B) Microwave- 165°F 2 Minute Standing Critical and non-critical violations, which do not relate to the Time* foodborne illness interventions and risk firctors listed above, can be. 3-403.11(C) Convnercialk Processed RTF Food- ,found in the following sections ref the Food Cade and 105 CMN 140'Fi 590.000. 3_ > Item Good Retail Practices FC 590.000 -' 403.11([3) RemainingUnslieedlorrions,ofBeet Roasts` 23. Management and Personnel FC-2 .003 1g Proper Cooling of PHFs 24. Food and food Protection FC-3 .004 25 _ E ui merit and Utensils FC 4 --.005- Cooling 3-5Ut.14(A) Cooked PHFs from 140`P to 26 Water,Plumbing and W rite FC 5 .006 70'F Within 2 Hours and From 70'F 27. Ph deal Facili1y FC-B .007 to 41.°F/45'F Within 4 Hours. '" 28. Poisonous or Toxic Materials FC-7 1 .008 3-501.14(B) Cooling PI-IFs Made From Ambient 29- S ecial Re uiremonts .009 Temperature Ingredients,to 41°F/45'7 30 Other Within 4 Hours* nr �rxta-zs,� Denotes adical item in the tcdend 1999 Food Code or 105 CNIR 590.000. i Commonwealth of Massachusetts e City of Salem Board•of Health 120 Washington Street,4th Floor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 01/03/2006 WHO'S PLACE OF BUSINESS IS: McSwiggins Irish Pub Restaurant File Number:BHF-2004-0061 121 Essex Street Salem MA 01970 LOCATED AT: 0121 ESSEX STREET SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes FOOD SERVICE BHP-2006-0157 ,Ian 3,2006 Dec 31,2006 $150.00 ESTABLISHMENT Total Fees: $150.00 PERMIT EXPIRES FDecember 31, 2006 Board of Health � �c This Permit Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, beofre any revonations, improvements, or equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Page 1 of 10 CITY OF SALEM, MASSACHUSETTS ° BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978.741-1800 STANLEY J. USOVICZ, JR, FAX 978-745-0343 MAYOR W W W.SALEM.COM JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT 2006 APPLICATION FOR PERMIT TO OPERATE A FOOD EST BL BL HMENT / c— NAME OF ESTABLISHMENT ;t{( l�jl/f/S ��j.L�p� L� � ADDRESS OF ESTABLISHMENT S MAILING ADDRESS (if different)_ OWNER'S NAME pCZ_ '� h� EL# �� Z � C� ADDRESS CITY STATE /�Lln_f=_ ZIP G CERTIFIED FOOD MANAGER'S NAME(S) CERTIFICATE (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON /Yl -HOME TEL# HOURS OF OPERATION: Mon. Tue. -Wed.—Thu.- Wed.YThu. riWat. Sun. Gv I;�G ¢ TYPE OF ESTABLISHMENT FEE (check only) RETAIL STORE YES NO less than 1000sq.ft. =$ 50 1000-10,000sgA, =$100 more than 10,000sq.ft. =$250 ............................................... le.s.s..t..h.an...25.....s.ea...t............=.$100. 0-- ................RESTAURANT YES NO s �r 25-99 seats more than 99 seats =$200 ..........................................*......................................$-10..........--------- BEDlBREAKfAST YES NO 0 - - --------------------------------------------------------------- ...-------------------------------------------------------- ... ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGURT, SOFT SERVE YES NO $5 TOBACCO VENDOR YES NO $50 ALL NON-PROFIT(such as church kitchens) YES NO $25 *Please pay total with one check payable to the City of Salem . This Permit is not transferable and must be reissued upon change of ownership. The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements,or equipment changes are made, all plans for slArh must be submitted to and approved by the Salem Board of Health. Pursuant GL Ch -ter C, Section 49A, I certify under the pains and penalties of perjury that I, to my best knowledg and belie av iled all state tax r u and paid all state taxes required under the law. SignatureDae Social Security or Federal Identification Number ------------------------------------------------------------ -------- ---------------------------------------------------------- Revised 11/03/05 FOODAP2.adm Check#&Date�� /az's5_dcr 1 /J� C`4 0121 Essex Street McSwiggins Irish Pub Restaurant City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Telephone: Item Status Violation Critical Urgency Nature of problem or correction 745-5656 - Non-compliance with: Not Done Owner: Anti-Choking PASS ❑ 'Andrew Mahoney,° Tobacco PASS ❑ PIC: �°�. FOOD PROTECTION MANAGEMENT Not Done Andrew Mahoney " PIC Assigned/Knowledgeable/Duties PASS ❑J RED :Inspector: David Gree6nbaum EMPLOYEE HEALTH Not Done ` Date Inspected'ICorrect By, Reporting of Diseases by Food Employee and PIC PASS ❑Q RED 5/19/2005- - Personnel with Infections Restricted/Excluded PASS 0 RED Risk Level: FOOD FROM APPROVED SOURCE Not Done Permit Number: ,, Food and Water from Approved Source PASS ❑d RED BHP-2005-0156 _ Receiving/Condition PASS ❑d RED Status: = Tags/Records/Accuracy of Ingredient Statements PASS ❑d RED SIGNED OFF #of Critical,Violations: m Conformance with Approved Procedures/HACCP PASS RED Plans 1 PROTECTION FROM CONTAMINATION Not Done Time IN Time OUT Separation/Segregation/Protection PASS RED Notes: Food Contact Surfaces Cleaning and Sanitizing FAIL Critical ❑J RED Cutting boards in ceokline need 172: resurfacing. The kitchen dishwasher guages were not working. Have dishwasher serviced to Urgency Description(s): insure proper operation. BLUE: 0. Proper Adequate Handwashing PASS RED Violations Related to Good " Retail Practices (Critical Good Hygienic Practices PASS ❑Q RED violations must be corrected Prevention of Contamination from Hands PASS ❑Q RED immediately or within 10 days)(Non-critical violations Handwash Facilities PASS RED GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. May 19,2005 ) Page I oft 0121 Essex Street McSwiggins Irish Pub Restaurant must be corrected immediately PROTECTION FROM CHEMICALS Not Done or within 90 days) Approved Food or Color Additives PASS ❑J RED RED: � 2 Violations Related to Toxic chemicals PASS ❑D RED Foodborne Illness Inter%entions TIMEITEMPERATURE CONTROLS(Potentially Haz Not Done and Risk Factors (Require,- Cooking Temperatures PASS ❑Q RED immediate corrective action) Reheating PASS ❑d RED Cooling PASS ❑d RED Hot and Cold Holding PASSd❑ RED Time As a Public Health Control PASS ❑ RED REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PO Not Done Food and Food Preparation for HSP PASS RED CONSUMER ADVISORY Not Done Posting of Consumer Advisories PASS 0 RED Violations Related to Good Retail Practices (Blue Not Done Management and Personnel PASS ❑ BLUE Food and Food Protection FAIL Non-Critical ❑ BLUE Butter should be covered to prevent cross contamination. Equipment and Utensils N/A ❑ BLUE Water, Plumbing and Waste PASS ❑ BLUE Physical Facility FAIL Non-Critical ❑ BLUE All floors and walls need a general cleaning. Poisonous or Toxic Materials PASS ❑ BLUE Special Requirements PASS ❑ BLUE Other-See Notes PASS ❑ BLUE 114( ) ) GeOTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. May 19,2005 ) Page 2 of2 ;ot 5+ e+tPv�r�i"2°�.+ .v +r 3..Mht�+a wNs .-w.a•«a�R'Bs4� ,:�..«m �, ...w` m3nz a C�e'Y"`�i�i. irk^ ,'," q'�"�3� i'1" �Sk+�e.°.. w.++» CITY OF SALEM, 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: McSwiggins Irish Pub Restaurant Address of Establishment: 121 Essex Street Owner's Name: Andrew Mahoney Restrictions: Application Date: 11/29/2004 Permit for Food Establishment 90-05 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 2005 This permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location in the Establishment, In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. qv-*�,1104� HEALTH AGENT CITY OF SALEM, MASSACHUSE BOARD OF HEALTH 3� gl 120 WASHINGTON STREET, 4TH FLOOR a 4 SALEM, MA O 1970 NOV 2 3 2004 .� TEL. 978-741-1800 FAX 978-745-0343 CITY OF SALEM STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO BOARD OF MAYOR HEALTH AGENT HEALTH 2005 APPLICATION �FOR [PERMIT TO OPERATE A FOODfESTABLI$HMENT NAME OF ESTABLISHMENT97 ADDRESS OF ESTABLISHMENT Z2 f-/ &-_e MAILING ADDRESS (if different) /� OWNER'S NAME / 6L,)/ mil Q4 TEL#D26 wOL") `/- ADDRESS �� ` J CITY 1'Hrr STATE M' g , ZIP P CERTIFIED FOOD MANAGER'S NAME(S) !2 Gy1 O CERTIFICATE#(s) (required in an establishment where potentially hazardous flood is prepared.) ' EMERGENCY RESPONSE PERSON �� yv HOME TEL# L/1,50 'i30— � (:3�- nth- ham HOURS OF OPERATION: Mon. oZ3rue. cYJWed.L" H77�Thu. Sat. Sun.�r� A•IH. Aw, /Tim, 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 r RESTAURANT YES NO 7 � 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 VENDOR YES NO $50 ALL NON-PROFIT(such as church kitchens) YES NO $25 Please pay total with one check payable to the City of Salem This Permit is not transferable and must be reissued upon change of ownership. The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Pursua to MGL C apter 2C, Section 49A, I certify u er the pains and penalties of perjury that I, to my bes le an belief have filed allt�tx re Asa paid all stat t xes required n rthp I w. Sign ture Date Social Security or Federal Identification Number -------- -- -- -------- Revised ------Revised 11/03/03 FOODAP2.adm Check#& Date 0� CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH s i . 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA O 1970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94, Section 305A and Chapter III, Section 5 of the General Laws, to operate a Food Establishment in the City of Salem is hereby granted to: Type of Establishment: FOOD SERVICE Name of Establishment: McSwiggins Irish Pub Restaurant Address of Establishment: 121 Essex Street Owner's Name: Andrew and John Mahoney Restrictions: Application Date: 12/4/2003 Permit for Food Establishment 111-04 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 2004 This permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location in the Establishment, 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 `t CITY OF SALEM, MASSACHUSETTS $III''^��0�r of � • " '� BOARD OF HEALTH ISS ru • s 120 WASHINGTON STREET, 4TH FLOOR AHI �� '�I/ SALEM, MA 01970 NOV TEL. 978-741-1800 FAX 978-745-0343 CITY OF SALEM STANLEY USOVICZ, JR. BOARD OF HEALTH JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 2004 APPLICATION FOR ERMIT TO OPERATE(A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT �I Trt t l // EL# ADDRESS OF ESTABLISHMENT l MAILING ADDRESS (if differ nt) / I �rn�^�/✓� �7 �j /� OWNER'S NAME !�V I/1(/� V, l4 TEL# /&—S2 —%o8)6 ADDRESS G� m �r/GLQ Sc(�P CITY Gil/ STATE ZIP 4 —ERTIFICA E (s) CERTIFIED FOOD MANAGER'S NAME(S) e /7�Z (required in an establishment where poten is hazardous food is prepared.) EMERGENCY RESPONSE PERSON <:�_C�'/'l,�L -Q HOME TEL#__,Y!? 4.30 Ll 3o y.3� nor✓A1y n° �2md �NpM 6�ov�/ HOURS OF OPERATION: Mon.1, 00 Tue.L -,OWed./ �fhu. ars Fri./-� at. aU Sun. TYPE OF ESTABLISHMENT FEE check only RETAIL STORE YES NO less than 1000sq.ft. =$50 f 1000-10,000sq.ft. =$100 more than 10,000sq.ft. =$250 RESTAURANT YES NO f less than 25 seats =$100 25-99 seats = 150 ' more than 99 seats =$200 BED/BREAKFAST YES ND $100 ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGURT, SOFT SERVE YES $5 TOBACCO VENDOR YES $50 ALL NON-PROFIT(such as church kitchens) YES O $25 Please pay total with one check payable to the City of Salem transferable and must be reissued upon change of ownership.This Permit is not t . The Permit must a p g p be posted in a prominent location in the Establishment. In accordance with the State.Sanitary Code before any renovations, improvements,. orequipment changes are made, all pl s for such must be submitted to and approved by the Salem Board of Health. Pursuant to L Chapter 2C Se io 49A, I certify under the pains and penalties of perjury that I, to my best kn e a d�tSeli ed II at tax returns a ' paid II state taxes required under the law. Signature Date oci S curity or Federal Identification tuber ----------------------------------------------------------------------------------------- ---- Revised 11/03/03 FOODAP2.adm Check#&Date 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 Date T e of O eration s T e of Ins ection UABdIn,f I01Sld P(4 d / {�y Food Service ®® outi Address r ` Risk ❑ Retail ❑ Re-inspection Level ❑ Residential Kitchen Previous Inspection-.r,- Telephone 7K S G SG M ' ❑ Mobile Date: OwnerA,QIfgW f 5-0101 MA#60 Y HACCP Y/N ❑❑ Catererary E] Pre-operation ❑Suspect Illness=` Person in Charge(PIC) Q ^,�� Time El &Breakfast ❑ General Complaint HACCP Inspector 0-ATIA1 ec. A�JA.4 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 EMPLOYEE HEALTH El 13. Handwash Facilities �" i:. .� 'PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC [:13. Personnel with Infections Restricted/Excluded El 14.Approved Food or Color Additives FOOD FROM APPROVED SOURCE F] 15.Toxic Chemicals_ , , '" - ' ❑ 4. Food and Water from Approved Source `TIME/TEMPERATURECONTROLS(Potentially Hazardous Foods) ` ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION "' ❑ 19. Hot and Cold Holding ❑ 8 eparation/Segregation/Protection ❑20.Time As a Public Health Control 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 10. Proper Adequate Handwashing El 21. Food and Food Preparation for HSP ❑ - El 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 1 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 o,CeaNh . 590.000/federal Food Code. This report, when signed below 3. 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 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: 5:5901nsp ctFo m 14 da Inspector's Signature• Print: 7 PIC's Signature.:.-I' Pri • n / Page of'Pages i� s iT y `• Violations Related to Foodborne Illness interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT R Cross-contamination I 590,003(A) I Assipmment of Responsibility* 3-302.11(,%)(1) Rain Am mat Foods Separated from 59UO3(B) Demonstration of Knowledge* Cooked and RTE Rods" 2-103.11_ I Person in charge--duties Contamination from Raw Ingredients 3-302.11(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other'' 2 590.003(C) Responsibility of the person in titan, to Contamination from the Environment require reporting by foal employees and 3-3011](A) Food Protection" applicants* 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility Of A Food Fnployee Or An 3-304.1.1 Food Contact with Equipment and Applicant To ReportTo The Person Ili Utensils* Charge* Contamination from the Consumer -:E]).003(G) Reporting by Person in Charge* 3-306.14(A)(B) Returned Food and Reservice of Food* 3 590.003(0) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003(E) Removal of Exclusions and Restrictions Food - 3701..11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Foodµ 4 Food and Wafer From Regulated Sources 9 Food Contact Surfaces 590.004(A-B) Compliance with Food Law`r 4-501.111 Manual Warewashing-Hot Water 3-Z,Ot.12 Food in a ermetically Sealed Container* Sanitization-Tem grottos* H 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-I-lot Water 3-202.13 Shell Eggs* Sanitization meraTetures* 3-202.14 Fi=gs and Milk Products.Pasteurized" 71-501.114 Chemical Semitizntion-temp., pH, 1-2021ii Ice Made From Potable Drinking Water* concentration and hardness. " 5-101.11 Drinking Water from an Approved Svstem° d-601.t 1(3) Equipment Clean* Contact Surfaces and 590.006(A) Bottled Orinkin*Water* Cleaning Clean' 4-602.11 Cleaning Frequency of Equipment Food-- 590.006(B) Water Meets Standards in 310 CMR 22-0* Contact Surfaces mid Iftensils* Shellfish and Fish From an Approved Source 4-902.1 1 Frequency of Saidtization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of E ui menu" Shellfish* 4-703.11 Methods of Sanitization--Hot Water and 3-201.15 Molluscan Shellfish from NSSP ListedChemiai[* - GameSources* Ii) Proper,Adequate Handwashing Rtgul and Authority Mushrooms Approved by Re Mato Atrthori 2-301.11 Clean Condition--Hmxls and Arms* 3-2011.8 Shellstock Identification Present* 2-301.12 Cleating Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash" 3-207..17 Game Animals* 11 Good Hygienic Practices g Receiving/Condition 2=401.11 Rating, Drinking or Using Tobacco* 3-202.11 PHFs Received at Pro Jer Tem ieratures* 2-401.12 Discharges From the Eyes.Nose and 3-202.15 Package Inteetity* Mouthy` 3-101.11 Food Safe and Unadulterated* 3-301.12 1 Preventing Contamination When Tasting* 6 Tags/Records:Sheilstock I Prevention of Contamination from Hands 3-21)2.18 S'hellstock Identification* -390.004(F) Prevent ng Contamination from 3-203.12 Sbellstock Identification Maintained* Em lovees* Handwash Facilities Tags/Records:Fish Products 13 3-402.11 Parasite Destruction* Conveniently Located and Rccessible 3-402.12 Records.Creation and Retention* 5-203.11 Numbers and Ca acities'r 890.004.(1) Labeling of Ingredients' 5-204.11 Location mud Placement* q Conformance with Approved Procedures 5-205.11 Accessibility,d oration and M'aintenatce 1HACCP Plans Supplied with Soap and Nand Drying 3-50211 Specialized Processin>Methods"' Devices 3-50212 Reduced oxygen aekaging,criteria" 6 301.11 Handwashing Cleanser.Avail,hilif 8-103.12 Conformance with A i roved Procedtrzes 6-30112 Hand Drvin>Provision *Uenote�critical item in the fedusl 1999 Prnid Code or 105 CNIR 590,000. i CITY OF SALEM BOARD OF HEALTH r Establishment Name: W5"WidW/N7 I/aff P06 Date: /ey Page: 2 of 7i ?, Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION bate r No. Reference R—Red Item PLEASE PRINT CLEARLY Verified y 6zS 3' G.+N #I Lr*W-s01 4 v r^ tdo RK//j b, i f& 00*t+L 6tI aJd�s re oft A1. I~rt* e'* 6A— rx#4in trt Fsrt-/ s-rwr-- vNf"►t_. ', K�f.t.. JAI-I +�dtCt�1 r4tl3t�� M;4tX r W 16V O je-OW aA_ 44-L- jeodd Ig /0tls'0' Co 14 /9 Bt` /f64<R/ uPr7dlid 6PN6 1^04W �U v.rlr�tni- 6�1'IS deA 7 r Q+ 1✓ /►0 d ttf Oe Of n�/s Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance L3 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 F/od Code. I understand that ,noncompliance may result in daily fines of tty-five oll s Or3usp revocation of EIEmbargo ❑ Emergency closure your food permit. l/ 1 El EI Disposal C3Other: 's i 1 - 3-501.14(0) PHFs,Received at'l'emperatures Violations Related to Foodborne Illness Interventions and Risk Accordifg to L.aw Cooled to Factors(Items 1-22) (Cont.) 41`IF/45"F Within 4 Hours. PROTECTION FROM CHEMICALS3-501.15 -Cooling Methods for PHFs 14 Food or Color Additives 19 PHF Hot and Cold Holding 3-501.16(B) Co(d P1IFs Maintained at or below 3-202.12 Additives* 590.004(F) 41%45 F" 3-302.14 Protection from Ula t rowed Additives" 1.5 Poisonous or Toxic Substances 3-501.L(i(A) Hof PHFs Maintained at or above 140'F. * 7-10LI l Identifying Information-Original 3-501.16(A) Roasts Held at or above 130°F. Containers* 7-102.11 Compton Name-Working Containers* 20 Time as a Public Health Control 7-201.11Se aration-Storages; 3-501-19 Time as a Public Health Control* 7-2G2.1 I Restriction-Preszncz and Use's 590.004(H) Variance Requirement 7-202.12 Conditions of Use" 7-203.1.1 Toxic Containers-Prohibitions"' REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanitizers,Criteria-Chemicals* POPULATIONS(HSP) 7-204.12 0hemicals Tor Washine Produce,Criteria" 21 3-SOI.11(A) Unpasteurized Pre-packaged Juices and 7-204.74 Dr'in Aents,Crlteria* Beverages with Warning Labels^ 7-205.11 .incidental Food Contact.Lubricants* 3-b01.1I(I3) Use of Pasteurized F;Qos* 7-206.11 Restricted Use Pesticides.Criteria* 3-801.11(D) law orPartially Cooked AnimFd Faid and Raw Seed Sprouts Not Served.'r 7-20613 Rodent Bait Stations* 3-801.11(C) Unopened Food Package Not Re-served. 7-206.13 Tracking Powders,Pest Central and Monitoring* CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-60111 Consumer Advisory Posted for Consumption of Animal Foods That are Raw. Undercooked or 16 Proper Cooking Temperatures for PHFs Not Otherwise Processed to Eliminate 3-40LLlA(1)(2) Eggs- 7.55F15See. Pathogens-*c"',rrosom figs-Immediate Service 145°F15sec* 3-302-13 Pasteurized Eggs Substitute for Raw Shell 3-401.11(A)(2) Comminuted Fish,Meats&Game figs* Animals- 155°F 15 sec. 3-401.11(13)(1)(2) Pork and Beef Roast- 130'F 121 min* SPECIAL REQUIREMENTS 3-401.t 1(A)(2) Ratites,Injected Meats-155F 1.5 590-009(A)-(D) Violations of Section 590.009(A)-(D)in sec.* catering,mobile food, temporary and 3-401.1l(A)(3) ,Poultry,Wild Game,Stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Pouln' or Ratites-165gF 15 sec. * above if related to foodborne iciness 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 145gF* 590.009 violations relating to good retail 3-401.1.2 Raw Animal Foods Cooked in a practices should be debited under//29- Microwave 165°F* Special Requirements. 3-401-I1(A)(1)(b) All Other PHFs-145°F 15 sec. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.11-(A)&(D) PHFs 165°F 15 see. * (Steins 23-30) 3-403.11(B) Microwave- 165"F 2 Minute Standing Cortical and non-critical violaliony.which do not relate to the Time* foodborne illness interventions and risk factors listed above, can be 3-403.11(0) Commercially Processed RTE Food- found in the following section of the Food Code and 105 CMR 1,4T`Fr 590.000. - - --.- 3-403.11(E) Remaiping Unsliced Portions of Beef item Goad Retail Practices FC 590-.000--- Roasts" 8(7.Aoo Roasts" _-nd Pars_-nel FC-2 .003 ,- 3. Mang ement and Person ___ 1g Proper Cooling of PHFs ?4. Food and Food Protection _ FC-3 . .004 25. Equi meat and Utensils FC-4--- .005 3-50114(.A) Cooling Cooked PHFs from 140°F to 26 Water,Plumbirin and Waste FC-5 L006__ 70°F Within 2 floors and From 70'F 27. ph sical Facility FC-6007 to 41'F/45°F Within 4 Hours. * 28Poisonous or Toxic Materials _FC--7 I .008 3-50L14(B) Coaling PHFs Made From Ambient 29. S ecialR utrements _ _ I .009 Temperature'Ingredients to 41°F/45`F 30_ t Other Within 4 Hours,r ,3vor Denote3 critical item in the iwdend 1999 Food Code or 105 CNIR 590.000- 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 Date Type of 0 eration(s) �De of Inspection C.S1^7 I 2 ( L/ y A o ] Food Service ❑ Routine Address Risk ❑ Retail P-Rb-inspection Telephone ( Level [I Residential Kitchen Previous In pection P El Mobile Dater.//, jP/ Owner HACCP Y/N E-1Temporary ElPre-operation dA/ p ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) Time ❑ Bed 8 Breakfast ❑ General Complaint d-4-' In: [IHACCP Inspector lei 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 " El 2. Reporting of Diseases by Food Employee and PIC PROTECTION FROM CHEMICALS E] 3. Personnel with Infections Restricted/Excluded El 14.Approved Food or Color Additives ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE ❑ 4. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition [:116. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements [117. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) E] 10. Proper Adequate Handwashing E]21. Food and Food Preparation for HSP ❑ 11. Good Hygienic Practices "CONSUMER ADVISORY ❑ 22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 1.05 CMR ofC eaNh. 590.000/federal Food Code. This report, when Signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent coristitutes 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 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: 5:5001Pe IFOm -NAX I spe for's S' nat / _ Print: PIC's Sig nna' e: L-.- ( Print,'' Pagej-of 1-Pages • ( r Violations Related to Foodborne illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 8 Cross-contamination 1 590.003(A) Assignment of Rosponstbtbty* 3-302.I I(A)(1) R tw Animal Foods Separated from i9D.003(B) Demonsy don of Knowled-W Cooked and RPF Foods* 103.11 Person in ch t3- e-dunes Contamination from Raw fngredfents 3-302-11(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other* 2 594.003(C) Responsibility of die person in charge to Contamination from the Environment requite repotting by food employees and 3-302A I(A) Food Protection* applicants' _ _ 3-302.15 Washing Fmits and Vcaetables 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 Utcnsils* Charge* Contamination from the Consumer 590.003(Ci) Re porting )y Person in Charge* 3-306.14(A)(B) Returned Food and Resta vice of Food* 3 590.003(D) Exclusions and Restrictions* Disposition ofAdufterated or Contaminated 590.0-Wk-) Removed of Exclusions and Restrictions Food 3-701..11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 4 Food and Water From Regulated Sources <) Food Contact Surfaces 590.004(A-B) Compliance with Food Law" 4-501.111. Manual Warewashing-Hot Water 3201.12 Food in a Hermetically Sealed Container* Sanitization Tent erahtres* 3-20113 Fluid Milk and Milk Products* 4-501112 Mechanical Warewashing-Hot Water 7202.13 She(t'Enns=� Sanitization Temperatures* 3-202.14 lig s and Milk Pralnets.Pastew�ized* 4-501.114 Chemical Sanitization-temp.,pH, concentration and hardness. 3-202.16 Ice Made From Potable Drinking Water'r 4_bpt.11 tA) Equipment Food Contact Surfa zs and 5-101.11 Drinking Water from an A rovzd System* EquipEquipmmClean* 590.006(A) Bottled Drinking Water* - Utensils4-602.11 Cleaning Frequencyof Equipment Food- 590.006(}3) Water Meets Standards in 340 CMR 229* Contact Surfaces and Utensils* Shefiffsh and Fish From an Approved Source 4-702.11 Frequency of Sa tiftzation of Utensils and. :3-201.14 Fish and Recreationally Caught klolluscan Food Contact Surfaces of bgeipment* _ Shellfish" 4-703.11 Methods of Sanitization--Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* ig Proper,Adequate Hantlwashing Re utato Authority Game and uMushrooms Approved by 2-301.1 1 Clem Condition- Hands and Arms* 3-2011.8 Shell nock Identification Present* 2-301.12 Cleaning Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 Came Animals* 11 Good Hygienic Practices g Receiving/Condition 2-401.11 Eatin ,Drinkin or Llsing Tobacco* 3-202,11 PHFs Received at Pro per Temperatures* 2-401.12 Discharges From the Eyes,Nose and 3-202.15 Package Integrity* Mouth* 3-I01.L1 Food Safe and Unadulterated'% 3-301.12 Preventing Contamination When Tastin=* 6 Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* Tags/Records: Fish Products 13 Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located andAccessible 3-402.12 Records.Creation and Retention* 5-203.11 Numbers and Capacities, 590.004(7) Labeling of Ingredients* 5-204.11 Location and Placemi 9 Conformance with Approved Procedures 5-205.11 Accessibility, Operation and Maintenance. tHACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-50212 Reduced oxygen acl<agin ,criteria" 6301.11 Handwtvshin Cleansti.Availability 8-103.12Conformancewith A roved Procedures" 6-301.12 Ela�d D ink Propdsion . Denote,critical item in the federal 1999 Food Code or 105 CMR 590.000. , F CITY OF SALEM BOARD OF HEALTH Establishment Name: M c S wa C 6 f"S /N s J i Pbfi Date: Page: of r Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY t Lc IilO ff ivr f y f, io �6/'o44— t sl VS B4F N6 !✓ e M ft^ I_fSCa i W K• `/0 U y. G t t L p� (yL 'R x� 4 i ` Discussion With Person in Charge: Corrective Action Required: ` ❑ No ❑ Yes have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion I ❑ Re-inspection Scheduled ❑ Emergency Suspension r comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five del aaors or Is nsio evocation of L3 Embargo ❑ Emergency Closure your food permit. 0 Voluntary Disposal ❑ Other: 3-501.14(C) PHFs Received at Temperatures - Violations Related to Foodborne Illness Interventions and Risk According to l,aw Cooled to Factors(Items 1-22) (Cont.) 4 FF/45'F Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14 Food or Color Additives 19 PHF Hot and Cold Holding 3-202.12 Additives'* 3-501,16(B) Cold PHFs Maintained at or below 590.004(F) 4l'/45°F"` 3-302.14 Protection from Una roved AddAivea* 3-501.16(A) Hot PHFs Maintained at or above 1.5 Poisonous or Toxic Substances 140'F. * 7-10111 Identifying Information-Original 3-50L16(A) Roasts Held at or above 130'F. Containers'* 7-102.11. Conunan None-Working Container&' 20 Time as a Public Health Control 7-201.11 Separation-Storae" 3-501.19 Time as a Public Health Control* 7-202.11 Restriction-Presence and Use'* 590A04(H) Variance Rt 7-20212 Conditions of Usc* 7-203.11 'Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanitizers.Criteria-Chenuails* POPULATIONS HSP 7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) I Unpasteurized Pre-packaged Juices and 7-204.14 Devin*A eats-Criteria* Beverages with Warning Labels* 3-801.11(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, 7-206.1.2 Rodent Bait Stations" 3-801.1.1(C) Unopened Fend Package Not Re-served. 7-206.13 Tracking Powders,Pest Control and Momtorin CONSUMER ADVISORY TIMEIfEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 15 Proper Cooking Temperatures for Animal Foods That are Raw.Undercooked m PHFs Not Otherv,'ise Processed to Eliminate Patho ens v o"" rte' 3-401.119(1)(2) Eggs- 155'F 15 Sec. 3-302.1.3 Pas caved EggsSubstitute for Raw Shell EF Rs-Immedi ate Service 145'Fl5sec* 340L I I(A)(2) Comminuted Fish.Meats&Game Ens* Animals-155'F 15 sec. 3-401.11(B)(1)(2) Pork and Beef Roast- 130'F 121.ntin* SPECIAL REQUIREMENTS 3-401.11(A)(2) Ratites,Injected Meats- 155'F 15 590.009(A)-(D) Violations of Section 590.009(A)-(D)in sec. * catering, mobile food, temporary and 3-401.11(A)(3) Poultry,Wild Game.Stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat. debited under the appropriate sections Poultry or Ratites-165'F 15 sec. * above if related to foodborne illness 3401.11(C)Q) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 145"F* 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Cooked in a practices should be debited under 7129- Microwave 165'F* Special Requirements. 3-401.11(A)(1)(b) All OtherPHFs- 145'F l5 sec. * 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 34031 I(A)&(D) PHFs 165'F 15 sec. " (Items 23-30) 3-403.11(B) Microwave-165'F 2 Minute Standing Critical and non-critical violations, which do not relate to the Time* foodborne illness intctrentions and risk.faclors listed above, can be 3-403.1.1(C) Commercially Processed RTE Food- found in the following sections of the Food Code and 105 CMA 1400F* 590.000. 3-403.11(E) Remaining Unsliced Portions of Beef Item Good Retail Practices 1 FC 590.000 Roasts* 23. Manu ament and Personnel I FC-2 .003 1 g Proper Cooling of PHFs 2,17- Food and Food Protection FC-3 .004 25. Equipment and Utensils FC-4 3-50L14(A) Cooling Cooked PHFs from 140°F to 26 Water.Plumbinq and Waste 70"F Within 2 Hours and From 70'F 27, Physical Facility FC-6 .007 ! to 41°F145"F Within 4 Hours. * 1 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(B) Cooling PHFs Made From Ambient 1 29. S eclat Requirements .009 Temperature Ingredients to 41'F/45'17 30. Other Within 4 Hours* Denotes critic,[item in rite federal 1999 Fard Code or 105 Cs1R 590.000. { 9 Massachusetts Department of Public Health Salem Board of Health 120 Washington Street;4th Floor Division of Food dnd Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax(978) 745-0343 Name Date T of 0 eration s Tvoe of Inspection A)r tSW1 /,vS k/S6 P,d /Aq Food Service ❑ Routine Address Risk ❑ Retail ❑ Re-inspection' /off/ ESSGX S� Level ❑ Residential Kitchen Previous Inspection Telephone e J S6 S6 yt/( ❑ Mobile Date:6-/57c3 OwnerHACCP Y/N ❑ Temporary ElPre-operation 15?� , ur 2eq ge)}/u A41A6y Ie_ll ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) I / 1d; 0 cG' Time El Bed&Breakfast El General Complaint o .c,1 In: ElHACCP InspectorD. ov lr411e1_2 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 El` 13. Handwash Facilities EMPLOYEE HEALTH i PROTECTION FROM CHEMICALS ' ❑ 2. Reporting of Diseases by Food Employee and PIC ' __- . `ti ❑ 3. Personnel with Infections Restricted/Excluded El 14.Approved Food or Color Additives FOOD FROM APPROVED SOURCE, �e.._ ,So, El15.Toxic Chemicals 0 4. Food and Water from Approved urce J TIME/TEMPERATURECONTROLS(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 re Prot a m PR ECTION FROM CONTAMINATION 19. Hot and Cold Holding 8. Separation/Se ation/Protection p g g ❑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 [3 10. Proper Adequate Handwashing -❑ 11. Good Hygienic Practices :.CONSUMER ADVISORY v ❑ 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 / G 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 N by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2)(590.0 order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.0044)) cited in this report may result in suspension or revocation of 25. Equipment and utensils (Fc-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing FR28. 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 t�q,r er. 30. Other DATE OF RE-INSPECTION: / OY s:ssornspecrFomura.ex Ins ct ' re: Print: PIt;'s Sign r : Pri . -"' Page-of Pages IV Violations Related to Foodborne Illness interventions and Risk Factors(items 1-22) PROTECTION.FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 8 Grass-contamination 1 590903{A} Assi*mment ofRonsibthty` 3-302.11(A}(1) Raw Animal Foods Separated from 590.003(B) DemanstraimnofBnowledbe= Cooked and RTE Foods* 2-_103.t I Person in charge--duties Contamination from Raw ingredients 3-302.11(A)(2) Raw Annual Foods Separated from Each EMPLOYEE HEALTH Other* 2 590.003(0) Responsibility of the person in charge to Contamination from the Environment require reporting by food employees end 1-302.110) Foal Protection* a tticantsx' 3-302.1$ Washin Fruits and Vegetables 590.003(F) Responsibility Of A Food Employee Or An 3-304.11, Food Contain with Equipment and Applicant To Report To The Person In Utensils* Charge* Contamination from the Consumer 590.003(G) 12e Cortina b-Person n C:batge* 3-306.14(A)(13) Returned Food and Rcscrvi e of Faxl* 3 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated i90.003(E) Removal of Exclusions and Restrictions Food _ 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food" 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 590.004(A-B) Com tliance with Food Law* 4-SQl.I l I Manual\4'arewashing-Hof Water 3-201.x' Food in a Hermetically Sealed Container* SanitiZatiOn Tem eratures* 3-201 !3 Fluid Milk and Milk Products* 4-501.11.2 Mechanical Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization Tent eratures* 3-202.14 E>>s and Milk Products,Pasteurized" 4-501.114 Chenicat Sanitization-temp., pH, concentration and hardness 3-202.16 lce Made From Potable Drinking Water* 'r 5-lOt.11 Dritd:in-Water farm an A roved Svstent* 4-601.11(&) Equipment Food Contact Surfaces and Utensils Clean" 590.006(A) Bottled Drinking Water* 4-602.71 Cleaning Frequency of Equipment Food- 590 006(B) Water Meets Standards in 310 CMR 22.Ot` Contact Surfaces and Utensils' ShefHsh and fish Froman Approved Source 4-71127 1. Frequency of Sanitization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of E ui ment" Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical"' Sources" Proper,Adequate Handwashing Re MatoAuthori[ Game and AutWild Mushrooms Approved by 2-301.I Ii Clean Condition-Hands and Arms* 3-20218 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash- 3-201.17 Game Animals' 11 Good Hygienic Practices 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-202.11 PHFs Received at Poolucr Temperatures* 2-401.12 Discharges,From the Eyes,Nose and 3-202.'15 Package Ince n,* Mouth' 3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When Tasting" Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from 3-20312 Shellstock Identification Maintained'" Em L? ees* Tags/Records: Fish Products 13 Handwash Facilities 3-402.11 Parasite Dcstruction* Convenientry Located and Accessible 33-402.12 Records.Creation and Retention* 5-203.11 Numbers mid Capacities"- 590.00-'ICI) Labeling of Ingredients' 5-204.11 Location and Placement* 7 Conformance with Approved Procedures 5-205.11 Accessibility_Operation and Maintenance /HACCP Plans Supplied with Soap and Hand Drying 3-50111 Specialized Processing Methods* Devices 3-502,12 Reduced oxygen >acki ring,criteria* 6-301.11 Handwashing Cleanser,Availability 8-103.12 Conformance with A. p roved Procedures* 6-301.1.2 Hand DMRProvision *Denotes critical item in the tisderal 1999 Food Code or 105 CMR590.000 CITY OF SALEM BOARD OF HEALTH y. Establishment Name: �?�, Suite/.mss 7/t/,sfr /'�//��'B Date: Page: 02 of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY S c5iZo,1z _ . 91. 9e ome Saw/ d f�wo L{ e - Psi C CP,4�9S Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion comply with all mandates of the Mass/Federal Food Code. I understand that LI Re-inspection Scheduled ❑ Emergency Suspension noncompliance may result in daily fines of two ty fiveo11ar or s spension/revvoccatiop of ❑ Embargo ❑ Emergency Closure your food permit. ❑ voluntary Disposal 0 Other: 3-501.14(C) PHFs Received at Temperatures Violations Related to Foodborne Illness Interventions and Risk Acc rding to Law Cooled to Factors(items 1-22) (Cont) 41'F/45'F Within 4 Houts. PROTECTION FROM CHEMICALS 3-501.15 -Cooling Methods for PHFs 14 ( Food or Color Additives 19 PHF Hot and Cold Holding 3-501.16(B) Cold PRFs Maintained at or below 3-202.12 Additives* 590.004(F) 41'/45°F* 3-302.14 Protection frorn Un2p roved Additives* 3-501.16(A) Hot PHFs Maintained at or above LS Poisonous or Toxic Substances IAO,F. 7-101.11 Identifying Information-Ori.nal 3-501.16(A) Roasts Held at or above 130'F. Containers" 20 7-102.11 Common Name-Working Containers"` 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) VWlance Requirement 7-202.12 Conditions of Use* 7-204.11 'toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanitizers.Criteria-Chemicals* POPULATIONS(HSP) 1-2('14.13 Chemk:ats for Washing Produce,Criteria* 21 3-801.1.1(A) Unpasteurized Pre.paokaged Juices and 7-204.14 Dr aria Agents.Criteria' Beveiattes with Wi ntin-I..abels* 7-205.1.1 Incidental Food Contact,Lubricants` 3-80 L71(B) Use of PastUuizad Ee*�+s* 7-206.11 Restricted Use Pesticides,Criteria"' 3-SQ1.1.1(D) Raw or Partially Cooked Animal Food and 7-206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served 3-801-i l(C) Re-served. 7-206.13 Tracking Powders, Pest Control and Monitoring* CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal F'oids'fhat are Raw. Undercooked or PHFs Not Otherv,isa Processed to Elhmnate 3-401.11A(1)(2) Eggs- 155'F 15 Sec. Patho ens F *s-Immedi Ira,Service 145°F t5sec* 3-302.13 Pasteun rend Fe„s Substitute fol Raw Shell F aasr 3-AQUI(A)(2) Comminuted f=ish.Meats&Game Animals- 155'F 15 sec. "` 3-401.11B)(1)(2) Pork and,Beef Roast- 1.30'F-121 min'" SPECIAL REQUIREMENTS _ 3-401.11(A)(2) Ratites,htjected Meats-155°F 15 590-009(A)-(D) Violations of Section 590.009(A)-(D)in ec.* entering, mobile fond, temporary and 3-401.11.(A)(3) Poultry,Wild Game, stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Poultry or Ratites-165'P 15 see. * above if related to foodborne illness 3-401.11(C)(3) Whole-muscle,Intact Beet Steaks interventions and risk factors. Other 145-F 1= 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Cooked in a practices should be debited under#29- Microwave 165`F* Special Requirements. 3-401.11(A)(1)(b) All Other PHFs-145'F '15 sea 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.11(A)&(D) PHFs 165`-F 15 sec. *= (Items 23-30) 3-403.11(B) Microwave-165'F 2 Minute Standing Critical and non-critical violations, which do not relate to the Time* foodbome illness interventions and risk factors listed above, call be 3-403.1.1(C) Commercially Processed RTE Food- 16uml in the following sections of die Food Code and 105 CA4R 14WF` 590.000. 3-403,11(E) Remaining Unsliced Portions of Beef )fast Good Retail Practices a FC 590.000 Roasts: 23. Manament andgePersonnel ! FC-2 .003 18 Proper Cooling of PHFs Utensils -- - 005 -- - 24. Food and Food Protection FC 3 004 25. Egwpment and Utensils I 4 .005 ! 3-501.14(A) Cooling Cooked PHFs from 140`F to 26. Water.Pumbir and WasteTFC-5 70'F Within 21-lours and From 70'F i 27. -Physical Facility FC-6 .007 C to 41'FI45"F Within 4 Hours. * 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(13) Cooling PHFs Made From Ambient 29. Special Requirements .009 Cooling - 30. Other Temperature 1n;;rulientx 0.i 41'F/4,5'F - 1 ........... . . Within A Hours" *Denotes critical item in the;red,ral 1999 Fnod Code no 105 C&IR 590.000. uHwr CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 3 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY 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 p P a Food Establishment in the City of Salem is hereby granted to: Owner ' s Name : Andrew & John Mahoney Name of Establishment : McSwiggins Irish Pub & Restaurant Address of Establishment : 121 Essex Street Type of Establishment : FOOD SERVICE Application Date : 12/19/2002 Restrictions : Permit for Food Establishment 107-03 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 2003 This permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. HEALTH (/ HEALTH AGENT o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 A'b'p FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS. CHO MAYOR HEALTH AGENT 2003 APPLICATIONFOR PERMIT TO OPERATE A FOOD�ESSTTABUSHMENT /�,, NAME OF ESTABLISHMENT /Y`6WI9/nS -7✓?!54 P�:4W L# CJ -/e- —7y-r S6S� ADDRESS OF ESTABLISHMENT ��J Ss�.(� 5>`' S 9 Lac`^ MAILING ADDRESS (if different) OWNER'S NAME 241JP � '"` h /Y) r!?oY��j TEL# 95 ADDRESS3� CITY 1,,4e STATE -v4 ZIP d/ CERTIFIED FOOD MANAGER'S NAME(S)4mdool✓ !'nehc";CERTIFICATE#(s) Ex '7ov'—A-05I 1&f2 (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON Ai, h/ HOME TEL# L/ 3 4 o '3 HOURS OF OPERATION: Mon' ue. ed./,'�AThu. /:ct� Fri./ ge8at/-� q..Yfiun./I�a //• - TYPE OF ESTABLISHMENT FEE check only RETAIL STOREYES 1�0 less than 1000sq.ft. =$ 50 1000-10,000sq.ft. =$100 more than 10,000sq.ft. =$250 RESTAURANT / 'ES NO '0.3 less than 25 seats =$100 l� 25-99 seats �],>tfU more than 99 seats =$200 BED/BREAKFAST YES NO $100 ADDITIONAL PERMITS MAKE ICE CREAM, YOGURT, SOFT SERVE YES N $5 TOBACCO VENDOR YES N $50 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. Pursua to MGL hapte 2C, Section 49A, I certify under the pains and penalties of perjury that I, to my best I d e d of have filed all st to t returns and paid all state taxes required under the law. Signature Datef Social Security or Federal Identification Number ----------------- --------------- ------------------------------- Revised 11/25/02 FOODAP2.adm Check#&Date r✓� /a��QoZ L THE COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM BOARD OF HEALTH Address: 120 Washington Street, 4th Floor Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel: (978) 741-1800 Fax: (978) 745-0343 Name /� Date Type of Operations) Tyne of Ins ection f u.� (�S OJ Food Service Routine Address Risk ❑ Retail ❑ Re-inspection Level ❑ Residential Kitchen Previous Inspection Telephone /9�� l El Mobile Date: Owner HACCP Y/N ❑ Temporary ❑ Pre-operation f,,� i'aH.� /�IIL9.46.oec ❑ Caterer ❑ Suspect Illness Person in Charge 7.IC) Time ❑ Bed&Breakfast ❑ General Complaint Inspector In: Ppt El HACCP TEl� Out: Permit No. /e7-03 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 ❑ 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 TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) El 4. Food and Water from Approved Source El16. Cooking Temperatures El 5. Receiving/Condition , El6. Tags/ Records/Accuracy of Ingredient Statements El 17. Reheating ❑ ❑ 7. Conformance with Approved Procedures/ HACCP Plans 18. Cooling ❑ 19. Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20. Time as a Public Health Control ❑ B. Separation/Segregation/ Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ❑ 21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related 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 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: � . ...� Print: PIC's Signature: ` Print: Page -L-ofPages FORM 734A HOBBS&WARREN - BOSTON Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) PROTECTION FROM CONTAMINATION i -8 Cross-contamination FOOD PROTECTION MANAGEMENT 3-302.11(A)(1) Raw Animal Foods Separated from 1" 590.003(A) Assignment of Responsibility* Cooked and RTE Foods* 590.003(B) Demonstration of Knowledge* Contamination from Raw ingredients 2-103.11 Person in Charge-Duties 3-302.11(A)(2) Raw Animal Foods Separated from Each Other* EMPLOYEE HEALTH Contamination from the Environment 2< 590.003(C) Responsibility of the Person in Charge to 3-302.11(A) Food Protection* require reporting by Food Employees and 3-302.15 Washing Fruits and Vegetables Applicants 3.304.11 Food Contact with Equipment and 590.003(F) Responsibility of a Food Employee or an Utensils* Applicant to Report to the Person in Charge* Contamination from the Consumer 3-306.14(A)(B) Returned Food and Reservice of Food* 590.003(G) Reporting by Person in Charge* Disposition of Adulterated or Contaminated 3590.0030) 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 ILL Food and Water From Regulated Sources 4-501.111 Manual Warewashing-Hot Water 590.004(A-B) Compliance with Food Law' Sanitization Temperatures* 3-201.12 Food in a Hermetically Sealed Container* 4-501.112 Mechanical Warewashing-Hot Water 3-201.13 Fluid Milk and Milk Products* Sanitization Temperatures* 3-202.13 Shell Eggs* 4-501.114 Chemical Sanitization-tem H, 3-202.14 Eggs and Milk Products,Pasteurized* P'p @g Concentration and Hardness 3-202.16 Ice Made from Potable Drinking Water* 4-601.11(A) Equipment Food Contact Surfaces and 5-101.11 Drinking Water from an Approved System* Utensils Clean* 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Equipment Food- 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces and Utensils* Shellfish and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils and 3.201.14 Fish and Recreationally caught Molluscan Food Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization- Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* 10 ; Proper,Adequate Handwashing Game and Wild Mushrooms Approved by 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* ]1 Good Hygienic Practices 3-20L17 Game Animals* 2-401.11 Eating.Drinking or Using Tobacco* 5- Receiving/Condition 2401.12 Discharges From the Eyes,Nose and 3-202.11 PHFs Received at Proper Temperatures* Mouth* 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-101.11 Food Safe and Unadulterated* :12'" Prevention of Contamination from Hands :6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from 3-202.18 Shellstock Identification* Employees* 3-203.12 Shellstock Identification Maintained* 13" Handwash Facilities Tags/Records: Fish Products Conveniently Located and Accessible 3-402.11 Parasite Destruction* 5-203.11 Numbers and Capacities* 3-402.12 Records,Creation and Retention* 5-204.11 Location and Placement* 590.004(1) Labeling of Ingredients* 5-205.11 Accessibility,Operation and Maintenance 7 Conformance with Approved Procedures Supplied with Soap and Hand Drying HACCP Plans Devices 3-502.11 Specialized Processing Methods* 6-301.11 Handwashing Cleanser,Availability 3-502.12 Reduced Oxygen Packaging,Criteria* 6-301.12 Hand Drying Provision 8-103.12 Conformance with Approved Procedures* •Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. r CITY OF SALEM BOARD OF HEALTH Establishment Name: c Sw; ;,.'r Date: Page: of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified PLEASE PRINT CLEARLY to H / a E 77'4/...:•.�7T/O.v r' .� Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask que tions a agree to correct all Voluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditio s as die cribed, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federa Food Code. !underst nd that noncompliance may result in daily fines of ty-five Bolla s or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: 3-501.14(C) PHFs Received at Tetvl)eratttres Violations Related to Foodborne Illness Interventions and Risk According to Law Cooled to Factors(Items 1-22) (Cont) 41'F/45'F Within 4 Hours, PROTECTION FROM CHEMICALS 3-501.15 CoolingMethods for PHFs 14 Food or Color Additives 19 PHF Hot and Cold Holding 3-262.12 Additives* 3-501.16(B) Cold PHN Maintained it or below 3-302.14 590.004(F) 41°/45°F* Protection from t1na� roved �dditivec* is Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above 140°F. 7-I0I.11 Identifying 7nformation-Original 3-501.10(A) Roasts Held atorabove 1.30'F.* ContainerO 7-102.11 Common Name:'�W)rkirig Containers* 20 Time as a Public Health Control 7.201.11 Separation-Svol dre' 3-501,19 Time as a Public Health Control* 7-202.11 Restriction-Presence and Use* 590.004(ti) Variance Requirement 7-202.12 Conditions of Ilse* 7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanitizers.Criteria-Chemicals* POPULATIONS(HSP) 7-204.12 Chemicals forWashin,Produce.Criteria* 21 3-ROI.Lt(.4) Unpasteurized Pre-packaged Juices and BeeaLes with 1>warnin-1. abels* 7-�04.I4 Drying Agents.C r teria* 3-801.11(8) Use of Pasteurized F-ns* 7-205.11 Incidental Food Contact,Lubricants* 7-206.11 Restricted Use Pesticides,Criteria* 3-801.1,I(D) Raw or Partially Cooked Animal Food and Raw Seed Sprouts Not Served. 7-20612 Roden'Bair Stailons" 3-801.1.1(0 L1no tined Ftwd Packa>e Not Re-served. * 7-206.13 Tracking Powders,Pest Control and Monitorin i* CONSUMER ADVISORY TIMEITEMPERAT_URE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods`that ate Raw. Undercooked or PHFs Not Otherwise Processed to Eliminate Patho ens' L ns-Immedt ate Service,145°ElSsecf r'.Grce, roof 3-401.115(1)(2) Es-s 155 15 Sea 3-302.13 Pasteurized Eggs Substitute for Raw Shell ed 3-401.il(A)(2) Comminuted Fish.Meats&Gsme go,,s* Animals 155+ 15 sec. 3-401.11(B)(1)(2) Poi kand Beef Roast- 130"F121min SPECIAL REQUIREMENTS 3-401.11(A)(2) Ratites, Injected Meats- 155'F 15 590.009(A) (D) ations of Section 590.009(A)-(D)in tic mobile food, temporary and 3-401.11(A)(3) Poultry,Wild Game Sabred PHFs. denunl kitchen operations should be 5tunrng l:ontaintng Fisb,Meat. ...,J,ew ..oder illi. _i�.te Poultry or Ratites-165'F 15 sec. * above if related to foodborne illness 3-401.11(0(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 145"17' 590.009 violations relating to good retail 3-101.12 Raw animal Foods Cooked in a practices Should he debited under#t29- Microwave 165'F* Special Requirements. 3-401.1I(A)(1)(b) All Other PHFs- 145'F15 sec. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.11(,5)&(D) PHFs 165'F 15 sec. * (Items 23-30) 3-403.11(B) Microwave- 165'F 2 Minute Standing Critical and non-critical violations, which do not relate to the Time* ,foodborne illness internentions and risk factor- listed aboee, care be 3-403.1.1(0 Commercially Processed RTF Faid- found in the follon ing sections of tine flood Code and 105 CMR 140W17 590.000. 3-403.'1l(E) Remaining Unsliced Portions of Beef Item 1 Good Retail Practices 1 FC 590.000 Roasts* 1_23_ _ 1 Management and Personnel FC FG-2 .003 ig Proper Cooling of PHFs 24. Food and Food Protection FC--3 .004 26. rVPlumbing and Waste -G 4 ,005 i 25. Equipment and Utensils__ _FG 3-501.14(5) Cooling Cooked PHFs from 14G°F to FC-5 .006 70'F Within 2 Hours and From 70'F 27. Physical FacilityFC-6 ,0077 T to 41'F/45'F Within 4 Hours. * 28. Poisonous or Toxic Materials IFC-7 .008 3-501.14(B) Cool ingPHFs Made From Ambient 29. Special Requirements .009 Temperature Ingredients to 41'F/45'F 30. Other Within 4 Hours* S') s Denore9 critical item in the federal 1999 Food Code ur 105 CMR 590.000.