The URL can be used to link to this page

NY GYRO - ESTABLISHMENTS N`I 1 33 5 LejF1jV Sj & U universal one. www.myuniversalop.com phone: 1-800-756-4676 UNV16162 MADE IN USA . C -J .k Note: 10' x 3' S.S.exhaust hood to be submitted for approval including make up air, exhaust to roof w/ gooseneck, flashing ,: No. / Desaiption Equipment / btu or elec, amp. details 10' from window, ansul system and underhood lighting.La 1 gyros slicer univex 6512 tluro slicer 551011 15' 211 _ 2 NLR23-s freezer.3/8 hp 115/60/1/ 7.5amp . F we Is. 3 oas hot lates 804H btu120000/104000 qDloayfrontl — as table ' as rid le 848T btu 60000 , „, 2 10 13 0 rel �� 5oos re sinkw/drainboards 18D18 EEIP �ar " , ; 1011011-- 6 Bev air 48"salad bar 60hertz 5 amp 115 volts. •Via, I Qua"Tile Kitchen ----- utt 12' 4 drain with trap7 i n it r 1 6r 12 9° s fbrml oo ter 9 ' "' sink T- SS 3� pa8 itoo 40 d as er 115000 btu En coup r38"wld y I S am ® - Boos pro bovrl ss. hand sink bhs-w 1410- sslr 63G eo r.r. FRPwai — = 10 NLR23-s refriger.3/8 hp 115/60/1/ 7.5am 23' 3" n_'_e p�� --1360w/ n� nt c H AC unk ci 11 display cooler 115/60/17.5 am 11= __ _____d� __��9_=_-____ 8 12 0 roilerG ros3N•380V/5 HZ2.6kw _ __ y__ ---__-____1______-___ Tiia P P walla. 13 Boos GS6 S. .table 6.3060 3048ss FRP AW. - i 14 Boos mo sink mounted EMS 2016-12 . 101611 15 Boos 3 compsink w/drainboards 3B16204-20118 rP Tile rest*K 51111 zco s El� r uNaeR------- restlpom I 5 6 4" 251011 531611 :7711 170 T7 New York Gyro MECHANICAL PLAN / TENANT FIT UP 335 Lafayette Street LEGEND: Scale: 3/16" = 1'•0° Salem, MA © smoke detector existing ® heat detector HHD sign Gro est• c�:JP emergency light existing m fire horn light NOTES: (Ceilings are existing 1HR 12 x 12 acooustic the at dining area), Marblehead, MA 01945 ® g n9 781 639 3493 carbon detector ® knox box New 2x2 vinyl 1 HR moisture resistant kitchervback counter•aooustcASTME84. David M. Haliotis, Assoc, AIA ED fire horn light existing Floors are existing VCT the with vinyl base. Ktchen new quarry tile floors and 9 9 base.All walls are painted gwb throughout. Prep counters are stainless steel 14 e Occupancy 20 Persons, &walls are FRP with vin ,E manual pull station existing 1,150 sq. ft. FYI base in kitchen. 9 existing callings. Hood wall areas Q��`s s C. 'rF� q (shown on plan)are 5/8 type x gwb w/1/2 durarock ovedayed&taped joints �6 y exit sign existing z A 1 9 g (1 HR)w!stainless steel finish panels. Customer service counters are formica. 0_0 emergency light w/ exit sign Lighting is existing and flourecent, w/new added lumination at prep areas, - No. 3299 BOSTON, u, New 200 amp electric sub panel, existing furence and existing hvac system :� MA � ® fire extinguiser and ducts to remain. rN Tic rn�SS� �'y�`oNDiTq�a� City of Salem, Massachusetts r f • �� _Y i. 3 Board of Health 120 Washington Street, 4th Floor, Salem, MA 01970 Tel. (978) 741-1800 Fax. (978) 745-0343 PlablicHealth M ,D Iramdin@salem.com Prevent. Promote. Protect. Kimberley Driscoll Larry Ramdin, MPH, REHS, CHO Mayor Health Agent FOOD ESTABLISHMENT PERMIT (must be posted on the Premises of the Food Establishment) 2016 Permit Number: FM-1669 Permit Type: Food Establishment< 25 seats Goods &Services: Food Service: 0-24 seats Name of License Holder: NY Gyro Dildar Hussain Name of Food Establishment NY Gyro Address of Food Establishment 335 Lafayette Street Restrictions: This License is granted in conformity with the statutes, Regulations and ordinances relating thereto,and expires on 12/31/2016 unless sooner suspended or revoked. Permit Fee: $140.00 Issued: 1/1/2016 • CITY OF SALEM, lu MASSACHUSETTS P191.1 xeatch BOARD OR HEALTH ..�...., 120 WASIIING I ON S'ilu;171 r,411,FLOOR KID4SERLEY DRISCOLL Tel..(978)741-1800 FAX(978)745-0343 LARRY RANIDIN,RS/W-;HS,Cr10,Cr-rS MAYOR Immdin@salem.com HI,ALU iAGHN,I, Food Establishment Permit Application (Application must besubmitted at least 30 days before the planned opening date) 1) Establishment Name: /v / 2) Establishment Address: 3-K La -71 3) Establishment Mailing Address(if different): 7/ 4) Establishment Telephone No: 7� / / - 2- 5) Applicant Name&Title: �i G�� NUSfl�/N 17 1'�16;r 6) Applicant Address: , )q^ 12)2 ell 4,141 7;/V;iZ4P 111.9 D 1'743 34 7) Applicant Telephone No: 9 J ' 4 H ouragency No: Email: 8) Owner Name&Title(if different from applicant): 9) Owner Address(if different from applicant): 10) Establishment Owned by: 11) If a corporation or partnership,give name,title and home address of officers or partner. An association Name Title Home Address A corporation, An individuals. A partnership Other legal entity 12 Person Directly Res onsible For Daily Operations Owner, Person in Charge, Supervisor,Manager,etc. Name&Title: n, �aVG°e Address: d />®✓1-O ejw / Telephone No: Doo- 32-7—Ey- Fax: Email: Emergency Telephone No: 13) District or Regional Supervisor(if applicable) Name&Title: Address: Telephone No: Fax: Email: Check#: //3-o _ Date: /02- 1 f-- /r Amount: / ( 0 ' 0 Food Establishment Information 14) Water Source: 15) Sewage Disposal: DEP Public Water Supply No: (if applicable) 16) Days and Hours of Operation: ( %�r� 11104 7014'A 17) No. of Food Employees: 18) Name of Person in Charge Certified in Food Protection Management: Required as of 101112001 in accordance with 105 CMR 590.003(A) 3 19) Person Trained in Anti-Choking Procedures( if 25 seats or more): ❑ Yes No 20) Location: 22) Establishment Type(check all that apply) (check one) ❑ Retail ( Sq. Ft) ❑ Caterer Permanent Structure r/ ❑ Food Service-( 20 Seats) O Frozen Dessert Manufacturer Mobile ❑ Food Service—Takeout ❑ Residential Kitchen for Retail Sale ❑ Food Service—Institution ❑ Residential Kitchen for Bed and ( Meals/Day) Breakfast Home ❑ Food Delivery ❑ Residential Kitchen for Bed and 21) Length Of Permit: --,-----Breakfast Establishments---------------------- (check one) RETAIL STORERR STI Annual ❑ Less than 1000sq.ft. $70 -Less than 25 seats $140 Seasonal/Dates: 17 1000-10,OOOsq.ft. $280 ❑ Residential Kitchens $140 ❑More than 10,000sq.ft. $420 ❑25.99 seats $280 ❑More than 99 seats $420 Temporary/Dates/Time: --------------------------------------------------- - _10'g----- ❑ Bed& BreakfastlChildcare Services/Nursing Home $ - - - -- - -- -------------------------------------------------------------- ------------ ---------- ADDITIONAL PERMITS ❑MAKE ICE CREAM,YOGURTISOFT SERVE $25 ❑ PASTURIZATION $25 ❑ALL NON-PROFIT' $25 *Including, church kitchens, state funded childcare&private club 23) Food Operations: Definitions: PHF—potentially hazardous food(timeltemperature controls required) Non-PHFs—non-potentially hazardous food(no timaltemperature controls required) (check all that apply): RTE—ready-to-eat foods Ex.sandwiches,salads, muffins which need no further processing Sale of Commercially PHF Cooked to Order Hot PHF Cooked and Cooled or Hot Held Pre-packaged Non-PHFs l.i for More Than a Single Meal Service Sale of Commercially Preparation of PHFs For Hot And PHF and RTE Foods Prepared For Highly Pre-packaged PHFs Cold Holding for Single Meal Service Susceptible Population Facility Delivery of Packaged PHFs Sale of Raw Animal Foods Intended to be Vacuum Packaging/Cook Chill Prepared by Consumer Reheating of Commercially Customer Self-Service Use of Process Requiring A Variance Processed Foods for and/or HACCP Plan(including bare hand Service Within 4 hours contact alternative,time as public health control. Customer Self-Service of Ice Manufactured and Packaged for Offers Raw or Undercooked Food of Non-PHF and Non- Retail Sale Animal Origin Perishable Foods Only Preparation of Non-PHFs Juice Manufactured and Packaged for Prepares Food/Single Meals for Catered Retail Sale Events or Institutional Food Service Offers RTE PHF in Bulk Quantities To be completed by the Board of Health Retail Sale of Salvage,Out of Date or Reconditioned Food Total Permit Fee: Payment is due with application I,the undersigned,attest to the accuracy of the informationprovidedin this application and I affirm that the food establishment operation will comply with 105 CMR 590.000 and all other applicable law. I have been instructed by the Board of Health on how to obtain copies of 105 CMR 590.000 and the Federal Food Code. 24) Signature of Applicant: 14 Pursuant to MGL Ch.62C, sec. 49A,I certify under the penalties of perjury that I,to my best knowledge and belief, Have filed all state tax returns and paid state taxes required under law/.' 25) Social Security Number or Federal ID: n �v 7 77 26) Signature of Individual or Corporate Name: -� 0 %�oNDIT�ydle� City of Salem, Massachusetts Board of Health q 120 Washington Street, 4th Floor, Salem, MA 01970 Pm Tel. (978) 741-1800 Fax. (978) 745-0343 PablicHealttl Iramdin@salem.com Prevent. Promote. Protect. Kimberley Driscoll Larry Ramdin, MPH, REHS, CHO Mayor Health Agent FOOD ESTABLISHMENT PERMIT (must be posted on the Premises of the Food Establishment) 2015 Permit Number: FM-15-287 Permit Type: Food Establishment< 25 seats Goods &Services: Food Service: 0- 24 seats Name of License Holder: NY Gyro Dildar Hussain Name of Food Establishment NY Gyro Address of Food Establishment 335 Lafayette Street Restrictions: This License is granted in conformity with the statutes, Regulations and ordinances relating thereto,and expires on 12/31/2015 unless sooner suspended or revoked. Permit Fee: $240.00 Issued: 419/2015 CITY OF SALEM, MASSACHUSETTS rnbttcIieatth BOARD OF HEA1;1'1-1 ....,.obm ...., 120 WASHINGTON S'IREE'1',4"'FLOOR KIMBERLEY DRISCOLL - TEL.(978)741-1800.FAX(978)745-0343 LARRY RAMDIN,RS/RI?IIS,CIIO,CP-FS MAYOR Iramdin@salem.com HEAll114AGF,NT Food Establishment Permit Application (Application must be submitted at least 30 days before the planned opening date) 1) Establishment Name: /V 2) Establishment Address: 3 3f Z /yA:' %7YF `ST 3) Establishment Mailing Address(if different): 4) Establishment Telephone No: / 7 79/ - 5) 9/5) Applicant Name&Title: J>" SSAjh/ OW N�- 6) Applicant Address: 0��/v1 7) Applicant Telephone No:`179'3278TIT-24Hour Emergency No:/�tf "32-7- Wll- Email: ,BllPitE(Dyu/�T�pQ r 8) Owner Name&Title(if different from applicant): 9) Owner Address(if different from applicant): 10) Establishment Owned by: 11) If a corporation or partnership,give name,title and home address of officers or partner. An association Name Title Home Address A corporation An individual `— A partnership Other legal entity 12 Person Directly Res onsible For Daily Operations Owner, Person in Charge,Supervisor,Manager,etc. Name&Title: 11US ,41A/� kows-P Address: 2- C0ep>% 4 P� I-rlk e- Telephone No: S-327 Fax: Email: Emergency Telephone No: 78-3z7 - 9Y(S 13) District or Regional Supervisor(if applicable) Name&Title: Address: Telephone No: Fax: Email: Check#: 13 9' Date: 19111 Q 9, Amount:_0 Food Establishment Information 14) Water Source: 613Lt'c. 15) Sewage Disposal: �J�Gt•c DEP Public Water Supply No: (if applicable) 0 16) Days and Hours of Operation: //415/fb 1111V 7PVIS 17) No. of Food Employees: QNB 18) Name of Person in Charge Certified in Food Protection Management: Required as of 1011/2001 in accordance with 105 CMR 590.003(A) Pi2-'9 ge 111"5f9/W 19) Person Trained in Anti-Choking Procedures(if 25 seats or more): ❑ Yes No 20) Location: 22) Establishment Type(check all that apply) (check one) 17 Retail( Sq. Ft) 0 Caterer Permanent Structure t,- JgFood Service-( 2 v Seats) 0 Frozen Dessert Manufacturer Mobile 0 Food Service-Takeout ❑ Residential Kitchen for Retail Sale ❑ Food Service-Institution ❑ Residential Kitchen for Bed and ( Meals/Day) Breakfast Home ❑ Food Delivery 0 Residential Kitchen for Bed and 21) Length Of Permit: - .Breakfast Establishments (check one) RETAIL STORE RESTAURANT Annual 0 Less than 1000sq.ft. $70 A Less than 25 seats $140 Seasonal/Dates: 13 1000-10,000sq.ft. $280 ❑ Residential Kitchens $140 0 More than 10,000sq.ft. $420 ❑25-99 seats $280 ❑More than 99 seats $420 ------- - ------------------------------------------------------------------------------ TemporarylDatesMme: ❑ Bed&BreakfasUChildcare Services(Nursing Home $100 --------------_................................................................... ----- .-... ...................... ADDITIONAL PERMITS 0 MAKE ICE CREAM,YOGURT/SOFT SERVE $25 0 PASTURIZATION $25 0 ALL NON-PROFIT" $25 *Including, church kitchens, state funded childcare&private club 23) Food Operations: _ Definitions: PHF—potentially hazardous food(umeltemperature controls required) Non-PHFs—non-potentially hazardous food(no dina/temperature controls required) (check all that apply): RTE—ready-to-eat foods Ex.sandwiches,salads,muffins which need no further processing Sale of Commercially PHF Cooked to Order Hot PHF Cooked and Cooled or Hot Held Pre-packaged Non-PHFs for More Than a Single Meal Service Sale of Commercially Preparation of PHFs For Hot And PHF and RTE Foods Prepared For Highly Pre-packaged PHFs Cold Holding for Single Meal Service Susceptible Population Facility Delivery of Packaged PHFs Sale of Raw Animal Foods Intended to be Vacuum Packaging/Cook Chill Prepared by Consumer Reheating of Commercially Customer Self-Service Use of Process Requiring A Variance Processed Foods for and/or HACCP Plan(including bare hand Service Within 4 hours contact alternative,time as public health control. Customer Self-Service of Ice Manufactured and Packaged for Offers Raw or Undercooked Food of Non-PHF and Non- Retail Sale Animal Origin Perishable Foods Only Preparation of Non-PHFs Juice Manufactured and Packaged for Prepares Food/Single Meals for Catered Retail Sale Events or Institutional Food Service Offers RTE PHF in Bulk Quantities To be completed by the Board of Health Retail Sale of Salvage,Out of Date or Reconditioned Food Total Permit Fee: Payment is due with application I,the undersigned,attest to the accuracy of the information provided in this application and I affirm that the food establishment operation will . comply with 105 CMR 590.000 and all other applicable law. I have been instructed by the Board of Health on how to obtain copies of 105 CMR 590.000 and the Federal Food Code. f (( 24) Signature of Applicant: -J), Pursuant to MGL Ch.62C, sec. 49A,I certify under the penalties of perjury that I,to my best knowledge and belief, Have filed all state tax returns and paid state taxes required under law. 25) Social Security Number or Federal ID: /� r bb y,/f7 7 26) Signature of Individual or Corporate Name: CITY OF SALEM BOARD OF HEALTH Establishment Name: N'9 Cay Iza Date: )0 g'/ Page: J of Rom Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. R=ence R—Red Item Verified PLEASE PRINT CLEARLY r- ra `n-11� �� ra i�J 1a a�� .� 1 � )�kms✓ 19� �ti SL-t✓^oG'Fi � v Lr�v� 1��, [t> ' by ate` )ta-)s-' 1� Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction inspection, to observe all conditions as described, and to Exclusion violations before the next ins P C3 Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal 0 Other: i Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1.22) (Cont.) 3-501.15 Cooling Methods for P131's 19 PHF Hot and Cold Holding PROTECTION FROM CHEMICALS 3-501.16(13) Cold PHFs Maintained at or below 14 Food or Color Additives 590 004(17) 410/450 F* 3-202.13 Additives* 3-501.16(A) Hot PHFs Maintained at or above 3-302.14 Protection from Unapproved Additives* 140°F 15 Poisonous or Toxic Substances 3-501.16(A) Roasts Held at or above 130°F. 7-101.11 Identifying Information-Original 20 Time as a Public Health Control Containers* 3-501.19 'Time as a Public Health Control* 7-102.11 Common Name-Working Containers* 590.004(l1) Variance Requirement 7-201.11 Separation-Stora e* s, 7-202.11 Restriction-Presence and Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-202.12 Conditions of Use* POPULATIONS HSP _ 7-203.11 Toxic Containers-Prohibitions* 21 3-801.1 1(A) Unpasteurized Pre-packaged Juices and 7-204.11 Sanitizers,Criteria-Chemicals* Beverages with Warnin� Labels* 7-204.12 Chemicals for Washing Produce,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 7-204.14 Drying Agents,Criteria* 3-801.11(1)) Raw or Partially Cooked Animal Food and 7-205.11 Incidental Food Contact,Lubricants* Raw Seed Sprouts Not Served * 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(C) Unopened Food Package Not Re-served. 7-206.12 Rodent Bait Stations* 7-206.13 Tracking Powders,Pest Control and CONSUMER ADVISORY Monitoring* 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or TIMEITEMPERATURE CONTROLS Not Otherwise Processed to Eliminate E Proper Cooking Temperatures for Patho gens.*Err«nro tnrzoot �+ PHFs 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* 3-401.11A(1)(2) Eggs- 155°F 15 Sec. Eggs-Immediate Service 145°I'15sec* SPECIAL REQUIREMENTS 3-401.11(A)(2) Comminuted Fish,Meats&Game 590.009(A)-(D) Violations Of Section 590.009(A)-(D) in Animals- 155°F IS sec. ' catering,mobile food,temporary and F. 3-401.11(6)(1)(2) Pork and Beef Roast- 130°F 121 min' residential kitchen operations should be 3-401.11(A)(2) Ratites, Injected Meats- 155°F 15 sec. debited under the appropriate sections 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHF's, above if related to foodborne illness Stuffing Containing Fish,Meat, interventions and risk factors. Other Poultry or Ratites-165°F 15 sec. * 590.009 violations relating to good retail 3-40t.1 I(C)(3) whole-muscle,Intact beef Steaks practices should be debited under 929- u 145°F* Special Requirements. 3-401.12 Raw Animal Foods Cooked in a Microwave 165°F* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-401 A I(A)(1)(b) All Other PI-IFs- 145°F 15 we.* (Items 23-30) 17 Reheating for Hot Holding Critical and non-critical violations, which do not relate to the J 3-403,11(A)&(D) PI-Ts 165°F 15 sec. * foodborne illness interventions and risk factors listed above, can be found in the following sections of the Food Code and 105 CMR 3-403.1](13) Microwave- 165°F 2 Minute Standing 590.000. r Time Item Good Retail Practices FC 590.000 3-403.11(C) Commercially Processed RTE Food- 23. Management and Personnel FC-2 .003 140°F* 24. Food and Food Protection FC-3 .004 S 3-403.11(F) Remaining Unsliced Portions of Beef 25. Equipment and Utensils FC-4 .005 Roasts* 26. Water,Plumbing and Waste FC-5 .006 i27. Physical Facility FC-6 .007 18 Proper Cooling of PHFs 28. Poisonous or Toxic Materials FC-7 .008 l 3-501.14(A) Cooling Cooked PHFs from 140°F to 29. Special Requirements .009 70°F Within 2 Hours and From 70°F to 30. Other 41°F/45°F Within 41lours. * s5mr-n.:.e+a� 3-501.14(13) Cooling PHFs Made From Ambient Temperature Ingredients to 4117/450F Within 4 Hours* et rl ) PHFs Received at Temperances '.� According to Law Cooled to 4 VF/45°F Within 4 Hours.' •Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. k Massachusetts Department of Public Health Salem Board of Health 120 Washington Street, 0 Floor Division of Food end Drugs Salem, MA 01970-3523 Tel. (978) 741-1800 Fax (978) 745-0343 City/Town of Address: FOOD ESTABLISHMENT INSPECTION REPORT Tel. Name 9 I�► Date T peofOperaflon(s) TJJJpe of Inspection NY 1 Rd i0-1--)S Food Service Routine Address - Risk Retail Re-inspection Telephone Level ❑ Residential Kitchen Previous Inspection ❑ Mobile Date: OwnerHACCP YIN ❑ Temporary ElPre-operation D 1 L ply v t sJ ❑ Caterer ❑Suspect Illness Person-in-Charge(PIC) Time ❑ Bed&Breakfast ❑General Complaint In: ❑ HACCP Inspecto VArf�fj,o 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_(Red Items) Anti-Choking 590.009(E) ❑ 590.009(F) Violations marked may pose an imminent health hazard and require immediate Tobacco ❑ Allergen Awareness 590.009(G) ❑ corrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT NK2. Prevention of Contamination from Hands 0-1. PIC Assigned/Knowledgeable/Duties ❑11Handwash Facilities EMPLOYEE HEALTH ❑ 2. Reporting of Diseases by Food Employee and PIC PROTECTIONTROWCHEMICACS E] 3. Personnel with Infections Restricted/Excluded E] 14.Approved Food or Color Additives El 15.Toxic Chemicals E] 4. F000ddand Water from Approved Source FOO.WRand APPROVED SOURCE TIMEITEMPERATURE:CONTROLS.(PotentfiltyHazardous Foods) ❑ 5. Receiving/Condition [116. Cooking Temperatures ❑ 6. Tags/Records/Accu racy.of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION 19. Hot and Cold Holding [D-lfSeparation/Segregation/Protection ❑ 20.Time as a Public Health Control EJ9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLYSU$CEPTIBLEPOPULATIONSI(Map)` ❑ 10. Proper Adequate Handwashing [121. Food and Food Preparation for HSP ❑ 11. Good Hygienic Practices CONSUMER ADVISORY ❑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. Noncritical(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-zxs90.00 order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3x590.004))) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4x590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5x590.006) establishment operations. If aggrieved by this order,you 27. Physical Facility (FC-6x590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7x590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: s: ara.doc Inspector's Si Print � 3. ) P[Cs Signature: r�S�?-t Priat: ��'G.vH/� /vt�9iN Page/ of_Pages Violations Related to Foodborne Illness interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION g Cross-contamination FOOD PROTECTION MANAGEMENT 3.302.11(A)(]) Raw Animal Foods Separated from 1 I 590,003(A) I Asst*anent of Responsibility* Coked and RTE Foods* 11 590A03(B) I Demonstration of Knowledge' Contamination from Raw Ingredients 2-103.11 Per-son to 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 3-302.1 t(A) Food Protection* require reportin¢by food employees and 3-30215 1 Washing Fruits and Vegetables a plieants* 3-304,11. - Food Contact with Equipment and 590.003(r) Responsibility Of A Food Employee Or An Utensils* Applicant To Report To The Person In Contamination from the Consumer Chat+e* 3-306.14(A)(B) Returned Fwd and Reservice of Food* 590.(N)3(Ci) Reporting by Person in Chargel e* Disposition of Adulterated or Contaminated 3 590.003(D) Exclusions and Restrictions* Food 590.003 E) Removal of Exclusions and Restrictions 3-701.1'1 Discarding or Reconditioning Unsafe Food* FOOD FROM APPROVED SOURCE 4 Food and Water From Regulated Sources 4 Food Contact Surfaces 4-501,.1.11 Manual Warewashm Hot Water 590.004(A-Bl Compliance with Food hawk Z~- 3-201.1,2 Fwd in a Hermetically Seated Container* Sanitization Temperatures* 3201..13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water - 3-202.13 Shell Eggs* Sanitization Tem erantres* 3-202.14 Eggs and Milk Products.Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.16 lee Made From PotableDrinkin Water* concentration and hardness. 5-101.11 DrinkinE Water from an Approved System* 4-601.11(A) Equipment Food Contact Surfaces and Utensils Cleats* 590.006(A) Bottled Drink b Water* 4-6(12.11 CleaningFrequency 590.006(B) Water Meets Standards in 310 CMR 22.0* urfacefacs anand Utensils* of Equipment Food- Contact Su Shellfish and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils and 3-20.1.14 Fish and Recreationally Caught Molluscan Foul Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and. 3-201.15 Molluscan Shellfish from NSSP Lasted Chemical* Sources" 10 Proper,Adequate Handwashing Game and Wil!Mushrooms Approved by 2-301.11. Clean Condition-Hands and Arms* Regulatory Authorft 3-202.18 ShellstockMentification Present* -2--3 Cleaning Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 GameAttimals* tl Good Hygienic Practices g ReceivingiCondit€on 2401.11 Eating,Drinking or Using Tobacco* 3-202.11 P11Fs Received at Properr Temperatures* 2 40 L12 Discharges From the Eyes,Nose,and 3-202.15 Package hitcgrit * Mouth* 3-101.11 Fwxl Safe std:Unadulterated* 3-301.12 Preventing Contamination When'lhstin * - Tags/Records:Shelistock 1.2 Prevention of Contamination from Hands 3-202.18 Shelistock Identification* 590.004(-5) Preventing Contamination from 3-203.7.2 Shellstock Identification Maintained* Employees* Tags/Records:Fish Products 13 Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located and Accessible 3-402.12 Records.Creation,and Retention* 5-1.03.11. Numbers and Capacities* 590.0040) Labeling of Ingredients* 5-204.7.1 Location and Placetnent* 7 Conformance with Approved Procedures 5-2115.11 -Accessibility,Operation and Maintenance fHACCP Plans Supplied with Soap and Hand Drying 3-502.77. Specialized Processing Methods* Devices 3-502.12 Reduced oxygen vacka- g,criteria* 6-3U1.i7. Handwashin Cleanser,Availability 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision '"Denotes critical item in the federal 1999 Food Code or 105 CNIR 590.0013. CITY OF SALEM BOARD OF HEALTH Establishment Name: Date: Page: 2 of Item Code C-Critical nem DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified PLEASE PRINT CLEARLY (kv*]V 'o f B'&Llnl a� N eEtO ^Aca i'vt tic t,I r v rM6rd IV-JP— 0 IS &vJL.4N3Ts2 r)k F,610 D4�46fLA) Qlw1 A o S��'t�v�• 1"'taa� y2+ �) va�I e•+S I� r-�on"5� o-r'. v�;Ili I-EA reieta 1Ja�1 6a /!vl vas t a I a &' 'Vo->� I=a Sod �� F't,✓or� Cooly ��, ��o �r'G6�.�iSFiO I d,lra F'o�� i7tANi - Y1= 1, n t )1—,,:'3r- qN, lIA_ > ` dap ra . o'R 1 .n nsL 14)6, E:r - ) 6�t, )2 (� - -� Qn dl.. To.-t��. l �,e-�iE,a�. )+•� i�►'LGc+i� ��® o��i' I.�o'ciXtc'l `%s 6%ex"D LrkoYcl)d jc44o asst` So I7» i Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion p ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. 11 Cl Voluntary Disposal ❑ Other: h 'v Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) (Cont.) 3-501.15 Cooling Methods for PIiPs 19 - PHF Hot and Cold Holding PROTECTION FROM CHEMICALS _ 3-501.16(13), Cold P1 1Fs Maintained at or below 14 Food or Color Additives 590.004(1,-) 410/450 F* 3-202.12 Additives* 3-501.16(A) Hot PHFs Maintained at or above 3-302.14 Protection from Unapproved Additives* 140°F.* 15 Poisonous or Toxic Substances 3-501.16(A) Roasts Held at or above 130°F 7-101.11 Identifying Information-Original 20 Time as a Public Health Control Containers* 3-501.19 Time as a Public Health Control* 7-102.11 Common Name-Working Containers* 590.004(Ii) Variance Requirement f 7-201.11 Separation-Storage* ' 7-202.11 Restriction-Presence and Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-202.12 Conditions of Use* POPULATIONS HSP 7-203.11 Toxic Containers-Prohibitions* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.11 Sanitizers,Criteria-Chemicals* Beverages with Warning Labels* 7204.12 Chemicals for Washin Produce,Criteria* 3-801.11 B Use of Pasteurized E es* 7-204.14 Drying Agents,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and 7-205.11 Incidental Food Contact,Lubricants* Raw Seed Sprouts Not Served * 7-206.11 Restricted Use Pesticides,Criteria* 1 3-801.11(C) Unopened Food Package Not Re-served 7-206.12 Rodent Bait Stations` 7-206.13 'fucking Powders,Pest Control and CONSUMER ADVISORY Monitoring* 22 3-603.1 I Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or TIME/TEMPERATURE CONTROLS Not Otherwise Processed to Eliminate 16 Proper Cooking Temperatures for ' Pathogens.*etteLn°'�200f PHFs 3-302.13 Pasteurized Eggs Substitute for Raw Shell E s* 3-401.11A(I)(2) Eggs- 155°F 15 Sec. 'r Eggs-Immediate Service 1450F15sec* SPECIAL REQUIREMENTS t• 3-401.11(A)(2) Comminuted Fish,Meats&GamO Oe 590.009 A - D } Violations of Section 590.009(A)-(D) in Animals- 155°F 15 sec. * catering,mobile food, temporary and 3-401.11(6)(1)(2) Pork and Beef Roast- 130°F 121 min* residential kitchen operations should be 3-401.11(A)(2) Ratites,injected Meats-155°P 15 sec. debited under the appropriate sections * t 3-401.1 l(A)(3) Poultry,Wild Game,Ss ,M above if related to foodborne illness PHP*' interventions and risk factors. Other Poultry Containing Fish,Meal, 590.009 violations relating to good retail Point or Ratites-1G5°F 15 sec. ` g t 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks practices should be debited under 429- 145°F* Special Requirements. 3-401.12 Raw Animal Foods Cooked in a Microwave 165°F* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-401.11(A)(1)(b) All Other PHFs- 145°F 15 sec.* (Items 23-30) 17 Reheating for Hot Holding Critical and non-critical violations,which do not relate to the t foodborne illness interventions and risk factory listed above, can be 3-403.11(A)&(D) Plus 165°F I S sec. * found in rhe following.sections of the Food Code and 105 CMR " 3-403.11(13) Microwave- 165°F 2 Minute Standing 590.000. Tinte* Item Good Retail Practices FC 590.000 3-403.11(C) Commercially Processed RTE Food- 23. Management and Personnel FC-2 .003 140°F* 24. Food and Food Protection FC-3 .004 3-403.11(i) Remaining Unsliced Portions of Beef 25. EciOpment and Utensils FC-4 .005 Roasts* 26. Water,Plumbing and Waste FC-5 .006 F-18 Proper Cooling of PHFs27. Physical Facility FC-6 .007 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(A) Cooling Cooked PHFs from 140°I'to 29. Special Requirements .009 ! 70°F Within 2 Hours and Front 70°F to 30. Other 41°F/45°F Within 4 flours. * s:svarua:.da 3-501.14(13) Cooling PHFs Made From Ambient ' Temperature Ingredients to 41°F/45°F Within 4 Hours* 3-501.14(C) PHFs Received at Tempemmres ' Accordine to Law Cooled to ' 410F/450F Within Hours. i i *Dentes critical item in the federal 1999 Food Code or 105 CMR 590.000. CITY OF SALEM BOARD OF HEALTH Establishment Name: tj` ` X R_C�l Date: to` 10 1S Page: - of Rem Code C-Crntcal nem DESCRIPTION OF VIOLATION/PLAN OF CORRECTION fate No. Reference R—Red Item Verified PLEASE PRINT CLEARLY e S .CS�5 " 7c, S I e3 }'t' vd e N CL.": C—, 2 3 �_)'1 — ► f�R� V es L- ,3 � 1 a n�F;I�V' t3%cs S i.� 'j3�S �G,�' . J.-AG 4- ALI,. alt lx� FJD� t c 1 ,. Z ) I jAo,0� I "S nc � CG�e► vl.ca ioN a� QZ n\, le2 1 f'W� �caarr✓ V lase r�Y�,e-+ I=mo Q"dv v-T. b,s.)r fVb ''}.moa-)tit- ds%-- Discussion With Person.in,Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion p ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. 1 understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. 11 13 Voluntary Disposal ❑ Other: t Violations Related to Foodborne Illness Interventions and Risk _.,,,,-'---'--- Factors(Items 1.22) (Cont.) 3-501.15 Cooling Methods for PHFs } 19 PHF Hot and Cold Holding PROTECTION FROM CHEMICALS 3-501.16(8) Cold PHPs Maintained at or below 14 Food or Color Additives 590.004(1') 410/450 P* ¢ 3-202.12 Additives* 3-501.16(A) Hot PHFs Maintained at or above i` 3-302.14 Protection from Unapproved Additives* 140°F. * 15 Poisonous or Toxic Substances 3-501.16(A) Roasts Ileld at or above 130°F. + 7-101.11 Identifying Information-Original 20 Time as a Public Health Control Containers* 3-501.19 Time as a Public Health Control* 7-102.11 Common Name-Working Containers* 3-501019 Variance RequirementlcHl 7-201.1 t Separation-Storage* 7-202.11 Restriction-Presence and Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE a 7-202.12 Conditions of Use* POPULATIONS HSP 7-203.11 Toxic Containers-Prohibitions* 21 3-901.11(A) Unpasteurized Pre-packaged Juices and 7-204.11 Sanitiaers,Criteria-Chemicals* Beverages with Warning Labels* 7-204.12 Chemicals for Washing Produce,Criteria* 3-801.11(B) Use of Pasteurized Eggs* ( 7-204.14 D ing Agents,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and 7-205.11 Incidental Food Contact,Lubricants* Raw Seed Sprouts Not Served. 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(C) Unopened Food Package Not Re-served 7-206.12 Rodent Bait Stations* 7-206.13 Tracking Powders,Pest'Control and CONSUMER ADVISORY Monitoring* 22 3-603.11 Consumer Advisory Postal for Consumption of Animal Foods"that are Raw, Undercooked or TIME/TEMPERATURE CONTROLS Not Otherwise Processed to Eliminate 16 Proper Cooking Temperatures for Pathogens.*EMeLrva1"200' PHFs 1 3-302.13 1 Pasteurized Eggs Substitute for Raw Shell Eggs* 3-401.1IA(1)(2) Eggs- 155°N)5Sec. Eggs-Immediate Service 145°1715sec* SPECIAL REQUIREMENTS 3-401.11(A)(2) .Comntimted Fish,Meats&Game 590.009(A)-(D) `y Animals- 155°F I S sec. * Violations of Section 590.009(A)-(D) in @)( )( � catering,mobile food, temporary and 3-401.t I 1 2 . Pork and Beef Roast- 130°F 121 min* residential kitchen operations should be 3-401.11(A)(2) Ratites, Injected Meats-155°F 15 sec. debited Linder die appropriate sections 3-401.11(A)(3) Poultry,Wild Game,StutTed PHFs, above if related to foodborne illness interventions and risk factors. Other Poul Stu Poultry Containing Fish,Meat,or Ratites-165°F IS sec. * 590.009 violations relating to good retail 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks practices should be debited under#29- 145°F* Special Requirements. 3-401.12 Raw Animal Foods Cooked in a Microwave 165°F* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-401.11.(A)(1)(b) All Other PHFs- 145°F 15 sec. * (items 23-30) 17 Reheating for Hot Holding Critical and non-critical violations, which do not relate to the f 3-403.11(A)&(D) PIFs 165°F 15 sec. * foodborne illness inlervenlion.s and riskfac/ors listed above, can be found in Ihefollowing.sections q/7he Food Code and 105 CMR 3-403.1](13) Microwave- 165°F 2 Minute Standing 590.000. Tine* Item Good Retail Practices - FC 590.000 3-403.11(C) Commercially Processed RTE Food- 23. Management and Personnel FC-2 .003 140°F* 24. Food and Food Protection FC-3 .004 3-40111(E) Remaining Unsliced Portions of Beef 25. Equipment and Utensils FC-4 .005 1 Roasts* 26. Water,Plumbing and Waste FC-5 .006 r 18 Proper Cooling of PHFs 27. Physical Facility FC-6 .007 28. - Poisonous or Toxic Materials FC-7 .008 3-501.14(A) Cooline Cooked PHF,from 140°F to 29. Special Requirements .009 70°F Within 2 Hours and From 70°F to 30. - Other 41°F/45°F Within 4 Hours. * s:5Wo b.ae' �0 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 41°1'/45017 Within 4 Flours* 3-501.14(C) PHFs Received at Temperatures - According to Law Cooled to 41°F/45°F Within 4 Hours. t *Denotes critical item in the Wend 1999 Food Code or 105 CMR 590.000. CITY OF SALEM BOARD OF HEALTH Establishment Name: y czly 9"0 Date: W to —1 S Page: `i` of Rem Code c-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Rem Verified PLEASE PRINT CLEARLY 2 S _ (� `i y� K c�� i env a U)A ,.el W4s i 5 yj s) C.L34 25 5 Sa.+ vas/ -' Yj e e.�>T�� ea1 or^ F:'k20 -9613n) I <e\%A'1� � 3 �Z,i) =3�k 'r�,v`t✓ YoLE�Z.� 11s� P ice-o-�'',�, ��t'��oo.,5 ��S \�.�.a� CLQ ;ao cS3 �5-- S'fasc�: �1ai'J t ELS•nS C2 1�: F'c�� `To VrLI(-1v*-e'3' dctio 1-i-A chvy`i' f3� lO+ff iL _ 2.S "��5 — 7'J�`�i S sar.�E FPt 2 t S +s, I r rLN raFP_Ov)c)(3 ( LLA t�0an1(�� l Im , Tri\) UNi a-s,SNX'�E: i'jr= � fir^ Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ inspection, to observe all conditions as described, and to Exclusion violations before the next ins p 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. 0 Voluntary Disposal 0 Other: i Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) (Cont.) 3-501.15 Cooline Methods for PHFs 19 PHF Hot and Cold Holding PROTECTION FROM CHEMICALS 3-501.16(8) Cold PRFs Maintained at or below 14 Food or Color Additives .590MW(F) 410/450 F* ! 3-202.12 Additives* 3-50L16(A) Hot PHFs Maintained at or above 1 3-302.14 Protection from Una 140°P Unapproved Additives* * . 15 Poisonous or Toxic Substances 3-501.16(A) Roasts Held at or above 130°F. 7-101.11 Identifying Information-Original 20 Time as a Public Health Control Containers* 3-501.19 Time as a Public Health Control* 590 7-102.11 Common Name-Working Containers* .004(14) Variance Requirenteat 7-201.11 Separation-Storage* 7-202:11 Restriction-Presence and Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-202.12 Conditions of Use* POPULATIONS HSP 7-203.11 Toxic Containers-Prohibitions* 21 3-801.1](A) Unpasteurized Pre-packaged Juices and 7-204.11 Sanitizers,Criteria-Chemicals* Beverages with Warning Labels* + 7-204.12 Chemicals forlAfashing Produce,Criteria* . 3-801.11(B) Use of Pasteurized Eggs* 7-204.14 Drying Agents,Criteria* 3-801.11(1)) Raw or Partially Cooked Animal Food and 7-205.11 Incidental(rood Contact,Lubricants* Raw Seed Sprouts Not Served. * 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(C) Unopened Food Package Not Re-served. 7-206.12 Rodent Bait Stations* 7-206.13 Tracking Powders,Pest Control and CONSUMER ADVISORY Monitonn� 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw, Undercooked or TIMEITEMPERATURE CONTROLS Not Otherwise Processed to Eliminate 16 Proper Cooking Temperatures for Path( ens.*"'a2001 PHFs 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* 3-401.11A(1)(2) Eggs- 155°F 15 Sec. t E -Immediate Service 145°1715sec* SPECIAL REQUIREMENTS 3-401.11(A)(2) Comminuted Fish,Meats&Game 590.009(A){D) Violations of Section 590.009(A)-(D) in Anunals- 155°F 15 sec. * catering,mobile food, temporary and ' 3-401.11(8)(1)(2), Pork and Beef Roast- 130°F 121 min* residential kitchen operations should be I' 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec. debited under the appropriate sections above ifrelated to foodborne illness 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, Stuffing Containing Fish,Meat, interventions and risk factors. Other Poultry or Ratites-165°F 15 sec. * 590.009 violations relating to good retail 3-401.11(0)(3) e Whole-muscle,Intact Beef Steaks practices should be debited tinder#29- 145°F* Special Requirements. 3-401.12 Raw Animal Foods Cooked in a Microwave 165°F* IVIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-401.11(A)(1)(b) All Other PHFs-145°F15sec. * (items23-30) . 17 Reheating for Hot Holding Critical and not-critical violations,which do not relate to the 3-403.11(A)&(D) PHFs 165°F 15 sec. * foodborne illness interventions and risk factos listed above, can be found in the following sections of the Fond Code and 105 CMR 3-403.11(13) Microwave- 165°F 2 Minute Standing 590.000. Tune* Item Good Retail Practices FC 590.000 3-403.11(C) Commercially Processed RTE Food- _23. Mann ement and Personnel FC-2 .003 140°F* 24. Food and Food Protection FC-3 .004 3-403.11(E) Remaining Unsliced Portions of Beef 25. Equipment and Utensils FC-4 .005 Roasts* 26. Water,Plumbing and Waste FC-5 .006 18 Proper Cooling of PHFs 27. Physical FacilityFC-6 .007 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(A) Cooling Cooked PHFs from 140°I'to 29, Special Requirements .009 70°F Within 2 hours and From 70°F to 30. Other t X41°F/45°F Within 4 Hours. * sezormuwsx.aa 3-501.14(13) Cooling PHFs Made From Ambient Temperature Ingredients to 41°F1450F Within 4 Hours* 3-501.14(C) PHFs Received at Temperances According to Law Cooled to 41°F/45°F Within 4 Hours. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. CITY OF SALEM BOARD OF HEALTH _ Establishment Name: t'o G\-) RG Date: Page: of Hem Coda C-Critical Rom DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Data No. Reference R—Red Item Verified PLEASE PRINT CLEARLY 3 Wit ) - Tragi rttE�+� � i t 5-N& �a� j� �S S") lit{�Lzj "�SL� k4-yv) a� F'-mp�ZDS 4QO?1 a '2i iru rti Cfzgz. " n ri dqyo SA uci-m 14r414r4A v0LnN1&, &%hT'3 i6nn- A V-X- vrj-1--31 trj c v (,Z�rar'r s' ka r�l vap-Mcg" AT Rao)-, no, Ila Q "`i11 r SL�� 1 cs 1 t 1�yo ZS O;�J �� 5�+�� F' 1S Y►-) )� he�oe'\"lam 1'� �Y2c�i 6��. �'� _ 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 o Voluntary Compliance ❑ Employee Restriction inspection, to observe all conditions as described, and to Exclusion violations before the next ins p ❑ Re-inspection Scheduled [3Emergency 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 a Embargo a Emergency Closure your food permit. ❑ Voluntary Dispose) ❑ Other: y i 1 Violations Related to Foodborne Illness Interventions and Risk 3-501.15 Cooling Methods for PRFs Factors(Items 1.22) (Cont.) l9 PHF Hot and Cold Holding PROTECTION FROM CHEMICALS 3-501.16(8) Cold PHFs Maintained at or below I 14 Food or Color Additives 590.004(F) 410/45'F* 3-202.12 Additives* 3-501.16(A) Hot PFIFs Maintained at or above t 3-302.14 Protection from Unapproved Additives* 140°F.* IS Poisonous or Toxic Substances 3-501.16(A) Roasts Field at or above 130'F. 7-101.11 Identifying Information-Original 20 Time as a Public Health Control Containers* 3-501.19 Time as a Public Health Control* 7-102.11 Common Name-Working Containers* 590.004(H) Variance Require cat 7-201.11 Separation-Storage* 7-202.11 Restriction-Presence and Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-202.12 Conditions of Use* POPULATIONS HSP ', 7-203.11 Toxic Containers-Prohibitions* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.11 .Sanilizers,Criteria-Chemicals* Beverages with Warning Labcls* 7 7-204.12 Chemicals for Washing Produce,Criteria*. 3-801.11(13) Use of Pasteurized Eggs* r 7-204.14 Drying A gents,Criteria* 3-801.11(1)) Raw or Partially Cooked Animal Food and 7-205.11 Incidental Food Contact,Lubricants* Raw Seed Sprouts Not Served- 7-206.11 erved7-206.11 Restricted Use Pesticides,Criteria* 3-80111(C) Unopened Food Package Not Re-served. 7-206.12 Rodent Bait Stations* 7-206.13 Tracking Powders,Pest Control and CONSUMER ADVISORY' Monitoring* 22 3-603.11 Consumer Advisory Posted for Consumption of 'Animal Foods That are Raw,Undercooked or TIMEITEMPERAT.URE CONTROLS Not Otherwise Processed to Eliminate 16 Proper Cooking Temperatures for Pathogens.*E"°""1 'e PHFs 3-302.13 Pasteurized Eggs Substitute for Raw Shell E s* 3-401.11A(1)(2) Eggs- 1550F 15 Sec. Eggs-Immediate Service 1450F15sec* SPECIAL REQUIREMENTS 3-401.11(A)(2) Comminuted Fish,Meats&Game 590.009(A)-(D) Violations of Section 590.009(A)-(D) in Animals- 155'F 15 sec. • catering,mobile food,temporary and 3-401.11(B)(1)(2) Pork and Beef Roast- 130'F 121 min* residential kitchen operations should be 3-401.1 1(A)(2) Ratiles,Injected Meats-155°F 15 sec. debited under the appropriate sections * 3401.11(A)(3) Poultry,Wild Game,Stuped PHFs, above if related to foodborne illness Stuffing Containing Fish,Iv(eat, interventions and risk factors. Other Poultry or Ratites-165'F 15 sec. * 590.009 violations relating to good retail 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks practices should be debited under#29- 145'F* Special Requirements. _T40 12 Raw Animal Foods Cooked in a Microwave 165'F* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-401.11(A)(1)(b) All Other PHFs- 145'F 15 sec.* (items 23-30) ? Critical and non-critical violations,which do not relate to the 17 Reheating for Hot Holding foodborne illness interventions and risk factors listed above, can he 3-4(13.11(A)&(D) PIiFs 165°F 15 sec. * found in the fgllowing.secrions of the Food Code and 105 CMR 3-403.11(13) Microwave- 165°F 2 Minute Standing 590.000. Tune* Item Good Retail Practices FC 590.000 3-403.11(C) Commercially Processed RTE-Food- 23. Management and Personnel FC-2 .003 140°F* 24. Food and Food Protection FC-3 .004 3-403.11(L•) Remaining Unsliced Portions of Beef 25. Equipment and Utensils FC-4 .005 Roasts* 26. Water,Plumbing and Waste FC-5 .006 F,_S Proper Cooling of PHFs 27. Physical Facility FC-6 .007 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(A) Cooling Cooked I'll Fs from 140'1'to 29. Special Requirements .009 70017 Within 2 Hours and From 70'F to 30. Other 41°F/45'FWithin 4Flours. * ss90rmdms2n. 3-501.14(8) - Cooling PHFs Made From Ambient Temperature Ingredients to 41'1'/45°12 Within 4 Hours* i 3-501.14(C) PHFs Received al'fempemlures ' Accordine to Law Cooled to 41'F745°F Within 4 1lours. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. CITY OF SALEM BOARD OF HEALTH n Establishment Name: �� Ci�az Date: /eD ' )J Page: 6 of 7 Item Code c-critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Hem Viritied PLEASE PRINT CLEARLY -T 343ea Ste'Y- � r- t, t.s\.= Vs �) ) r�r�J IL I r77 rf t� v a� z3m-hn' 3' Sir\ AS fir` X17 Ii O JSe.s> e� yi -en dliS S` S a ` I')VASES 3 y�r n '3G&A>s_-� c-1 CC5r- oat c'\s` Yn V, w fame )r' QIL6 �4L 1: aar` �aU io f'It1svL?59 )2 s _ -' GiP3 A 631!✓1 V p� s _ Yy wiT- 'D@ N16irf_S D n E Dt J )r' nA--D)i?,*SYi S Fco+Nn CiVe b t1191 w a1C7 va S • b '- VL �E.NtA7 \AT ftA n, 2Ql. IN �CdJ�Eso'•(S pa-,vS"p s{ E�+l;�1F.G� .ssi-0 Tc�o'a 2Y Sri L — v�� Fes., n s-�o v�: P v S ra a �i n"dc + 0 $ v SL S0 ate` astobT b-kiti ves t ,,ti S�cRJ 146 s)j 5)e+1L 1'avao )mc1r0 WAS14 S)rf ti S Ys u 1 9 & ka A V\- ev%w- Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ inspection, to observe all conditions as described, and to Exclusion violations before the next ins p O Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal 0 Other: Violations Related to Foodborne Illness Interventions and Risk I Factors(Items 1.22) (Cont.) 3-501.15 Cooling Methods for PHF's 19 PHF Hot and Cold Holding PROTECTION FROM CHEMICALS 3-501.16(B) Cold PHFs Maintained at or below 6F 14 Food or Color Additives 590,004(F) 410/450 F* 3-202.12 Additives* 3-501-16(A) Hot PFIFs Maintained at or above 3-302.14 Protection from Unapproved Additives" 140°F.* 15 Poisonous or Toxic Substances 3-501.16(A) Roasts Held at or above 130°F. ° t 7-101.11 Identifying Information-Original 20 Time as a Public Health Control Container* 3-501.19 Time as a Public Health Control* 7-102.1 I Common Name-Working Containers` 7-201.1 1 Separation-Storage* 590.004(H) Variance Requirement 7-202.11 Restriction-Presence and Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-202.12 Conditions of Use* POPULATIONS HSP 7-203.11 Toxic Containers-Prohibitions* 21 3-801.1](A) Unpasteurized Pre-packaged.luices and 7-204.11 Sanilizers,Criteria-Chenucals" - Beverages with Wanting Labels* 7-204.12 Chemicals for Washing Produce,Criteria` 3-801,11(B) Use of Pasteurized Eggs* 7-204.14 Drying A ents,Criteria*. 3-901.11(D) Raw or Partially Cooked Animal Food and 7-205.11 Incidental Food Contact,Lubricants* Raw Seed Sprouts Not ServLd. * 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(C) Unopened Food Package Not Re-served. 7-206.12 Rodent Bait Stations* 7-206.13 Tracking Powders,Pest Control and CONSUMER ADVISORY Monitoring* 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw, Undercooked or TIME/TEMPERATURE CONTROLS Not Otherwise Processed to Eliminate 16 - Proper Cooking Temperatures for pathogens.*EHu6i 1n200' PHFs 3-302.13 Pasteurized Eggs Substitute for Raw Shell E s` 3-401.11AH)(2) Eggs- 155°F 15 Sec. Eggs-Immediate Service 145°1715sec* SPECIAL REQUIREMENTS 3-401.1 1(A)(2) Conuttitmted Fish,Meats&Game 590.009(A)-(D) Violations of Section 590.009(A)-(D) in Amimals, 155°F 15 sec. " r catering,mobile food,temporary and 3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 min* A 2 , residential kitchen operations should be 3-401.11 ( )O Ratites, Lgjec[ed Meats-155'F 15 sec. debited under the appropriate sections * 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, above if related to foodborne illness Stuffing Containing Fish,Meat, interventions and risk factors. Other i Poultry or Ratites-165°F 15 sec.* 590.009 violations relating to good retail 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks practices should be debited under#29- 145°F• Special Requirements. 3-401.12 Raw Animal Foods Cooked in a Microwave 1650F` VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-401.11(A)(1)(b) All Other PHFs- 145°F 15 sec. ` (items 23-30) 17 Reheating for Hot Holding Critical and non-critical violations, which do not relate to the 3-40.3.11(A)&(D) PHFs 165°F 15 sec. * ,foodborne illness interventions and ri,skfactors listed above,can he ,found in the following sections of the Food Code and 10.5 CMR 3-403.11(B) Microwave- 165°F 2 Minute Standing 590.000. Tune* Item Good Retail Practices FC 590.000 3-403-1 1(C) Commercially Processed RTE Food- 23. Management and Personnel FC-2 .003 140017* 24. Food and Food Protection FC-3 .004 3-403.11(E) Remaining Unsliced Portions of Beef 25. _Ecluipment and Utensils FC-4 .005 Roasts* 26. Water,Plumbing and Waste FC-5 .006 1g Proper Cooling of PHFs 27. Ph sical FacilityFC-6 .007 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(A) Cooling Cooked PUTS from 140°F to 29- Special Requirements .009 70°F Within 2 Hours and From 700F to 30. 1 Other 41°F/450F Within 4 Hour. * ssvor,.;,,nmxsed� 3-501.14(13) Cooling PHFs Made From Ambient Temperature Ini-er ients to 41017/45°F Within 4 Hours* 3-501.14(C) PHFs Received at Temperatures t According to Law Cooled to 410F/450F Widmi 4 Hours.* •Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000- CITY OF SALEM BOARD OF HEALTH Establishment Name: ��l G01 P-4) Date: 16 -(.c - IS Page:--2-- of S Rem Code C-Critical Rom DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Daft No. Reference R-Red ltem Verified PLEASE PRI CLEARLY ),3 L UJA'SN f2 to ) PtoV tic oe1iiee 5)\se a s F'Pa6)Eit� o. �F 1 1+ i 111 V T v.. T r� 4 snizx n s l flv\\_© V ov s� . a av Cid fir? Tla S 14-AC4 0 10.4A J5\"N- 3 \"N.- 1 f'YCY'� A3tA.. "L OOJ�. "a.�e7.S 1 �� 1 dJSs•+"'� Vl`t� (,o1b7 tlrlo-Ir+ icy A� ►�I ra SL�;r sL� - i�x�. mss., i a� Yr.� lm-� 2 L I S -•7il&, aglOt_ UrTkA 'T► 'D)S f�`��'6�10�.-- )�L,� U )rt '1� "_- ,c�..- )+,v�-1 $'�i ' 4a •C, 2-`5 •4'A'arJ 5 74UU-_ 1-S n )ivt--_ oF l.) Oci T)4,2_ +s v) S'1��✓ � }s �'w Eve 6a T)2tSla�a► Slr*-olLesl' )� B1a)a 1 Ari� bo 4- IW 1 DC4 o), r> C b1_ _ -mt> wn-w f)e�>t 1•-3 T14& I ;l',,ss)C� Pr-%P-V eu. W_.-0v)0X-' 011 a10 \'t- '?A% 7,7,.-srr,)� A-7 Av . ","",ni Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ inspection, to observe all conditions as described, and to Exclusion violations before the next ins p ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. Cl Voluntary Disposal ❑ Other: Violations Related to Foodborne Illness Interventions and Risk 3-501.15 Coolin Methods for PI-LFs Factors(Items 1-22) (cont.) g (9 PHF Hot and Cold Holding PROTECTION FROM CHEMICALS 3-501.16(B) Cold PHFs Maintained at or below, 14 Food or Color Additives 590 004(F) 410/4501,* 3-202.12 Additives* 3-501.16(A) Hot PI-1Fs Maintained at or above 3-302.14 Protection from Unapproved Additives* 1400E * 15 Poisonous or Toxic Substances 3-501.16(A) Roasts Held at or above 1300F. 7-101.11 Identifying talonnation-Original. 20 Time as a Public Health Control Containers* 3-501.19 Time as a Public Health Control* 7-102.11 Common Name-Working Containers* 590.004(H) Variance Requirement 7-201.11 Separation-Stora e* 7-202.11 Restriction-Presence and Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-202.12 Conditions of Use* POPULATIONS HSP 7-203.11 Toxic Containers-Prohibitions* 21 3-801.11(A) Unpasteurized Pre-packaged.luicesand ( 7-204.11 Sannizers,Criteria-Chemicals" Beverages with Warning Labels* 7-204.12 Chemicals for Washing Produce,Criteria* 3-801.11 Use of Pasteurized Eggs* 7-204.14 Drying Agents,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and 7-205.11 Incidental Food Contact,Lubricants* Raw Seed Sprouts Not Served. * 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(C) Unopened Food Package Not Re-served. 7-206.12 Rodent Bail Stations* 7-206.13 Tracking Powders,Pest,Control and CONSUMER ADVISORY Monitoring" 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or TIME/TEMPERATURE CONTROLS Not Otherwise Processed to Eliminate 16 Proper Cooking Temperatures for Pathogens.*"'n20°' PHFs 3-302.13 Pasteurized Eggs Substitute for Raw Shell E s" 3-401.1IA(1)(2) Eggs- 1550E 15 Sec. Eggs-Immediate Service 14501715sec* SPECIAL REQUIREMENTS 3-401.11(A)(2) Comminuted Fish,Meats&Game 590.009(A)-(D) Violations of Section 590.009(A)-(D) in Animals- 1550F 15 sec. * ` * catering,mobile.food, temporary and 3-401.11(13)(1)(2) Pork and Beef Roast- 130017 121 num residential kitchen operations should be 3-401.11(A)(2) Ratites,Injected Meats-1550F 15 sec. debited under the appropriate sections r 3-401.11(A)(3) Poultry,Wild Game,Stuffed PIIFs, above if related to foodborne illness Stuffing Containing Fish,Meat, interventions and risk factors. Other Poultry or Ratites-1650F 15 sec. * 590.009 violations relating to good retail 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks practices should be debited under#29- 1450F* Special Requirements. 3-401.12 Raw Animal Foods Cooked in a Microwave 1650F" VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-40 IJ I(A)(1)(b) All Other PHFs-145017 15 sec. * (Items 23-30) 17 Reheating for Hot Holding Critical and non-critical violations, which do not relate to the 3-403.11(A)&(D) PFIFs 1650F 15 sec. * foodborne ithress interventions and risk factors listed above,can he found in the fallowing sections of the Food Code and 105 CMR 3-403.11(B) Microwave- 1650 F 2 Minule Standing 590.000. Time* Item Good Retail Practices FC 590.000 r 3-403.11(C) Commercially Processed RTE Food- 23. Management and Personnel FC-2 .003 1400F* 24. Food and Food Protection - FC-3 .004 3-403.11(E) Remaining Unsliced Portions of Beef 25. Equipment and Utensils FC-4 .005 Roasts* 26. Water,Plumbing and Waste FC-5 .006 r 18 Proper Cooling of PH Fs 27. Physical FacilityFC-6 .007 28. Poisonous or Toxic Materials FC-7 .008 i 3-501.14(A) Cooling Cooked PHFs from 1400E to 29. Special Requirements .009 I 7001'Within 2 Horn's and From 700F to 30. Other e 410F/45017 Within 4 Hours. " ssuor�esu4:.da 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 4101714501' Within 4 Hours* 3-501.14(C) PHFs Received at Temperatures t According to Law Cooled to 410F/450F Within 4 Hours. " *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. r CITY OF SALEM BOARD OF HEALTH Establishment Name: N"1 ra\) 6Zo Date: Page: of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date - No. Reference I R-Red Item Varlhed PLEASE PRINT CLEARLY 21 J4(, rq)>,Rz ;to ter.- �� f2t�6Loast, i�drs �r Ff testa 2s �,_�' — +�'ci _ � ��-+ lata wws� S��L � •' 1 "i7a��L.�.1 \ •, �, a, 20 SR.7,0.;-) )-k 12�1'C�.r� 1a�i� �ae�U . IaE3al_ 5'4a\ems t Thi �i�i.1 27 — l iitZu a�skr i�'J �.\sj ;,c3 l` \1 \cs U CI y-`>©z•Il C. aL — v c3 carie ��C ray '► �l�ai� wa+ rJo ae' l I'1.\ S� \� u nol love Yam 04 a+ "�C T U -31=31.1) G dL - Tt*l SL 1 jw, )�seri s� sa " SNlt' u >�' Iz " "' b S\ hie, v--'T Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ .Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction inspection, to observe all conditions as described, and to Exclusion violations before the next ins 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. ❑ Voluntary Disposal ❑ Other: 3-501.14(C) PHFs Received at Temperatures Violations Related to Foodborne fliness Interventions and Risk According to law Cooled to Factors(Items 1-22) (Cont.) 417145-F Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 Ctx)IinR Methods for PHFs Food or Color Additives 19 PHP Not and Cold Holding 14 3-501.16(B) Cold PHFs Maintained at or below 3.202.12 Additives* 590.004(F) 41°1450 F* 3-302.14 Protection from Unapproved Additives* 3-501.16(A) Hot PRFs Maintained of or above 15 Poisonous or Toxic Substances - 140°R 7-101.11 Identifying Information-Original 3-501.16(.x) Roasts Held at or above 13WF. Containers* - Time as a Public Health Control 7-103.11. Common Name-Working Containers" 20 3-501.19 Time as a Public Health Contra!* 7-201.11 Separation-Stora e` 7-202.11 .Restriction-PresenceandUse* 590.004(11) VarianeeR airement 7-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions* POPULATIONS(HSP) 7-204.11 Sanirizers.Criteria-Chemicals' yl 3-801.1 I(.x) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals for Washing Produce,Criteria* 7-204.14 n Beverages with Warning Ube]s" Agents.Criteria* 3-801.11(B) Use of Pastearized E w* 7-205.1.1 Incidental Food Contact,Lubricants* 3-801.11(D) Raw or Partially Cooked Animal Faad and 7-206.11 Restricted Use Pesticides;Criteria* Raw Seed Sprouts Not Served. " 7-206.12 -1 Rodent Bait Stations* 3-801AI(C) Unopened Food Package Not Re-served. 7-206.13 Tracking Powders,Pest Control and Momutrin * CONSUMER ADVISORY TIMEIT'EMPERATURE CONTROLS 22 3-603.11. Consumer Advisory Posted for Consumption of Animal Foods That are Raw.Undercooked or 16 Proper Cooking Temperatures for Not Otherwise Processed to Eliminate PHFs „*rn2oai 3-401.11A(t)(2) Eggs- 155715 See. Pathogens.' Em.-Immediate Service 145°F15sec* 3-302.1.3. Pasteurized Eggs Substitute for Raw Shell E * 3-401.11(A)(2) Comminuted Fish.Meats&Crime Animals-155'F 15 see. * SPECIAL REQUIREMENTS 3.401.11(8)(1)(2) Pork and Beef Roast- 1309F 121 min* 3-441.11(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 3-401.1.t(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..1.1(C)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 1450F t' 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. 3-401:1 I(.A)(I)(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 sec.* (Items 23-30) 3-403.11(B) Microwave- 165'F 2 Minute Standing Critical,and non-critical violations,which do not relate to the Time* foodborne illness interventions and risk factors listed above, can be 3.403A I(C) Commercially Processed RTE Food- found in the fallowing sections of the Food Code and 105 CMR 140°F* 590.01/0. 3403.11(E) Remaining Unsliced Portions of Beef 1 ttetn Good Retail Practices FC 1 590.000 I .Roasts* 23. 1 ManagementandPersonnel L �FC-2 .003 Food od and Food Protection FC-3 1 .004 gg Proper Cooling of PRFs -} - . 1 25, 1 Epuinment and Utensils I FC- 005 3-501.14(A) Cooling Cooked PHFs from 140°F to t 26, -1 Water,Plumbing and Waste - j FC-6 .006 ' 70'F Within 2 Hours and Front 70°F 27 Physicai Facility FG-6 007 to 41°F/45"F WWithin 4 Hours. * 28. Poisonous or Toxic Materials FC-7 .008 I 3-501.14(B) Cooling PHFs Made From Ambiens 29. 1 Special Requirements .009 I Temperature Ing"dients to 41'F/45°F 30 1 Other -------1 Within 4 Hours* *D> aotee critical item in the federal 1999 Fend Cade or 105 CMR 590.0ix1. CITY OF SALEM BOARD OF HEALTH Establishment Name: N9 L 9 0-n Date: Page:_ of Rem Code C—Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item - Verltled PLEASE PRINT CLEARLY C- dL fir,, - �s v., ^��, A-� r✓s^ G�vl � N�; )�/ Tlav C�a r s\' e. `�N*_ 2-S S Xl — L .- Ptc3dcamA unv,\- e"O 6t=_3 )4n y ca'0 'c7�,t3 $Nv-"s1�S' �va� • `iTa�SL�v v ALX_ 4 LL�� cau A�D v til Wcj , . J7J ^ -nu 11,j4—t-LjrA-, of 16t-, \_ YNaa ea d S vco; .0 Sties 1't1}� of TA S pu'vw ave c' T"N'-t'-44Ca ra 1 ms's-ias wiT Fq2\ cU V' u�� C �)Y C--rt7 '? _7\0<3 , I Discussion With Person in Charge: Corrective Action Required: LI No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. �✓ r(/", ❑ Voluntary Disposal ❑ Other: 3-i01.14(0 PHFs Received at Temperatures Violations Related to Foodborne Illness Interventions and Risk According to Law Cooled to Factors(items 1-22) (Cant.) 41"F/45*F Within 4 Hours. PROTECTION FROM CHEMICALS3-501.15 Cooling Methods for PRFs 14 Food or Color Additives 19 PHF Not and Cold Holding 3-501.16(B) Cold PHFs Maintained at or below 3-202.12 Additives* 590.004(F) 410/450 F* 3-302.14 Protection from Un roved Additives* 3.501.16(A) Hot PRFs Maintained at or above 15 Poisonous or Toxic Substances 1400F * 7-101.1.1 Identifying Infonnation-Original 3-501.16(A) Roars Held at or above 130'F. Containers* Time as a Public Health Control 7-102.11. Common Name-Working Containers* 20 - 3-501.19 TimeVariance na Public Health Control* 7-201.11 Separation-Storage* 590.004(H) Varia 7-202.11 .Restriction-Presenceand Use' nceR nirement 7-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions* POPULATIONS HSP 7-204.11 Sanitizers.Criteria-Chemicals* 7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(.4) Unpasteurized Pre-packaged juices and -�-- Bevera es with Waming Labels* 7-204.14 Drying encs.Criteria*„__ 3-801.11(B) Use of Pasteurized Eggs* 7-205.11 Incidental Food Contact,Lubricants* 3-801A I(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.il(C) Unopened Food Package Not Re-served. 7-206.13 Tracking Powders,Pest Control and Monitoring* CONSUMER ADVISORY 71MEIrEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or 16 Proper Cooldrig Temperatures for Not Otherwise Processed to Eliminate PHFs Pathogens,'c'!lectiva YN2001 3-401.11A(l)(2) Eggs- 155F 15 Sec. Eggs-Immediate Service 145°F15sec* 3-302.13. Pasteurized Eggs Substitute for Raw Shell 3-401.11(A)(2) -Comminuted Fish.Meats:&Game E * Animals-1.55F 15 sec. * SPECIAL REQUIREMENTS 3.401.11(B)(1)(2) Pork and Beef Roast- 130'F 121 min* 590.009(A)-(D) Violations of Section 590.000(A)-(D)in 3-401.11(A)(2) Rallies,Injected Meats-155°F 15 sec. * catering,mobile food,temporary and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Poultry or Ratites-165'F 15 sec.* above if related to foodborne illness 3-101 AI(C)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 1450F* 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Cooked in a practices should be debited trader#29- Microwave 165°F* Special Requirements. 3-401;11(A)(1)(b) All Other PRFs-145'F 15 sec. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3403AI(A)&(D) 'PHFs 165°F 15 sec.* (Items 23.30) 3-103.1.1(B) Microwave-'165`F 2 Minute Standing Critical and non-critical violations,which do not relate to the Time* foodborne illness interventions and risk factors listed above,can'be 3-403.11(C) Commercially Processed RTE Food- found in the following sections of the Food Code mrd 105 CMR 140°F* 590.000. 3-403.11(E) Remaining Unsliced Portions of Beef 1 + Goad Retail Practices FC 590.000! 2 4.3. Manartement and Personnel FC-2 I .00:3_ Roasts* 2Foot and Food Protection FC-3 ( 004 ! 18 Proper Cooling of PHFs �� 25.- j Equinmentand Utensils -� FC-4 X005 ! 3-501.14(A) Cooling Cooked PRFs from 140'F to f 26, 1 Water,Plumbing and Waste i FC-5 .006 i 70'F Withis2 Hours and From 70`F 1 27. 1 PhVsical Faclfi FC-6 W7 to 41'F/45°F Within 4 Hours. * 28. PoisonMaterials ous or Toxic FC=7 .008 i 3-501.14(B) Cooling PHFs Made From Ambient 29. Spatial A uirema ants ! .009 Temperature Ingredients to 4FRI45°F 30. ( _..._ ._.J Within 4 Hours reH a a *lhnons critical item in the federal 1999 Fail Code a 103 Otlk 390.000. Massachusetts Department of Public Health Salem Board of Health 120 Washington Street,0 Floor Division of Food and Drugs Salem, MA 01970-3523 Tel. (978) 741-1800 Fax(978) 745-0343 City/Town Of Address: FOOD ESTABLISHMENT INSPECTION REPORT Tel. Name Date Type ofOperation(s) Type of Inspection ❑ Food Service ❑ Routine Address Risk ❑ Retail ❑ Re-inspection Telephone Level El Residential Kitchen Previous Inspection p ❑ Mobile Date: OwnerHACCP YIN ❑ Temporary ❑ Pre-operation ❑ Caterer ❑Suspect Illness Person-in-Charge(PIC) Time ❑ Bed&Breakfast ❑ General Complaint In: ❑ HACCP Inspector 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_(Red Anti-Choking 590.009(E) ❑ Items) Violations marked may pose an imminent health hazard and require immediate Toe590.009(F) ❑. Allergen Awareness 590.009(G) ❑ corrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities 'EMPLOYEE HEALTH . �PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC - r ❑ 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals FOOD-FROM-APPROVED SOURCE F1 4. Food and Water from Approved Source TIMEREMPERATURIFCONTROLS(P.oteralalty 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 HIGHLYStusdEP.TIBLE-POPULATIONS-:(H8p): El21. 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-(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. Nan-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-2X order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3X590.004) ) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4X590.005) the food establishmentp ermit 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-6X590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (Fc-7X590.000) 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: .a.aoc Inspector's Signature: Print: PICS Signature: Print: Page_0f Pages Violations Related to Foodborne illness interventions and Risk Factors(items 1-22) PROTECTION_ FROM CONTAMINATION fi 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 Mlowledge* 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.(X)3(,C) Responsibility of the person in charge to 3-302.1 UA) Food Protection* require reporting by food employees and 3-30115 Washing Fruits and Vegetables applicants= 3-304.11 Food Contact with Equipment and 590.003(F) Responsibility Of AFood Employee Or An Utensils* Applicant To Report To The Person In Contamination from the Consumer Char n'* 3-306.14(A)(B) Returned Foal and Resctvice of Food* 590.003(G) Reporting by Person in Charge* Disposition of Adulterated or Contaminated 3 590.003(D) Exclusions and ReSLrictiont* Food 590.003(E) Removal of Exclusions and Restrictions 3-701.11 Discarding or Reconditioning Unsafe Food* FOOD FROM APPROVED SOURCE _ 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 590.004(A-B) Compliance with Food.Law* 4-501..1.1 I Manual W arewashing-Hot Water 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 3-202.13 Shell E s* Sanitization Temperatures* 3-202.14 Eggs and Milk Products,Pastenrsed* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.16 tee Made From Potable Drinkin*Water* concentration and hardness. 5-101.11 DrinkmE Water from an A roved S stem" 4-001..1t(A) Equipment Food Contact Surfaces and 590.006(A) Bottled Drinkin Watcr* Utensils Clean* 590.IMIb(B) Wates Mzzts Standards in 3 LO CMR 22.(}"' 4-602.11 Cleaning Frequency of Equipment Frxpd- Contact'Surfaces and Utensils* Shellfish and neat From an Approved Source 4-702-1 t Frequency of Sanitization of Utensils and 3-201.14 Fish and Rzcreati molly Caught Molluscan _ Food Contact Surfaces of E ui pment* Shellhsh* 4-703.11 Methods of Sani ization-Hot Water and 3-20115 Molluscan Shellfish from NSSP Listed Chemical* Sources* 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved bV 2-301,11 Clean Condition-Hands and Arms°' Ra u(ator Authorit 3-202.18 Shellstock Identification Present* 2-301.1.2 Cleaning Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-201.1.7 Game Attirrals* 11 Good Hygienic Practices 5 Receiving/Condition 2401.1 1 Eating,Drinking or Using Tobacco* 3-202.11 PHFs Received at Proper Temperatures* 2401.12 Discharges From the Eyes,Nose and 3-202.1.5 Packs e hneitrit * Mouth* 3-101.11. Food Safe and:Unadulterated* 3-301.12 Preventing Contamination When Tasting* Tags/Records:Shelistock 12 Prevention of Contamination from Hands 3-202.13 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.12 ShellstockldenfilicationMaintained* Eruplo ees* TagalRecords: Fish Products 13 Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located and Accessible 5-?03.11 Numbers and Capacities* 3-402.12 Records.Creation and Retention* 590.3040) Labeling of ingredients* 5-204.1.1 Location and Placement* -7 Conformance with Approved Procedures 5-205-11 Accessibility,Operation and Maintenance /HACCP Plans Supplied with Soap and Hand Drying 3-502.1Specialized rMoveethdoPdrso*cedu res" . , . Devices 3-502.12 Reued ox processing nom,criteria* E6301 1.11Handwa shin Cleanser, Availability 3-10312 c 12 Hand Drying Provision 'Denotes critical item in the feilerel 1999 Fapd Code ur i 05 CMR 590.000. Massachusetts Department of Public Health Salem Board of Health 120 Washington Street,0 Floor Division of Food and Drugs Salem, MA 01970-3523 Tel. (978) 741-1800 Fax(978) 745-0343 City/Town of Address: FOOD ESTABLISHMENT INSPECTION REPORT Tel. Name Date Type of Operation(s) Type of Inspection ❑ Food Service ❑ Routine .Address Risk ❑ Retail ❑ Re-inspection Telephone Level El Residential Kitchen Previous Inspection P ❑ Mobile Date: Owner HACCP YIN ❑ Temporary ❑Pre-operation ❑ Caterer ❑Suspect Illness Person-in-Charge(PIC) Time ❑ Bed&Breakfast ❑ General Complaint In: ❑ HACCP inspector 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_(Red Items) Tobacco 590.009(E)009 ❑ Violations marked may pose an imminent health hazard and require immediate Tobaeeo 590.009(F) ❑ y P q Allergen Awareness 590.009(G) ❑ corrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities 'EMPLOYEE HEALTH PROTECTIONFROM-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 F60D'FRONI APPROVED SOURCE ❑ 4. Food and Water from Approved Source TIMErrEMPERATUfttcONTROL5(Rotent(aliy 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) E]21. 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_(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. Noncritical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code. This report,when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2X590.003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (Fc-s)(sso.00a) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4X590.005) the food establishment permit and cessation of food 26.Water, Plumbing and Waste (Fc 5)(590.006) establishment operations. If aggrieved by this order,you 27. Physical Facility (Fc-6X590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (Fc-7X590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: J]Bo-u.aa Inspector's Signature: Print: PLCs Signature: Print: Page_of Pages Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION $ Cross•contamination _FOOD PROTECTION MANAGEMENT 3-302.11(A)(]) Raw Animal Foals Separated front 1 I 590.003(A) Asara ent of Responsibility* Cooked and RTE Foods* 590.003(B) Demonstration ation of Rtrowledge* Contamination from Raw ingredients 2-103.11. Person in charge.-dutres 3-302.11(A)(2) Rau Animal Foals Separated from Each Other* EMPLOYEE HEALTH _ Contamination from the Environment 2 590.003(C) Responsibility ofthe person in charge to 3-30111(A) Food'Protection* require reporting by fo:xl employees and 3-302-15 Washi ng Fruits and Ve etables applicants* 3-304.11. Food Contact with Equipment and 590.003(F) Responsibility Of A Food Employee Or An Utensils* Applicant To Report,ro'fhe Person In Contamination from the Consumer Report'" 590.(N)3(G) Reporting by Person in Ch 3-306.14(A)(B) Returned Food and Reservice of Food* Dispoar�e* 3 590.00302) Exclusions and Restrictions* Food top of Adulterated or Contaminated 590.003(E) Removal of F,xclusi,ons and Restrictions 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food.* q 1 Food and Water From Regulated Sources 9 Food Contact Surfaces 590.004(A-B) C0n01[114811ce with Food law* 4-501.111 Manual Warewashing-Hot Water 3-201.12 Fcwd in a flennetically Sealed Container* Sanitization Temperatures* 3-201.13 Fluid Milk and Milk Products* 4-501112 Mechanical Warewashind Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.t4 E >s and Milk Products,Pasteurized* 4-501.114 Chemical Sardtizltion-temp.,pH, 3-202.16 Ice Made From Potable Drinkin*Water'" concentration and hardness.* 5-101.11 Drinking Water from an Approved System* 4-601.I1(A) Equipment Food Contact Surfaces and 590.006(A) BokHul Dri,nkin Water- Utensils Clean* 590.006(B) Water Meets Standards in 310 CMR 22.0"` 4-602.1 L Cleaning Frequency of Equipment Food- 590J)06(B) Surfaces and Utensils* Shetttish and Fish From an Approved Sourco 4-702.71 Frequency of Sanitization of Utensils and 3-201.14 Fish and Reereationally Caught Molluscan Food Contact Surfaces ofui anent* Shellfish* 4-703-11 Methods of Sanitization-[tot Water and 3-201.15 Mollascan Shellfish from NSSP Listed Chemical* Sources* 10 Proper,Adequate Hantlwashing Game and Wild Mushrooms Approved by Re Mato Authorit 2-301,11 Clean Condition-Hands and Arms" 3-202.18 Shellstock Tdentificaiion Present* 2-301.12 C:leanimr Procedure* 540.004(C) Wild Mushrooms* i 2-30114 When to Wash* 3-201.17 Game Animals* 1.1 Good Hygienic Practices g Receiving/Condition 2-401-11 Eating,Drinkinor Usin Tobacco* 3-202.11 PHFs Received at Proper Temperatures;, 2-001.12 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 Tastin * Tags/Records:Shelistock 12 Prevention of Contamination from Hands 3-202.18 Shellstock identification 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* Em zlo ees* TagstRecords: Fish Products 13 Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located and Accessible 3-402.12 Rewrds.Creation and Retention* 5-203.11 Numbers and Capacities* acities* 590.0040) Labeling of Ingredients' 5-204.1.1 1,ocation and Placement* Conformance with Approved Procedures 5-205.11 Accessibility,Operation and Maintenance fHACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized ProcessingMethods* Devices 3502. 2 Redued ox envaca *,criteria* 6-301.11 1 Handwashing Cleanser, Availability 8-103.12 Conformance with Approved Procedures* 6-307.1.2 Hand Drying Pmviaion *Denotes critical item in the tedei al 1999 Fa>d Code or 105 CMR.590.066. CITY OF SALEM BOARD OF HEALTH Establishment Name: Date: Page: of Rem Cods C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date- No. R=ence R-Red Item yenned PLEASE PRINT CLEARLY Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. 0 Voluntary Disposal 0 Other: Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) (Cont.) 3.501.15 Cooling Methods for PHI7s _ 19 PHF Hot and Cold Holding PROTECTION FROM CHEMICALS 3-501.16(13) Cold PRFs Maintained at or below 14 Food or Color Additives 590.004(F) 410/450 P* 3-202.12 Additives* 3-501.16(A) Hol PHFs Maintained al or above 3-302.14 Protection from Unapproved Additives* 1400F.* 15 Poisonous or Toxic Substances 3-501.16(A) Roasts Held at or above 1300E ` 7-101.1 I Identifying Information-Original 20 Time as a Public Health Control Containers* 3-501.19 Time as a Public Health Control* 7-102.11 Common Name-Working Containers* 590.00404) Variance Requirement 7-201.11 Se arntion-Slam e* 7-202.11 Restriction-Presence and Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-202.12 Conditions of Use* POPULATIONS HSP 7-203.11 Toxic Containers-Prohibitions* 21 3-801.11(A) Unpasteurized Pre-packaged.Mises and 7-204.11 Sanitizers,Criteria-Chemicals* Beverages with Warning Labels* 7-204.12 Chemicals for Washing Produce,Criteria" 3-801.11(B) Use of Pasteurized G s` ` 7-204.14 Drying A gents,Criteria* 3-801.110)) Raw or Partially Cooked Animal Food and 7-205.11 Incidental Food Contact,Lubricants* Raw Seed Sprouts Not Served. * 7-206.1 Res I tneted Use Pesticides,Criteria* 3-801.11(C) Unopenedg Food Package Not Re-served 7-206.12 Rodent Bait Stations* 7-206.13 "tracking Powders,Pest Control and CONSUMER ADVISORY Monitoring* 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or TIME/TEMPERATURE CONTROLS Not Otherwise Processed to Eliminate 16 Proper Cooking Temperatures for Pathogens,*8rr mmol PHFs 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* 3-401.11A(1)(2) Eggs- 1550F 15 Sec. Eggs-Immediate Service 145°Fl5sec* SPECIAL REQUIREMENTS 3-401.11(A)(2) Comminuted Fish,Meals&Game 590.009(A)-(D) Violations of Section 590.009(A)-(D) in Animals- 1550F 15 sec. * catering; mobile food,temporary and 3-401.1 1(3)(1)(2) Pork and Beef Roast- 1300E 121 nein* residential kitchen operations should be 3-401.11(A)(2) Ratites, Injected Meats-1550F 15 sec. debited winder the appropriate sections 3-401.11(A)(3) Poultry,Wild Game,Smfled PHFs, above if related to foodbome illness Stalling Containing Fish,Meal, interventions and risk factors. Other Poultry or Ratites-1650F 15 sec. * 590.009 violations relating to good retail 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks practices should be debited under#29- 145017* Special Requirements. 3-401A2 Raw Animal Foods Cooked in a Microwave 1650F* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES l 3-401.1 10)(1)(b) All Other PHFs-1450F 15 sec. * (Items 23-311) 17 Reheating for Hot Holding Critical and non-critical violations, which do not relate to the foodborne illness interventions and ri.skfactas listed above, can be 3-413.11(A)&(1)) PHFs 1650F 15 sec. * found in the following sections of the Food Code and 105 CMR 3-403.1](13) Microwave- 1650 F 2 Minute Standing 590.000. Time* Item Good Retail Practices FC 590.000 3-403.11.(C) Commercially Processed WIT Food- 23. Management and Personnel FC-2 .003 1400F* 24. Food and Food Protection FC-3 .004 I 3-403.11(1-) Remaining Unsliced Portions of Beef 25. Equipment and Utensils FC-4 .005 Roasts* 26. Water,Plumbing and Waste FC-5 .006 18 Proper Cooling of PHFs 27. Physical Facility FC-6 .007 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(A) Cooling Cooked PRFs from 1400F to 29. S ecial Requirements .009 700F Within 2 Hours and Front 700F to 30. Other 410F/4501- Within 4 Hours. * oor�n�t�..aa 3-501.14(13) Cooling PHFs Made From Ambient Temperature Ingredients to 410F/450F 11'ithin 4 Hours* 3-501.14(C) PHFs Received at Temperatures According to Law Cooled to 410F/450F Within 4 Hours. * *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. CITY OF SALEM BOARD OF HEALTH Establishment Name: r- M-Date: Page: of Rem Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Rem Verified PLEASE PRINT CLEARLY Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion P O 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. 0 Voluntary Disposal ❑ Other: Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1.22) (Cont.) 3-501.15 Cooling Methods for PHPs 19 PHF Hot and Cold Holding PROTECTION FROM CHEMICALS 3-501.16(B) Cold PIVs Maintained at or below 14 Food or Color Additives 590.004(1-) 410/450 F* 3-20212 Additives* 3-501.16(A) Hot PHFs Maintained at or above 3-302.14 Protection from Unapproved Additives* 1400E * 15 Poisonous or Toxic Substances 3-501.16(A) Roasts Held at or above 130*F. 7-101.11 Identifying Information-Original 20 Time as a Public Health Control Containers* 3-501.19 Time as a Publicllealth Control* 7-102.11 Common Name-WorkingConuiners* 590.004(H) Variance Requirement 7-201.11 Separation-Storage* 7-202.11 Restriction-Presence and Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-202.12 Conditions of Use* POPULATIONS HSP 7-203.11 Toxic Containers-Prohibitions* 21 3-801.11(A) Unpasteurized Pre-packaged.luicesand 7-204.11 Sanitizers,Criteria-Chemicals* Beveran,es with Warning Labels* 7-204.12 Chemicals for Washing Produce,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 7-204.14 Drying Agents,Criteria* 3-801.1 1(D) Raw or Partially Cooked Animal Food and 7-205.11 Incidental Food Contact,Lubricants* Raw Seed Sprouts Not Served. * 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(C) Unopened Food Package Not Re-served 7-206.12 Rodent Bait Stations* 7-206.13 Tracking Powders,Pest Control and CONSUMER ADVISORY Monitoring* 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or TIME/TEMPERATURE CONTROLS Not Otherwise Processed to Eliminate 16 Proper Cooking Temperatures for Pathogens,*O1et6Ye X12001 PHFs 3-302.13 Pasteurized EESs Substitute for Raw Shell Eggs* 3-401.11A(1)(2) Eggs- 1550F 15 Sec. Eggs-h»mediate Service 145°Fl5sec* SPECIAL REQUIREMENTS 3-401.11(A)(2) Comminuted Fish,Meats&Game 590.009(A)-(D) Animals- 155°F IS sec. * Violations of Section 590.009(A)-(D) in @)( )O ° * catering,mobile food, temporary and 3-401.11 1 2 Pork and Beef Roast- 130 F 121 min residential kitchen operations should be 3-401.11(A)(2) Ratites,Injected Meats-155OF 15 sec. debited under the appropriate sections * 3-401.1 I(A)(3) Poultry,Wild Game,Sabove if related to foodborne illness - interventions and risk factors. Other Scoffing Containing Fish,Meat, Poultry or Ratites-1650F 15 sec. * 590.009 violations relating to good retail 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks practices should be debited under 929- 145°F* Special Requirements. 3-401.12 Raw Animal Foods Cooked in a Microwave 1650F* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-401.11(A)(1)(b) All Other PHFs- 145°F 15 sec.* (Items 23-30) 12 Reheating for Hot Holding Critical and non-critical violations, which do not relate to the 3-403.11(A)&(D) PliFs 165*F 15 sec. * foodborne illness interventions mrd risk factors listed above, can be found in the following.sections of the Food Code and 105 CMR 3-403.1 I(13)• Microwave- 165°F 2 Minute Standing 590.000. Time* Item Good Retail Practices FC 590.000 3-403.11(C) Commercially Processed RTE Food- 23. Management and Personnel FC-2 .003 14001-* 24. Food and Food Protection FC-3 .004 3-403.11(E) Remaining Unsliced Portions of Beef 25. Equipment and Utensils FC-4 .005 Roasts* 26. Water,Plumbing and Waste FC-5 .006 18 Proper Cooling of PHFs 27. Physical Facility FC-6 .007 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(A) Cooling Cooked PIIFs from 1400F to 29. Special Requirements .009 700E Within 2 Hours and From 70°F to 30. Other 410F/4501'Within 4 Honrs. * sswr t..kaz.na 3-501.14(B) Cooling PI IFs Made From Ambient Temperature Ingredients to 41'F/45017 Within 4 flours* 3-501.14(C) PHFs Received at"femperacores According to Law Cooled to 41017/45°F Within 4 Hours.* •Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. °"° City of Salem;_MaS$bChusetts <_ W -Board of Health 9 120 Washington Street, 4th Floor, Salem, MA 01970 ` Tel -(978)741-1800 Fax. (978) 745-0343 PllblieHealth Prevent. Promote Protect. - Irarndin@salem.corn Kimberley Driscoll 4, Larry Ramdin RSlREHS,CHO,CP-FS Mayor Health Agent FOOD ESTABLISHMENT PERMIT x - (must be posted on the Premises of the Food Establishment) 20'I4 g r{ y Permit Number: K FM-14-500 Permit Type: Food Establishment< 25 seats W e d Goods&Services`. Food Service: 0`=24 seats 'Name of License Holder: ,-, Dttdat Hussain j" y - Name of Food-Establishment NY Gyro Address of Food Establishment 335 Lafayette Street ` Restrictions: x j This License is granted in conformity with the statutes Regulations and ordinances relating'thereto and expires on 12/31/2014 unless sooner suspended or revoked: Permit Fee: $140.00, Issued: 8/19/2014 m a� x Y 9 _, i CITY OF SALEM, MASSACHUSETTS I Ith BOARD or HeAIA]I 120 WASHINGTON S'11(L I',4'''"FLOOR KIMBERLEY DRISCOLL TeL.(978)7414800 FAX(978)745-0343 L iuty RAMDIN,RS/REI-IS,CFIO,Cl'-IS MAYOR Iraindin@silem.com H:FAJ:n-I AC'I,'N"I' Food Establishment Permit Application (Application must besubmitted at /beast 30 days before the planned opening date) Alv 1) Establishment Name: y / rJi//C U L 2) Establishment Address: 33S ,4�4y2`7-re Sr 3) Establishment Mailing Address(if different): 4) Establishment Telephone No: 5) Applicant Name&Title: �iLD/J/� /rUSsg%/�n DG✓NE�' 6) Applicant Address: ZG Fv✓ES%�YE . / S/>LG%�'/ /y//� d%97U 7) Applicant Telephone No:R 78-3 27' S4 &Hour Emergency No V 2-1Y1-21'77 Email: �A�Pk' }'i✓ 8) Owner Name&Title(if different from applicant): 9) Owner Address(if different from applicant): 10) Establishment Owned by: 11) If a corporation or partnership, give name,title and home address of officersor partner. An association Name Title Home Address A corporation An individual ✓" A partnership Other legal entity 12 Person DirectlyRes onslbI For Dail Operations Person in Charge,e, Manager,etc. Name&Title: /�%LD/�R fIUSSA.i✓ /nDGvNE%P Address: 7�o/jCS%�'✓C?t 7i J/>�G%T/ A O/97v Telephone No: 97,q'327 �., r Fax:979=71141- 9�i0 �� yw o Email: v G Emergency Telephone No: 7 el - 2—t// — 2-/ 77 13) District or Regional Supervisor(if applicable) Name&Title: Address: Telephone No: Fax: Email: - Check#: 3 Date: D(1 —e%� Amount: /7V' 0 Food Establishment Information 14) Water Source: 15) Sewage Disposal: DEP Public Water Supply No: (if applicable) A'BL�G 7 y 6A117 70 12_,4'r7 16) Days and Hours of Operation: 17) No. of Food Employees: 72- 18) Name of Person in Charge Certified in Food Protection Management: DiGDH�' NvfS9%/✓ Required as of 101112001 in accordance with 105 CMR 590.003(A) 19) Person Trained in Anti-Choking Procedures( if 25 seats or more): ❑ Yes No 20) Location: 22) Establishment Type(check all that apply) (check one) ❑ Retail ( Sq. Ft) ❑ Caterer Permanent Structure t✓ 34 Food Service-( Zo Seats) ❑ Frozen Dessert Manufacturer Mobile ❑ Food Service-Takeout ❑ Residential Kitchen for Retail Sale ❑ Food Service-Institution ❑ Residential Kitchen for Bed and ( Meals/Day) Breakfast Home ❑ Food Delivery ❑ Residential Kitchen for Bed and 21) Length Of Permit: --------------------- - Breakfast Establishments (check one) RETAIL STORE RESTAURANT Annual L/ ❑ Less than 1000sci t. $70 ess than 25 seats $140 Seasonal/Dates: ❑ 1000-10,OOOsq.ft. $280 ❑ Residential Kitchens $140 ❑More than 10,OOOsq.ft. $420 ❑25-99 seats $280 ❑ More than 99 seats $420 TemporarylDates/Time: . .............................................................. ... ....................................... .......... ........ ❑ Bed&Breakfast/Childcare Services/Nursing Home $100 ADDITIONAL PERMITS ❑MAKE ICE CREAM,YOGURT/SOFT SERVE $25 ❑ PASTURIZATION $25 ❑ALL NON-PROFIT* $25 *Including, church kitchens, state funded childcare&private club 23) Food Operations: Definitions: PHF-potentially hazardous food(timeltemperature controls required) Non-PHFs-non-potentially hazardous food(no timeltemperature controls required) (check all that apply): RTE-ready-to-eat foods Ex.sandwiches,salads, muffins which need no further processing Sale of Commercially PHF Cooked to Order Hot PHF Cooked and Cooled or Hot Held Pre-packaged Non-PHFs for More Than a Single Meal Service 2/ Sale of Commercially Preparation of PHFs For Hot And PHF and RTE Foods Prepared For Highly Pre-packaged PHFs Cold Holding for Single Meal Service V Susceptible Population Facility Delivery of Packaged PHFs Sale of Raw Animal Foods Intended to be Vacuum Packaging/Cook Chill Prepared by Consumer Reheating of Commercially Customer Self-Service Use of Process Requiring A Variance Processed Foods for and/or HACCP Plan(including bare hand Service Within 4 hours contact alternative,time as public health control. Customer Self-Service of Ice Manufactured and Packaged for Offers Raw or Undercooked Food of Non-PHF and Non- Retail Sale Animal Origin Perishable Foods Only Preparation of Non-PHFs Juice Manufactured and Packaged for Prepares Food/Single Meals for Catered Retail Sale Events or Institutional Food Service Offers RTE PHF in Bulk Quantities To be completed by the Board of Health Retail Sale of Salvage,Out of Date or Reconditioned Food Total Permit Fee: Payment is due with application I,the undersigned,attest to the accuracy of the information provided in this application and I affirm that the food establishment operation will comply with 105 CMR 590.000 and all other applicable law. I have been instructed by the Board of Health on how to obtain copies of 105 CMR 590.000 and the Federal Food Code. / 24) Signature of Applicant: //i tiL1U��iGyg Pursuant to MGL Ch.62C, sec. 49A, I certify under the penalties of perjury that I,to my best knowledge and belief, Have filed all state tax returns and paid state taxes required under law. 25) Social Security Number or Federal ID: 26) Signature of Individual or Corporate Name: N`SS CITY OF SALEM BOARD OF HEALTH Establishment Name: CIV 9-0 Date: v - f S Page:—L—of Rem Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item verified PLEASE PRINT CLEARLY P.IR) ,J ] A*oCau o 1Zdv�r ) NS Pt, orJ t I T) L Y) a I W A'te'.- < E I »CL`C-- N.5-) L.1 r--, Fid E. 1 . rNo ScSW ) .-A �N1� 6S L111 arrcat Z- oco cx!49 fa aSS> Fq o.. aY-+".3 aw Ar-4q--V Lt-0 y 1 rr, G'G1.s�A�. 1 1x51 a' 1 d is �do'9 5• S c.-bk-�a 1� 1 � `leu G�Ai� S la M`�'l- �� oa�-i t'✓1 � SE,1L-1 n Ir-�.�2.m Q ) � rl rJT)L SAV u cdF A 6\V b, `T/� d�� 111-\, � � SC:e✓ ut�-6� � d'�S?F.�.id� W }�vrJa�\� `�� i•1��; 1-��q `oc� +ra^ r� i� � m 'f\c�t, Sa (�� (1-0�� Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ inspection, to observe all conditions as described, and to Exclusion violations before the next ins p ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. 1441"4 13 Voluntary Disposal 0 Other: I - , 1 ' Violations Related to Foodborne Illness Interventions and Risk 3-501.15 Cooling Methods for P1-IFs c' Factors(Items 1.22) (Cont.) g 19 PHF Hot and Cold Holding , PROTECTION FROM CHEMICALS 3-501.16(6) Cold PIEFs Maintained at or below I 14 Food or Color Additives 590.004(F) 410/450 F* 3-202.12 Additives* 3-50I A6(A) Hol PHFs Maintained at or above 3-302.14 Protection from Unapproved Additives* 140°F * 15 Poisonous or Toxic Substances 3-501.16(A) Roasts Fleld at or above 130°F. * ' 7-101.11 Identifying Information-Original 20Time as a Public Health Control Containers* 3-501.19 Time as a Public Health Control* 7-102.11 Common Nene-Working Containers* 590.004(H) Variance Requirement 7-20t.II Separation-Storae* S. 7-202.11 Restriction-Presence and Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-202.12 Conditions of Use* r; POPULATIONS HSP 7-203.11 Toxic Containers-Prohibitions* 21 3-801.11(A) Unpasteurized Pre-packaged.luicesand 7-204.11 Sanitizers,Criteria-Chemicals* Beverages with Warning Labels* 7-204.12 Chemicals for Washing Produce,Criteria* 3-80 L 11 Use of Pasteurized Eggs* y 7-204.14 DryiDg DryingAgents,Criteria* 3-801.11(1)) Raw or Partially Cooked Animal Food and 7-205.11 Incidental Food Contact,Lubricants* Raw Seed Sprouts Not Served. * 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(C) Unopened Food Package Not Re-served 7-206.12 Rodent Bait Stations* 7-206.13 Tracking Powders,Pest Control and CONSUMER ADVISORY Monitoring* 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or T1MEfrEMPERATURE CONTROLS Not Otherwise Processed to Eliminate 16 Proper Cooking Temperatures for pathogens. PHFs 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* 3-401.11 A(l)(2) Eggs- 155°F 15 Sec. ,ry Eggs-[mmediateService145°FlSsec* SPECIAL REQUIREMENTS 3-401.1 1(A)(2) Comminuted Fish,Meats&Game Animals- 155°F 15 sec. 590.009(A)-(D) Violations of Section 590.009(A)-(D) in 'k 3-401.11(13)(1)(2) catering,mobile food, temporary and Pork and Beef Roast- 130°F 121 min* residential kitchen operations should be 3-40L11(A)(2) Ratites, Injected Meats-155°F 15 see, debited under the appropriate sections v * above if related to foodbome illness i 3-401.11(A)(3) Poultry,Wild Game,StulTed PHFs, interventions and risk factors. Other i+ Stuffing Containing Fish,Meal, Poultry or Ratites-165°F 15 sec. * 590.009 violations relating to good retail 3-401.11(C)(3) N9tole-muscle,Intact Beef Steaks practices should be debited under 429- 145°F• Special Requirements. e 3-401.12 Raw Animal Foods Cooked in a r Microwave 165°F* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES t 3-401.11 A I Hold I S sec. * (Items 23-30) ( )( )(b) All Other PRFs- Critical and non-critical violations, which do not relate to the 17 Reheating for Hot Holding foodborne illness hnervenlions and risk./actors listed above, can be 3-403.11(A)&(D) PIFs 165°F I S see. * jormd in the following sections of the Food Code and 105 CMR 3-403.11(B) Microwave- 165°F 2 Minute Standing 590.000. t Timm* Item Good Retail Practices FC 590.000 3-403.11(C) Commercially Processed RTE Food- 23. Management and Personnel FC-2 .003 r 140°F* 24. Food and Food Protection FC-3 .004 3-403.11(E) Remaining Un$liced Portions of Beef 25. Equi ment and Utensils FC-4 .005 Roasts* 26. Water,Plumbing and Waste FC-5 .006 4 18 Proper Cooling of PHFs 27. Physical Facility FC-6 .007 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(A) Cooling Cooked PRFs from 140°F to 29. Special Requirements .009 70°F Within 2 Hours and From 70°F to 30. Other �r 41°F/456I'Within 4 hours. * ssvor�u�to-:.n« 3-501.14(13) Cooling PHFs Made From Ambient '. Temperature Ingredients to 41°F/457 ,.' Within 4 1lotns* -1' 3-50LA(C) PHFsReceived atTemperatures �F According to Law Cooled to 41°1745°F Within Hours. r •Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. x 'S d Name of Recipient: dildar hus$ain C*ertificate umber: ��i19� Date of ornpletion: 0312812013 • � a e of -x iration: 03/2712018 (DIP Issued By: e e- amedp rson is e y issued this eertcate ('� CpmpuW4 is c "feting n allergen awareness training program n:zed a assac usetts Department of Public Health GampuWorks S stems ne. in cc rd c z 0 •MR 90.00 (G'' 3 a . 41 North Avenue, or Wakefield, mum jol 1, P: 781-224-11+1�3 Massachusetts Department of Public Health Salem Board of Health 120 Washington Street, 0 Floor Division of Food and Drugs Salem, MA 01970-3523 Tel. (978) 741-1800 Fax(978) 745-0343 City/Town of SALU%j Address: FOOD ESTABLISHMENT INSPECTION REPORT Tel. Name Date Type of Operation(s) Type of Inspection N Y G Food Service El Routine Address �, Risk Retail ❑ Re-inspection Telephone Level El Residential Kitchen Previous Inspection ct ❑ Mobile Date: OwnerHACCP YIN ❑ Temporary Pre-operation 'D )t_rXW�' W V S.S )t__1 ❑ Caterer E Suspect Illness Person-in-Charge(PIC) Time ❑ Bed&Breakfast ❑ General Complaint In: ❑ HACCP Inspector l v� Out: Permit No. ❑.Other Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors_(Red Items) - Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate Tobacco 590.009(F) ❑, ❑ corrective action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities 'EMPLOYEE HEALTH PROTECTIONFROM'CHEMICAC$- ❑ 2. Reporting of Diseases by Food Employee and PIC E:114.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals FOOD'FROM APPROVED SOURCE n 4. Food and Water from Approved Source TwEITEMPERATURE:CONTROLS(Potenttelty Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans [118. Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time as a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY4USCEP718LE=POPULATIONS-.(HS?): ❑21. Food and Food Preparation for HSP El 10. Proper Adequate liandwashing ❑ 11. Goad Hygienic Practices CONSUMER ADVISORY ❑ 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): �J 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. C N 590.000/federal Food Code.This report,when signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food establishment permit and cessation of food 26.Water, Plumbing and Waste (Fc 5)(59o.006) establishment operations. If aggrieved by this order,you 27. Physical Facility (FC-6X590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7X590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: J. a,. lespector's Signature-, Print:I J L , PICS Signature: �' Print: 7L/ vs f' Page ofPages Violations Related to Foodborne Illness interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION 8Cross-coruaminanon FOOD PROTECTION MANAGEMENT 3-302.11(A)(1) Raw Animal Foods Separated from 1 590.0030,1) AssigDprnent of Responsibil,it * Cooked and RTE foods* 590.003(B) Demonstration of Knowledge* Contamination from Raw Ingredients 2-103.11 Person in charge.-duties 3-302_1.1(A)(_) Raw Animal Faods 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 a Aicantsa 3-304.11. Foal Contact with Equipment and 590.003(F) Responsibihty Of A Fool Employe,Or An Utensils* Applicant To Report To The Person In Contamination from the Consumer Char e* 3-306.14{A)B) Returned Food and Reservice of Food* 590.003(G) Re�ott nliby Person in Charge* Disposition of Adulterated or Contaminated 3 590.003(D) Exclusions and Restrictions* Food 590.003(E) 12enroval of Exclusions and Restrictions 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) Compliance with Food Law* 4-501..111 Manual Warewashing-Hot Water 3-201.12 Foal in a Hermetically Sealed Container* Sanitization Temperatures* 3 201.l3 Fluid Milk and Milk Products* 4-501.'112 Mechanical Warewashina Hon Water 3-202.13 Shell Eggs*s* ___ Sanitization Tem. cratures* 3-202.14 E s and Milk Produces,Pasteurim& 4-501.114 -Chemical:Sanitization-temp.,pH, 3-202.16 lee Made From Potable Diinkinm Water* concentration and hardness.* 5-101.:17 Dri eking Water from an A roved S 'rem"' 4-601.11(A) Equipment Food Contact Surfaces and �P -� Utensils Clean" 590,006(A) Bottled Drinking Water" -T602 1 t Cleaning Frequency of Equipment Food- 590.006(13) Water Meets Standards in 310 CMR 22.01' Contact Surfaces and Utensils* Shellfish and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils mid 3-201.14 Fish and Reerearionally Caught Molluscan Food Contact Surfaces of E ui ment* _ Shellfish* 4-70111 �'- Methods of Sanitization-Hot Water and. 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* to Proper,Adequate Handwashing Game and Wild Mushrooms Approved by 2-301.11 Clean Condition-Hands and Arms" Regulatory Authority 3-202.18 Shellsto ck Tdentification Present* 2-30(.12 Dean ng Procedure* 590.004(C) Wild Mushtoams* 2-301.14 When to Wash* 3-201.17 Game Animals4' L11 Good Hygienic Practices 5 Receiving/Condition 2401.11 Eating,Drinking or Using Tobacco* 3-202.11 PTTFs Received at Proper Tem ranues'" 2401.12 Discharges From the Eyes,Nose and 3-202.1.5 Packa>ehneerit * Mouth* 3-101.11 Food Safe and Unadulterated " 3-301.12 PreventimContamination When Tastin 6 Tags/Records:Shelistock L12 Prevention of Contamination from Hands 3-202.18 Shel'lsttx:k identification* 590.004(E) Preventing Contamination from 3-203.12 Shellstoek Tdenti'fication Maintained* Employees-* Handwash Facilities Tags/Records: Fish Products 13 3-402.1.1 Parasite Destruction* CanveniertttytocatedandAccessible 3-402.12 Records.Creation and Retention* 5-203.11 Numbers and Capacities* 590.004(1) Labeling of Ingredients" 5-204.11 fixation and Placement* Conformance with Approved Procedures 5-205.11 Accessibility,Operation and Maintenanee /HACCP Plans Supplied with Soap and Nand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packagin2.criteria* 6-301.11. Handwashing Cleanser,Availability 8-103.12 Conformance with Approved Procedures" 6-301.12 HandDr in*Provision *Denotes,critical Item in Vie Weral 1999 Food Code of 105 CMR 590.010. '' � / /r � r � � � � �� J�� ". f �� Ta DI LDAR H U SSA N ors ccessf Ily completing the standards set forth for the ServSafe® Foad Protection Manager w ich is accredited by t e American National Standartls fnstit to TANS 1—Conference f r Fo �J� 1 ��Z i*1 � 2 DATE OF EXAiv11NATION C}5j14/2017 DATE OF EXPIRATION Local laws apply. Check with your local regulatory agency for recertification requirements. r � S ♦ � s CITY OF SALEM BOARD OF HEALTH Establishment Name: tM CI94.o Date: Page: of Z Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item - - Verified PLEASE PRINT CLEARLY �SII1G3\.l $ 1411F,7f' ^I � o )=\�41' CA,)&QK rte l5` zj Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: 3-501.14(C) PRFs Received at Temperatures Violations Related to Foodborne limas.Interventions and Risk According to Law Cooled to Factors(Items 1-22) (Cont. 4l'F/45°F Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 CoolingMethods for PHFs 14 Food or Color Additives 19 PHF Not and Cold Holding s 3-501.16(B) Cold PHFs Maintained at or below 3-202.12 Additives ° 590.004(F) 41 14 1 50 F* 3-302.14 Protection from Un raved Additives" 3-501.16(Al Hot PRFs Maintained at or she Poisonous or Toxic Substances 25 * 140°F. 7-101.11 IdentiTying Information-Original 3-501.16(A) Roasts Held at or above 1300F. Containers* Time as a Public Health Control 7-102.11. Common Name-Working Containers* 20 3-501.19 Time as a Public Health Conant* 7-201.11 Separation-Storage*.. 590.004(H) Variance 7-202.11 Restriction-Presence and Use* e Requirement 7-202.12 Conditions of Use'* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions* POPULATIONS HSP 7-204.11 Sanitizers.Criteria-Chemicals" 21 3-801.11(.4) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals for Washine Produce,Criteria' Beverages with W'arnin°Labels* 7-204.14 n Agents.Criteria" 3-801.11(H} Use raof Pasteurized Eggs ng 7-205.11 Incidental Food Contac[,Lubricants* 3-801.1I(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 Momtonnq* CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-603.11. Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods That are Raw,Undercooked or PHFs - - Not Otherwise Processed to Eliminate Pathogens.'`"ec°"°'`1 3-401.11A(1)(2) Eggs- 155°F 15 Sec. Eggs-Immediate Service 145°F15sec* 3-302,13 Pasteurized Eggs Substitute for Raw Shell 3401.11(A)(2) Comminuted Fish.Meats&Game E zs* Animals-155°F 15 sec. * SPECIAL REQUIREMENTS 3401.11(B)(1)(2) Pori,and Beef Roast- 130°F121 min* 3-401.11(A)(2) Ratites,Injected Meats- 155°F 15 590.009(A)-(D) Violations of Section 590.009(A)-(D)in see,* catering,mobile food,temporary and 3401A I(Ax3) 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)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 145°F s 590.004 violations relating to good retail 3-401.12 Raw Animal Foods Cooked in a practices should be debited under#29- Microwave 165°F* Special Requirements. 3-401.11(A)(1)(b) All Other PHFs-145'F 15 sec, 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.11(A)&(D) PHFs 165°F 15 see.* (Items 23.30) 3403.1.1(B) Microwave--165°F 2 Minute Standing .Critical,and non-critical violations,which do not relate to the Timc* foodborne illness interventions and risk factors listed above, can be 34WA I(C) Comm{,ercially Processed RTE Food- found in the following sectiorts of the Food Corte and 105 CMR 140°F" 590.000. 3-403.11(E) - Remaining Unsticed Portions of Beef /tern I Good Refaff Practices .FC 590.000 Roasts} 18 Proper Coaling of PHFs 23. Manauement and Personnel - FC 2 .043 24.. Food and Food Protection FC-3 .004 ! - 25. 1 Equipment and Utensils _ 1 F8-4 .005 3-501.14(A) Cooling Cooked PHFs from 14WF to r26. 1 Water.Plumbino and Waste - i FC-5 .606 70°F Within 2 Hours and From 70°F 27. 1 Physical Facility FC-6 067 s to 41°F/45`F Within 4 Hours. ' 28. Poisonous or Toxic Materials ' FC=7 .008 3-501.14(11) Cooling PHFs Made From Ambient 29. S eciai R irements 009 I Temperature Ingredients to 41°F/45°F 30 1 Other .Within 4 Hoot's* "IJrnotes criticai item in the federal 1999 Fvwd Code or 165 G14R 590.000. CITY OF SALEM BOARD OF HEALTH Establishment Name: Date: Page: of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Pee No. Reference R-Red nem verified PLEASE PRINT CLEARLY ELE1 Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion P o Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other. 3-501.14(C) PHFs Received at Temperatures Violations Related to Foodborne Illness.Interventions and Risk According to Law Cooled to Factors(Rams 1-22) (Cont.) 41.'Fi45'F Within 4 Hours.' 3-501.15 Cooling Methods for PHFs PROTECTION FROM CHEMICALS 19 PHF Not and Cold Holding 14 - Food or Color Additives 3-501.16($) Cold MIN Maintained at or below 3-202.12 Additives* 590.004(F) 41*145°F* 3-302.14 Protection from Unapproved Additives* 3-501.16(A) Hot PRFs Maintained at or above L5 Poisonous or Toxic Substances 140,E 7-101.11 identifying Information-Original 3-501.16(A) Roasts Held at or above 130'F. Containers* 20 rim as a Public Health Control 7-102.11, Common Name-Working Conminers* 90.004( Time a - 7?01.11 Separation-Storage*, 590.004(H) u Public Health Conical* 7-202.11 .Restriction-Presenceand Usc' 9U.0H) Varianc eRnirement 7-202.12 Conditions of Ilse* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions* POPULATIONS HSP 7-204.11 Sanitizers.Criteria-Chemicals* 21 3-80.1AI(.A) Unpasteurized Pre-packaged Juices and 7-204-12 Chemicals for Washing Produce,Criteria* .Severn es wait Warning labels* 7-204.14 n encs.Criteria" 3-801.11(p)_ Use of Pasteurized Eggs, 7-205.11 Incidental Foal Contact,Lubricants* 3-801.11(D) Raw or Partially Cooked Animal Food and 7-206.11. Restricted Use Pesticides;Criteria* Raw Sad Sprouts Not Served. * 7-206.12 - Rodent Haft Stations* 3-801.il(C) Unopened Food Package Not Re-served. 7-106.13 Tracking Powders,Pest Control and Momtorin * CONSUMER ADVISORY TIMENEMPERATURE CONTROLS 22 3-603.11, 1 Consumer Advisory Posted for Consumption of lb Proper Cooking Temperatures for Animal Foods That are Raw,Undercooked or Not Otherwise Processed to Eliminate PHFs Patho *`" .Yrtrznoi 3-401.110(1)(2) Eggs- i55T 15 Sec. Eggs-Immediate Service 145'F15sec* 3-302.13. Pasteurized Eggs Substitute for Raw Shell 3-401.11(A)(2) Comminuted Fish.Meats&Game E * Animals-155'F 15 see. " SPECIAL REQUIREMENTS 3.101.11(B)(1)(2) Pork and Beef Roast- 130'F 121 min* 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 590.009(0)-(D) Violations of Section 590.009(0)-(D)in SM* catering,mobile food,temporary and 3-401.1 t(A)(3) Poultry,Wild Gate,Stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Poultry or Ratites-165°F 15 sec.* above if related to foodborne illness 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 1450F t' 590.009 violations relating to good retail 3-401.12 Raw Animal Foals Corked in a practices should be debited under#29- Microwave 165'F* Special Requirements. 3401;1 i(.A)(l)(b) All Other PHFs>14PF 15 sec:. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403AI(A)&(D) PRFs 165°F 15 sec.* (Items 23-30) 3-403.11(B) Microwave 165'F 2 Minute Standing CrUicat,and non-critical violations,which do not relate to the Time* foodborne illness interventions and risk factors listed above, cnn'be 3-403.11(C) Commercially Processed RTZ;Food- found in the following sections of the Food Cade acrd 105 CMR 1400F* 590.000. 3-403.11(E) - Remaining Unsticetl Portions of Beef j:.._ftern I Good Retall Practices I ,FC 590 aw i Roasts° 23. i Management and Parson rel FC-2 .003 18 Proper Cooling of PHFs 24.. Food and Food Protect on Fc-3 .004 i 25.- E viomenl and Utensils FC-4 'ODS i 3-501.14(A) Cooling Cooked PHFs from 140'F to 26, Water,Plumb and Waste i FC-5 .006 70'F Within 2 Hours and From 70'F 27. Physical Facility FC-6 W7 to 4 VF145'F Within 4 Hours. * 28. Poisonous a Toric Materials FC-7 .008 j 3-501.14(B) Cooling PHFs Made From Ambient 29. Special R2guirements .009 Temperature Ingredients to 41'F/45'F ---- Within 4 Hours* lhnous critical irzm in the iultrai t 949 Ft+oc1 Cale or 105 CZAR 590.0N. CITY OF SALEM BOARD OF HEALTH Establishment Name: Date: Page: of Item Code C—CrNicai item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION nate No. Reference R-Red item Verified PLEASE PRINT CLEARLY Discussion With Person in Charge: Corrective Action Required: ❑ No O Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal Cl Other. 3-501.14(C) PHFs Received at Temperatures Violations Related to Foodborne Illness interventions and Risk According to Law Cooled to Factors(Items 1-22) (Coni.) 41.0F/450F Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 CoolingMethtxis for PHFs 14 Food or Color Additives 19 CHF Not and Cold ineHoldingat 3-501.16(B) Cold PHFs Maintained at or below 3-202.12 Additives* 590.004(F) 410/450 F* 3-302.14 Protection from Unapproved Additives*. 3-501.16(A) Hot PRFs Maintained at or above 15 Poisonous or Toxic Substances 140°F. * 7-101.1.1 Identifying Information-Original 3-501.16(.A) Roasts Heid at or above 130°F. Containers* Time as a Public Health Control 7-102.1 I. Common Name-Working Containers* 3-501.19 Time as a Public Health Control* * 7-201.11 Separation-Stom - 7-202.11 Restriction-Presence and Use* 590.0t)4(H) Variance Re nirement 7-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions* POPULATIONS(HSP) 7-204.11 Sanitizers.Criteria-Chemicals° 3-801.11(A) Unpasteurized Pre- ckag Juices and 7-204.12 Chemicals for Washing Produce,Criteria* 7-204.14 Drying Agents.Criteria* 21 Beverages with Warning Labels* 7-205.11 Incidental Foal Contact.Lztbricants* 3-801.118 Use of Pasteurized Eggs* 7-205.11 Restricted Use Pesticides;Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and Raw Seed Sprouts Not Served 7-206.12 Rodent Haft Starions* 3-801A I(C) Unopened Food Packs a Not Re-served. 7-206.13 Tracking Powders,Pest Control and Monitarin * CONSUMER ADVISORY T1ME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods That are Raw.Undercooked or PHFs Not Otherwise Processed to Eliminate 3-401.I1A(1)(2) Eggs- 1557 15 Sec. Patho ens.*`"°"`a rnnoot Ems-Immediate Service 145°Fl5sec* 3-302.13. 1 EPasteurized Eggs Substitute for Raw Shell 3-401.11(A)(2) Comminuted Fish.Meats&Game gg Animals-155°F 15 sec.* SPECIAL REQUIREMENTS 3.401.11(B)(I)(2) Pork and Beef Roast- 130'F 121 min* 590-009(A)-(D) Violations of Section 590.009(A)-(D)in 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec. * catering,mobile food,temporary and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Poultry or Ratites-165°F 15 sec.* above if related to foodborne illness 3-401.11(C)(3) Whole-muscle,head 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 tinder#29- Microwave 165°F* Special Requirements. 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec. 17 Reheating for trot Holding VIOLAT/ONS RELATED TO GOOD RETAIL PRACTICES 3403A1(A)&(D) `PHR I65°F 15 sec.* (Items 23-30) 3-403.11(B) Microwave 165°F 2 Minute Standing Critical,and non-critical violations,which do not relate to the _ Time* foodborne illness interventions and risk factors listed above, can be 3-403.11(C) Commercially Processed RTE Foal- found in the following sectionsof the Food Code and 105 CMR 140°F* 590.000. 3-403.i I(E) Retraining Unsliced Portions of Beef t Item Good Retail Practices FC 590-QUO :Roasts* 123. 1 Management and Personnel i FC-2 .003 _i 124 Food and Food Protection FC-3 ( .004 18 Proper Cooling of PHFs - ---- - (-25. (Epvigrstent and Utensils ! FC-4 005 ! 3-501.14(A) Cooling Cooked PHFs from 140°F to 1-26, 1 Water,Plumbinit and Waste i FC-5 70°F Within Hours and Front 709F 27. Ph sical FaolN i FG-6 .007 to 41°F/45 F Within 4 Hours. ° 2B. Poisonous or Toxic Materials FC-7 .008 3-501.14(B) Cooling PHFs Made From Ambient 29. Special R uirementsI .009 i Temperature Ingredients to 41°F/45°F I Other Within 4 Hours* "d "Drnonca critical item in the federal 1999 F(*d Cixle a 105 CMR 590.0(10. o CITY OFSALEM, NL1SSACHUSLTTS BOARD .)FHEAI ITi 120 WASHINGTON STREET,4"'FLOOR PubhcHealth PrPvcnt.Praimtt.Prnt¢t. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL, lramdin&salem.com LARRY RAMDm,Rs/RF:xs,rrxO,ch-cs MAYOR I WA f,I I I A(i 17INI PLAN REVIEW APPROVAL DATE: June 27,2014 To: Dildar Hussain ESTABLISHMENT: NY Gyro DATE RECEIVED: 6/11/2014 The Salem Board of Health has reviewed your submitted plans and has approved them as follows: [ ] AS SUBMITTED [ ] Rejected [X ] Conditionally as follows: Owner must submit a revised floor plan indicating the new location for the prep sink and mop sink. The plan is otherwise approved. Reviewed By: Date: June 27,2014 You are required to contact the Salem Board of Health to schedule an inspection prior to opening the establishment or utilizing the renovated/newly constructed space, at least five(5) business days prior to desired occupancy/opening. This approval is issued by the Salem Board of Health; the applicant is required to secure all other permits, and approvals that are required by other Municipal, State and Federal agencies. LMICKEX 0.1LE Fd LdFEL plTd ✓^ CXICKEN HIIGGFTS LlY CNEESE STEGN GYRO, 8� 'K14BABs BURGE.R 'C'O)MBO \�jTz r • LAMB LHOpS CNILNEN tIJKNd LAMOTIKNA IBillCNEESERV PGFR LNILNEX BHPGEP fISN GHRGEP ..H,;. LtPMB PILE LAMB PITA Iio� + ' 4</ - '1` � LHICKEN TENDER CHIPS SNP 8'CX_IP• } I �SSFCECA FALAFEL RICESIEFFIR COMBO PLATTER CHAPLI KAP..GOI&MTl LAPIA FISH SAMOSAMOZZAPELLd STICKS mmmEP PATTY XOT WING 8 CHIPS ISH fl LHID$ rte_� l � ire I • f CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 4`"FLOOR Pttl>liCm;�ltb , Prevent.Promote.Protect. TEL. (978)741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL lramdinQsalem.com LARRY RAMDIN,WRENS,CHO,CP-FS MAYOR - HEALTH AGENT Procedures to obtain a Food Establishment Permit Salem is a business friendly community and a destination for many restaurants. In order to facilitate a smooth licensing process and to ensure you can meet your opening targets. We are providing Food Establishments with this guide to the licensing process. The Food Establishment permitting procedure is a(2)part process • Plan review to Food Establishment Permit Inspection Plan Review 1. Schedule a meeting with Health Agent to discuss proposal and requirements for licensure 2. Schedule a site visit. The site visit allows the applicant to describe their plans for the location and the Board of Health to provide information on necessary work to be done to ensure the facility meets compliance for licensure. Because the Public Health codes change, facility upgrades may be necessary. Even if you are going to conduct a similar type of business as previously existed at the location.- 3. Submit plan review application a. Plan review application has to completely filled out b. Plans must be submitted 30 days prior to the start of construction c. Professionally drawn plans must show: i. Site plan and floor plan, ii. Elevation and wall floor joint details, iii. Lighting, plumbing/drainage details, iv. Lighting schedule and surface finish schedule. d. Specification sheets for all equipment and surfaces must be provided with plan e. Menu f. Fee These requirements are all detailed in the plan review application Once the plans are reviewed a plan review approval will be issued and construction can begin, once approvals from the building and other municipal state and federal departments has been received. The Board of Health may visit during the construction to ensure that the construction is following the plans submitted. If there are any changes to the approved plan, please contact the Board of Health office, as soon as possible before proceeding. This allows us to make an assessment, as to whether there is any negative food safety impact on the change and advise on actions that can be taken to remediate those negative impacts. Food Establishment Permit In order to ensure that your food establishment is inspected and permitted, to meet your projected opening date. Please contact the Health Department(1)week prior to your proposed opening date to schedule an inspection and submit your food establishment permit application with the appropriate fee. Permit Documents The documents that are needed will depend on the type of operation. Some may not be applicable to your establishment. We will advise you as to what is needed at the time of the plan review application. The following are documents that may be needed to schedule the inspection are: 1. Food Establishment Application form and fee( Check made out to the City of Salem) 2. Certified Food Manager Certificate ( for establishments that sell anything other than prepackaged food) 3. Allergen Awareness Certificate 4. Workmen's compensation insurance affidavit 5. Pest �CIAIUI�11LIWL 6. Trash disposal contract 7. Grease disposal contract 8. Choke Save training certificate-if you have 25 or more seats 9. Lab results- if you prepare frozen Desserts 10. Variance requests with supporting documentation The food establishment permit inspection should be scheduled after other departments (except the Building Department),have completed their inspections. Once the inspection is completed and the facility has met the requirements for their Food Establishment permit, the inspector will sign the building card for the occupancy permit. We will also advise the Licensing Department that we have completed our inspection so they can issue the Common Victualler permit (if needed). The Food Permit will be issued to you to begin operations after the Building Department has issued the Certificate of Occupancy. Please feel free to contact us at 978-741-1800 if you have questions. CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR KIIvIBERLEY DRISCOLL TEL (978)741-1800 MAYOR FAX(978)745-0343 IramclinQalem.com LARRY RAMDIN,RS/REHS,CHO,CP-FS HEALTH AGENT Fees:New Establishment:$180.00 Remodel:$90.00 Make Checks payable to:The City of Salem No cash is accepted FOOD ESTABLISHMENT PLAN REVIEW APPLICATION V NEWMODEL CONVERSION Date: Name �•1'o..f� VEstablishment: t.]"Cta b�6�� rattegg* tatiTant stltut-Iet_ Other Address: SM260 -51 , 7�, Phone if available: -?;:,2,:;7 �J(G Name of Owner: Mailing Address: � S C/ ��-J , Kz t ✓ Telephone: Applicant's Name: -t lt-PAC- �)VS5-p<\k> Title(owner,manager, architect, etc.): ��, ➢��1 ��a� � 5 Mailing Address: J Telephone: I have submitted plans/applications to the following authorities on the following dates: j Licensing Board Plumbing l l -73 7 - Zoning Electric JT Planning Police1 Building Fire Conservation Other( ) Hours of Operation: Sun EMUMThurs 1'NI Mon6�47&gFri_&L4,IeP TuesG2 _ 2DASat 90\4 L00 Wed&& Idin Number of Seats: Number of Staff: 2 (Maximum per shift) Total Square Feet of Facility: Number of Floors on which operations are conducted Maximum Meals to be Served: Breakfast (approximate number) Lunch V Dinner Projected Date for Start of Project: � — Ak � I�t Projected Date for Completion of Project:�V Z17�h20 Type of Service: Sit Down Meals (check all that apply) Take Out Caterer Mobile Vendor Other Please enclose the following documents: JProposed Menu(including seasonal,off-site and banquet menus) J✓ Manufacturer Specification sheets for each piece of equipment shown on the plan Site plan showing location of business in building;location of building on site including alleys, streets; and location of any outside equipment(dumpsters,well, septic system-if applicable) Jl Plan(floor and elevations shown)drawn to scale of food establishment showing location of equipment,plumbing, electrical services and mechanical ventilation Equipment schedule CONTENTS AND FORMAT OF PLANS AND SPECIFICATIONS 1. Provide plans that are a minimum of 11 x 14 inches in size including the layout of the floor plan accurately drawn to a minimum scale of 1/4 inch= 1 foot. This is to allow for ease in reading plans. 2. Include: proposed menu, seating capacity, and projected daily meal volume for food service operations. 3. Show the location and elevated drawings of all food equipment. Each piece of equipment must be clearly labeled on the plan with its common name. Submit drawings of self-service hot and cold holding units with sneeze guards. 4. Designate clearly on the plan equipment for adequate rapid cooling,including ice baths and refrigeration, and for hot-holding potentially hazardous foods. 5. Label and locate separate food preparation sinks when the menu dictates to preclude contamination and cross-contamination of raw and ready-to-eat foods. 6. Clearly designate adequate hand washing lavatories for each toilet fixture and in the immediate area of food preparation. 7. Provide the room size, aisle space, space between and behind equipment and the placement of the equipment on the floor plan. 8. On the plan represent auxiliary areas such as storage rooms,garbage rooms,toilets,basements and/or cellars used for storage or food preparation. Show all features of these rooms as required by this guidance manual. 9. Include and provide specifications for: a. Entrances, exits, loadinglunloading areas and docks; b. Complete finish schedules for each room including floors,walls, ceilings and coved juncture bases; c. Plumbing schedule including location of floor drains, floor sinks,water supply lines, overhead wastewater lines,hot water generating equipment with capacity and recovery rate,backflow prevention, and wastewater line connections; d. Lighting schedule with protectors; (1)At least 110 lux(10 foot candles)at a distance of 75 cm(30 inches) above the floor, in walk-in refrigeration units and dry food storage areas and in other areas and rooms during periods of cleaning; (2)At least 220 lux(20 foot candles): (a)At a surface where food is provided for consumer self-service such as buffets and salad bars or where fresh produce or packaged foods are sold or offered for consumption; (b) Inside equipment such as reach-in and under-counter refrigerators; (c) At a distance of 75 cm(30 inches)above the floor in areas used for hand washing,ware washing, and equipment and utensil storage, and in toilet rooms; and (3)At least 540 lux(50 foot candles)at a surface where a food employee is working with food or working with utensils or equipment such as knives,slicers, grinders,or saws where employee safety is a factor. e. Food Equipment schedule to include make and model numbers and listing of equipment that is certified or classified for sanitation by an ANSI accredited certification program(when applicable). f. Source of water supply and method of sewage disposal. Provide the location of these facilities and submit evidence that state and local regulations are complied with; g. A color coded flow chart demonstrating flow patterns for: -food(receiving,storage,preparation, service); -food and dishes(portioning,transport, service); -dishes(clean,soiled, cleaning, storage); -utensil (storage,use, cleaning); -trash and garbage(service area, holding, storage); h. Ventilation schedule for each room; i. A mop sink or curbed cleaning facility with facilities for hanging wet mops; j. Garbage can washing area/facility; k. Cabinets for storing toxic chemicals; 1. Dressing rooms,locker areas, employee rest areas, and/or coat rack as required; m. Completed Section 1; n. Site plan(plot plan) FOOD PREPARATION REVIEW, Check categories of Potentially Hazardous Foods (PHF's)to be handled,prepared and served. CATEGORY* 1' S N(DOO 1. Thin meats, poultry, fish, eggs (hamburger; sliced meats;fillets) ( ( ) 2. Thick meats,whole poultry(roast beef whole turkey, chickens,hams) ( / ( ) 3. Cold processed foods (salads, sandwiches,vegetables) 4. Hot processed foods(soups, stews,rice/noodles,gravy, chowders,casseroles) ( ) 5. Bakery goods(pies, custards, cream fillings &toppings) ( ) 6. Other s A generic HACCP plan for each category of food may be available from the regulatory authority for reference. PLEASE CIRCLE/ANSWER THE FOLLOW17VG QUESTIONS FOOD SUPPLIES: 1. Are all food supplies from inspected and approved sourceseE /NO 2. What are the projected frequencies of deliveries for frozen foods Refrigerated foods 2 LK6"k , and Dry goods 2(. �— 3. Provide information on the amount of space(in cubic feet)allocated for: Dry storage •LOQ DA10, Refrigerated Storage ?�O(°V, 1� and Frozen storage VW 4. How will dry goods be stored off the floor? COLD STORAGE: 1. Is adequate and approved freezer and refrigeration ailable to store frozen foods frozen and refrigerated foods at 41°F(5°C)and below. E /NO Provide the method used to calculate cold storage requirements. 2. Will raw meats,poultry and seafood stored in the same refrigerators and freezers with eoeked/ready to ear€oods? 1'FS,y If yes,how will cross-contamination be prevented? 3. Does each refrigerator/freezer have a thermometer. YES NO Number of refrigeration units: 2 Number of freezer units: 4. Is there a bulk ice machine available? YES NO o - THAWING FROZEN POTENTIALLY HAZARDOUS FOOD: Please indicate by checking the appropriate boxes how frozen potentially hazardous foods (PHF's) in each category will be thawed. More than one method may apply. Also,indicate where thawing will take place. Thawing Method *THICK FROZEN *THIN FROZEN FOODS FOODS Refrigeration Running Water Less than 70°F(21°C) Microwave(as part of cooking process) Cooked from Frozen state 'S Other(describe) *Frozen foods: approximately one inch or less =thin,and more than an inch=thick. 1. Will food product thermometers be used to measure final cooking/reheating temperatures of PHF's? YES/NO What type of temperature measuring device: Minimum cooking time and temperatures ofproduct utilizing convection and conduction heating equipment: beef roasts 130°F (121 min) solid seafood pieces 145°F(15 sec) other PHF's 145°F (15 sec) eggs: Immediate service 145°F(15 sec) pooled* 155°F(15 sec) (*pasteurized eggs must be served to a highly susceptible population) pork 145°F (15 sec) comminuted meats/fish 155°F(15 sec) poultry 165°F(15 sec) reheated PHF's 165°F (15 sec) 2. List types of cooking equipment. HOT/COLD HOLDING: 1. How will hot PHF's be maintained at 140°F(60°C)or above during holding for service? Indicate type and number of hot holding units. 2. How will cold PHFs be maintained at 41 OF(5°C)or below during holding for service? Indicate type and number of cold holding units. COOLING: Please indieateby-eheeking-th"ppropriate-boxes haw I IU, will bo eaaled-to-4 "%F within 6 hours (i 40°F to 70°F in 2 hours and 70°F to 41 OF in 4 hours).Also, indicate where the cooling will take place. COOLING THICK THIN THIN THICK RICE/ METHOD MEATS MEATS SOUPS/ SOUPS/ NOODLES j GRAVY GRAVY Shallow Pans 1 1 Ice Baths a I Reduce jVolume or V v Size Rapid Chill Other (describe) 1 REHEATING:. 1. How will PHF's that are cooked, cooled, and reheated for hot holding be reheated so that all parts of the food reach a temperature of at least 165°F for 15 seconds. Indicate type and number of units used for reheating foods. NA hl"Ck-5 NS 2. How will reheating food to 165°F for hot holding be done rapidly and within 2 hours? PREPARATION: 1. Please list categories of foods prepared more than 12 hours in advance of service. 2. Will food employeestain ed in NO Method of training: Number(s) of employees: 2 Dates of completion: 3. Will disposable glow and/or utensils and/or food grade paper be used to prevent handling of ready-to-eat foods? S NO 4. Is there apolicy to exclude or restrict food workers who are sick or have infected cuts and lesions? YE /NO Please describe briefly: Gi"1(X(7It 065'. Will employees have paid sick leave?YES 6 5. How will cooking equipment, cutting boards, counter tops and other food contact surfaces which cannot be submerged in sinks or put through a dishwasher be sanitized? Chemical Type: aVIG4-AM/A/1� Concentration: Test Ki, YES/ O 6. Will ingredients for cold ready-to-eat foods such as tuna,may and eggs for salads and sandwiches be pre-chilled before being mixed and/or assembled. YES O If not,how will ready-to-eat foods be cooled to 41'F? 7. Will all produce be washed on-site prior to use? ES/NO Is there a planned location used for washing produce?"E E /NO Describe Q SI a,� > If not,describe the procedure for cleaning and sanitizing multiple use sinks between uses. 8. Describe the procedure used for minimizing the length of time PHF's will be kept in the temperature danger zone(416F- 140°F)during preparation. FeryN� Vic' � �C>ce 7'A0 CSO Ltc\je=; c lel4 TS' 9. Provide a HACCP plan for specialized processing methods such as vacuum packaged food items prepared on-site or otherwise required by the regulatory authority. 10.Will the facility be serving food to a highly susceptible population?YES/NO If yes,how will the temperature of foods is maintained while being transferred between the kitchen and service area? A.FINISH SCHEDULE Applicant must indicate which materials (quarry tile,stainless steel,4"plastic coved molding, etc.)will be used in the following areas. Kitchen FLOOR COVING WALLS CEILING Bar Food Storage Qom( VIGwGI �L Other Storage P�N GcAJb Gw� I Toilet Rooms Dressing A-1111Rooms 0\/�� 44 I Garbage& IRefuse Storage Mop Service 1 Basin Area 1,(AVL Ware washingLA n Area Walk-in Refrigerators and Freezers B. INSECT AND RODENT CONTROL APPLICANT.-Please check appropriate boxes. YE N N S ,t} A _ 1.Will all outside doors be self-closing and rodent proof? ( ( } ( } 2. Are screen doors provided on all entrances left open to the outside? 3. Do all openable windows have a minimum#16 mesh screening? ( ) ( ) 4. Is the placement of electrocution devices identified on the plan? ( ) ( ) 5. Will all pipes &electrical conduit chases be sealed;ventilation systems exhaust and intakes protected? 6. Is area around building clear of unnecessary brush, litter,boxes and other { } ( } harborage? 7. Will air curtains be used? If yes,where? { ) {t { } C. GARBAGE AND REFUSE o o- a Inside —.---8. Do all containers have lids? 9. Will refuse be stored inside? { } { { } If so, where? 10. Is there an area designated for garbage can or floor mat cleaning? (V) ( ) { ) Outside 11. Will a dumpster be used? { ) ( ) Number Size Frequency of pickup Contractor G� 12. Will a compactor be used? Number Size 'f Frequency of pick up Contractor 13. Will garbage cans be stored outside? ( ) ( ( ) 14. Describe surface and location where dumpster/compactor/garbage cans are to be stored 15. Describe location of grease storage receptacle -oN P�mrvs — 3 ca o 'nv� 16. Is there an area to store recycled containers? Indicate what materials are required to be recycled; ( ) Glass \ ( )Metal ( ) Paper ( ) Cardboard ( )Plastic 17. Is there any area to store returnable damaged goods? ( ) ( ) D.PLUMBING CONNECTIONS AIR AIR *INTEGRA *"P" VACUUM CONDENSAT GA BREA L TRAP TRA BREAKE E PUMP P K P R 18.Toilet 19. Urinals i Dishwasher �l�" 21. Garbage (/ jGrinder 22.Ice / machines Ice storage storage bin i 24.Sinks a. Mop b.Janitor c. Hand wash d.3 Compartment e. 2 Compartment E l Compartment g.Water � on 1 25. Steam a tables i 26.Dipper j wells j 3 27. { Refrigeration condensate/ idrain lines { 28.Hose 1 connection 3 29.Potato peeler i 130.Beverage 1 Dispenser w/carbonator 31.0ther i *TRAP:A fitting or device which provides a liquid seal to prevent the emission of sewer gases without materially affecting the flow of sewage or waste water through it. An integral trap is one . that is built directly into the fixture, e.g., a toilet fixture. A?P?trap is a fixture trap that provides a liquid seal in the shape of the letter?P.?Pull?S?traps are prohibited. 32.Are floor drains provided &easily cleanable, if so,indicate location: E.WATER SUPPLY 33. Is water supply public{ or private( )? 34. If nrivzte,has source been approved?YES U NO ( )PENDING( ) Please attach copy of written approval and/or permit. 35. Is ice made on premises ( }or purchased commercialiyo If made on premise,are specifications for the ice machine provided? YES( )NO Describe provision for ice scoop storage: dos Provide location of ice maker or bagging operation—a- 36. perationa36. What is the capacity of the hot water generator? 37. Is the hot water generator sufficient for the needs of the establishment?Provide calculations for necessary hot water(see Part 5 &Part 9 Under Section III in this manual) 38. Is there a water treatment device?YES (';-No If yes,how will the device be inspected &serviced? 39. How are backflow prevention devices inspected&serviced? ''~f A F. SEWAGE DISPOSAL 40. Is building connected to a municipal sewer?YES NO( ) 41. If no, is private disposal system approved?YES ( )NO O PENDING( ) Please attach copy of written approval and/or permit. 42. Are grease traps provided?YES (-NO ( ) Ifso,where? KC\ k6Cgpj Provide schedule for cleaning&maintenance G.DRESSING ROOMS 43.Are dressing rooms provided?YES ( )NO 44. Describe storage fKiTiries or emp oyees person be o gi�i.e.,purse, coa s, oo s, umbrellas, etc.) & GENERAL 45. Are insecticides/rodenticides stored separately from cleaning&sanitizing agents? YES (t�NO( ) Indicate location: AC 46.Are all toxics for use on the premise or for retail sale(this ' cludes personal medications), stored away from food preparation and storage areas?YES VNO(• ) 47. Are containers of toxics including sanitizing spray bottles clearly labeled? YES )NO( ) 48. Will linens be laundered on site?YES ( )NO If yes,what will be laundered and where? If no,how will linens be cleaned? 49. Is a laundry dryer available?YES ( )NO 50. Location of clean linen storage: 51. Location of dirty linen storage: 52. Are containers constructed of safe materials to store bulk food products?YES aNO( ) Indicate type: 53. Indicate all areas where exhaust hoods are installed: I LOCATIO FILTERS SQUAR FIRE AIR AIR N WOR E FEET PROTECTIO CAPACIT MAKEU EXTRACTIO N Y CFM P CFM N DEVICES i i i i 54. How is each listed ventilation hood system cleaned? AN I. SINKS 55. Is a mop sink present?YES ( )NO If no,please describe facility for cleaning of mops and other equipment: 56. If the menu dictates,is a food preparation sink present?YES VNO( ) J.DISHWASHING FACILITIES 57. Will sinks or a dishwasher be used for ware washing? Dishwasher( Two compartment sink( ) Three compartment sink 58. Dishwasher Type of sanitization used: Hot water(temp. provided) kM�" Booster heater Chemical type Is ventilation provided?YES(AMNO( ) 59. Do-Alrdish machines have templates with oper�g instructions. 60. Do all dish machines have temperaturetpressure gauges as required that are accurately working?YES( )NO O A114— 61. Does the largest pot and pan fit into each compartment of the pot sink?YES*-�N'O( ) If no,what is the procedure for manual cleaning and sanitizing? 62. Are there drain boards on both ends of the pot sink? YES M NO ( ) 63.What type of sanitizer is used? ( Chlorine Iodine ) Quaternary ammonium,/ ) Hot Waterer Other ) ( 64. Are test papers and/or kits available for checking sanitizer concentration?YES ( )NO ( ) IC. HANDWASHING/TOILET FACILITIES - 65.Is there a washing sink in each food preparation and ware washing area?YES 4NO{ 2 `etzor,/ oD P O(U QCx*Z 66. Do all hand washing s' , including those in the restrooms, have a mixing valve or combination faucet?YES 1�NO( ) 67.Do self-closing metering faucets provide a flow ofater for at least 15 seconds without the need to reactivate the faucet? YES ( }NO 68. Is hand cleanser available at all hand washing sinks?YES aNO( ) 69.Are hand d g facilities(paper towels, air blowers,etc.)available at all hand washing sinks?YEW) O( ) 70.Are covered waste receptacles available in each restroom?YES..(/)NO{ ) s oan co d-ntMh%waterundarpressuree availabieateachhan"whingsink.It� NO( 72. Are all toilet room doors self-closing? YES O/NO( ) 73.Are all toilet rooms equipped with adequate ventilation?YES t-�NO( ) 74. Is a hand washing sign posted in each employee restroom?YES ( NO( ) L.SMALL EOIAPMENT REOUIREMENTS 75. Please specify the number, location, and types of each of the following: Slicers Cutting boards ! Can openers Mixers Floor mats Other r e STATEMENT: I hereby certify that the above information is correct,and I fully understand that any deviation from the above without prior permission from the Salem Board of Health may nullify final approval. Signature(s) owner(s)or responsible representative(s) Date: ************ Approval of these plans and spWilicMions by true Salem Board of Health d esnotindicate compliance with any other code,law or regulation that may be required--federal,state,or local. It further does not constitute endorsement or acceptance of the completed establishment (structure or equipment). A preopening inspection of the establishment with equipment in place &operational will be necessary to determine if it complies with the local and state laws governing food service establishments. r . The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations I Congress Street'Suite 100 Boston,AM 02114-2017 www.massgov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Le¢ibly Business/Organization Name: Address: City/State/Zip: _ Phone#: Are you.an employer?Check the appropriate box: Business Type(required): 1;❑ I am a employer with employees(full and/ 5. ©Retail orpart-time)* 6. ❑Restaurant/Bar/Eating Establishment 2.El I am a sole proprietor or partnership and have no 7_ Office and/or Sales(incl,real estate,auto,etc.) employees working for me in any capacity. [No workers'comp.insurance required] g• ❑Non-profit 3.El We area corporation and its officers have exercised % ❑Entertainment their right of exemption per c. 152, §1(4),and we have 10.0 Manufacturing no employees.[No workers'comp,insurance required]* 4 11.0 Health Care __... .Q__V4'e.aze_a_Hort-profiftt�gaut�ati9u,.x�ff�by volunteers,_ _ ._ ___-. with-no emp oyees. o wor els comp.rnsuriince req. .. 'Any app}icant that checks box#t muss also fill out the section below showing ttreirworkers'eompeasatioa policy infonua6on. rrlf the coryomte ot&oembave exempted themselves,but the corporation has other employees,a workers'compensation policy rs required and such an otgArtixation should cheek box#}. . I am an employer that isproviding workers'compensation insurance for my employees Below is thepolky information. Insurance Company Name: Insurer's Address: City/Stak&ip: Policy#or Self-ins.Lic.# Expiration Date: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerafy,under the pains and penaltiesof perjury that the informadion provided above is true and correct Signature: Date: Pie#: Official use only. Do not write in this area,to be completed by city or town o8`iciat City or Town' PermiVLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department.3.City/Town Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: V a±' . . .a-' �'"'�.�r',m;�'.r?t�'ny"�a�y � Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However,the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shad withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply your insurance company's name,address and phone number along with a certificate of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members __...__ or partners,are not required to carry workers'compensation insurance.. If an,LLC_or LIP does have_employees,apolicy____ r�equre.Be-adv—md that this—adv—mamdavit may be submitted to the Department ot industrialAccidents tor co on o insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fid in the permit/license number which will be used as a reference number.In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture(i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston,MA 02114-2017 Tel. #617-7274400 ext 406 or 1-877-MASSAFE Fax#617-727-7744 Formx"isea7n010 www.mass.gov/dia Delfield SAFPTI-S 26.64 Cu. Ft. One Section Solid Door Pass-Thru Freezer- Specificati... Page 1 of 5 W sflauran store http://www.gotowebstore.com/305SAFPTIS WebstaurantStore > Restaurant Equipment > Refrigeration Equipment > Spec Line/Institutional/Heavy Dutv Pass Thru/Roll In/Roll Thru Refrigerators and Freezers > Pass In/Pass Thru Spec Line/Institutional/Heavy Duty Freezers > Solid Door Pass In/Pass Thru Spec Line/Institutional/Heavy Duty Freezers > Delfield SAFPTI-S 26.64 Cu.Ft.One Section Solid Door Pass-Thru Freezer-Specification Line Delfield SAFPT1-S 26.64 Cu. Ft. One Section Solid Door Pass-Thru Freezer - Specification Line FREE SHIPPING! 9 Each Only I is �x n`rv� � Via,+."- '. ' • Ir :zr To see our price Add this item to your cart. (You con remove it at any time.) } p � Ii i��'Grya � 6 1 j Q .i�� + V 3 Year Parts and Labor Warranty i 3 V Stainless steel exterior, aluminum interior J 6"adjustable stainless steel legs V UL and NSF Listed V 3/4 hp top mounted compressor i Item: 305SAFPTlS Units: Each Shipping: Usually Ships in 7 Business Days l MFR Item: SAFPT1-S http://www.webstaurantstore.com/delfield-safpt 1-s-26-64-cu-ft-one-section-solid-door-pas... 6/17/2014 Delfield SAFPTl-S 26.64 Cu. Ft. One Section Solid Door Pass-Thru Freezer- Specificati... Page 2 of 5 White Glove Delivery •AVAILABLE. What is White Glove service?A Delflel+d View all Delfield Solid Door Pass In/ Pass Thru Spec Line/Institutional/ Heavy Duty Freezers i Details I Streamline your servingcanito process with the Delfield ood rvic INREST FtNMCtNG SAFPT1-S 26.64 cu. ft. one section solid door Pay no Interest for 24 months! pass-thru freezer! This Offer valid through June 36,2614 • " '� premium pass-thru ---_-____ --------,_ r freezer is perfect to bridge the gap between your kitchen and serving areas, so that SPECS i kitchen staff can place dishes inside from one I end as servers come to retrieve them from Width zq Incnes the other end. And thanks to its stainless - -- - steel exterior and heavy gauge aluminum Depth 36 1/4 Inches interior, you can be sure this unit will reliably Height 811/8 Inches serve your establishment's needs for years to Amps 11 Amps i come. Hertz 60 Phase 1 To keep your valuable food safe from Voltage 115 Volts tampering after business hours, this state-of- Capacity 26.64 Cubic the-art pass-thru freezer features built-in door ; Feet locks with heavy duty strikes, ensuring that Compressor Top Mounted the doors stay closed and locked until you're Door style 1 swing ready to open them. The door gaskets Door Type solid guarantee a secure seal when the doors are Horsepower 3/4 i http://www.webstaurantstore.com/delfield-safpt 1-s-26-64-cu-ft-one-section-solid-door-pas... 6/17/2014 Delfield SAFPTI-S 26.64 Cu. Ft. One Section Solid Door Pass-Thru Freezer- Speciffcati... Page 3 of 5 closed, and their dependable tear-proof construction means they will stay in great SPECS i condition. - ------------ i A top mounted 3/4 hp compressor circulates Number of Doors 2 environmentally friendly R404A refrigerant to Number of 3 Shelves maintain food safe holding temperatures. The top mounted design prevents dust, food, and Pass-Through Yes j spills from damaging the compressor's fan Sections 1 1 intake, and it also frees up more space for Split Doors No storage. Three chrome plated adjustable Temperature -5 o Degrees shelves help you make the most out of this Range 1 pass-thru freezer's 26.64 cu. ft. of space, and an externally mounted digital thermometer Customer questions about this jclearly displays the temperature so that you product can adjust.it with the microprocessor can i store stuff on the top of my controls. It also has an alarm to alert you of unit? any sudden drops or rises in temperature. Nothing should be stored on top of your unit.Typically,top mount refrigerators I and freezers do not have an actual top. The Delfield SAFPT1-S is UL and NSF Listed. If you're looking for extra storage Please consult the Specification Sheet for space,we recommend choosing a bottom mount unit. additional details. 3 Dimensions: { Width: 29" Depth: 361/4" i Height: 811/8" This Item Ships via Common Carrier. For more information and tips to help your delivery go smoothly, click here. i Because this item is not stocked in our warehouse, processing and transit times will vary. If you need your items by a certain date, please note this in the comment section while checking out! Please feel free to log on to our Live Chat http://www.webstaurantstore.com/delfield-safptl-s-26-64-cu-ft-one-section-solid-door-pas... 6/17/2014 Turbo Air MSF-49NM 54" Two Door Reach In Freezer- 49 Cu. Ft. Page 1 of 6 WE=TLaTrant Bs' store http://www.gotowebstore.com/902MSF49NM WebstaurantStore > Restaurant Equipment > Refrigeration Equipment > Reach In Refrigerators and Freezers > Solid Door Reach In Freezers > Turbo Air MSF-49NM 54"Two Door Reach In Freezer-49 Cu.Ft. Turbo Air MSF-49NM 54" Two Door Reach In Freezer - 49 Cu. Ft. ! FREE SHIPPING! 0 Enter your email to be T.Rinstantly sent the x E ^� price UES .re '°3.„!lt!� Illt�ig�jF ] � W i 1q� 3 I : i ! Note: images currently missing! i V Digital temperature controls V Ergonomically designed swing doors Six heavy duty shelves V 3/4 hp Compressor with R-404a refrigerant V Stainless steel construction V Energy Star, ETL, LIL and NSF Listed,115V i Item: 902MSF49NM Units: Each Shipping: Special OrderQ MFR Item: MSF-49NM http://www.webstaurantstore.com/turbo-air-msf-49nm-54-two-door-reach-in-freezer-49-cu... 6/17/2014 Turbo Air MSF-49NM 54" Two Door Reach In Freezer- 49 Cu. Ft. Page 2 of 6 White Glove Delivery -AVAILABLE- I What is White Glove service?Q i i I i View all Turbo Air Refrigeration Solid Door Reach In Freezers i Details For advanced frozen food preservation, this execs i Turbo Air MSF-49NM 54" two door reach in freezer is sure to meet your needs! Its precise : width 54 3/8 Inches digital temperature controls and high-tech Depth 30 3/4 Inches _._ monitor ensure maximum control and food Height ys 1/4 Inches safety! Made of durable stainless steel, this Amps 10.5 Amps i model is easy to clean, and its six adjustable Hertz 60 heavy duty polyethylene coated wire shelves - accommodate your various storage needs. Phase 1 Please consult the Specification Sheet for voltage 115 Vons additional details and installation Access Type Doors requirements. Capacity 49 Cubic Feet i Compressor Bottom Digital temperature control system and Mounted high-tech monitor alerts you if door has been construction All stainless opened for more than 30 seconds steel Door Style Swing Stainless steel interior; stainless Steel Door Type Solid exterior with galvanized top, bottom and Energy star Yes back Certified t Horsepower 3/4 Includes six heavy duty, adjustable Installation Type Freestanding polyethylene coated wire shelves Number of Doors 2 http://www.webstaurantstore.com/turbo-air-msf-49nm-54-two-door-reach-in-freezer-49-cu... 6/17/2014 Turbo Air MSF-49NM 54" Two Door Reach In Freezer - 49 Cu. Ft. Page 3 of 6 - Oversized, balanced refrigeration system specs with 3/4 hp compressor, R-404A refrigerant and high density polyurethane insulation _ w...-._ _ . ., Number of 6 Shelves - Ergonomically designed door with built-in - — _ Pass-Through No locks, self-closing and stay-open features; - I magnetic door gasket sections 2 Split Doors No - 4" swivel casters Temperature -14-Q Degrees Range F i - Holds -10 degrees Fahrenheit to 0 degrees Fahrenheit t Energy Star, ETL, UL and NSF Listed; 115V, 9' cord and NEMA 5-15P plug included Overall Dimensions: Left to Right: 54 3/8" Front to Back: 30 3/4" Height: 781/4" Volume: 49 cu. ft. This Item Ships via Common Carrier. For more information and tips to help your delivery go smoothly, click here. Because this item is not stocked in our warehouse, processing and transit times will vary. If you need your items by a certain date, please note this in the comment section while checking out! Please feel free to log on to our Live Chat should you have any questions before placing your order. After your order is a placed, we will update you via email to let you know how this will be shipping to you. Certifications i C ! us- �( " USM rntxrtek http:/hvww.webstaurantstore.eom/turbo-air-msf-49nm-54-two-door-reach-in-freezer-49-cu... 6/17/2014 Continental Fridge- SW27-8 - I Door Sandwich Prep Unit I eTundra Page I of 3 1-888388 6372 or-cam-., 11 0 product name Item number,sku i Search Sian My A=unt Tock order snnppir8 can o items in your can = REST All tis -`y eTUNDRA.com Item Total. RESTAURANT SUPPLY Equipmart Polls I Ptionlirtg I Mchilj DAying ROOM Filetipture DISPOSWUS � sefety 8thandi, ! ctoonarica Shop by specialty: Asian Bakery Bar Catering and Buffet Coffee Concession Ice Cream Mexican Pizza! Sandwich ininn i/Refrigeration 1 Prep Tables/Sandwich Prep Tahles SKU CTRSM78 Continental Refrigeration - SW27-8 - 1 Door Sandwich Prep Unit Price:$1,600.87/EA g " Lease for as little as g42.411month•learn More evi xe"� Shipping Info:Usually Ships Within 1-3 Business Days,M-F ice.. ' . Quantity 1 _ Add To Cart ... 7 --._ .- ._-_ _-_. . -. .._...., _....... . ... .._.. . ..._._.., t Ilya # d Be the first CO write a RVIeW _. .. -. t • a , y•1°T p 3 Lase, .t.,:).� PN.ie Product QW t Question I 1 Answer Read all the Q&As Documents: .Malnlal )rodUct Details Reloted Products • One-section Sandwich unit 77— Includes:{8}118 size z 4'deep pans12"cutting board !#� • (1)Epoxy coated shelf • (1)field re-hingeable door • Stainless steel top and front Turbo Air-M3 Series 2 Door 48` • Aluminum sides and interior Sandwich Prep Table &KU:TURMST48 • 6"adjustable legs • Rear-mounted refrigeration system Price' • Spring loaded,self closing door $2,0$8.8Oiea • Interior hanging thermometer See Details • Unique airflow keeps product at even,constant temperature • Self-contained refrigeration FREE SHIPPING • 10'cord and plug • UL listed • NSF certified • t year parts and labor warranty f-5/ar • 5 year compressor warranty T G�n • Depth:30" • Width:27112" • Height:36" https://www.etundra.com/restaurant-equipment/refrigeration/prep-tables/sandwich/contine... 6117/2414 SaladBars.com Page l of 2 �; PHm to RDrj a contatt ,� Uva chat �� 07ck to crCli� . MY A.oad]! MY Wish Sl �A,4,pK ChayKP t 1 oa nr µ're" CHOICES i Refrigerated Salad,Condiment&Cold 72e igenrad$died Bend Food or Beverage Bar,NSF7,64.5",Closed i�C<:ndaaalads.1 -� _ d' `d§` r` Front Food Protector,Unlighted Hct Pond Barej Stearr Tables ',, nk-'"i•""�"�`+�;s--'* �.4 Model;9640W/FH(524845 - Opal T&mpmalixe Salad Oars Price $4971.41y s I Soup R CNN Hers Buy 2 br$4922.27 em'A Seung Counters r k}yT-fL;tiCF f$ ,} Buy 4for 54677.80 each i 'r^rs. i i ar r .i Buy 6 for$4,53717 sect, AccPistol onesTray Siherea s Stales I 1 4 e r H l �;; €�s, x _ P I Acces ones I Tray Slides(Shelves Fpl,l, i apfY.jris doot.. , `A Special DeaisOn peti._ xsr" 1 T„a OYY Resau ces r +7 t r n � 111 r:Ve� 4 Cent3'i[let uL i E Britain Adtl S E Cafeteria Liss d dSdeL ,. w,. -.. _._... ... n Cave { Sharm an Emit$ DampenDampen'---s tdORE VIEWS Cash er Stalitlns _..._.. star (ampere Chat MPe, Fxcebq@k Fgend Cpa91er Co idai a H Swi'wvfo y . AJ $0 AV,,hfls2 Del Be s i,,, ;3' �-.,Stliq_ li° Ou3ck Overview y He Food Tabes....x m ' x.-. --_. _.. SERVING SHELF .. tray Sides R Plate Brans FOUR WELL COLD PAN AN r' UNLIGHTED CANOPY i Our Wondeltu Custorne s&Clients i ...,..._. ............... STAINLESS RTEL ya-LIM UP GO1RliERTOP ,3 SAFETY GUARS ' - BREATH GUARD RELATED PRODUCTS ' t..®.......... _. FARM-Y OURA N FPan Supp:n Far OPEN IN REAR MO MODULE Factional i ens.'!" 3 MODIRE BODY Wide ACCESS Add to As low as,$12.97 CONCEALED PANEL i 1V(ahiist LWKIWG Add to CASTERis Compare Tilly Side Front Side- 64.3'-Stainless Steel 1 Grodutt Description As low as $399.98 I Add to wtshtst Model Name Refrigerated Salad,Condiment&Cod Fad or Beverage Be(,NSF7,64.5'.Closed Fran { Add to f Food Protector Unlighted t pomp m Model Number(9KU) 9640WlFR15248-05 Food Pan St pPort for cold Well Features 10 Deep Energy EFfigenL Refrigerated Stainless Steel Insulates Cold Well&3'Cold Apr I "@ Fut And Fractional Size Blankol i Pans. Vide Model Factors. NSR Refrigerated&Insulated Stainless Steel Step-Rail Cold Pan includes 17"High Unlighted Closed Front Food Protector with Serving Sher[10"Deep x 55 5"Long Holds(4) Add to As low as $12.97 12"x 20"pa.^s with a 3"Cotd Ae Blanket,t"Drein Hose with Bress Shut OH Valve,114 HPWthfist - j Add W Canopy Model Unlighted Single Deck 18"Deep Glass Shelf Closed Front Breath Shield(Galley Model rIP cimm_ #5248-05) SM Color Dove Mite& Steel dylFoYaWhite Light t and Luminous End 1,each Guald-Full bidet h Body Counter Dea<npto Galley Model As 9640W 64 S NSF r Mil Refngera ._ Salad Bar j End) DranProvided far Clean Out 1 Ola Gran Hose wlErass Shut OH Valve(Floor Dred NOT Required) I Add to As low,as:$133.11 Comp Motor Horsepower HP 114 He carried ..._.,... Add to End Pan t Gas I or I i pilon Slantlard Flat hods(Model#B731 W&Model 48732WQ ' c@mpam ovenit DtmeoaFans 64 5 Wde x 52 5 Hi h x 28 De th'163.8 cm Wide x 1334 em H x 1 t rfn Depth) g P , � P Plate R st Front Side Countertop Height 36 Standard Adult Height ! I Ifor345" Stanless Steel Vohs l Cycle.l Phase 120MI t As low as $395.89 Amps Add to NEMA Plug Provitled 5-15P Wirthiht .._.. .... P._it'll. __.,, __. -. .. .. Ada to Power Cordand lug Langlh 95ft - v........... .... . ._........ __._.... ....,..._.._ t pard Safety Glass,A85 Camposae Cwnpare e Locking Castteera(Wheels) - 4i Did,ConcealedeLoc -.- _ i Stainless;Slocl Underk-InPlace Plate Mounted NoroSkitl Casters Provide For Easy Mobility y fr��i Shelf.Cz4 b' NSF&UL Approvals. NSF Standard, UL _ As low as:$395.99 Warranty(See Full Policy in 90 Days Pans If Labor.Optional 1 Year&5 Year warranties available See full details m jAdd to q R@...rade) Resources f ....__r.. ..._.., „- _,_.,_... >_.__.,�- ,. _............. ..... .. . ..-..-_.,. WilderManufa.<amr Galley Lineby Galleylnc. j ComPam Wdght(lba) 791 I '-" 'J""""' Freight Cl... 925 i Plate Rest Rear$,do -.... ..... .... .._ -.. .. ._.... 64.5" Stainless Steel ( MedeE Numed,(SKU)- SB9640W198 Original j n As low as $382.93 http:(iwww.saladbars.com(refrigerated-salad-barslcold-food-bar-nsfl-refrigerated-64-5-clo... 611712414 VjT&A (Tga9%'kWtfL MMXi QKs4Dao dcg5*zdtJle - Manual Controls - For ... 1$8get2D9?2 Catalog Quick Order Email Signup Contact Us I My Account Login g 9 P Roquoet®cdtial¢p 0 items$D.OD Search 43,000 Products Search Refrlpongon ( Pizza and I Furniture I Food I Shelving Carta( Dishwashing I Cooking Dining Room I Sale Items ( Ciearsnu Concessions Preparotlon and Rsoke Sanitation Equipment See all.Cooking EgulpmeM See all,Commercial Deep Frvers See sic commercial Gas Fryers See al!'.Vulcan Commercial Gas Frvem Vulcan LG300-Gas Fryer,40 Ib. Oil Capacity Ensure Operator and Kitchen Safety During Use Brand:Vulcan Mfg Part#:LG300-2 �AF- •i2 amu-. Model#:515-159 Your Cost: a $8$0.00/Each �., SHIPPINGFREE u{ Make your selecfan ro zee itis f.,a!ptice ---1 SELECT GAS TYPE i a,un A yy Quantity: ih .jp� to el ElSubmit Query 3 � � 4 C ,y MCW I,k KKK i , rl•s Reed t Review 'Ahle a Review LIVE CHAT SEND A QUESTION a'}g�}'^' t, f Product Details Speciflcagons Ii�Reviews This freestanding Vulcan LG300 is a gas fryer.This model has a 40 pound capacity.This Vulcan L3300,known as a deep fryer,is 90,000 BTU.This unit has two 6�/i Wxl3Y,"D baskets.This Vulcan LG300 has a 14•'Wx14"D fry area and is 15V2'Wx30V4'Dx47Ye'H overall.This model cooks 57P ounds of French fries per hour.This floor model fryer,Vulcan LG300 has a stainless steel tank,front and double layer door.This deep fryer have galvanized sides and back.This gas Vulcan LG300 has a tube design has a large cold zone for trying battered products.This model has a IY."drain.This Vulcan LG300 is available in natural or LP gas.This unit has a+200"F to +400°F snap action millivolt thermostat.Central Restaurant Products offers this Vulcan LG300 with free start up by Hoban Sales&Service. This Vulcan LG300 has these main features: 401b.capacity Gas,90,000 BTU(please specify natural or LP gas) 15Yz'Wx30Ya"Dx47Ye'H overall 150 lbs. ONE YEAR PARTS AND LABOR WARRANTY,FIVE YEAR LIMITED TANK WARRANTY (ENTIRE FRYER REPLACED IF TANK LEAKS DURING FIRST YEAR OF OPERATION) ht3 } 1 r� astemt?bIglnatF4-L�in�Oga�®6iF gCo�ag �1L=tel st�t��P2... 6M�NPJ4 Garland G244T 4 Burner Modular Top 24" Gas Range - 132,000 BTU Page 1 of 5 ` . EB §iaurant store, http://www.gotowebstore.com/372G244T WebstaurantStore > Restaurant Equipment > Cooking Equipment > Modular Restaurant Ranges > Garland G24-4T 4 Burner Modular Top 24"Gas Range-132,000 BTU Garland G24-4T 4 Burner Modular Top 24" Gas Range - 132,000 BTU Select Fuel Type v� 3 I fl .Mn.} .awry ii! } ' Fah i Note: Model G24-41-top shown. V (4)33,000 BTU open burners V 4" adjustable stainless steel legs V Modular(no base) design V CSA and NSF Listed i Item: 372G244T White Glove Delivery -AVAILABLE- 1 What is White Glove service?Q http://www.webstaurantstore.com/garland-g24-4t-4-burner-modular-top-24-gas-range-132-... 6/17/2014 Garland G244T 4 Burner Modular Top 24" Gas Range - 132,000 BTU Page 2 of 5 "Garland View all Garland / US Range Modular Restaurant Ranges Companion Items Caster Set for SunFire X24,X36.X60 and 1n, Garland/U.S.Range G. $143.995et Details Thanks to its 4 Starfire-Pro 33,000 -FoodserviceINTEREST FtNANONG BTU burners, this Garland G24-4T Pay no Interest for 24 monthsl modular top 24 gas of t valid through.tuna 3t]„204 ' range provides you with top-of-the-line cooking performance every time! With a 27" deep cooking area SPECS and 5" deep front ledge, this range has the largest usable cooking surface in the Width 23 5/8 industry. Its cast iron grates allow you to Inches easily slide heavy pots from one section to 341/2 j another, while protected individual burner Depth Inches pilots eliminate spillover outages. Height 155/8 Inches To facilitate a quick cleanup, this Garland Cooking Surface 155/8 Inches modular top range boasts sleek and sturdy Griddle None stainless steel construction, while its split Griddle BTU1 18000 ergonomic grates, 2-piece burners and 12" http://www.webstaurantstore.com/garland-g24-4t-4-burner-modular-top-24-gas-range-132-... 6/17/2014 Garland G24-4T 4 Burner Modular Top 24" Gas Range - 152,000 BTU Page 3 of 5 F fully sealed crumb trays are easy to remove and clean. i SPECS The Garland G24-4T 4 burner modular top 24" gas range is CSA and NSF Listed. Inlet Size sty inches Choose fuel type. For additional details and insta(Iatlon Type Modular installation requirements, please consult the Number of Burners ' 4 Specification Sheet. i Overall Dimensions: Left to Right: 23 5/8" Front to Back: 34 912" Cooking Surface Height: 95 518" Height (including legs): 25" Manufacturer's Item Number(s): G24-4T-LP , G24-4T-NAT This Item Ships via Common Carrier. For more information and tips to help your delivery go smoothly, click here. Certifications Mew replaceirren i Downloads http:i/www.webstaurantstore.com/garland-g24-4t-4-burner-modular-top-24-gas-range-132-... 611712414 I Toastmaster Toastmaster TMGM24 24" Gas Countertop Griddle - Manual Controls - For ... Page l of 2 iS/Nr-1 rs sign in I join for free I set location CLsloo-mer Seroce'.t-800-697.3277 Toastmaster Toastmaster TMGM24 24" Gas Sold by:TheWEBstaurantStore Countertop Griddle - Manual Controls _. __. Description $656.00 View site for shipping rates Go to site .q$�� view AieskatNawaif Pntiig AI Description atm#SPi0t.A9GB2S-439590504 Model'4 TMGM24 Easily grill burgers,bacon,cheesesteaks,and other mouthwatering menu items with this Toastmaster TMGM24 24"gas countertop griddle with manual controls!Boasting a 5/8"thick polished steel griddle plate,manual 1/4 tum controls,and individually controlled burners for every 12"of the cooking surface,this unit delivers fast,even heating no matter what you're making.Cleaning this griddle is also easy thanks to its spatulawidth 3 14'grease trough and chute,and to keep your walls sate from splashes it also features rear and side guards.Please consult the Specification Sheet for additional details and installation requirements.Manual controls with standing pilot 20,000 BTU aluminized steel"U"burners Stainless steel front panel, bull nose,and grease drawer 4"nickel plated steel legs Ships ready for natural gas; ! fieldconvertible to LP with included orifices UL Listed;3/4"NET rear gas Connection Overall Dimensions;Left to Right:24"Front to Back:27 13/16"Height:15 16132"TMGM24 From Toastmaster Toastmaster Griddles&Grill Pans Itaa'tmaiter• Ail'Toastmaster http:tlwww.sears.comltoastmaster-tmgm24-24inch-gas-countertop-griddle-manual-control... 6/17/2014 Star-M t VBG30 45 lb. Gyro Machine - 30,000 BTU Page 1 of 4 The WEBstaurant store, http://www.gotowebstore.com/793VBG30 WebstaurantStore > Restaurant Equipment > Cooking Equipment > GyroMachines > Star-Max VBG30 451b. Gyro Machine-30,000 BTU Star-Max VBG30 45 Ib. Gyro Machine - 30,000 BTU { FREE SHIPPING! A Select Fuel Type 4 ¢ 2 r & f i 4 u Avg c;?;,Un- I i Hi I cy Item: 793VBG30 I _ i i WA View all Star Gyro Machines Companion Items http://www.webstaurantstore.com/star-max-vbg30-45-lb-gyro-machine-30-000-btu/793 VB... 6/17/2014 Star-M-iax VBG30 45 lb. Gyro Machine - 30,000 BTU Page 2 of 4 T i i t x Optimal Automatics Optimal Automatics Metal - Dormont 1650KIT i ;. Plastic Gyro Knife-120V Gyro Knife-120V - �5�� - Gas Connector He I 1i° 48"x 1/2" $599.00 $739.00 .�h $94.99 n I 4 ; Details Perfect for making gyros, shawarmas, tacos el pastor, and doner kebabs, this Star-Max - - - ----- - ---- VBG30 45 Ib. gas vertical broiler is a versatile addition to any ethnic restaurant! A 45 Ib. width 16 Inches meat capacity and a full rotisserie rod allow Depth 25 inches you to prepare your larger quantities and Height 32 Inches control broiling speed. The unit's compact Amps 0.4 Amps dimensions allow for convenient, space- Voltage 120 volts efficient countertop installation. Adjustable - - - Capacity 45 Pounds heat shields help protect you from the extreme heat of the 30,000 BTU output and Inlet Size 1/2 Inches allow for faster cooking to maximize Total BTU 30000 efficiency and reduce energy costs. Type Gas The Star-Max VBG30 45 Ib. gas vertical Customer questions about this broiler boasts an automatic friction drive that product i stops rotation during slicing to allow for -- — - My business is at a high elevation; simple and safe carving. Built for long-lasting does this change anything when I performance, the front and sides of this unit order gas cooking equipment? are constructed of stainless steel while the Many gas equipment manufacturers j need to make adjustments to the back, bottom, rotisserie rod and pans are equipment so it operates correctly at made of aluminized steel. It disassembles elevations over 2,000 feet.sometimes we can special order from the easily for convenient end of day cleaning. manufacturer and have your cooking I equipment delivered ready-to-go, but in other cases,you'll need to have a The Star VBG30 45 Ib. gas vertical broiler is qualified service technician come to field convertible for a liquid propane or your location and alter your unit at the time of installation so that it is natural gas connection. It also requires a compatible with a higher elevation. Contact our Customer Solutions team http://www.webstaurantstore.com/star-max-vbg3 0-45-lb-gyro-machine-3 0-000-btu/793 V B... 6/17/2014 Star-Max VBG30 45 Ib. Gyro Machine - 30,000 BTU Page 3 of 4 120V electrical connection and comes with a prior to placing your order,and we will let you know what will work best for the cord and NEMA5-15P plug. ETL Sanitation equipment you are planning to order. a Listed. Please consult the Specification Sheet for additional details and installation i requirements. i 3 Overall Dimensions: Width: 16" Depth: 25" Height: 32" Manufacturer's Item Number(s): VBG30 , VBG30 LP i Downloads It t . I € 2E Specsheet Warranty A PDF viewer is required to view this product's information.Download Adobe Acrobat software Warranty Info RESIDENTIAL USERS:Star Manufacturing assumes no liability for parts or labor coverage for component failure or other damages resulting from installation in non-commercial or residential applications. Related Items k JJI i � I http:!lwww,webstaurantstore.com/star-max-vbg30-45-lb-gyro-machine-30-000-btu1793 V B... 611712014 True GDM-47 I Black 54" Sliding Glass Door Refrigerator (GDM-47) Page 1 of 5 Murant stare, WebstaurantStore > Restaurant Equipment > Refrigeration Equipment > Merchandising Glass Door Refrigerators/ Coolers > 2 Section Glass Door Merchandising Refrigerators > Black True GDM-47-LD 54"Slide Glass Door Refrigerator-47 Cu.Ft. Checkout our recommended product i "O I Try the Turbo Air TGM-48RB black sliding glass door refrigerator instead!It has all ? of the some great features as the True GDM-47. YOUR SELECTION > RECOMMENDED PRODUCT > FREE SHIPPING! FREE SHIPPING! Black True GDM-47-LD 54"Slide Turbo Air TGM-48RB Black 56" Glass Door Refrigerator- 47 Cu. Two Sliding Glass Door Ft. Refrigerator- 48 Cu. Ft. Enter your emall to be ; Enter your email to be instantly sent the price! ? instantly sent the price! One of our friendly Customer Service reps will be j One of our friendly Customer Service reps will be ' i happy to give you the lowest possible price for this happy to give you the lowest possible price for this l item!Click here for live chat,or call 717-392-7472 item!Click here for live chat,or call 717-392-7472 Mon-Thur Sam-12om,Fri 8am-8pm EST. Mon-Thur 8am-12om,Fri 8am-8pm EST. 9 j I t f 3 I j � € 0 i 8 U/ 'vt a 3 http://www.webstaurantstore.com/black-true-gdm-47-ld-54-slide-glass-door-refrigerator-4... 6/17/2014 T'ue GDM-47 I Black 54" Sliding Glass Door Refrigerator(GDM-47) Page 2 of 5 i Item: 902TGM48RB Units: Each Item: 890GDM47BK Units: Each FREE Freight on this item! ! FREE Freight on this item! Special Order Shipping: Usually Ships in 1 Business MFR Item: TGM-48RB Day When will l receive my Item? MFR Item., GDM-47 With a sleek sliding door design and double pane glass, this black Turbo Air TGM-48RB black 56"two door reach in merchandising This black True GDM-47-LD 54"two section 3 refrigerator showcases all your products! Made of durable stainless steel, this model is glass door merchandiser refrigerator comes easy to clean, and its eight adjustable heavy � with 8 adjustable vinyl-coated shelves, duty polyethylene coated wire shelves making it ideal for increasing impulse sales of accommodate your various storage needs. cold beverages and grab-and go food items! Please consult the Specification Sheet for Two sliding, "Low-E"double pane glass door i additional details and installation assemblies conserve energy, and enable requirements. easy access to your products. Plus, their counter-balanced, self closing design results 3 _Ener fan control conserves in smooth, even opening and closing. Energy conserving energy and increases compressor life This double sliding door glass merchandiser's Hot gas condensate system resists corrosion oversize CFC-free(134A)refrigeration system and prevents overflow of condensate water with a 1/2 hp bottom mounted compressor holds a consistent temperature of 33 to 38 -Double pane heated glass doors have a degrees Fahrenheit. High density ± patented layer of thermal insulating film to polyurethane insulation, and an easy to clean I reflect heat laminated exterior cabinet also contribute to easy maintenance, energy efficiency, and a _Stainless steel interior;stainless steel long-lasting good looks. The True GDM-47-LD exterior with galvanized top, bottom and back 47 cu. ft. glass door merchandiser requires a 115V electrical connection, and is UL, CE, and Includes eight heavy duty, adjustable NSF Listed. For additional details and polyethylene coated wire shelves features,please consult the Specification Sheet � - Oversized, balanced refrigeration system with 1/2 hp compressor, R-134a refrigerant 3 Overall Dimensions: � and high density polyurethane insulation 54"W x 29 5/8"D x 78 5/8"H Ergonomically designed sliding doors with self-closing and stay-open features;magnetic door gasket http://www.webstaurantstore.com/black-true-gdm-47-ld-54-slide-glass-door-refrigerator-4... 6/17/2014 True GDM-47 I Black 54" Sliding Glass Door Refrigerator (GDM-47) Page 3 of 5 This Item Ships via Common Carrier. For I more information and tips to help your i -Holds 33 degrees Fahrenheit to 38 degrees delivery go smoothly, click here. Fahrenheit I ETL, UL, and NSF Listed;115 V, 6'cord and NEMA 5-15P plug included Overall Dimensions: Left to Right:55 718" Front to Back:30" Height: 781/2" Volume:48 cu. R. This Item Ships via Common Carrier. For # more information and tips to help your delivery go smoothly, click here. j i http://www.webstaurantstore.com/black-true-gdm-47-ld-54-slide-glass-door-refrigerator-4... 6/1712014 14 Gauge Advance Tabco Premium Series SS-306 30" x 72" Stainless Steel Commercial ... Page I of S —�T �brant store httpaJwww.gotowebstore.comfl0955306 WEBS a WebstaurantStore > Restaurant Equipment > Commercial Work Tables and Stations > Stainless steel Work Tables with Undersheif > Commercial Work Tables with Undershelf-14 Gauge Heavy Duty Top > 14 Gauge Advance Tabco Premium Series SS-306 30"x 72"Stainless Steel Commercial Work Table with Undershelf 14 Gauge Advance Tabco Premium Series SS- 306 3011 x 72" Stainless Steel Commercial Work Table with Undershelf Each Onl�y�{/�'�/4} /�� YLai+-� { ■VI69\/V Eel To see our price Add this item to your cart. ! s (You can remove it at any time) ' - }"fR,'f Accessories$Options Knife Rack u! Scrap Chute ]' i J Heavy duty 14 gauge type 304 stainless steel top V 18 gauge stainless steel adjustable undersheif V NSF Listed Item: 109SS306 Units: Each Shipping: Usually Ships in 1-2 Weeks Reviews: 1! *#* k 1 review MFR Item: SS-306 i j White Glove Delivery -AVAILABLE http://www.webstaurantstore.com/14-gauge-advance-taboo-premium-series-ss-306-30-x-7... 611712014 14 Gauge Advance Tabco Premium Series SS-306 30" x 72" Stainless Steel Commercial ... Page 2 of 5 What is White Glove service?Q i I ADVANCE TABCO, SMART FABRICATtONTM View all Advance Tabco Commercial Work Tables with Undershelf-14 Gauge Heavy Duty Top Companion Items , Advance Tabco FS-2020 4 Regency 5"Caster Set for Advance Tabc Budget Drawer 20"x 20" Work Tables and Stainless Stem ! j x 5" Equipment Stands �90�.j Mound _.. $97.99re.�h 46t�A $113.991sn $14 _ __- 1 I i I Details 3 For superior quality and lasting durability, use this Advance Tabco Premium 3 Series SS-306 30" x 72" stainless steel commercial work table with stainless I i steel undershelf. It's constructed of a heavy duty, first-rate 14 gauge type 304 series stainless steel work surface, accented by rolled front and rear i edges, with square sides. i This 30" x 72" stainless steel work table offers a convenient, adjustable 18 gauge stainless steel undershelf, held securely in place by die cast leg I clamps. For further stability, each table includes 15/8" diameter tubular stainless steel legs, each with a 1" adjustable stainless steel bullet foot. NSF Listed. Please consult the specification sheet for additional details. Overall Dimensions : i 30V x 72"L x 351/2"H Also known as: SS 306, SS306, or SS.306 http://www.webstaurantstore.com/14-gauge-advance-tabco-premium-series-ss-306-30-x-7... 6/17/2014