The URL can be used to link to this page

SPIRITS - ESTABLISHMENTS� � rp� 4 � .. .$ .. ' ti r. s ., .. y, - �.��.. v�a�.�.. ,. r� �r.rw++w.r-.!F...�..r+... �.. ' �.. _ �.. ... .. ��_- .. ...-.�w�+.h.�y,...rrawF� ..'..�i+r�..�alw.nn.�r.. � .' _ �. � ,, 3 ,� '� .. _ .. t '. '+ - .. y � . _ � .,. - .. .. � (., _ y Commonwealth of Massachusetts s e City of Salem Board of Health Kimberley Driscoll 120 Washington Street, 4th Floor Mayor SALEM, MA 01970 Food/Retail Establishment Permit DATE PRINTED: 12/23/2008 ESTABLISHMENT NAME: File Number: BHF -2008-000003 LOCATED AT: Spirit's 300 Derby Street SALEM MA 01970 SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions / Notes FOOD SERVICE BHP -2009-0221 Dec 23, 2008 Dec 31, 2009 $420.00 Pem7it opened 2nd floor bar. ESTABLISHMENT Restriction on 2nd floor kitchen PERMIT EXPIRES Total Fees: $420.00 This Permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, beofre any revonations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Page 1 CITY OF SALEM, MASSACHUSETTS • BOARD OF HEALTH 120 WASHINGTON STREET, 4" � FLOOR TFL. (978) 741-1800 KIMBERL.EY DRISCOLL FAX (978) 745-0343 MAYOR IDtONNE&ALEN COM JANET DIONNE, ACTING HEALTH AGENT 2009 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT Spa `lrj TEL # q7 9 - 744 - 6&$ ADDRESS OF ESTABLISHMENT Am J2 op — FAX# h1AILING ADDRESS (if dFffereny EMAIL - Business': Website: OWNER'S NAME C I CV ' Re,�l-r„ 'TiZ Va —TEL #, ADDRESS :3 ©O DL R-6 -SA(CP4 M 01 Qlq?Q STREET/ CITY STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S) _ _ 1�Fv�;a �(r.CERTIFICATE#(S) ti'T8 Y.3 IG (Required in an establishment where potentially hazardous food is prepared)u EMERGENCY RESPONSE PERSON loon Pliki»Acrn HOME TEL# '78 63;L-<) ,9y DAYS OF OPERATION `: Monday Tt esdayi '; Wednesday °' .Thursday � ' .Fdday Saturday. Sunday '' HOURS OF OPERATION Please write in time of day i$b�x.�i eo0A✓K scloApt 1 $OoAn cnd w 50c) An tf+UpArn $ A (For example Ilam -11 pm) I `ce Atl 100 AA 7CC) {41 )DO AA i 4, DO (q4 jV0 198 1CO-Aft TYPE OF ESTABLISHMENT,� FEE (check only) RETAIL STORE YES 4p' less than 1000sq.ft. =$ 70 1000-10,000sq.ft. =$280 more than 10,000sq.ft. =$420 ------------------------ - RESTAURANT - ------------------------------ NO less ------than--- 25 seats $14--0---- (Outdoor Stationary Food Cart $210) 25-99 seats =$280 more than 99 seats <i - m) BED/BREAKFAST/ YES $100 CHILDCARE SERVICES ----------------------------------------------------------------------------------------------------------------------------- - ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGURT/SOFT SERVE YES 10 $25 TOBACCO VENDOR YES $135 ALL NON-PROFIT (such as church kitchens) YES $25 "Please pay total with one check payable to the City of Salem. This Permit is not transferable and must be reissued upon change of ownership. The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 62C, Section 49A, I certify under the pains and penalties of perjury that I, to my best knowledge and belief, have filed all state tax returns and paid all slate taxes required under the law. _ it Date - Social Security or Revised 424/07 FOODAP2008.adm Check# & Date 144 D"1 1( 1 r ._ I w $ ZI d—D O - Qe>� ��'✓ Ord Commonwealth' of Massachusetts City of Salem Board of Health Kimberley Driscoll 120 Washington Street, 4th Floor Mayor SALEM, MA 01970 Food/Retail Establishment Permit DATE PRINTED: 06/24/2008 ESTABLISHMENT NAME: File Number: BHF -2008-000003 LOCATED AT: Spirit's 300 Derby Street SALEM MA 01970 SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions / Notes FOOD SERVICE BHP -2008-0386 Jan 23, 2008 Dec 31, 2008 $420.00 Permit opened 2nd floor bar. ESTABLISHMENT Restriction on 2nd floor kitchen Total Fees: $420.00 PERMIT EXPIRES December 31, 2008 Board of Health --7 This Permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, beofre any revonations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Page 1 r roo<A r Drink ST I -T � � p30o erby Street, Salem, Massachusetts 01970 @ 300 ])erbrj Telephone (978)744-8889 PPcturs Nachos Grande $ 7.99 Three Chicken Sliders $ 6.99 Warm tortilla chips covered with Monterey jack and Cheddar cheeses, topped with sliced black olives, jalapenos, red onion and salsa Mozzarella Sticks $ 4.99 Served with homemade marinara Spirits Crab Cakes $ 10.99 Two home made cakes served with a creamy sauce Hand -cut Onion ]i�ings $ 3.00 Three mini chicken sandwiches with lettuce, tomatoes, red onion and sliced pickles Hand -breaded Chicken Tenderloins $ 5.99 Grilled Shrimp $ 6.99 Three Cheese Sliders $ 6.99 Thrice mini burgers with lettuce, tomatoes, red onion and sliced pickles Spirits House $ 5.99 Classic Caesar $ 6.99 Mixed greens, roasted peppers, bacon and apples Topped with grilled chicken $ 9.99 tossed in a balsamic vinaigrette }zomaine hearts tossed with cacsar dressing, parmesan Cheese, and croutons. Anchovies avail_ Lightly breaded chicken breast with marinara and provolone checse Meatloahsandwich $ 8.99 Served in a fresh baked torpedo roll with marinara and provolone checse Grilled Sausage w/peppers & onions $ 7.99 buffalo chicken fingers, lettuce, diced tomato, and 6lue checse dressing Grilled Chicken Cacsar Wrap $ 7.99 Grilled chicken, romaine lettuce, creamy cacsar dressing and croutons Turkey or Ham Club $ 7.99 Served with bacon, lettuce, tomato and cheese SouPs New rngland Clam Chowder baked French Onion Soup Ig. Crock $ 4.99 bowl - 55.99 Cup - a3.99 Soup/Salad Com6ination Soup pu ,our Soup of the pay and Garden Salad $ 5.99 bowl - $ 3.99 Cup - $2_99 Clam Chowder and Garden salad $ 6.50 Sandwic�res 8OZAngus burger $ 7.99 Grilled Chicken Sandwich $ 6.99 Served with cheese $ 8.75 Served with cheese $ 7.75 Scrvcd with bacon $ 9.25 Scrvcd with bacon $ 8.75 Grilled Veggie with Festo $ 6.99 Moth -Watering culled Pork $ 7.99 Turkey or Ham Club Wrap $ 7.99 5.L -T. Wrap $ 6.99 Served with bacon, lettuce, tomato and cheese Crisp bacon, diced tomato, {resp lettuce and mayo Chicken rarmcsan $ 7.99 buffalo Chicken Finger Wrap $ 7.99 Lightly breaded chicken breast with marinara and provolone checse Meatloahsandwich $ 8.99 Served in a fresh baked torpedo roll with marinara and provolone checse Grilled Sausage w/peppers & onions $ 7.99 buffalo chicken fingers, lettuce, diced tomato, and 6lue checse dressing Grilled Chicken Cacsar Wrap $ 7.99 Grilled chicken, romaine lettuce, creamy cacsar dressing and croutons Turkey or Ham Club $ 7.99 Served with bacon, lettuce, tomato and cheese Seafood Lobster Pie Market Price Homemade lobster Pic baked with butterwbite wine, lemon and topped with fresh cracker crumbs. Salem's Own Seafood Casserole $ 13.99 5call'ops, Shrimp, and Scrod baked casserole in a light cream sauce Fried Boston Scrod Sandwich $ 7.99 A band -cut fillet lightly breaded, on a fresh roll Shrimp Scampi $ 14.99 Sautded and served over angel Bair pasta E)oston Baked Scrod $ 14.99 A band -cut fillet lightly breaded Broiled Scallops $ 15.99 Large sea scallops, broiled in white wine, lemon butter and topped with fresl, cracker crumbs. Pan -Seared Tilapia $ 13.99 A delicate flavored white fish, lightly seasoned and pan- fried served on a bed of lemon tbymc rice Honey Glazed Salmon $ 14.99 Grilled and drizzled with ourhoncy glaze Lobster ]Zoll Market Price Fresh lobster meat, piled high on a bed of romaine lettuce served on a grilled roll. Topped with mayonnaise and celery cried Seafood Generous portion of fresh seafood lightly floured then deep fried, served with french fries, onion rings and tole slaw Fried Shrimp $ 12.99 Fried Whole Clams $ 17.99 Fried Scallops $ 12.99 Fisherman's Platter $ 18.99 Fried Calamari $ 12.99 Wholc clams, scallops, shrimp, scrod, and calamari Fish and Chips $ 14.99 1 2 oz Filet Mignon $ 20.99 Grilled to perfection and topped with red wine demi glaze 14 oz New York Sirloin $ 17.99 Mouthwatering 1 4oz New York Sirloin topped with caramelized onions and red wine demi glaze 5teakTips $ 10.99 Hand cut, house marinated steak tips grilled Pork chops and vinegar peppers $ 11.99 Boneless pork chops sautEed in traditional vinegar peppers Chicken broccoli Alfredo $ 13.99 This classic dish is prepared with fresh chicken breast tossed with penne pasta, fresh broccoli and homemade alfredo Monterey Chicken Salsa $ 13.99 A mild, Soutbwestem twist on Chicken Parmesan F ntrces getter Than Your Mothers Meatloaf $ 12.99 Our take on this American classic features Black Angus ground beef Nonni's Spaghetti and Meatballs $ 10.99 Italian style meatballs, homemade marinara on top of a bed of angel Bair pasta Pasta Primavera $ 10.99 Fresh linguine tossed with seasonal vegetables Chicken Parmesan $ 15.99 Lightly breaded, deep fried chicken breast topped with parmesan cheese and homemade marinara Vegetarian $ 12.99 Grilled vegtables with roasted red peppers, polenta with your choice of gorgonzola cream sauce or homemade pesto In compliance with the Department of Health, we advise you that eating raw or undercooked meat, poultry, or seafood poses a risk to your health. Seafood Lo6ster Pie Market Price Pjroiled Scallops $ 15.99 Homemade lo6sterpic 6akcd with 6uttcrw6ite wine, Large sea scallops, broiled in white wine, lemon butter and lemon and topped wit6 fresh cracker crumbs. topped with fresh cracker crumbs. Salem's Own Seafood casserole $ 13.99 Pan -Seared Tilapia $ 13.99 Scallops, 56rimp, and Scrod baked casserole in a light A delicate flavored w6itefis6, Iig6tl3 seasoned and pan - cream sauce fried served on a bed of lemon thyme rice Fried Boston Scrod 5andwic6 $ 7.99 Honey Glazed Salmon $ 14.99 A band -cut fillet lightly breaded, on a fresh roll Grilled and drizzled with our 6one3 glaze 56rimp Scampi $ 14.99 Lobster Roll Market Price 5aut6ed and served over angel 6air pasta Fresh lobster meat, piled 6ig6 on a 6cd of romaine lettuce 5oston E)aked Scrod $ 14.99 served on a grilled roll. Topped with mayonnaise and A 6and-cut fillet Iig6tly 6readcd celery cried Seafood Generous portion of fresh seafood lig6tly floured then deep fried, served with french fries, onion rings and tole slaw Fried 56rimp $ 12.99 Fried Whole clams $ 17.99 Fried Scallops $ 12.99 Fisherman's Platter $ 18.99 Fried ealamari $ 12.99 Whole clams, scallops, shrimp, scrod, and calamari Fish and c6ips $ 14.99 Fntrccs 12 oz Filet Mignon $ 20.99 PjctterThan Your Mother's Meatloaf $ 12.99 Grilled to perfection and topped with red wine demi Our take on this American classic features Pjlack Angus glaze ground 6eef 14 oz New York Sirloin _ $ 17.99 Nonni's 5pag6etti and Mcat6alls $ 10.99 Mouthwatering 1 4oz New York Sirloin topped with Italian style meatballs, homemadc marinas on top of a bed caramelized onions and red wine demi glaze of angel hair pasta 5teakTips $ 10.99 Pasta Primavera $ 10.99 Nand cut, house marinated steak tips grilled Fres6 linguine tossed with seasonal vcgeta6les Pork chops and vinegar peppers $ 11.99 chicken Parmesan $ 15.99 Ejonelcss pork chops saut6ed in traditional vinegar Lightly breaded, deep fried chicken 6reast topped with peppers parmesan c6cesc and 6omcmade marinara c6icken broccoli Alfredo $ 13.99 Vegetarian $ 12.99 This classic di56 is prepared wit6 fresh c6icken 6reast Grilled vegtablcs with roasted red peppers, polcnta with tossed with penne pasta, fresh broccoli and homemade your c6oice of gorgonzola cream sauce or 6omemade alfredo pcsto Monterey chicken Salsa $ 13.99 A mild, 50ut6westcm twist on c6icken Parmesan In compliance with the Department of Health, we advise you that eating raw or undermoked meat, poultry, or seafood poses a risk to your health. r Food Drink )002, �:i�r j ;s�- 3o0 Der63 Street, Salem, Massachusetts 01970 a 5oo Derbtj Telephone (978)7++-8889 APP°tizers Nachos Grande $ 7.99 Three Chicken Sliders $ 6.99 Warm tortilla chips covered with MontereyJack and Cheddar cheeses, topped with sliced Mack olives, jalapcnos, red onion and salsa Mozzarella Sticks $ 4.99 Served with Homemade marinara Spirits Crab Cakes $ 10.99 Two Home made cakes served with a crcamy sauce Three mini chicken sandwicbcs with lettuce, tomatoes, red onion and sliced pickles Hand -breaded Chicken Tenderloins $ 5.99 Grilled Shrimp $ 6.99 Three CHccse Sliders $ 6.99 Three mini burgers witH lettuce, tomatoes, red onion and sliced pickles Hand -cut Onion Kjngs $ 3.D0 Salads _._---------._ Spirits House $ 5.99 Classic Caesar $ 6.99 Mixed greens, roasted peppers, bacon and apples Topped witH grilled chicken $ 9.99 tossed in a balsamic vinaigrette Romaine Hearts tossed with cacsar dressing, parmesan cHccsc, and croutons.Anchovics avail_ New England Clam Chowder baked French Onion Soup Ig. Crock $ 4.99 bowl -3599 Cup -$i-99 15oup/5alad Combination Soup Du ,our Soup of the Day and Garden Salad $ 5.99 bowl - $ 5.99 Cup - $7.-99 Clam Chowder and Garden Salad $ 6.50 Sandwiches 8ozAngus burger $ 7.99 Grilled Chicken Sandwich $ 6.99 Served with cheese $ 8.75 Served witH cheese $ 7.75 Served with bacon $ 9.25 Scrved with bacon $ 8.75 Grilled veggie with Pesto $ 6.99 Mouth -Watering Pulled Pork $ 7.99 Turkey or ham Club Wrap $ 7.99 b.L.T. Wrap $ 6.99 Scrvcd with bacon, lettuce, tomato and cheese Crisp bacon, diced tomato, fresh lettuce and mayo C6ickcn Parmesan $ 7.99 buffalo Chicken ringer Wrap $ 7.99 LigHtly breaded cbicken breast witk marinara and buffalo chicken fingers, lettuce, diced tomato, and blue provolone cheese cheese dressing Meatloaf `,7andwich $ 8.99 Grilled Chicken Caesar Wrap $ 7.99 Scrvcd in a fresH baked torpedo roll with marinara and Grilled chicken, romaine lettuce, creamy cacsar dressing provolone cheese and croutons Grilled Sausage w/peppers & onions $ 7.99 Turkey or Ham Club $ 7.99 Served with bacon, lettuce, tomato and cbeesc CITY OF SALEM BOARD OF HEALTH f ) �? I Establishment Name:l ll� Date: LQ l 2�1 %� J� Page: I of Item Code c- Critical Rem, DESCRIPTION OF VIOLATION / PLAN OF CORRECTION FDate No. Reference I R — Red Item'+. _ _ „ Verified Discussion With Person in Charge: a h.0 I have read this report, have had the opportunity to ask questions and agree to correct all violations before the next inspection, to observe all conditions as described, and to 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 your food permit. i� n ��. , ❑ Voluntary Compliance ❑ Re -inspection Scheduled ❑ Embargo ❑ Voluntary Disposal S ❑ , No I ❑ \Yes ❑ Employee Restriction! Exclusion ❑ Emergency Suspension ❑ Emergency Closure 0 Other: Violations Related to Foodborne illness Interventions and Risk Factors (itilins 1-41 (Cont) PROTECTION FROM CHEMICALS i�i Poisonous at i oxic suostances I Ifrlenliiyhlg Information - Ori; gjnal I Common Name 7-201.11 NV Lion Stor 7-202,11 Restrictloo —Pic;. 7-20112 roadiuons of Usz 12 1 Criteria"' 1 -/-205,11 ---' 7-206.12 TIMEITEMF 16 ----i— — 3 -16 1' 1 A IF) (2) 3-401.11W(2) 14"IAPI, 404.11 3A01.12 3 - OL!IT, )(l11(1 17 3-203J11A)&(r 403.11(8 403.11(C) 3-403 11 18 Restricted 'U a pea ides Criteria' Rodew pair Smtkeks- nz PI-IF's Received lu Temperatures According In lain Cooled In 4 1 "F/4,5`F Within 4 Hours 3-501.16(g) 1 Cold Pffs, Maintained at or below 3-5011 16(A) Nor f1HFq Mautlained at or above 140"F, * 3-501, 16(1) Roasts field at or above 130,T. 20 Time as a Public Health Control 3-5011 191 Time as a public Health Control- REOUIREMENTS FOR HIGHLY SUSCEPTIBLE 21 3-801,11(A) Unpmtrurnaal Pre -pack, aged Juices and with offla,teurized I, iLL.L- 3-80 1. 11 (1)) 1 Raw or Partialh Cwkd Andrial Food wid Raw su'd a)TIT—ti itis Urex) ned Fklod circ rite Not Re Served. x led for (7 22 34�,;O-. 1 �1(,ongujwr �Uyisoly -onsucaption of Animal Foo& I'liat are. flaw, Undercooked or for Not Othe wise pr(x�e5sed to h"limillaw. Fggs- 151'F 15 &,c. commilltued F=ish. %Iedls & Gallic Arlilrals 155"Figsec. - Pork and 13cot Roast - 13)0'F 121 nlm4 RAiite<, lnj-c-eki Mutab - 155"F 15 so'. lloultn, Wild Game, Sullied PHFs, Slafiing Containing Fish, Meat, PLuftrLor2tues�k .1 65'T i5 sec. whole-musd, lnt,,t BetSwaks Raw Animail Klfs]s Cooked in Acw,law 165'F * ;Ah —Other '-P—Ws— 1-45'F 1-5s-ce'l— Reheating for Hot Holding P1 -Ips 1657 1S sec. *� Mictowave- 165' F 2 Minute, Siarid*,, Cotninerciallv Processed RTE FiW - 40 �F`" Remaining UtOwed. portions or beef Roast,,* CwJwg Ccok:x1 PHF's final 140'Fto 70°F Winkin 2 liours and From 70"T to 4 1 'F/45 ' F Will it n 4 Hours. x 3-501,14(13) Ciaaling PHFa Made Front Ambient Teuipenaure ingredients to 4101,/45°F Within 4 fjkwO 11knoles 0111e 1 item t!l the 10,1eral 1999 F o(XIGe of 105 CMR 590 006, 4 11 Vifilatiow, of Section 590,009(A) -(D) in catering. mobik, food, tenip(wilik, slid rei,iderillat kitchen operations should be debited ander the appropriate sections above if related to foodborne fflncss interventronc and risk fucrors_ Other 590.009 violatiovis relating to good retail Inactices should be debited under #29 - Special Requirenuefts. (Items 23-30) Critiral sand non-criora; riotationl, o'bach do w; idate jo PIC foodhoole ilkazss elfovenliunsand risAfilliorr lisleclabove, (an be found in theefiollen, iug x ertions of the Food Code and 105 CAIR 411 ed Ile ppaCe he hod m reg wd 6dtb� Caw*/If t Qdok �tc. {'1,01 A� gi� 1 �� k said- W /L zffil ' oau b4a Am -/�u L ssm WS bw o-,^ 5)131 08 �c baa ro �dd'kma �� q12 �- -,,2- � la," �,o �o 4n A Gusem.., �an d�bn9ori had �ru � �m nrol cued 4eel ��ehLe4k CNoiWj FOR DATE %Y----"E'�8' M - PLEASE CALL OF ' CAME TO SEE YOU wm.r970Nr AREA CODE NUMBER EXTENSION U FAX O MOBILE AREA COE) UMBER TIME TO CALL TELEPHONED - PLEASE CALL ' CAME TO SEE YOU C.. WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU SIGNED re FORM 4009 MARE IN U.S.A. NOTES IMPOORT�AN7 ESSAGE FOR• CAME TO SEE YOU - WILL CALL AGAIN WANTS TO SEE YOU RUSH' `._.-. RETURNED YOUR CALL DATE WILL FAX TO YOU TIME , -,x, _ Z% M/!7�� 7 !`ei De OF ✓ i/l�i i u a/-eA7.5 PHONE /7d '7- " ;,gb.6" AREA CODE NUMBER EXTENSION U FAX U MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU - WILL CALL AGAIN WANTS TO SEE YOU RUSH' `._.-. RETURNED YOUR CALL WILL FAX TO YOU i it ► �- .. i . • • A _. SIGNED *-bps FORM 4009 YYY��///MADE IN U.S.A. NOTES w CITY OF SALEM Violations Retail to Foodborne Inness Interventions and Risk Factors (items 1-22) (Cont.) m � I Food or C< 12 Additive.,* i -2t}5, t 1 Huadentmi Itnxl C uata sbaht scants 7-206 I3 Rlcmo ed Use Pe ricides_ Criteria" 7-°05.13 i Tracking flowders. Pest Control and 3-401A 1 A(7)(2) Fggs- 155"F 15 Sec. 3-401AT(A)i") j Ctmaninmed Fish, Meats & Garlic Animals - 155`F IS sec. 3-401.1](13)(1 ,( Pork and Beet Roast -130'1' 121 ndn' 401.11(Ai(2) t—Rrtttca,Iniccl d silents 155 F 1.5 34{7I.11tA;raj Pou�trp, lkrild ritme. $tu€ted !'IIFs, Stuffing Containing Fish, Mean, _Poultry or Ratites 165"i 0 sec.` 3-401.I IlC?f3) Leh le -inns le. Intact ficef Steaks , 40IJ2 ---1451; _.__�_ Raw Animal Fcvxls Cooked Is a 'microwave 165'T 401.17.(A)(1)(b) All OtherPHls 145°11`sec, 3-403,11(A)&tI)) MIN 165°F I5 sec 3-4(73.11(&) Microwave- 165" F 2 Minnie 5€anding Tithe" __ 3-463.1 l(C) Commercially Processed RTF build - 144'F`__ 3-4(33.11(E) RenaandngL'-nsii,cedPo:densofl?eef jg ' �� I Proper cooling at P"Fs, .� 1 3.-i{I t 4 )� 1 Corli�}IFs from 140-F to t0'F Within 2lFours and From 791' l ill 41'F/45`FWithin 4Hours.+ 3-501. Wit) Cooling PHFs Made From Ambient - Tcrnpara sure hagredicnis to, 41'Fi45`F Within 4l-iunrs' w Acn0cs critical stern in the Galexai t Son FoM Code or 105 Child 5941 000 j 3-Si3l.ld(C} Poisonous or Toxic Substances - 7 -101.11 Identifying Info) - Original ��31(�� _ C:on ainers 7-102,11 Common Name 'Working C oat bners* Of.Y1 Seoarancn SYorag 7-202.1 ! Restrietion - Pse scnu and UI * 7-202.12 ConditfomcofU_sc" ?-203. I I Toxic Container, - P ollibitiom* 7-262 ntiz_m Crteria-_chenscls` 3-%1.15(A) n7-2441licas for Washinct Produce. Cdteris* i -2t}5, t 1 Huadentmi Itnxl C uata sbaht scants 7-206 I3 Rlcmo ed Use Pe ricides_ Criteria" 7-°05.13 i Tracking flowders. Pest Control and 3-401A 1 A(7)(2) Fggs- 155"F 15 Sec. 3-401AT(A)i") j Ctmaninmed Fish, Meats & Garlic Animals - 155`F IS sec. 3-401.1](13)(1 ,( Pork and Beet Roast -130'1' 121 ndn' 401.11(Ai(2) t—Rrtttca,Iniccl d silents 155 F 1.5 34{7I.11tA;raj Pou�trp, lkrild ritme. $tu€ted !'IIFs, Stuffing Containing Fish, Mean, _Poultry or Ratites 165"i 0 sec.` 3-401.I IlC?f3) Leh le -inns le. Intact ficef Steaks , 40IJ2 ---1451; _.__�_ Raw Animal Fcvxls Cooked Is a 'microwave 165'T 401.17.(A)(1)(b) All OtherPHls 145°11`sec, 3-403,11(A)&tI)) MIN 165°F I5 sec 3-4(73.11(&) Microwave- 165" F 2 Minnie 5€anding Tithe" __ 3-463.1 l(C) Commercially Processed RTF build - 144'F`__ 3-4(33.11(E) RenaandngL'-nsii,cedPo:densofl?eef jg ' �� I Proper cooling at P"Fs, .� 1 3.-i{I t 4 )� 1 Corli�}IFs from 140-F to t0'F Within 2lFours and From 791' l ill 41'F/45`FWithin 4Hours.+ 3-501. Wit) Cooling PHFs Made From Ambient - Tcrnpara sure hagredicnis to, 41'Fi45`F Within 4l-iunrs' w Acn0cs critical stern in the Galexai t Son FoM Code or 105 Child 5941 000 j 3-Si3l.ld(C} } PHFs Received of Tempetatnres j I lecording to Law cooled to ��31(�� _ .. 'I T/45'F i4ithsn_4 Her", f -' 561.15_._,.-.�,.._ Conlin)) Methods fir PHR 19 '�.�. PHF Hot and Cold Holding -TW,_16(B) Cold PIfF, Maintained at or below 590.00'(Ft 41V45° F" 3-501.16(A) _ I int PHFc %fantamed at or above 140'F 3-%1.15(A) Reasts Heid at or abaoe 130'F, ** 20 3.501 Time as a Public Health Control _was t9 a Pv61ie Health ConiroI" _ 59o.0oa(Eil 3 VarianceReanerenmest REQUIREMENTS FOR HIGHLY SUSCEPTIBLE _ POPUI_AT1ONS (HSP} 2T7 :5-561. i I (A)Tifnpa teurized Pra pas aged Snicas and 3-#01.11(1?) ftau u P�rtinity Glokd Animal Faid and _ R ru Sc cd :yar lots Not Served 3-R(ii.litClntre FadPaYaarM1otReserved* CONSUMER ADVISORY 22 3-60: l l I :onstrmer Advisory Pristed for Comtnnption of ;ntn-tl I+wrh That arc Rain, Undercoulcol or dot Odlerc tic Processed to Eliminate P..St" rrrcd Lgg> Scobantnte fo Raw Shell SPECIAL REQUIREMENTS 590.009(,V -(D) T Vielalinns of Section 5t?07i)4(A)-(D) in I catering. nmobilc food, temporary and resickav al kitchen operations should Ix; debited ander the appropriate sections alcove if related to tixAbornU Illness interventions and risk Factors. Chimer 590.009 violaiiom relatin. to ;mod retail larac aces should be debited under #29 -- SpeC3al Retlnircmants. VIOLATIONS RELATED TO GOOD RETAIL PRACTICES (Items 23-30) Criateai ,Biel non-crawat viokrfiuris, which do nor rebate ur the ,rnodhorne illness interventions and risk facrom tWed above, (on be ,found in lire joibrwing secrirnss of the Food Code and 10.5 CMR ss x�.�rwes.zs� n .Me�, a� .� n s R � 3a4 1 ,.i..�a 'q ;1-: 4�' i �� S'E.1', rt • . -CommonwSealth'of Massachusetts 3 .. 7 h r' City of Salem Board of Health IGmberley Drisooll 120 Washington Street, 4th Floor Mayor SALEM, MA 01970, Food/Retail Establishment Permit DATE PRINTED: 01/23/2008 ESTABLISHMENT NAME: - File Number. BHF -2008-000003 LOCATED AT: Spirit's 300 Derby Street SALEM MA 01970 SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions / Notes FOOD SERVICE BHP -2008-03a6 Jan 23, 2008 Dec 31, 2008 $420.00 PERMIT LIMITED TO FIRST ESTABLISHMENT FLOOR ONLY Total Fees: $420.00 PERMIT EXPIRES December 31, 2008 Board of Health This Permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, beofre any revonations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Page 1 of 1 KIMBERLEY DRISCOLL MAYOR JOANNE SOOTT, HEALTH AGENT QTY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4T FLOOR TEL. (978) 741-1800 FAX (978) 745-0343 ISCorrnn SALEM COM 2008 APPLICATION FOR PERMIT TO A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT Q o o3P Ue-li' S �I r4 f 3 TEL # ADDRESS OF ESTABLISHMENT �1 00 D e Q (t7 S CRtCT FAX # MAILING ADDRESS (it diffe%,t) L ocibt IMHRoTTA 300 Ov_l STQeei EMAIL - Business': Website: OWNER'S NAME L o I_SN. MA Q,vTT A TEL # 1a 1 7 (c 1b $ $ R 8 ADDRESS O #J y ST a CERTIFIED FOOD MANAGER'S NAME(S) 1<16n nil It 'I Vole 7 3 R CERTIFICATE#(S) y 1 S 4a (o (Required in an establishment where potentially hazardous food is prepared) EMERGENCY RESPONSE PERSON HOME TEL # DAYS OF OPERATION Monday Tuesday Wednesday Thursday Friday Saturday Sunday Please write in time of day. j C'C o A r'l 10'. or Fi a� (Forexample 11am-11pm) I rL'c a Pi 1 'C a FlD TYPE OF ESTABLISHMENT RETAIL STORE YES NO RESTAURANT ESNO (Outdoor Stationary Food Cart $210) BED/BREAKFASTI YES NO CHILDCARE SERVICES-. ADDITIONAL PERMITS 1 C%t'a :7 rt � 1 0; c• n arLM ' l fi'1=n a7 r�u i.Y.a "III I LD Avy FEE (check only) less than 1000sq.ft. 1000-10,000sq.ft. more than 10,000sq.ft. --------------------------- less than 25 seats 25-99 seats more than 99 seats MAKE (not just serve) ICE CREAM, YOGURT/SOFT SERVE YES NO TOBACCO VENDOR YES NO ALL NON-PROFIT (such as church kitchens) YES NO (V`.Pa Aw taw um =$ 70 ,-$280-, =$420 =$140 =$280 =$420 $100 $25 $135 $25 01 ac. iA— l.W 4A 'Please pay total with one check payable to the City of Salem. This Permit is not transferable and must be reissued upon change of ownership. The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 62C, Section 49A, I certify under the pains and penalties of perjury that I, to my best knowledge and belief, have filed all state tax_ returns and paid all state taxes required under the law. 01�?-15b D1117 Signature A//,///�/ ��,��r��® Date lq 14'11J/l Social Security or Federal Identification Number Check4 & Date i HOV-21-2007 09:16 AN WHEN SECONDS COUNT P.O2 _.. ' i yi, fjt l , Choke Saving Course RegistrationIf Each attendee must complete a Registration For, I �; P , 41 To reserve a span: in the Choke Saving Course Registration Form, please complete and Main! II h Registration form to the Salem Board of Health. Come provided by When Seconds Co I nt, Ute oat 'Class size is limited and will be on a first come first serve basis. *Registration Fee is Non -Refundable fi II I ! I M •Registration Deadline is Friday, December 28, 2007 at 4:00 p.m. to ' I � '�-2�- O Form Completed b . + ' S; 1 P Y Date of Registration:a•- �Z _� �— Name: Err �o A CY _ Restaurant: 91ec, r., 5t<� u Business Address: 'i Cit__ 24itNi.. City/Town fi Business Phone: (!l 't — ._)-�i . State & Zip—n✓� � [. �,... yy Email: ia4"cw I understand that the information provided to the City of Salem &When Seconds Cou�t. ID !'Jibe f confidential and I hereby attest that the information supplied on this Course Application is c Zite accurate.' 1P�i�l I Cost: Choke Saving Class $5.00 per person $ l I I•.:' . r Course Date: Wednesday, January 16, 2008 Time: 2 p.m. to 4 p.m. Location: City Hall, 120 Washington Street, Floor 3 Salem MA �'- I have read and understand the above registration form, its requirements. Student Signature: Date: /a ! %Y /1 i Return the completed application and payment to: Salem Board of 120 Washington Nell:; ! a ._,P, Salem, MA 1970; 4 B i y I. Y I , HOV-21-2007 09:16 AM WHEN SECONDS COUNT P•02 Choke Saving Course Registration tor"' qj F Each attendee must complete a Registration FormPi To reserve a space in the Choke Saving Course Registration Form, please complete and return j Registration form to the Salcm Board of Health. Course provided by When Seconds Count, o 3. *Class size is limited and will be on a first come first serve basis. ' I �, *Registration Fee is Non -Refundable f Registration Deadline is Friday, December 28, 2007 at 4:00 p.m. Date of Registration: Z/ 2 3/ d 1 Form Completed by: Name: Restaurant: 1` Oy$e UC rn qq P I k yyt s�, City/Town Business Address: g Business Phone: 7 I State & ZipLA i Email: q tlW � 1 understand that the information provided to the City of Salem &When Seconds Count, In 1 b0 t confidential and 1 hereby attest that the information supplied on this Course Application is e accurate. 9 Cost, Choke Saving Class 55.00 per person Course Date: Wednesday, January 16, 2008 Q 2 p.m. to 4 p.m. Time: ,a Location: City Hall, 120 Washington Street, Floor 3, Salem, MA 1 i I have read and understand the abov re 'Sir tion fort, its requirements. Student Signature: I Date: i Return the completed applic on and payment to: Salem Board of 120 Washioptontl' Salem, MA 01970: NOV-21-2007 09716 AM NHEN SECONDS COUNT P.02 °, Choke Saving Course Registration #orit �' F Each attendee must complete a Registration Form t P To reserve a span: in the Choke Saving Course Registration Form, please complete and retum Registration form to the Salem Board of Health. Course provided by When Seconds Co I nt o. al G *Class size is limited and will be on a first come first serve basis. G i �t k *Registration Fee is Non -Refundable a f ' Registration Deadline is Friday, December 28, 2007 at 4:00 p.m. I'r • i ; i EI Date of Registration: /.2 / JS' 1 4 7 Form Completed by: Name: _ oi9�� 7ltrnsc:t _ Restaurant: 0se c t e v rr OIJ Business Address: City/Town • I Business Phone:C�� 4 ti State & Zip __ NI ri D ! } 2 i Email: � ;IM II I understand that the information provided to the City of Salem &When Seconds Couitt, la .„ 1!b0.k t confidential and i hereby attest that the information supplied on this Course Appliwtioo is i to accurate. Cost: Choke Saving Class $5.00 per person ° t ` Y i Course Date: Wednesday, January 16, 2008 Q k ! Time: 2 p.m. to 4 p.m. I, Location: City Hall, 120 Washington Street, Floor 3, Salem, MA 2 i I have read and understand the above registration form, its requirements. Student Signature: Dale:1_1 chi Return the completed application and payment to: Salem Board of 120 Wsshin on Salem, MA 01970;'` 1; NOV-21-2007 09:16 aM WHEN SECONDS COUNT i kiAj ti Choke Saving Course Registration #ol Each attendee must complete a Registration Form i To reserve a space in the Choke Saving Course Registration Form, please complete and rctui Registration form to the Salem Board of Health. Course provided by When Seconds Co; nt, I •Class size is limited and will be on a first come first serve basis. 1 *Registration Fee is Non -Refundable • Registration Deadline is Friday, December 28, 2007 at 4:00 P.M. S Date of Registration: / /027 / tU 7 Form Completed by: n Name: _Tz a / I l c ° I_ Restaurant: o t, ,c ve- S_ Business Address: 3 GC, JC, 44 5t • City/Town Bcuiness Phone: (o / 7 7 i 7 7. /L. State & Zip I ' i P.02 i . Email: _ t C a L. 1 U Sj, r� e i. I understand that the information provided to the City of Salem &When Seconds Count, ln�'M' liibt:k confidential and I hereby attest that the information supplied on this Course Application is i�te accurate. i Cost: Choke Saving Class 55.00 per personI I I: Course Date: Wednesday, January 16, 2008 Time: 2 p.m. to 4 p.m. Location: City Hall, 120 Washington Street, Floor 3, Salem, Mx 1 have read and understand the ahove registration form, its requirements. F /9 r Student Signature: Date: �i Ili Return the completed application and payment to: Salem Board of , Ili 120 Washinptondebt: Salem, MA 1970; FORM 4009 �� MADE IMPORTANT MESSAGE FOR DATE l ^ fl M IFLW Ct4et,41!fS'c7r� �S A, M, TIME P.M. OF PHONE �of'�''7-5- 23 2Z AREA CODE NUMBER EXTENSION ❑ FAX Q MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED � PLEASE CALL, CAME TO SEE YOU WILL CALL AGAIN wANrs rD SEElybu r`?Usly RETURNED YOUR CALL - :WILL FAXTO YOU MESSAGE to (�Ti7 SIGNED FORM 4009 �� MADE IN 11.5. A. NOTES Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Salem Board of Health 120 Washington Street, 4t" Floor Salem, MA 01970-3523 Tel. (978) 741-1800 Fax (978) 745-0343 Name/ �� Vj Date I �� TVpe of Operations) Type of Inspection ❑ Routine 0'Re-inspection 'Previous Inspection Date: ElPre-operation ❑ Suspect Illness ❑ General Complaint ❑ HACCP ❑ Other ❑� Food Service ❑ Retail ElResidential Kitchen El Mobile Ll Temporary ❑ Caterer ❑ Bed & Breakfast Permit No. Address r�VI�� / �� n Risk Level^ /1k ` Telephone /oil 0Il r d Cni o (HCl Owner 1 41 Il I HACCP YIN Person in Charge (PIC) f I a ) Time In: Out: Inspector r� `✓ Each violation'che&k Wrequires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti -Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009( E) ❑ 590.009 (F) ❑ action as determined by the Board of Health. PP06DPROTECTIONMANAGEMENT�'�„x ❑ 1. PIC Assigned / Knowledgeable / Duties "EMPLOYEE HEALTH 7--7L ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 3.. Personnel with Infections Restricted/Excluded r FOOD FROM APPROVED SOtIRCE �",�fi�s„v',,"x,s{g`� "�".',y ❑ 4. Food and Water from Approved Source ❑ 5. Receiving/Condition ❑ 12. Prevention of Contamination from Hands ❑ 13. Handwash Facilities `PROTECTION FROM CHEMICALS ��" x m ,. R ...... .... ,.a ❑ 14. Approved Food or Color Additives ❑ 15. Toxic Chemicals `TIME7rEMPERATURE CONTROLS (P6ten6ally Hazardpua Footls) .1 ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements [117. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling t PROTECTION FROM CONTAMINATION T? 1 1 ❑ 19. Hot and Cold Holding, ❑ 8 Separation/ Segregation/ Protection ❑ 20. Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ❑ 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices Violations Related to Good Retail Practices Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board of Health. 23. Management and Personnel (FC -2)(590.003) 24. Food and Food Protection (FC -3)(590.004) 25. Equipment and Utensils (FC -4)(590.005) 26. Water, Plumbing and Waste (FC -5)(590.006) 27. Physical Facility (FC -6)(590.007) 28. Poisonous or Toxic Materials (FC -7)(590.008) 29. Special Requirements (590.009) 30. Other 5: 5901nspec(Pomi614.Goc ' � � I. 4 REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSPj;;y. ❑ 21. Food and Food Preparation for HSP epi �.IN ❑ 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne Illnesses Interventions C and Risk Factors (Items 1-22): Official Order for Correction: Based on an inspection today, the items checked indicate violations of 105 CMR 590.000/federal Food Code. This report, when signed below by a Board of Health member or its agent constitutes an order of the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food establishment permit and cessation of food establishment operations. If aggrieved by this order, you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF RE -INSPECTION: Inspector'sSigriaWie Prink 11 ( f Y( /� 7 't o ��- PIC'sSi aterei i' �" %'1 -� J� Print: +� --Irt w kf: ,n I �`% it iI S o') Pae/of=Pa es B B Violations Related to Foodborne Illness Interventions and Risk Factors (items 1-22) FOOD PROTECTION MANAGEMENT 1 590.003(A) _Assignment of Responsibility* 590.003(8) Demonstration ofKnowled e* 2-103.11 Person in charge - duties 2 590.(X)3(C) Responsibility of the person in charge to Compliance with Food law* 3-201.12 require mporting by fool employees and 3-201.13 Fluid Milk and Milk Products* a licants* Shell Eggs* 590.003(F) Responsibility Of A Food Employee Or An 3-202.16 Ice Made From Potable Drinking Water* Applicant To Report To The Person In Drinking Water from an Approved System* 590.006(A) Charge,* 590.006(B) 590,003(G) Reporting by Person in Charge* 3 590.003(D) Exclusions and Restrictions* 3-201.15 590.003(E) Removal of Exclusions and Restrictions In L6 FOOD FROM APPROVED SOURCE -Denott4 craiad item in the fedetni 1999 Rxxi Code or 105 CMR 590.000. 8 Food and Water From Regulated Sources 590.004(A -B) Compliance with Food law* 3-201.12 Food in a Hermetically Scaled Container* 3-201.13 Fluid Milk and Milk Products* 3-202.13 Shell Eggs* 3-202.14 Eggs and Milk Products. Pasteurized* 3-202.16 Ice Made From Potable Drinking Water* 5-101.11 Drinking Water from an Approved System* 590.006(A) Bottled Drinking Water* 590.006(B) Water Meets Standards in 31.0 CMR 22.0* Fruits and Veeetables Shellfish and Fish From an Approved Source 3-201.14 Fish and Recreationally Caught Molluscan Shellfish* 3-201.15 Molluscan Shellfish from NSSP Listed Sources* Contamination from the Consumer Game and Wild Mushrooms Approved by Regulatory Authord 3-202.18 Shellstock Identification Present* 590.004(0) Wild Mushrooms* 3-201.17 Game Animals* 3-701.1.1 Receiving/Condition 3-202.1.1 PHFs Received at Proper Temperatures* 3-202.1.5 Packa e Ihte it * 3-101.11. Food Safe and Unadulterated Tags/Records: Shellstock 3-202.18 Shellstock Identification * 3-203.12 Shellstock Identification Maintained" Tags/Records: Fish Products 3402.11 Parasite Destruction* 3-402.12 Records. Creation and Retention* 4(1) Labeling of Ingredients` Frequency of Sanitization of Utensils and Food Contact Surfaces of Equipment* Conformance with Approved Procedures /HACCP Plans11S L tecialized Processing Methods* 1.2 Reduced oxygen Packa 'ng, criteria* 12 Conformance with Approved Procedures* -Denott4 craiad item in the fedetni 1999 Rxxi Code or 105 CMR 590.000. 8 Cross -contamination 3-302.11(A)O) Raw Animal Foods Separated from Cooked and RTE Foods* Contamination from Raw Ingredients 3-302.1.10)(2) Raw Animal Foods Separated from Each Other* Contamination from the Environment 3-302.11(A) Food Protection* 3-302.15 Fruits and Veeetables 3-304.11 -Washing Food Contact with Equipment and Utensils* Contamination from the Consumer 3-306.14(A)(B) Returned Food and Resereice of Food* Disposition of Adufferated or Contaminated Food 3-701.1.1 Discarding or Reconditioning Unsafe Food* 9 Food Contact Surfaces 4-501.11 t. Manual Warewashing - Hot Water Sanifization Tem eratures* 4-501.112 Mechanical Warewashing- I-Iot Water Sanitization Temperatures* 4-501..114 Chemical Sanitization- temp., pH, concentration and hardness. 4-601..11(A) Equipment Foal Contact Surfaces and Utensils Clean* 4-602.1 I Cleaning Frequency of Equipment Food - Contact Surfaces and Utensils* 4-702.1.1 Frequency of Sanitization of Utensils and Food Contact Surfaces of Equipment* 4-703.11 Methods of Sanitization - Hot Water and Chemical* 14 Proper, Adequate Handwashing 2-301.1.1, Clean Condition - Hands and Arms* 2-301.12 Cleaning Procedure* 2-301.14 When to Wash* it Good Hygienic Practices 2-401..11 Eating, Drinking or Usirre, Tobacco* 2401.12 Discharges From the Eyes, Nose and Mouth` 3-301.12 Preventing Contamination When Tasting* 12 Prevention of Contamination from Hands 590.004(F) Preventing Contamination from Em lovices* 13 Handwash Facilities Conveniently Located and Accessible 5-203.11 Numbers and Capacities* acities* 5-204.1.1 Location and Placement* 5-205.11 Accessibility, Operation and Maintenance Supplied with Soap and Hand Drying Devices 6-301.11 Handwashin Cleanser, Availability b-301.1.2 Hand.Drying Provision CITY OF SAL BOARD OF HEALTH (, Date: �� f��X Page: 1:�;,) of Rem No.`: Code Reference C — Critical Item R — Red Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION .a --• 1. /`� ` PLEASE PRINT CLEARLY `"', - `• Date Verified - C4, �lU✓tp fz7 / /)P 12i c=471&_ /� e� /2 / J 7 �//�/i /i., �� Discussion With Person in Charge: I have read this report, have had the opportunity to ask questions and agree to correct all violations before the next inspection, to observe all conditions as described, and to comply with all mandates of the Mass/Federal Food Code. I understand that sor suspension/revocation of noncompliance may result -in daily fines of twenty-five dollars your food permits t t- ' — ��fi{ �i'' , �i( ,j� Corrective Action Required: ❑ No ❑ Yes ❑ Voluntary Compliance ❑ Employee Restriction / Exclusion ❑ Re -inspection Scheduled ❑ Emergency Suspension C3 Embargo Li Emergency Closure ❑ Voluntary Disposal 0 Other: Violations Related to Foodsorne Illness lntrrveniions and Risk Factors ( haps 1-22) (Cont) PROTECTION FROM CHEh 14 T --I Food or 3-302.14 i Prowciian �fronl I"n t >ris ed Add i --7-Po�i�ous or Toxic Substances -Inll identifying hil'o) Inalion -- on"iflia 7 102,11 Comanon 'Name - 'A ork;fl- ColoaawnO "7-26(,11 --rSj�L)aiadoq -- St R-Csvielion - Po,sctwand Use* 7-203 11 , Toxtu Coha D , s - 7� 20JA I Incidental Fta-)d Bons est. lAdo WauoW 7-106 P Roilen, Bait Sita i ss* 7206.'1 I'mcking Pumle.t&�, P,m Control and TIMErrEMPERATURE CONTROLS —7-- jWr-Cooking Temperatures for PH -Fs 3 401 A(l): eggs- 15,5'F 15 &-,�c. `4 Tlpp`�' c(urowlitood Fish' 'k Gantt 3-103. I I (C.) Cotoratocidly Processed RTEKNA - 140'* 34fi 03,11 (Ft Rcutawin,, Unshced Portions of Beef Proper Cooling of PHFa cooking coolit'd PIFs ir"sn 14W F to 76°F Within 2 flout and From TfT to 41 'F!45'F W'ifliin 4 Htxuts. F(;sIw4 PHF, 'Made Floor A7kenl Tenaperatore Ingredients to 41'F!45`17 )XIthin 4 IhArrs* I Beo"wscrov'a hem ol nos' rolkllwl I a<)9 Foal (,Yjc,,r 105 C%4109i' 000 '?tit S4tt;ij PliFs Reu,ived at Temircialores ACCOTdiat, ut Dov CWW to a# 1.1451 Witbin 1 Hous, 3�5 ("I I T5 C1,11n7t llfl�iiiw" for FHv-1 3 501,160) I Animals 0'y'F 15 aec. �r 7',4iT) 1 . I I (B)( I C2 i I Porkand Becl Roast - 1301 121 lolr' 1 (AY21) Ratites, ht�jeoeei Mwats -- 155`F 15 14WP 40lAJiA)t3) llokotry' Wild cranw, stuffed PffFa'> sujfful4 Containing Fish, Meat, Poiduy or Rufitcs- 165°F j 5 scc, 3461 INC)(3) Alhore Intact Beof Slwaks 1451 3-401.12 Rao Amawl Ftkxbq Coo&it to a Mi^rowave 165'F* T461 7 HA)0) All Other PlIF,; -- 149"F 15 sec Reheating farNotR-OTil—n-9— -1 P—KF"- 1-403.11 (b) Viictowtiw- T6 F2 Minute Standing 3-103. I I (C.) Cotoratocidly Processed RTEKNA - 140'* 34fi 03,11 (Ft Rcutawin,, Unshced Portions of Beef Proper Cooling of PHFa cooking coolit'd PIFs ir"sn 14W F to 76°F Within 2 flout and From TfT to 41 'F!45'F W'ifliin 4 Htxuts. F(;sIw4 PHF, 'Made Floor A7kenl Tenaperatore Ingredients to 41'F!45`17 )XIthin 4 IhArrs* I Beo"wscrov'a hem ol nos' rolkllwl I a<)9 Foal (,Yjc,,r 105 C%4109i' 000 '?tit S4tt;ij PliFs Reu,ived at Temircialores ACCOTdiat, ut Dov CWW to a# 1.1451 Witbin 1 Hous, 3�5 ("I I T5 C1,11n7t llfl�iiiw" for FHv-1 3 501,160) Cold PFIS vlaentziuul t or beloa. ! 3 -SOL ta P lot i- lot FI" lifiloalond at or abov'� 14WP 3-501 iti(A) Roasts Heid at or Ahovc 13VE 1'ime as a Public Health Corib at 31-io 1, €g 7une as a Public 1 lealth control, REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 21 1 3-801,!ItA'j I Scdd�irx�suts'tisl —St"Id- CONSUMERADVISORY 22 "Al clonsutoer &t 7 lm'� v posT�j pw mtSR1P1d[t;n of �UuolAl foot Int Raw i ndenxvakr<7 ul Not (R0itrwise Pr(wcgsed to 171; unite 1,302.13 PiafCm i zvI Egam S sbsi i hit t fbi RA'w Shell SPECIAL REQUIREMENTS 190,009tA) (D) Vidationof Section 590JI(MA)4D) in tZer:ng, rocibilo frx)d, temporal y said residerl;al kitchen operation, Awuld be "'hticd under the appropriate qes:uons abuve if refated to f(x)d1x)rnc illness Other 590J)09 violations relating to 1�ood retail practices should 1ve debited under #29 - Speial Riujuiretrieliots. (items 23-30) CPuoa!,,uid rion, ruh.aj violations, which de) vm eelate to the foodboruedlnesr infetventiow and rink fin tori livede&ot-,e, tfut be finvrd in ehe folimmig s cturn of the Food Code and 105 CMI? Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Salem Board of Health 120 Washington Street, 4t" Floor Salem, MA 01970-3523 Tel. (978) 741-1800 Fax (978) 745-0343 Name 471 Printf \M6) Il�rl i �,�.I,1.,�, 0- Date Type of Operation(s) Type of Inspection Page_ of_ Pages � t 1717 n52 Q Food Service El Retail ❑ Routine [E.Re-inspection Address-� / Risk t_ Level A 7V1 A E:] Residential Kitchen Previous Inspection Telephoners l ao, � ❑ Mobile Date: (/VOF ll�� 1 1 E3 Temporary ❑ Caterer ❑ Bed & Breakfast ElPre-operation ❑ Suspect Illness El General Complaint Owner Ot jK� MDQ HACCP YM Person in Charge (PIC) L 1 Time .112 CSV C)l0, In. Out: Permit No. ElHACCP [I Other Inspector T,l p �tIQN �fPcz Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti -Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009( E) ❑ 590.009 (F) ❑ action as determined by the Board of Health. F000 PROTECTIONMANAGEMENTa.�.,`w' ❑ 1. PIC Assigned/ Knowledgeable/ Duties e�F EMPLOYEEHEAtTHsa,ai "M g ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 3.. Personnel with Infections Restricted/Excluded L FOOD FROM APPROVED SOURCE ❑ 4. Food and Water from Approved Source ❑ 5. Receiving/Condition ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM cokumikATtoN ❑ 8. Separation/ Segregation/ Protection ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ❑ 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices Violations Related to Good Retail Practices Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board of Health. •C� iN') 23. Management and Personnel (FC -2)(590.003) 24. Food and Food Protection (FC -3)(590.004) 125. Equipment and Utensils (FC -4)(590.005) 26. Water, Plumbing and Waste (FC -5)(590.006) 27. Physical Facility (FC -6)(590.007)' 28. Poisonous or Toxic Materials (FC -7)(590.006) 29. Special Requirements (590.009) 30. Other S, 5MnsXdFFoor 14O ❑ 12. Prevention of Contamination from Hands ❑ 13. Handwash Facilities 'PROTECTION FROM CHEMICALS', '1 p = r M 7' ryr.0 v•{... ❑ 14. Approved Food or Color Additives ❑ 15. Toxic Chemicals 'R'TIMEirEMPERATURE CONTROLS (Pctetrttally Hazardous Foods) ❑ 16. Cooking Temperatures ❑ 17. Reheating ❑ 18. Cooling ❑ 19. Hot and Cold Holding ❑ 20. Time As a Public Health Control 11hE4U1HE4E4TS FOR HIGHLY SUSOEPTIBLE POPULATIONS (HSP) _(.. ❑ 21. Food and Food Preparation for HSP L�cONSUMER,ADVISORy s .,.. aa,a' µ:„ El 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Items 1-22): Official Order for Correction: Based on an inspection today, the items checked indicate violations of 105 CMR 590.000/federal Food Code. This report, when signed below by a Board of Health member or its agent constitutes an order of the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food establishment permit and cessation of food establishment operations. If aggrieved by this order, you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF RE -INSPECTION: Inspel oS'krgnature: Y',✓ /X.:.�,-/.a;'a. 471 Printf \M6) Il�rl i �,�.I,1.,�, 0- PIC's Signature:_ .'7 2 . i .. 7 Print: Nom- �, LQ v 1` 1 � Page_ of_ Pages v Violations Related to Foodborne Illness Interventions and Risk Factors (items 1-22) FOOD PROTECTION MANAGEMENT 1 590.003(A) Assignment of Responsibility* 590.003(B) Demonstration of Knowledge* 2-103.11. Person in charge - duties EMPLOYEE HEALTH 2 590.003(,C) Responsibility of the person in charge to Compliance with Food Law* 3-201.12 require reporting by food employees and 3-20t.13 Fluid Milk and Milk Products* a tlicants* Shell Ea s* 590.003(F) Responsibility Of A Food Employee Or An 3-202.16 Ice Made From Potable Drinking Water* Applicant To Report To The Person In Drinking Water from an Approved System* 590.006(A) Charge* 590.006(13) 590.003(G) Re orcin b Person in Charge* 3 590.003(D) Exclusions and Restrictions* 3-201-15 590.003(E) Removal of Exclusions and Restrictions C C C C ' Denotes critical item in the federal 1999 rood Code or 105 CMR 590.000. R � .fu•. -11, s. 8 Food and Water From Regulated Sources 590.004(A -B) Compliance with Food Law* 3-201.12 Food in a Hennctically y Sealed Container* 3-20t.13 Fluid Milk and Milk Products* 3-202.13 Shell Ea s* 3-202.14 Eggs and Milk Products. Pasteurized* 3-202.16 Ice Made From Potable Drinking Water* 5-101.1.1 Drinking Water from an Approved System* 590.006(A) Bottled Drinking Water* 590.006(13) Water Meets Standards in 310 CMR 22.0* Washing Fruits and Ve. etables Shellfish and Fish From an Approved Source 3-201.1,4 Fish and Recreationally Caught Molluscan Shellfish* 3-201-15 Molluscan Shellfish from NSSP Listed Sources* Contamination from the Consumer Game and Wild Mushrooms Approved by Regulatory Authorit 3-202.18 Shellstock Identification Present* 590.004(C) Wild Mushrooms* 3-201.17 Game Animals* 3-701.11 Receiving/Condition 3-202.1.1. PHFs Received at Proper Temperatures* 3-20115 Package Integrity* 3-101.11. Food Safe and Unadulterated Togs/Records: Shellstock 3-202.18 Shellstock Identification * 3-203.12 Shellstoek Identification Maintained* Tags/Records: Fish Products 3-402.11 Parasite Destruction* 3-402.12 Records, Creation and Retention* 590.004(J) Labeling of Ingredients' Frequency of Sanitization of Utensils and Food Contact Surfaces of E ui ment* Conformance with Approved Procedures /HACCP Plans 3-502.11 S ecialized �ethods* 3-502.1.2 Reduced oxygen packaging, criteria* 8-103.12 Conformance with Approved Procedures* ' Denotes critical item in the federal 1999 rood Code or 105 CMR 590.000. R � .fu•. -11, s. 8 Cross -contamination 3-302.11(A)(l.) Raw Animal Foods Separated from Cooked and RTE Foods* Contamination from Raw Ingredients Raw Animal Foods Separated from Each Other* Contamination from the Environment 3-302.11(A) Food Protection - 3 -302A5 Washing Fruits and Ve. etables 3-304.11 Food Contact with Equipment and Utensils* Contamination from the Consumer 3-306.14(A)(B) Returned Food and Resc vice of Food* Disposition of Adulterated or Contaminated Food 3-701.11 _ Discarding or Reconditioning Unsafe Food* 9 Food Contact Surfaces 4-501..111 Manual Warewashing - Hot Water Sanitization Temperatures* 4-501.112 Mechanical Warewashin;- Hot Water Sanitization Tem eratures* 4-501.114 Chemical Sanitization- temp., pH, concentration and hardness.* 4-601.11(A) FAluipment Food Contact Surfaces and Utensils Clean* 4-602.11 Cleaning Frequency olf Equipment Food - Contact Surfaces and Utensils* 4-702.11 Frequency of Sanitization of Utensils and Food Contact Surfaces of E ui ment* 4-70311 Methods ofSamtization-Hot Water and Chenucal* It Proper, Adequate Handwashing 2-301.11 Clean Condition - Hands and Arms* 2-301.12 Cleaning,Procedure* 2-301.14 When to Wash* It Good Hygienic Practices 2-401.11 Eating, Drinking or Usin Tobacco* 2-401.12 Discharges From the Eyes, Nose and Mouth* 3-301.12 Preventing Contamination When Tasting* 12 Prevention of Contamination from Hands 590.004(E) Preventing Contamination from Em to ecs* 13 Handwash Facilities Conveniently Located and Accessible 5-203.11. Numbers and Capacities* 5-204.11 Location and Placement* 5-205.11 Accessil iht . Operation and Maintenance Supplied with Soap and Hand Drying Devices 6-301.11 Handwashing Cleanser, .Availability 6-301.1.2 Hand Drying Provision CITY OF SALEM BOARD OF HEALTH Establishment Name: Date: I/11/0a_ Page: of Item -. Code C - Critical item DESCRIPTION OF:VIQLATION /PLAN OF CORRECTION gra °Date <� No. Reference R—Red (tern ` �'x Verified �' - '� � '�' PLEASE PRINT CLEARLY / ost tiy r v;cilt f�.c� attic a a(Iac��ina (tnrp Or)fpd! r 'oZ5 txlicc' -{-c'., }- 7�JVIOc CPA drvJY I;,r. � �? 's��rli�l'�l 1 { Y r �i° F CX �,P.��i.l (a_ rnrxnr�cArttC�. Ma-�,. `4rA ri loci In--'pr1"inh (^\Q , r1t ial Inn — i lCrl/-�X� t .JFN r (I�� I�.A1 f i47C1��A Ltir \I 1 nc.�-h tws not(d 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. �� J ❑ Voluntary Disposal ❑ Other: � r/ Violations Related to Foodborne times-- Interventions and Risk Factors (Items 1-22) (Cont) Is FIM M TIME/TEMPERATURE CONTROLS Proper Cooking Tempetatures, Fo—r- PHFs I N( )(21 Eggs 153'—Fi 5 S"ei;7 I Egie- hrinx,.drac, 4ef,,,icc 1,5'F15 ec Comminuted FishMeai4 & Gainc Aramithi 15�1'T' 15 sec . 74 F)L 1-1 kZSl7—"0"F' 12-1 -OQE� 3-401A 1 (',-W-)-Rautci.inieeted Meats 175°F 15 401 11(A)llouftr%, 'Wild Game, -turfcTl��Hr %offnal C(inholling Fish, Meal, Poultry (n, kadtas. 165`F t5 s c, 1 61 . I I f —C)(3) Whole-awst1e, Intact Beef Steaks 145 F * Raw Animal Rxk Cooked m a Nlictowave 16.5'F 3-401,11W(1)(bi Ah tither PIIFs - 145'T 15 sec, lie—heating for—Hot Holding ToTi -I -(AF I'llFs 16.1"T 15 sec. 3-403.11 (Bi Microwave 165" 1- b3tnute Standing Time" I Conottercial1v —Pr(hesied —RIJ-. 140'F" 1-403,11 (Fj Renlavull, Roast"'i Proper Cooling at PHFs i4(A) Cooling Cookfd PI-IFs from 1407t,—, 70'Y7 Within 21 fours and From 7O) F to 41'F)45'F W'dhin 4 Hoans. I —5054(B) Cfroliug Pf`[Fc Made. From Ambient Temperature lngredlciag to 41 OFAS'F - DMIteS LooCla MY)! Ill thy 1111tMi 1999 vot"I (Axle or 365 C"AR 591" O(Ah -501.) VC) PHP's Ree.-ived ai'Fl mrperaturcs According in Cowled to 1 41 - F/45'F Wifidn 4 Hou�,, ')-501 17 Cooling Mmhods for PRIF, 1 SW. 16(g) Poisonous or Toxic Substances 161 it hierallymg c Origin,—, 3-561-1 r, —,)- I lot PF11 4trintafned at er above 1 10211 t Common laine, - W ,rkin" Container 7-201A 1 Serlwauon - St I estrictiorl - Pivonce and U�e� 7-20112 .... . . ... ..... .. 1 Conditions of ljso" 7-20111 ToxrQ Conuanrua - Prolnlnnons* 7-204.11 sanni7ers, Criteria -- Chemic he` -la -Is 7-204. 1 T— Tf-11-11 in for wilshi k lit 7-204.14 Drd as,enis. Crnevia` 'I -205 11 incidental Folill CoinactLidincanh;r` -T 7-206.11 nudes- Criteria" ��irned Uw f1c, a 7 -206.E i R«lam Bair stationz� 1-206 13 1 Tr,wking Powders, Pesi Control and TIME/TEMPERATURE CONTROLS Proper Cooking Tempetatures, Fo—r- PHFs I N( )(21 Eggs 153'—Fi 5 S"ei;7 I Egie- hrinx,.drac, 4ef,,,icc 1,5'F15 ec Comminuted FishMeai4 & Gainc Aramithi 15�1'T' 15 sec . 74 F)L 1-1 kZSl7—"0"F' 12-1 -OQE� 3-401A 1 (',-W-)-Rautci.inieeted Meats 175°F 15 401 11(A)llouftr%, 'Wild Game, -turfcTl��Hr %offnal C(inholling Fish, Meal, Poultry (n, kadtas. 165`F t5 s c, 1 61 . I I f —C)(3) Whole-awst1e, Intact Beef Steaks 145 F * Raw Animal Rxk Cooked m a Nlictowave 16.5'F 3-401,11W(1)(bi Ah tither PIIFs - 145'T 15 sec, lie—heating for—Hot Holding ToTi -I -(AF I'llFs 16.1"T 15 sec. 3-403.11 (Bi Microwave 165" 1- b3tnute Standing Time" I Conottercial1v —Pr(hesied —RIJ-. 140'F" 1-403,11 (Fj Renlavull, Roast"'i Proper Cooling at PHFs i4(A) Cooling Cookfd PI-IFs from 1407t,—, 70'Y7 Within 21 fours and From 7O) F to 41'F)45'F W'dhin 4 Hoans. I —5054(B) Cfroliug Pf`[Fc Made. From Ambient Temperature lngredlciag to 41 OFAS'F - DMIteS LooCla MY)! Ill thy 1111tMi 1999 vot"I (Axle or 365 C"AR 591" O(Ah -501.) VC) PHP's Ree.-ived ai'Fl mrperaturcs According in Cowled to 1 41 - F/45'F Wifidn 4 Hou�,, ')-501 17 Cooling Mmhods for PRIF, 1 SW. 16(g) Cold PHFNiHinuJifed at or heh,w 590,0(14F) 41°/45° F, 3-561-1 r, —,)- I lot PF11 4trintafned at er above 140"F. 3-'5o 1 � 16(ik) FC, -ai;-Ho1d4t or —abovc —130'F, I Time as a Health Control — --iw 'FieYffi Com'mf 3_5{)1Public 11.b, REQUIREMENTS FOR HIGHLY SUSCEPTIBLE -.--POPULA IONS HSP�_-- 21 with ftO 1, 11 (B) I'sc of pasteri—W41ge-- 3-801A I(D) Raw or Piunall,, 0K)ked.kninial Fold and Rv, ScedSprotm Not Served, I I —nor—tnej _Fwd Pattiie —NorRe-w,rved 22 3-60, 11 (-Xvstancy Advv�ory Posted for Corionription (4 Aidin tI Fool� flov irc Raw, Under"ked or I�'vot isc Prlx:e1ed to Alininare 3 1 P&qteurlzed Egwc Silbstitute for Raw Shelf SPECIAL REQUIREMENTS 590,0(9(A)-{1)) Violotiops of Section 590,009fA)-(D) in catering, mobil . lead, temporary and residerl kitchen operations should be debited under the apprupriatc,;ections abuye if related to foodIx)rric diners interventions and risk factors. Other 590.009 violations relatill'o to Good retail practices ihould be debited under #29 - Special Requirtniorrts. (Items 23-30) � '()0V Wo. Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Salem Board of Health 120 Washington Street, 4 1 Floor Salem, MA 01970-3523 Tel. (978) 741-1800 Fax (978) 745-0343 Name r) vpl (Z( Date C 1 9'16 0 Type of Operations) Tvpe of Inspection ❑Routine ElRe-inspection Previous Inspection Date: /021 n/( Pre-operation ❑ Suspect Illness Complaint ElHGeneral ACCP ❑ Other M• Food Seryice E]Retail ❑ Residential Kitchen El El ElTemporary El Caterer El Bed & Breakfast Permit No. Address i �O 1 0( 1 Risk Level Telephone(71 ( t Yin Q Owner'n)14-'eIll HACCP YM Person in Charge (PIC)) ' t UIP 1 Time Out: Inspector ` , \) Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti -Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009 (F) ❑ action as determined by the Board of Health. "FOOD PROTECTION MANAGEMENT„T!„�'_� ❑ 1. PIC Assigned/ Knowledgeable/ Duties a EMPLOYEEHEALtm-- m a ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 3. Personnel with Infections Restricted/Excluded "FOOD FROM APPROVED SOU,RCE,.� `"��'�+l`�, , ' ` P� " a x.:m,., �+a�sada,.d.t ❑ 4. Food and Water from Approved Source ❑ 5. Receiving/Condition ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 7. Conformance with Approved Procedures/HACCP Plans ' PROTECTION FROM CONTAMINATION " R'" 11r 9 9N ❑ 8 Separation/ Segregation/ Protection j ®9. Food Contact Surfaces Cleaning and Sanitizing ❑ 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices Violations Related to Good Retail Practices Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board of Health. G, IN' 23. Management and Personnel (FC -2)(590.003) 24. Food and Food Protection (FC -3)(590.004) �D V ✓ 25. Equipment and Utensils (FC -4)(590.005) 26. Water, Plumbing and Waste (FC -5)(590.006) ✓ 27. Physical Facility (FC -6)(590.007)' 28. Poisonous or Toxic Materials (FC -7)(590.008) 29. Special Requirements (590.009) [4� 30. Other S : 5BOln I&Fw 14.tl ❑ 12. Prevention of Contamination from Hands [113. Handwash Facilities PROTECTION FROM ,mt ❑ 14. Approved Food or Color Additives ❑ 15. Toxic Chemicals -TIME/TEMPERATURE CONTROLS (Potentlaliy Hazar'dotra Foods) 1, ''T i ? 7�. x.... , , i i w^w a SE.� d i .e t .� A, ,,,hti „�T_�. ❑ 16. Cooking Temperatures ❑ 17. Reheating ❑ 18. Cooling ❑ 19. Hot and Cold Holding ❑ 20. Time As a Public Health Control "`I?EflUIHEMENTS FOR HIIGHLYSt1SCEPTIBLE POPULATIONS (HSP)m,ll ❑ 21. Food and Food Preparation for HSP ❑ 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Items 1-22): Official Order for Correction: Based on an inspection today, the items checked indicate violations of 105 CMR 590.000/federal Food Code. This report, when signed below by a Board of Health member or its agent constitutes an order of the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food establishment permit and cessation of food establishment operations. If aggrieved by this order, you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF RE -INSPECTION: Inspector�SilH �t Print: 1A,kP+ j !l 0 tnl PIC13'S gp4t6ie: �tli�7 Print:A /n -i 7 1)o I �t t1ole Page of Pages U Violations Related to Foodborne Illness Interventions and Risk Factors (items 1-22) FOOD PROTECTION MANAGEMENT 590.003(A) Assignment of Responsibility* 590.003(B) Demonstration ofl{nowtede* 2-103.11. Person in charge - duties EMPLOYEE HEALTH 2 590.003(C) Responsibility of the person in charge to Compliance with Food Law" 3-201.1.2 require reporting by food employees and 3-201.13 Fluid Milk and Milk Products* applicants* Shell Fens* 590.003(F) Responsibility Of A Food Employee Or An 3-202.16 Ice Made From Potable Drinking Water` Applicant To Report To The Person In Drinking Water from an Approved System* 590.006(A) Charge* 590.006(B) 590.003(0) Reporting by Person in Charge* 3 590.003(D) Exclusions and Restrictions* 3-201.15 590.003(F) Removal of Exclusions and Restrictions 4 C C C FOOD FROM APPROVED SOURCE * Denotes critical item in the federal 1999 Foal Code or 105 CMR 590.000. PROTECTION FROM CONTAMINATION S Food and Water From Regulated Sources', 590.004(A -B) Compliance with Food Law" 3-201.1.2 Food in a Hermetically Sealed Container* 3-201.13 Fluid Milk and Milk Products* 3-202.13 Shell Fens* 3-202.14 Eg =s and Milk Products. Yasteurizad* 3-202.16 Ice Made From Potable Drinking Water` 5401. t I Drinking Water from an Approved System* 590.006(A) Bottled Drinking Water* 590.006(B) Water Meets Standards in 310 CMR 22.0* Washing Fruits and Vegetables Shellfish and Fish From an Approved Source 3-201.14 Fish and Recreationally Caught Molluscan Shellfish* 3-201.15 Molluscan Shellfish from NSSP Listed Sources" Contamination from the Consumer Game and Wild Mushrooms Approved by Regulatory Authority 3-202-18 Shellstock Identification Present* 590.004(0) Wild Mushrooms* 3-201.17 Came Animals* 3-701.11 Receiving/Condition 3-202.11 PHFs Received at Proper Temperatures* 3-20215 Package Inte it -" 3-101.11 Food Safe and Unadulterated Tags/Records: Shellstock 3-202.18 Shellstock Identification 3-203.12 Shellstock Identification Maintained" Tags/Records: Fish Products 3-402-11 Parasite Destruction* 3-402.12 Records. Creation and Retention* 590.004(1) Labeling of Ingredients' Frequency of Sanitization of Utensils and Fowl Contact Surfaces of Equipment* Conformance with Approved Procedures /HACCP Pians 3-502.11. Specialized Processing Methods* 3-502.12 Reduced ox men acka rin«. criteria* 8-103.12 Conformance with Approved Procedures* * Denotes critical item in the federal 1999 Foal Code or 105 CMR 590.000. PROTECTION FROM CONTAMINATION S Cross-contaminatbn 3-302.11(X)(1) Raw Animal Foods Separated from Cooked and RTE Foods* Contamination from Raw Ingredients 3-30211(A)(2) Raw Animal Foods Separated from Each Other* Contamination from the Environment 3-302.11(A) Food Protection* 3-30215 Washing Fruits and Vegetables 3-304.11 Food Contact with Equipment and Utensils* Contamination from the Consumer 3-306.14(A)(B) Returned Food and Resecvice of Food* Disposition of Adulterated or Contaminated Food 3-701.11 Discarding or Reconditioning Unsafe Food* 9 Food Contact Surfaces 4-501.111 Manual Warewashing - Hot Water Sanitization 'reniperatures* - 4-501.1'12 Mechanical Warewashing- Hot Water Sanitization Tem cratures* 4-501.114 Chemical Sanitization- temp., pH, concentration and hardness. 'k 4-601.11(X) Equipment Food Contact Surfaces and Utensils Clean - 4 -602.11 Cleaning Frequency of Equipment Food - Contact Surfaces and Utensils* 4-702.11 Frequency of Sanitization of Utensils and Fowl Contact Surfaces of Equipment* 4-703.11 Methods of Sanitization - Hot Water and Chemical* 10 Proper, Adequate Handwashing 2-301.11 - Clean Condition - Hands and Arins* 2-301.12 Cleanin Prtxedme* 2-301.14 When to Wash* 11 Good Hygienic Practices 2-401.11 ..Eating, Drinking or Using Tobacco* 2-401.12 Discharges From the Eyes, Nose and Mouth* 3-301.12 Preventing Contamination When Tasting* 12 Prevention of Contamination from Hands 590.004(E) Preventing Contamination from Employees* 13 Handwash Facilities Conveniently Located and Accessible 5-203.11 Numbers and Ca aeities* 5-204.11 Location and Placement* 5-205.11 Accessibility. Operation and Maintenance Supplied with Soap and Nand Drying Devices _ 6-301.11. Haralwashing Cleanser, Availability 6-301.12 HandD 'n *Provision CITY OF SALEM C�� J BOARD OF HEALTH Establishment Name: ^CJI V�T� Date: I I R �D Page: a of ItemCode No. s Refer ence R —Red Item C -Critical Item ,,, " DESCRIPTION OF VIOLATION! PLAN OF CORRECTION N, ¢� ¢ ' g Vm . ' PLEASE PRINT CLEARLY �=" '� ''' J ttDate 1 Verified OS'�blSl''Pl ria �/. ' nd4�4 P/2)v1de C6 h hoa idS-- ra C" CQ CrG/2L a //Ii12/Z 9: �S / r /1 r /Ul r7( elle aim M -% J1r //7 �) /uas 01 Yn L - 9 ®l /9 / III 7V Z 12 0�G ( / 0 / I - // J�IIf a�cd�p �) cLeo r g_ ,/ r!_,i O ,/ af GC/CLL / �0/C..S G� lire:V aA0 /els Gl�imss' 9i d�2� Cf ./ U J ff /i aA oI7- / 1m_v Discussion With Person in Charge: f I have read this report, have had the opportunity to ask questions and agree to correct all violations before the next inspection, to observe all conditions as described, and to 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 your food permit. Corrective Action Required: ❑ No ❑ Yes ❑ Voluntary Compliance ❑ Employee Restriction / Exclusion ❑ Re -inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 6tak?tums Related to Foodborne Illness intementions and Risk Factors (Ramer 1.22) (Cont) M 1.5 M I-St31.24{C} PfIfts Reonved at Teniperatares Acc;urdia. to L'av: Cased to ; I `:F -51a t4'itltizr 4 kiout's. 3-301,15 -»--.__ , Ccx,lin2 S4ethocls fitr PTIFs ---------� j 3 501,16(B) Cold PFfi.'4laitnai ted at or belt,, 01.11 j Ici riaEvin.infi;rivaticn Cltisrn } _.._.�. __ C� — 0 I 7-10iTI I Commen Name Worklar Cowainers*_ _ ----- :...._.._......t_ _-._._�.._..r....ncat._.._.�__ REQUIREMENTS FOR HIGHLY SUSCEPTIBLE _ POPULATIONS �_.-�_ 21 3_4iil 1 tA} 1'np„sienrizcxd Yrt pack2fyed Juices za d Cuter e ] 590.fHta(Er� � i2°I)5°Y _ _ -Jt i i 6(4) It Yt PF'IF `Sdznratn ,d E r X abOre� AnhrWs - 15,5'T' 15 sec. _ 7',Z1 11(13)(i)(27 pork and_I3cef Roast1 ,0 t 121 nimn �� ', 40f.i 1(r3}(21 Il°thi�S IC1d at SX EbGYE l3t1 �F-* -...... .i. I iil'ttE a3 8 FU211iC }{Ealttt lrl:VbfYOt ;,. 5(} y '1 t3 � ftlnC as d plltTfiC f%alih f`UnY11)LY 59G.t)(WrH} 1 iJariantx: Re��uuenaent r-202.1' j Re�trzt ioa - P1 scncc aua_d 1 :e, 7-202.12 i Conditions of [Ise* 1 7-204.11 20s,II 7-206.12 ?rJ6.'13 _ TIME for Incidental F i.W C untact, I chi icants Re�utcied iYsc: pE ricidet. cnteYrs'a. Tracking Powder„ pest Control and 5-`401.1IA(I}(2j 4 r'.gg- I55 F15Se< F a Inst x dY sit. Se is 145 F )Ssec° u 3-401.1I(A)(2) Cummintw d F i, ?'less h Ci wic AnhrWs - 15,5'T' 15 sec. _ 7',Z1 11(13)(i)(27 pork and_I3cef Roast1 ,0 t 121 nimn �� ', 40f.i 1(r3}(21 KatiC�ti, Inju ..ti Sicdfs i�5 F l5 te141 "1145 (^ Wzthzn 4 Haafi's. * _ CoolingPHFP NladeNoMAmbtent 3.40111(A}tai portirrx W"tldGame Stu{tedPKF's, T mperatur flagredient5 to 4€"F74S°F st,Yllcig Cunt,n,rng Fish Meat, Poultry o�itatitu. 165°1 t 5 xc. 3401.t1(C)(3} Yhclt-mur 1c. GttactButSi<.aks 115°P `- _ .1-{, j.FvnYnW1 F old (110 to A Nfioeowave 165`F __ -......._�._.-._..�-..__.-__ 3-40i.t1(A}(I}tb) .411Chhar PFIk's- 145`F 15Scc' ^..� REhEating tnr Hot Htgiding 3-403.23t,�}&{f)} P6If Ifi5` F% i5 sri,. ^403.11(8) sfttrowave toy' F <Tvbnwe Standing 3--irJ3.i 1(C) (zmmerciatly Ptueessed RTE Food - ,40.Ps 3-403'11W ( Ronaminz.Lnsli,r�edportions ofH(:ef ($ Proper Cooling of FHFS Ca:�1iz}„eConA�cipAFsEztYez3ttl`Fto i I 70°F Within 2 Hours and From 701, _ 011414�'B) te141 "1145 (^ Wzthzn 4 Haafi's. * _ CoolingPHFP NladeNoMAmbtent T mperatur flagredient5 to 4€"F74S°F Within d FhAns'� "7letwks trilWat t6ctn III Ihv' k! lei.1 1991) FOaI ("We or 105 (. MR 59i” 000, 3-$i t.I I(j} ( Rus or Partially Cx)kcd Animal FcIA and -�� lx St Ed Yum tt�, Not Secyn d. u k0L11 Ef.'a 1 I,3stocne(1 paxz pttf Sae 1oi Re-servcrF. * CONSUMER ADVISORY C.ousttna r Adzisoa Po�iW for Cclisumppon of Snip z1 I odi 1 -hat i t Raw, Undasax)ked o. Not Odt r4 iw Prwessr u o i lemmare _ pdrh(ILa ' a I P,.,aeY u�d Lgt. `,nbsututr for flaw Shell SPECIAL REQUIREMENTS 590.Oti9{Ai ;f3}� VicfaI, of Setfioit 011W )� mobilo food, teiripurary and to idi t al kitchen opera€ions ,,hotdd be I uebted underthe approprwc sec'f.ions abua e if related to foodborne iilnc-ss intersenti4ns and risk factors, Other .`,90 009 violations retable. to good raiii1 practicesrshotild be debited under #29 -- Special Reclnirenrents. Warms 23-30) t,rioca? awl elan-crirfrat woiaoi ro''which do xol retrare Po the firodbornc rid ess tmeivooions rand risk j ttors listed above, c on be found in r7ta 'etlntming ser7i,>rcr of 1he, Food Code and 105 CUR CITY OF SALEM BOARD OF HEALTH Establishment Name: ';0 1 IZt � Date: Page: of Item Code C—CriticalltdmDate DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Verified No. ReferenceR — Red Item V0 O� I V - ";P' PRINT CLEARLY -- 4 4 - -PLEASE S / ci��44�hl/ Qdn, -Had 0 A. ��Xjre (t) t 2 �PA7�62 /242 -Yo /� is t �/) iA%M191dVwi;? &2s�'�Zej X)L,,1"6 li&eA ims al?, -Y {qv & -7D 0,4 —)WK ' 1_.Pj_4 67 � I(YIPI-I0/Q J 9j'- 0ZO4 P 12�2 72 e)1? _&7&_ .101acie- -/V 0�'9ew � La;11t) old- Iti IJQPr, VA/e _-b/WJ. 1�111jnl)12 ilqll<.4 7(7 k7 1A ol ao , iv, 4-o be of Mall? r t Discussion With Person in Charge: Corrective Action Required: U No Q Yes I have read this report, have had the opportunity to ask questions and,agree to correct all 0 Voluntary Compliance 0 Employee Restriction Exclusion violations before the next inspection, to observe all conditions as described, and to L:j Re -inspection Scheduled Lj Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty -f iv6 dollars or suspension/revocation of Li Embargo L3 Emergency Closure your food permit. U Voluntary Disposal LI Other: I Violations Related to Foodborne illness Interventions and Risk Factors (items 1-22) (Cont) 14 Food or Color Additives ——:I:,p 3-202,12 Ad&ti% �s 2"Ithit'l, "fro 3302.14 - ii 3-4011l(E)(ln2) 1 Poisonous or Toxic Substances 7.161 11 1 Identifying information -- Original 340I1I(A){2, 1551E15 501.16(11) 7-162.11 Common 'Naind :-W ).rkincoatanlers` 3-461.I I (A)(3) 1-201,11 Seiniradon 3 50 1, 1 (it A) 7-20111 Restrict.on-- Prunw and UNCK 7-202.12 Condition, of uao' 3-401 7-103 11 Toxic Conlairiels - Prohibi:i(nml 77204.11 Sankizers, Criteria - Chcmieits� 7'04.12 licak for WaN ,fna1'rL)d2ice, Clitelial -40 1 Di 7204,14 J!T A jtnv, Criteria�l - 1-2 5,11 Acid tnHist kxxi i oni5ct A 40 Ll I (A)(1)(b) [:T?0�. �[ �,sjmtad Uae Pe Critstw` 7-206.12 Rotiont Bait Siatiom 106 13 Tracking Powders. P'ia Control and L7 = TIME(TEMPERATURE CONTROLS 16 1 1 Proper Cooking Temperatures 17 3-46L1 I A(l)(211 I F.gg�- 15 S,�e 3 -103.11(A)& -(D) PHF,, 165`F 15 sec. 11 3-403. I I (B) Mio*owave- 165 F2 hiinu standing Time" 3-4,03.11(() corinmovialls, i-1511XT 3-,303.1 I (F) I RQi'naljliag ulslwed Portion's Cooling cocked PKiA from Ja(YF to 70°F Within 2 Hours and From 70'F to 41 Within 4 Hours. e Cooling PHFs Made From Ambient TmMauwc ho"redictits to 4!'B'45°F I D-nvIes cnmal item m � iaJelal V)99 Fomj ("xie rr h)5 r MR 590 (I'Do, fiflf,s Receivedai'Fmperatures A(-,ardiog to Taus Cooled to Animals -155r 15 sec.;' 3-4011l(E)(ln2) Iml, and Pwin Roam - 130,F 121 11141; 340I1I(A){2, 1551E15 501.16(11) ii 3-461.I I (A)(3) Pouftrs, Wild (Tarne� Stuffed PKF%, 3 50 1, 1 (it A) contaimm. Fish, Meal, Pouitry <,r hatnes- i 65"T' 1'i see. 3-401 Beef Steaks 145"F -40 1 Ria An; i f I �Ild � ccx�iicedl- e n Miciov:ave 10.5'F *, 40 Ll I (A)(1)(b) Ali Other PHFs-- 149°F 15 scw. 3 -103.11(A)& -(D) PHF,, 165`F 15 sec. 11 3-403. I I (B) Mio*owave- 165 F2 hiinu standing Time" 3-4,03.11(() corinmovialls, i-1511XT 3-,303.1 I (F) I RQi'naljliag ulslwed Portion's Cooling cocked PKiA from Ja(YF to 70°F Within 2 Hours and From 70'F to 41 Within 4 Hours. e Cooling PHFs Made From Ambient TmMauwc ho"redictits to 4!'B'45°F I D-nvIes cnmal item m � iaJelal V)99 Fomj ("xie rr h)5 r MR 590 (I'Do, I Ponsts field at or above 130'F, 7-7 fiw-a; 'ai3ablic —Health control Variance REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS {HSPS® 21 3-401110) i npa enri d Pre Packaged Juices and i I Bevcra2e_c with Warnin2 t,abols* 3-&01 1 I (Fo 1 Raw or Pcinialiv Cooked Atuard Ftiod and 18 iw S(oLiLrouts Not Scivej. t momned Fcxxi Packaec Not Re -served, CONSUMER ADVISORY 22 (0rkVTyier Athisory Posted for Consumption of AoimA F,,ods'Deo are Raw. Undercooked in N(,4 Other v, i.w Processed to PHininate ---t--73-0; —1; Fvg::—Subsntule for—Raw Shelf 590 009(A) -if)) Viokifians of Section .590.(4)9(A) -(D) in caterme. mobik fixxL temporary and remelt mual kitchen operationsAiould be I ddhiled under the aW, ve if related to foodborne illness Intel Veltillons and risk factom Other 590.009 violations relating to good retail pracoccs should be debited under 1129 - Special Requirefllents. (items 23-30) i1okit"inj, which do nm relate to the fiotalborne diness risk factors Itivo-d above. can be f(,und in ole.ft)i1owing sernoinn of the Fcwd Code and 105 C7,141? fiflf,s Receivedai'Fmperatures A(-,ardiog to Taus Cooled to -4 PF/4YIP Within 4 Roam 5 Coolin,, Mcthodfor PHR, PHF Hat and Cold Holding 501.16(11) cold PHI S Maiindined at or below 590,6r,)4(P1 41°45` F' 3 50 1, 1 (it A) I lot PHF� Maini ained at or above I'MITZ � I Ponsts field at or above 130'F, 7-7 fiw-a; 'ai3ablic —Health control Variance REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS {HSPS® 21 3-401110) i npa enri d Pre Packaged Juices and i I Bevcra2e_c with Warnin2 t,abols* 3-&01 1 I (Fo 1 Raw or Pcinialiv Cooked Atuard Ftiod and 18 iw S(oLiLrouts Not Scivej. t momned Fcxxi Packaec Not Re -served, CONSUMER ADVISORY 22 (0rkVTyier Athisory Posted for Consumption of AoimA F,,ods'Deo are Raw. Undercooked in N(,4 Other v, i.w Processed to PHininate ---t--73-0; —1; Fvg::—Subsntule for—Raw Shelf 590 009(A) -if)) Viokifians of Section .590.(4)9(A) -(D) in caterme. mobik fixxL temporary and remelt mual kitchen operationsAiould be I ddhiled under the aW, ve if related to foodborne illness Intel Veltillons and risk factom Other 590.009 violations relating to good retail pracoccs should be debited under 1129 - Special Requirefllents. (items 23-30) i1okit"inj, which do nm relate to the fiotalborne diness risk factors Itivo-d above. can be f(,und in ole.ft)i1owing sernoinn of the Fcwd Code and 105 C7,141? Establishment Name: 00'0/ CITY OF BOARD OF HEALTH 1? Date Page: of Item,,,,, No. Code A Refer an ce ��' C — Critical It am Z R Red Item DESCRIPTION OF VIOLATION PLAN OF CORRECTION �P/ �"- " -"�" � *I �� j� , f "k� -j"" Ile, SE PRINT CLEARLY Date Verified a b) IJ 10�2 ICZ:Z!�7 I I ,A � 0�ea if) G/002 02SI2:2CA7 me t W -6F AY:k(1(7'7111,74X111f`—_ JJ2 Discussion With Person in Charge: I have read this report, have had the opportunity to ask questions and agree to correct all violations before the next inspection, to observe all conditions as described, and to 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 your food permit. Corrective Action Required: LI No Q Yes o Voluntary Compliance 0 Employee Restriction Exclusion Lj Re -inspection Scheduled Lj Emergency Suspension 0 Embargo 0 Emergency Closure Ll Voluntary Disposal 0 Other: M Violations, Related to Foodborne illness Interventions and Risk Factors (Years IV) (Cont) FiRUMMMUMMSEW.75 M., I D-�n'ses critical nein ill the letkq,1994 FOM Ctide er 105 CMI2 59t) FiM 34-50 I . 14(C!,t PHFs Reexivedtit Temperatures According to I-aw Cooled to At P WZA':—! " ... -" * 1 3-501A5 Coolie- Mcthtids for 111-[Fii 19 PRF Not and CWd Holding Cold �PHF'Mainutifled at or below 41°(45° F* lint PFIFLs Maintained at or above lAn"W * 3 -Stat, i h(A) Roasts Held at or above 130°'. * _ 20 1 Time as a Public Health Control Variance REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS 21 1 T—SOITJ(T)TETmclarizcd Pre-packafted Jurors and 3-W 1. 11 (D) I Raw or Parhally Cooked Annual Fuad and I Rink, ,, Nxld Package Not ltte-sewed, CONSUMER ADVISORY 22 3-66- 11 TCOINUTTW Advimay Poxted for Coviumption of ,Ariimal I tloJs That are. Raw. Undercooked of tiirr Otherwise Process .d to Eliminate 1-302.13 j Pasteunci,tl Egg:; Subboulac lot Raw 590009(A7-tfl) Violations OfSectiort 590,00)(A)4D) in CaLerljleMobile tcxak tetriporart, and reside nual kitchen operations Jwuld be troth ed under lhcapfi,opnale sections, 'buve if related to foodhorne i [Iness interventions and 0.31, faclori, Other 590.009 violations relatino to nous retail practices ;hould be debited under #29 - Special ReqUiretn"ritS, RETAIL PRACTICES (W,ms 23-30) Ciiii.,-al marl non-, firrotal which rictoro i rdate to the foodborne ilincTS iet,'10 Venhuresand rickjacocri listed above can ll", fituml in the foil ovvi;jg u,ctions 2I chc Itoud Cade and 10-i ('111l Proper Cooking Temperatures for PHFS 7 �401 � I IA(l)(2) Figgs- 155'F 1S 3-302,14 Protection from E2a rt:�e<I Addittses*—.� IS Poisonous or Toxic Substances 101.11 - Oligmal 3-407_1 I (A)Q) 4 Rahtce, Mtge et imcus - I -55"3F 15 Sic. colturitters, 1-102,11 Common Narne - Workin, Coeuuners* loultry or Kathcs- 165'F 15 sec. 0Q.IjtQ(3) Intact Beef Sicalts 145"It Nliciowave 1WF 7-202.I1 lttincJon - Presence and Use* Reheating for Hot Holding 7-202.12 Corafifltrns of Use" 1-20111 Toxic Containxto, - Prichilivicirl Time 7-204.11 sanili7tri' cwcrta-- chclaicak� 204. t2 Chet Irditce-, 0iteriChemicalsflor2�'a±�E�j±t 3-4031 1 (r) Remainire, Unsficed Portions, (if Beef 7-204,14 Dntng Aeem. Critcria� 5-1-561 7-205.11 Incidental Fiiod Contact. 1-tibluants", 14(A)'oofirig Ccoked PHFe from 140" to 12L200,1 1_ Rearicted Use PeNticides, Critettal 7-206.12 1 Rodent Bait statir)ns 3-561. i4iBj Cooling Pllfis Marto From Ambient 206.13 racking Powdeei lltsa Control gild L-1 I D-�n'ses critical nein ill the letkq,1994 FOM Ctide er 105 CMI2 59t) FiM 34-50 I . 14(C!,t PHFs Reexivedtit Temperatures According to I-aw Cooled to At P WZA':—! " ... -" * 1 3-501A5 Coolie- Mcthtids for 111-[Fii 19 PRF Not and CWd Holding Cold �PHF'Mainutifled at or below 41°(45° F* lint PFIFLs Maintained at or above lAn"W * 3 -Stat, i h(A) Roasts Held at or above 130°'. * _ 20 1 Time as a Public Health Control Variance REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS 21 1 T—SOITJ(T)TETmclarizcd Pre-packafted Jurors and 3-W 1. 11 (D) I Raw or Parhally Cooked Annual Fuad and I Rink, ,, Nxld Package Not ltte-sewed, CONSUMER ADVISORY 22 3-66- 11 TCOINUTTW Advimay Poxted for Coviumption of ,Ariimal I tloJs That are. Raw. Undercooked of tiirr Otherwise Process .d to Eliminate 1-302.13 j Pasteunci,tl Egg:; Subboulac lot Raw 590009(A7-tfl) Violations OfSectiort 590,00)(A)4D) in CaLerljleMobile tcxak tetriporart, and reside nual kitchen operations Jwuld be troth ed under lhcapfi,opnale sections, 'buve if related to foodhorne i [Iness interventions and 0.31, faclori, Other 590.009 violations relatino to nous retail practices ;hould be debited under #29 - Special ReqUiretn"ritS, RETAIL PRACTICES (W,ms 23-30) Ciiii.,-al marl non-, firrotal which rictoro i rdate to the foodborne ilincTS iet,'10 Venhuresand rickjacocri listed above can ll", fituml in the foil ovvi;jg u,ctions 2I chc Itoud Cade and 10-i ('111l Proper Cooking Temperatures for PHFS 7 �401 � I IA(l)(2) Figgs- 155'F 1S 145"F) Secy 3401.11(A)(2) Comminuted Trish, Metes & Gaint Animak . l5 'F 15 sec.:' 1(13)(1)(2) I Pork and Beet Poicia - 130'F 121 !Liinn_ 3-407_1 I (A)Q) 4 Rahtce, Mtge et imcus - I -55"3F 15 Sic. 3 401.11(A)(3) trxrtdtry, Wild Game, $rutted 111-IFs, Siliffing Conudning Fish, Meal, loultry or Kathcs- 165'F 15 sec. 0Q.IjtQ(3) Intact Beef Sicalts 145"It Nliciowave 1WF 3-401A I (A l(l)(b) All 0dica PliFs 1.1517 15 scc. LIZ- Reheating for Hot Holding 3-iOT, 11 (A)&, (D) 1'H1> 165'F 15 sec. :403.11(13) Miciclwave- 165"P, Nlinuic Standing Time 3-403A I(C) 1 Comjnry ialiv RTFF ' 140'1," 3-4031 1 (r) Remainire, Unsficed Portions, (if Beef Roast:"* 5-1-561 Proper Cooling of PHFs 14(A)'oofirig Ccoked PHFe from 140" to 70°hWithin 2 flours and From 70'T' to 41''145"P Within 4 Hours, " 3-561. i4iBj Cooling Pllfis Marto From Ambient Tevilia attire Ingredients to 41 1V45'F Within 4 H,,urN* I D-�n'ses critical nein ill the letkq,1994 FOM Ctide er 105 CMI2 59t) FiM 34-50 I . 14(C!,t PHFs Reexivedtit Temperatures According to I-aw Cooled to At P WZA':—! " ... -" * 1 3-501A5 Coolie- Mcthtids for 111-[Fii 19 PRF Not and CWd Holding Cold �PHF'Mainutifled at or below 41°(45° F* lint PFIFLs Maintained at or above lAn"W * 3 -Stat, i h(A) Roasts Held at or above 130°'. * _ 20 1 Time as a Public Health Control Variance REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS 21 1 T—SOITJ(T)TETmclarizcd Pre-packafted Jurors and 3-W 1. 11 (D) I Raw or Parhally Cooked Annual Fuad and I Rink, ,, Nxld Package Not ltte-sewed, CONSUMER ADVISORY 22 3-66- 11 TCOINUTTW Advimay Poxted for Coviumption of ,Ariimal I tloJs That are. Raw. Undercooked of tiirr Otherwise Process .d to Eliminate 1-302.13 j Pasteunci,tl Egg:; Subboulac lot Raw 590009(A7-tfl) Violations OfSectiort 590,00)(A)4D) in CaLerljleMobile tcxak tetriporart, and reside nual kitchen operations Jwuld be troth ed under lhcapfi,opnale sections, 'buve if related to foodhorne i [Iness interventions and 0.31, faclori, Other 590.009 violations relatino to nous retail practices ;hould be debited under #29 - Special ReqUiretn"ritS, RETAIL PRACTICES (W,ms 23-30) Ciiii.,-al marl non-, firrotal which rictoro i rdate to the foodborne ilincTS iet,'10 Venhuresand rickjacocri listed above can ll", fituml in the foil ovvi;jg u,ctions 2I chc Itoud Cade and 10-i ('111l