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THE SCREAMERS - ESTABLISHMENTSuniversal onew ph; 4. UNV16162 MADE IN USA 4 -� TAS fcromtrY Go wvblffA sh44 EXAM FORM NO. 4604 CERTIFICATE NO. 7554747 f7. M-l'--��"I'A'-7 J7T ;'� '�� "�ot To TIMOTHY S.HOPKINS for successfully completing the standards set forth for the ServSafe® Food Protection Manager Certification Examination, which is accredited by the American National Standards Institute (ANSI) -Conference for Food Protection (CFP). 1/20/2011 DATE OF EXAMINATION 1/20/2016 DATE OF EXPIRATION Local laws apply. Check with your local regulatory agency for recertification requirements. w V=_ ® Paul Hineman #0655 Executive Director, National Restaurant Association Solutions ®2010 National Restaumat Associetian Educedonal Foundation. All rights reserved. ServSefe and the SarvSafa logo are registered trademarks of the National Rostaurant Association Educational Foundation, and used under license by National Restaurant Association Solutions, LLC, a wanly, owned subsidiary of the Natural Restaurant Association. This document cannot be reproduced or altered. lo0IDI01 v.1012 NATIONAL RESTAURANT ASSOCIATION, Ass EXAM FORM NO. 4604 CERTIFICATE NO. 7554750 To ALEX KRAM E R for successfully completing the standards set forth for the ServSafe® Food Protection Manager Certification Examination, which is accredited by the American National Standards Institute (ANSI) -Conference for Food Protection (CFP). 1/20/2011 DATE OF EXAMINATION 1/20/2016 DATE OF EXPIRATION Local laws apply. Check with your local regulatory agency for recertification requirements. j laulne ® Paul Hineman 40655 Executive Director, National Restaurant Association Solutions 02010 National Restaurant Association Educational Foundation. All rights reserved. ServSafe and the Servsefe logo are registered trademarks of the National Restaurant Association Educational Foundation, and used undo, Ilcense by Nadonal Restaurant Association Solutions, LLC, a wholly awned subsidiary of the Natronal Restaurant Association. This document cannot be reproduced or altered. 10020201 v.1012 NATIONAL RESTAURANT ASSOCIATION® EXAM FORM NO. 4604 CERTIFICATE NO. 7554754 •. L Am Mv '0 a.i ,r>.»v' w' a £.,,,,da✓' Cer aI AN TO PAUL TENHOPE for successfully completing the standards set forth for the ServSafe® Food Protection Manager Certification Examination, which is accredited by the American National Standards Institute (ANSII—Conference for Food Protection (CFP). 1/20/2011 DATE OF EXAMINATION 1/20/2016 DATE OF EXPIRATION Local laws apply. Check with your local regulatory agency for recertification requirements. i #0655, ® Paul Hineman Executive Director, National Restaurant Association Solutions 02010 National Restaurant AsS061don Educ8t.nal Foundation. All rights reserved. ServSafe and the ServSafe logo are registered trademarks of the National Restaurant Association Educational Foundation, and used under license by Negona) Restaurant Associa0on Solutions, LLC, a wholly awned subsidiary of the National Restaurant Association. This document cannot be reproduced or altered. 10070201 V.1012 NATIONAL SSl TAOC ION® EXAM FORM NO. 4604 CERTIFICATE NO. 7554745 Y ,dvtl' e, l �cai +. dA 3 dj x.,' E ' TO DAVIDW COMPROSKY for successfully completing the standards set forth for the ServSafe® Food Protection Manager Certification Examination, which is accredited by the American National Standards Institute (ANSI) -Conference for Food Protection (CFP). 1/20/2011 DATE OF EXAMINATION 1/20/2016 DATE OF EXPIRATION Local laws apply. Check with your local regulatory agency for recertification requirements. gbdkdk ® Paul Hineman #0655 Executive Director, National Restaurant Association Solutions 02010 National Restaurant Association Educational Foundation. All rights reserved. ServSafe and the ServSafe logo are registered trademarks of the National Restaurant Association Educational Foundation, and used under license by National Restaurant Association Solutions, LLC, a wholly owned subsidiary of the National Restaurant Association. This: document cannot be reproducod or altered. 10070201 va02 NATIONAL RESTAURANT ASSOCIATION® CERTIFICATE OF ALLERGEN AWARENESS TRAINING Name of Recipient: David M Comprosky Certificate Number: CW3511 Date of Completion: 03/02/2011 Date of Expiration: 02/29✓2016 The above-named person is hereby issued this certificate for completing an allergen awareness trainingprogram recognized by the Massachusetts Department of Public Health in accordance with 105 CMR 590.009(G)(3)(a). This certificate will be valid for five (5) years from date of completion. Issued By: �GJil; tai-Vori<5 CompuWorks Systems, Inc. 591 North Avenue, Door 2 Wakefield, MA 01880 P:781-224-1113 F. 781-224-0504 w ..compuworks.com CERTIFICATE OF ALLERGEN AWARENESS TRAINING Name of Recipient: Timothy S Hopkins Certificate Number: CW3472 Date of Completion: 02/28/2011 Date of Expiration: 02/27/2016 Be above-named person is hereby issued this cert ficate for completing an allergen awareness trainingprogram recognized by the Massachusetts Department of Public Health in accordance with 105 CMR 590.009(G)(3)(a). Bis certificate will be valid for five (5) years from date of completion. Issued By: .]I Works CompuWorks Systems, Inc. 591 North Avenue, Door 2 Wakcfield, MA 01880 P:781-224-1113 F:781-224-0504 www.compuworks.com M CERTIFICATE OF ALLERGEN AWARENESS TRAI1 Name of Recipient: PAUL TEN HOPE Certificate Number: CW3528 Date of Completion: 03/03/2011 Date of Expiration: 03/01/2011 The above-named person is hereby issued this certocate forcompletingan allergen awareness trainingprogram recognized by the Massachusetts Department of Public Health in accordance with 105 CMR 590,009(C)(3)(a). This certificate will be valid forfive (5)years from date of completion. Issued By: tj Work! CompuWorks Systems, In, 591 North Avenue, Door W,.dmhdd, IIIA 01880 P:781-224-1113 F: 781-224-0504 www.cpmpuworks.com CERTIFICATE OF ALLERGEN AWARENESS TRAINING Name of Recipient:Alex Framer Certificate Number: CW354-0 Date of Completion: 03/04/2011 Date of Expiration: 03%02/2016 7br: above-narne,l person is hereby issued this cert f' cate for completing an allergen awareness trainingprogram recognized by the Massachusetts Department of Public Health in accordance with 10.5 CMR 590.009(G)(3)(a). /j'/ will l:JLL_r /['I r...:-. J..,.. r1,; �., 1...:.._. L/.l is cev,'lcaie will b4' va lfI VI✓L'Ue Il�yea%Jiro". L(GLE V� LV/ILpfG[fV/L. LM Issued. By: CompuWorks Systems, Inc. 591 North Avenue, Door 2 Wakefield, MA 01880 P:781-224-111.3 i': /2'S1-224-UJV4 w ,compuworks.com I 1 1 I 7 ,r � I II I _ I _?, j I � t � � i l! i � i ! I , i ,_ ' J � I i i 1 , ' , ' , , 1 J11 1 , 1, ITT I _ j j _7 T it j 1 14 4 Ad -!I. If I (DIP - J1 _1 J T I --t t --T--7 1 T -T oil F 1 1 1-4 ARCO 1 TF -1 T T_ -!J 1 1 1 1-J! I —1 _T FT K T. i 4 A f— f - T I I e If IIII J_ T F Ll I u- I T' I vj, _1� J 1 r -T-,- _T M- 1 t — F f+ T— —7-1 i1 1 —1 A 1 r r -1 1 I I I 1 I_{l 1 V 114105 M 11WD]t1.YK01to CITY OF SALEM, MASSACHUSETTS BOARD o IT H 13Af; Ll.-[ AF 120 WASHINGTON STRI_,& P, 4"' FLOOR Er.. (978) 741-1800 KkYOR C� T /V LARRY RAMDIN, RS/REHS, CHO, CP - APR 1�2 2013 Z4()HEALTH AGENT OgR�%OFHpFM FAX (978) 745-0343 1ramdi1iR,sa1em.com Fees: New Establishment: $180.00 Remodel: $90.00 Make Checks payable to: The City of Salem No cash is accented FOOD ESTABLISHMENT PLAN REVIEW APPLICATION )CNEW Date: 31111 o Name of Establishment: REMODEL CONVERSION Category: Restaurant, Institution _, Daycare , Retail Market Address: GD t Sk.� Vt-. c) cq:.'.� Phone if available: A-79 "-7414 -15CO Name of Owner: Yom_. ' MQOCqftTttk 1w`4aS t\7P og CwUq-0%yA WZ' v-PB"'Ik� Mailing Address: to tAj (k U1li)(116 & -R&I- (SK6N MA Telephone: Applicant's Name: SkM1l� ACS OVdan Title (owner, manager, architect, etc.): VW9625 Mailing Address: Telephone: I have submitted plans/applications to the following authorities on the following dates: Licensing Board Zoning Planning Building Conservation Plumbing Electric Police + Fire y1g1) Other ( ) C'e, /1�a;5 V Hours of Operation: Sun Thurs MonV Fri 1� Tues kH SatIFIF Wed Number Number of Seats: ' D Number of Staff: (Maximum per shift) Total Square Feet of Facility: S50 Number of Floors on which operations are conducted Maximum Meals to be Served: Breakfast � (approximate number) Lunch 0 Dinner Projected Date for Start of Project: VA I k `J Projected Date for Completion of Project: 61(11,3 Type of Service: (check all that apply) Sit Down Meals _ Take Out _ Caterer Mobile Vendor Other Please enclose the following documents: Proposed Menu (including seasonal, off-site and banquet menus) 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) 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, loading/unloading 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 waste -water 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; in. 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* (YES) (NCO 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) (., 04) 5. Bakery goods (pies, custards, cream fillings & toppings) ( ( ) 6. Other * A generic HACCP plan for each category of food may be available from the regulatory authority for reference. PLEASE CIRCLE/ANSWER THE FOLLOWING QUESTIONS FOOD SUPPLIES: 1. Are all food supplies from inspected and approved sources/ NO 2. What are the projected frequencies of deliveries for fr zen foods 3 vk Refrigerated foods ',301%4L , and Dry goods 31VX 3. Provide information on tl,, -m—nt of space (in cubic feet) allocated for: Dry storage t 0 CJS �� Refrigerated Storage �" (00 and Frozen storage tB�( -'Cu 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 be stored in the same refrigerators and freezers with cooked/ready-to-eat foods? YES NO If yes, how will cross -contamination be prevented? 3. Does each refrigerator/freezer have a thermometer YE NO Number of refrigeration units: le— Number of freezer units: " 4. Is there a bulk ice machine available? YE, N 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 g 70°F(21°C) Microwave (as part of cooking process) Cooked from Frozen state / ✓ C Q$� Other (describe) 3 *Frozen foods: approximately one inch or less = thin, and more than an inch = thick. COOKING: 1. Will food product i thermometers be used to measure final cooking/reheating temperatures of PHF's? YES / NO k tltl II What type of temperature measuring device: N Minimum cooking time and temperatures of product 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* 1557 (15 sec) (*pasteurized eggs must be served to a highly susceptible population) pork 145°F (15 sec) comminuted meats/fish 1557 (15 sec) poultry 1657 (15 sec) reheated PHF's 165°F (15 sec) 2. List types of cooking equipment. ()ov 19— C<V"iCQT :)0 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. X14 2. How will cold PHF's be maintained at 41'F (5°C) or below during holding for service? Indicate type andnumberof cold Bolding units. L �l � CW� 99� COOLING: Please indicate by checking the appropriate boxes how PHF's will be cooled to 41'F (5°C) within 6 hours (140°F to 70°F in 2 hours and 70°F to 41°F in 4 hours). Also, indicate where the cooling will take place. COOLING THICK THIN THIN THICK RICE/ METHOD MEATS MEATS SOUPS/ SOUPS/ NOODLES GRAVY GRAVY Shallow Pans Ice Baths Reduce Volume or Size Rapid Chill Other (describe) 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. 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. ti J� k VBG P&4 s alute , fkzgo CCO&G V 2. Will food employees be trained in good food sanitation practice . ES /NO Method of training: S�Qad� Number(s) of employees: Dates of completion: 3. Will disposable es and/or utensils and/or food grade paper be used to prevent handling of ready -to -eat food . /NO 4. Is there a olicy to exclude or restrict food workers who are sick or have infected cuts and lesion YE O Please describe briefly: VO Oe� tF S1GC ocz CR Will employees have paid sick leave? YES 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: Concentration: �J Test Kit�9/NO 6. Will ingredients for cold ready -to -eat foods such as tuna, mayonnaise and eggs for salads and sandwiches be pre -chilled before being mixed and/or assembled? YES/NO If not, how will ready -to -eat foods be cooled to 41°F? 7. Will all produce be washed on-site prior to use? YES / NO N I Pt Is there a planned location used for washing produce? YES / NO 0l'N Describe If not, describe the procedure for cleaning and sanitizing multiple use sinks between uses. I k 8. Describe the procedure used for minimizing the length of time PHF's will be kept in the temperature danger zone (41'F - 140°F) during preparation. 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. NIP 10. Will the facility be serving food to a highly susceptible population? YES 1 O 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 9 CEILING Bar Food Storage Other Storage Toilet Rooms T`I e Dressing Rooms ,1 Garbage & Refuse Storage Mop Service Basin Area Ware washing r I �E " Area Walk-in Refrigerators S� (1111�LFf S` and Freezers B. INSECT AND RODENT CONTROL APPLICANT: Please check appropriate boxes. 7. Will air curtains be used? If yes, where? ( ) (-10 C. GARBAGE AND REFUSE YE N N Inside S O 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? O O (lc) 3. Do all openable windows have a minimum #16 mesh screening? ( () ( ) 4. Is the placement of electrocution devices identified on the plan? O 4O ( ) 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? ( ) (-10 C. GARBAGE AND REFUSE Inside <> <> <> 8. Do all containers have lids? 0 O ( ) 9. Will refuse be stored inside? N O ( ) If so, where? 5r. Sr Mnrnn,l 10. Is there an area designated for garbage can or floor mat cleaning? 40 Outside 11. Will a dumpster be used? Number Size Frequency of pickup Contractor 12. Will a compactor be used? Number Size Frequency of pick up Contractor 13. Will garbage cans be stored outside? O (*)q () 14. Describe surface and location where dumpster/compactor/garbage cans are to be stored 15. Describe location of grease storage receptacle 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 O YN O OHO AIR GA P AIR BREA K *INTEGRA L TRAP *"P" TRA P VACUUM BREAKE R CONDENSAT E PUMP 18. Toilet 19. Urinals 20. Dishwasher 21. Garbage Grinder 22. Ice machines 23. Ice storage bin 24. Sinks i a. Mop b. Janitor c. Hand wash d. 3 Compartment e. 2 Compartment f.1 Compartment g. Water Station 25. Steam tables 26. Dipper wells 27. Refrigeration condensate/ drain lines 28. Hose connection 29. Potato peeler 30. Beverage Dispenser w/carbonator 31. Other * 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.? Full ?S? traps are prohibited. 32. Are floor drains provided & easily cleanable, if so, indicate location: W E. WATER SUPPLY 33. Is water supply public ()o or private ( )? 34. If private, has source been approved? YES ( ) NO ( ) PENDING ( ) Please attach copy of written approval and/or permit. 35. Is ice made on premises ( ) or purchased commercially Y"' If made on premise, are specifications for the ice machine provided? YES ( ) NO ( ) Describe provision for ice scoop storage: Provide location of ice maker or bagging operation 36. 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 (•A If yes, how will the device be inspected & serviced? 39. How are backflow prevention devices inspected & serviced? F. SEWAGE DISPOSAL 40. Is building connected to a municipal sewer? YES (f) NO ( ) 41. If no, is private disposal system approved? YES ( ) NO ( ) PENDING ( ) Please attach copy of written approval and/or permit. 42. Are grease traps provided? YES`( -J) NO ( ) If so, where? Provide schedule for cleaning & G. DRESSING ROOMS 43. Are dressing rooms provided? YES ( ) NO (?q 44. Describe storage facilities for employees' personal belongings (i.e., purse, coats, boots, umbrellas, etc.) H.GENERAL 45. Are insecticides/rodenticides stored separately from cleaning & sanitizing agents? YES D )NO( ) Indicate location: 46. Are all toxics for use on the premise or for retail sale (this includes personal medications), stored away from food preparation and storage areas? YES-) NO( ) 47. Are all containers of toxics including sanitizing spray bottles clearly labeled? YES �4NO ( ) 48. Will linens be laundered on site? YES ( ) NO (4 If yes, what will be laundered and where? If no, how will linens be cleaned? JWy- R.L 49. Is a laundry dryer available? YES ( ) NO 114 50. Location of clean linen storage: 51. Location of dirty linen storage: g I FY 52. Are containers constructed of safe materials to store bulk food products? YES ( ) NO ( ) Indicate type: 53. Indicate all areas where exhaust hoods are installed: LOCATIO N FILTERS &/OR EXTRACTIO N DEVICES SQUAR E FEET FIRE PROTECTIO N AIR CAPACIT Y CFM AIR MAKEU P CFM 54. How is each listed ventilation hood system cleaned? I. SINKS 55. Is a mop sink present? YES (-,4jNO ( ) If no, please describe facility for cleaning of mops and other equipment: 56. If the menu dictates, is a food preparation sink present? YES ( ) NO (2� J. DISHWASHING FACILITIES 57. Will sinks or a dishwasher be used for ware washing? Dishwasher( ) Two compartment sink( ) Three compartment sink (1Q 58. Dishwasher Type of sanitization used: v Hot water (temp. provided) Booster heater Chemical type Is ventilation provided? YES () NO 59. Do all dish machines have templates with operating instructions? YES ( ) NO ( ) 60. Do all dish machines have temperature/pressure gauges as required that are accurately working? YES ( ) NO ( ) 61. Does the largest pot and pan fit into each compartment of the pot sink? YES (Yj NO ( ) If no, what is the procedure for manual cleaning and sanitizing? 62. Are there drain boards on both ends of the pot sink? YES (Z�NO ( ) 63. What type of sanitizer is used? ( Chlorine Iodine ) Quaternaryc ammonium ) Hot Water Other ( 64. Are test papers and/or kits available for checking sanitizer concentration? YES (9 NO ( ) K. HANDWASHING/TOILET FACILITIES 65. Is there a hand washing sink in each food preparation and ware washing area? YES ()�NO ( 66. Do all hand washing sinks, including those in the restrooms, have a mixing valve or combination faucet? YES qp*� NO ( ) 67. Do self-closing metering faucets provide a flow of water for at least 15 seconds without the need to reactivate the faucet? YES 6 NO ( ) 68. Is hand cleanser available at all hand washing sinks? YES (yo NO ( ) 69. Are hand drying facilities (paper towels, air blowers, etc.) available at all hand washing sinks? YES (P NO ( ) 70. Are covered waste receptacles available in each restroom? YES Qq NO ( ) 71. Is hot and cold running water under pressure available at each hand washing sink? YES 9Q NO( 72. Are all toilet room doors self-closing? YES (10,NO ( ) 73. Are all toilet rooms equipped with adequate ventilation? YES r NO ( ) 74. Is a hand washing sign posted in each employee restroom? YES ku[N� NO ( ) L. SMALL EQUIPMENT REQUIREMENTS 75. Please specify the number, location, and types of each of the following: Slicers tj/l4 Cutting boards Can openers �6-1 !N/( Mixers A[ 1 Floor mats fvli�" Other 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 specifications by the Salem Board of Health does not indicate 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. Kimberley Driscoll Mayor City of Salem, Massachusetts 10 Board of Health 120 Washington Street, 4th Floor, Salem, MA 01970 Tel. (978) 741-1800 Fax. (978) 745-0343 PabliCHealth Iramdin@salem.com Prevent, Promote. Protect. Larry Ramdin RS/RENS, CHO, CP -FS Health Agent FOOD ESTABLISHMENT PERMIT (must be posted on the Premises of the Food Establishment) 2014 Permit Number: FM -14-435 Permit Type: Temporary Food Non -Profit Goods & Services: Food Service: Non -Profit Name of License Holder: Salem Screamery Name of Food Establishment The Screamery Address of Food Establishment 60 Washington Street SALEM MA 01970 Restrictions: North Shore Pride Festival Salem Common 6/21/14 Serving, ice cream in cups and cones This License is granted in conformity With the statutes, Regulations and ordinances relating thereto,and expires on 6/21/2014 unless sooner suspended or revoked. Permit Fee: Issued: 0.00 6/18/2014 KIMBERLEY DRISCOLL MAYOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4°I FLOOR TEL. (978) 741-1800 FAX (978) 745-0343 Iramdin@salem.com CHECK PAYABLE TO THE CITY OF SALEM. NO CASH FEE: NON-PROFIT = $25 1-3 DAYS = $300 4-7 DAYS = $600 lu pIlY7.iCiEiC81t}l Prevent. Promote. Protect. LARRY RAMDIN, RS/RENS, CHO, CP -PS HEALTH AGENT OVER 7 DAYS = >7 DIVIDED BY 7 X 600 = THE AMOUNT DUE (EXAMPLE: 14 DAYS DMDED BY 7 = 2 X 600 =$1200 APPLICATION FOR ATEMPORARY FOOD SERVICE PERMIT NAME OF EVENT T i�\(I� Qi'/� 'nYP�^�� '� LOCATIONS L 9l E m /� 1' I "'o� DATES) OF EVENT 1(� 1 �C.. ri.� g� TIME OF DAY q oV) - (; m Sr M J' t�/��y� NAME OF APPLICANT �Q ,Y\'(�, l T'Q,� �p �J � i C�� ) a TELEPHONE# q 1(I' / ��T ' `8M NAME OF BUSINESS !�c r_ea ilQ.aa TELEPHONE#" j O /4500 CERTIFIED FOOD MANAGERS NAME: 6�4�� CERTIFICATION#: *A PLAN OF THE ESTABLISHMENT FOR THE EVENT MUST BE ATTACHED TO COMPLETE THIS APPLICATION* FOR ESTABLISHEMNTS OUTSIDE OF SALEM, MA: TYPE OF REFRIGERATION: _GAS LICE DRY ICE METHOD FOR COOKING/HOT HOLDING: GAS OTHER METHOD FOR SANITIZING: FOODS TO BE SERVED INCLUDING I HAVE READ THE BOARD OF HEALTH, 'REQUIREMENTS FOR TEMPORARY FOOD ESTABLISHMENTS." I HAVE HAD THE OPPORTUNITY TO ASK QUESTIONS REGARDING THOSE REQUIREMENTS. I UNDERSTAND THEM, AGREE TO ABIDE BY THEM AND UNDERSTAND THAT FAILURE TO DO SO WILL RESULT IN REVOCATION OF MY TEMPORARY FOOD ESTABLISHMENT PERMIT. PURSUANT TO MGL C62C, S49A, I CERTIFY UNDER THE PENALTIES OF PERJURY THAT I, TO MY BEST KNOWLEDGE AND BELIEF, HAVE FILED ALL STATE TAX RETURNS AND PAID UNDERLAW. 6 SOCIAL SECURITY OR FEDERAL ID # AMOtm PNO: TPMDADDI Vp-11 , I IDIIATPn 1/1Nn Guidelines for Temporary Food Vendors 11 In order to ensure that safe and sanitary foods are served to the public, your temporary food permit is issued based on the following conditions: Your Certified Food Manager certificate, temporary food and propane permits (if applicable) must be conspicuously displayed on site. • Only the foods stipulated on your temporary food permit may be sold. • Foods must be obtained from an approved commercial source. Proof of source such as boxes, receipts etc. must be on site. • All potentially hazardous foods such as hot dogs, commercially pre-cooked sausages, hamburgers, prepared vegetables, must be maintained either above 140°F or below 41'F. • Only mechanical refrigeration or crushed / cubed ice is allowed as a cooling medium. Foods shall not come in contact with water or undrained ice. Packaged foods may not be stored directly in ice if it is subject to the entry of water. • Cooking temperatures are as follows: § Commercially pre-cooked products -140°F • All foods, drinks and condiments shall be handled and stored ina manner that prevents contamination such as using clean covered containers, storing equipment and food up off the ground etc. Trash bags are not to be used for food storage. • Running water with liquid soap and disposable paper towels for hand washing must be available and set-up prior to food preparation. Bottled water with a pull out spout is acceptable. Check with the Health Department for other acceptable methods. • All food handlers shall wash their hands after utilizing the toilet facilities, smoking, eating, changing tasks, and changing gloves or when hands become contaminated. All wrist jewelry and adomments must be removed. • Bare hands may not contact ready -to -eat foods. Suitable utensils shall be used such as deli tissue, spatulas, tongs, single -use non -latex gloves etc. Bare -hand contact shall be minimized with foods that are not ready -to -eat. • All equipment, utensils, containers etc. shall be in clean, sanitary condition. Where there are no warewashing facilities obtainable, a spare set of work utensils shall be available. • All carts must be thoroughly pre -cleaned before set-up at the event. • People handling the food shall wear clean outer garments, hair restraints, and utilize good hygienic practices. •, Vendors licensed to sell scooped ice cream must store scoops individually in each tub of ice cream or provide dipper well with running water • Smoking is prohibited within 10 feet of a cart or food storage area. Employee must wash their hands thoroughly with soap before returning to work • Garbage and refuse shall be disposed of in a satisfactory manner. The premises shall be kept clean. • A stem type of thermometer that has been properly calibrated must be available for testing potentially hazardous foods on site. The thermometer must be cleaned and sanitized before and after use in a manner approved by the Health Department. Refrigerated units must have thermometers • A labeled spray bottle of sanitizer prepared at proper concentration must be on site and used on all food contact surfaces, utensils etc. Proper concentrations should be determined with pH papers. Concentrations are as follows: § Chlorine sanitizer: 50 —100 PPM § Quaternary sanitizer: 200 PPM If any of these conditions are not set-up and maintained, your temporary food permit will be immediately revoked and you will be ordered to stop serving food. If you have any questions regarding the above conditions, call the Salem Board of Health at 978-741-1800 prior to the event.. I have re*e*,�tood and agree to adhere to the above conditions. Date Massachusetts Department of Public Health Division of Food and Drugs City/Town of e,vyl FOOD ESTABLISHMENT INSPECTION REPORT Salem Board of Health 120 Washington Street, 4"' Floor Salem, MA 01970-3523 Tel. (978) 741-1800 Fax (978) 745-0343 Address: Tel. q ' I Name a Type peration(s) LtTood Service ❑ Retail El Residential Kitchen ❑ Mobile ❑ Temporary ❑ Caterer Bed 8 Breakfast E] Bed Permit No. Type of Inspection [ nihe ElRe-inspection Previous Inspection Date: ❑ Pre-operation ❑ Suspect Illness General Complaint ❑.Other Address Rrs Level Telephone Owner HACCP YM Person -in -Charge (PIC) I n:❑HACCP Ou / Inspector Each violaf�W checked requires ane�cp(anation on the narrative page(s) and a citation of specific provision(s) violated. �J Norwcompliance with: Violations Related to Foodborne Illness Interventions and Risk Factors_(Red Items) Anti -Choking 590.009(E) ❑ /Y 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) El FOOD. PROTECTION MANAGEMENT _ _ _� ❑ 12. Prevention of Contamination from Hands ❑ 1 PIC Assigned/Knowledgeable/Duties ,.- ;3 Handwash Facilities EMPLD HEALTH -V;xC APROTECTIONFROM'MIC_ ❑ 2 Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded I--- -- - _ _-_ - _ _ _ _ , ❑ 15. Toxic Chemicals FOOD FROMAPPROVED SOURCE __ �, _ ❑ 4. Food and Water from Approved-'T�F�TEMPERATURE.C,ONTROLS(P.otentlallyHaxardousFoo-a)._, ❑ 5. Receiving/Condition ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 7. Conformance with Approved Procedures/HACCP Pians L PROTECTION FROM CONTAMINATION, _ ❑ 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_ (Blue Items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Noncritical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. Management and Personnel (FC -2x590.003) 24. Food and Food Protection (Fc -3x590.004) 25. Equipment and Utensils (FC -4x590.005) 26. Water, Plumbing and Waste (FCSx590.006) 27. Physical Facility (FC -6x590.007) 28. Poisonous or Toxic Materials (Fc -7x590.008) 29. Special Requirements (590.009) 30. Other ❑ 16. Cooking Temperatures ❑ 17. Reheating ❑ 18. Cooling [119. Hot and Cold Holding ❑ 20. Time as a Public Health Control _ -: r _ REQUIREMENTS FOR,NIGHLYSUSCEPTIBLE=POPULATIONS':(H_8P) ❑ 21. Food and Food Preparation for HSP COI- NSUNIERADVISORY 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red 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's Signature: Print: t� PICS Signature: Print: Page \ of 3 Pages M ..-.aW'rs^ws+r."n.`.rr-.v ":'. � �„iTisP"�+..-�✓4�:.-i `�,. I1IY.�,w`. _ ✓ \.nti«V��i^ 1."� .� .v" col+��•.rtiY 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* r2-103.11 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 3-201.13 Fluid Milk and Milk Products* applicants* Shell Eggs* 590.003(F) Responsibility Of A Fax! Employee Or Ar 3-202.16 Ice Made From Potable Drinking Water* Applicant To Report To The Person In Drinking Water from an A2proved System* 590.006(A) Charge* 590.006(B) 590.003 G Reporting by Person in Charge* 3 590.003(D) Exclusions and Restrictions* 3 01.15 590.003(E) Removal of Exclusions and Restrictions 4 C C C FOOD FROM APPROVED SOURCE Food and Water From Regulated Sources 590.004(A -B) Compliance with Food. law* 3-201.12 Food in a Hermetically Sealed Container* 3-201.13 Fluid Milk and Milk Products* 3-202.13 Shell Eggs* 3-202.14 Eggs and iMilk Products. Pasteurized* 3-202.16 Ice Made From Potable Drinking Water* 5-101.1.1 Drinking Water from an A2proved System* 590.006(A) Bottled Drinking Water* 590.006(B) Water Meets Standards in 310 CMR 22.0* - ShelBish and Fish From an Approved Source 3-201.14 Fish and Recreationally Caught Mol!uscsn Shellfish* 3 01.15 _ Molluscan Shellfish from NSSF Listed Sources* 4-703.11 Game and Wild Mushrooms Approved by Regulatory Authority 3-202.18 Shellstock Identification Present* 590.004(C) Wild Mushrooms* 3-201.17 Game Animals* Receiving/Condition 3-202.1.1 PHFs Received at Proper Temperatures* 3-20215 Package litre it •* 3-101.11 Food Safe and Unadulterated __ Tags/Records: Shelistock 3-202.18 Shellstock Identification * 3-203. t2 Shellstock ldentificationMaintained* _ Tags/Records: Fish Products _3402. 11 Parasite Destruction* 3-40112 Records, Creation and Retention* 590.004(n Labeling of ingredients* Conformance with Approved Procedures IHACCP Plans 3-502.11. Specialized Processing Methods* 3-502.12 Reduced oxygen packaging,criteria* 8-103.!2 Conformance with Approved Procedures* Denotes critical item in.the federal 1999 Fax( Code or 105 CMR 590.OM. C PROTECTION FRnU CnNTAUINATlnra 10 ----------- " Cross -contamination 3-302.11 (A)0) Raw Animal Foals Separated from Cooked and RTE Foods* 2-301.11 Contamination from Raw Ingredients 3-302A I(A)(2) Raw Animal Foods Separated from Each Other* Cleaning Procedure* Contamination from the Environment 3-302.11(A) Foal Protection* 3-302,15 Washing Fruits and Vegetables 3-30411 - Food Contact with Equipment and Utensils* 2-401.11 Contamination from the Consumer 3-306A4(A)(B) Returned Food and Reservice of Food* - Disposition ofAdufterated or Contaminated Food 3-701.11 Discarding or Reconditioning Unsafe Food* 10 Food Contact Surfaces 4-501..1.11. Manual Warewashing - Hot Water 2-301.11 Sanitization Temperatures* 4-501.112 Mechanical W'arewashing-HM Water Cleaning Procedure* Sanitization Temperatures* 4-501.114 Chemical Sanitization- temp., pH, 1.1 concentration and hardness. * 4-601.11(A) Equipment Food Contact Surfaces and 2-401.11 Utensils Clean* 4-602.11 Cleaning Frequency of Equipment Food - Discharges. From the Eyes, Nose and Mouth* .. Contact Surfaces and Utensils* 4-702.11 Frequency of Sanitizatign of Utensils and Food Contact Surfaces of Equipment* 4-703.11 Methods of Sanitization -Hot Water and 10 Proper, Adequate Handwashing 2-301.11 Clean Condition -Hands and Arms* 2-301.12 Cleaning Procedure* 2-301.14 When to Wash* 1.1 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 Tas Emolovees* Handwash Facilities ConvenisnW Located Numbers and Capaci Location and Placem * t9hhLp.e4 &2vt1 Dot � opoe U2�a,�6) CITY OF SALEM BOARD OF HEALTH Establishment Name: -AOon n SOA&emn-_OJ,, Date: 2 —dQ�1) Pager of 3 ---•r.II��,' I., r/J �l J./- �l��J.�♦_� ��v�-�_.11 �i� f1�1�./i"�_ plo NMI YlUM /d1 ..J M�M.SRI- _., �.!i!'�'?�lG� .. -��•■J wL@ Jul A. V I • �� r .iilZriJ ATMAM I 1 _ II _I� � §PWIP � LU � ice.• t'� �t '�IuI• __ v r_�"Ift I I I1 J _�._- 1�fld aw �_I� I. ��.�'� �I� I.. I• • • •- • •- • • •• • • • •• •-• • • your ••• permit.�r• ✓� &�'Voluntary Compliance a Employee Restriction Exclusion r ••• • -•uled ■ Emergency Suspension Li Emergency Closure0 Embargoi 113 Voluntary Disposal El Other: Violations Related to Foodborne Illness Interventions and Risk Factors (items 1-22) (Cont) 14 Food or Calor Additives 3-202.12 Additives* 3-302.14 Protection from Unapproved Additives* j5 Poisonous or Toxic Substances 7-101 A t Identifying Information - Original Containers* 7-102.11. Common Name - Working Containers" 7-201.11 1 Separation - Storage* - 7-202.11 Restriction - Presence and -Use* 7-202.12 Conditions of Use° - 7-203.11 Toxic Containers - Prohibitions* 7-204.11 Sanitizers. Criteria - Chemicals* 7-204,12 Chemicals kit WashinE Produce, Criteria* 7-204.14 Drying Aecats. Criteria" 7-205,11 Incidental Food Contact, Lubricants* 7-206.31 Restricted Use Pesticides, Criteria* ,-?06.22 - Rodent Bait Stations* _ ' 7-206.13 Tracking Powders, Pest Control and Monitorin *. 16 go 18 * Denotes criticat iarn in the 1--derai 1999 Foal Cate or 105 CMR 590.000. 20 3-50I A 4(C) Proper Cooking Temperatures for 3-501.15 PHFs _ 340i.IIA(1)(2) Eggs- 155°F 15 Sea 3-501,16(B) 590.004(17) Eggs- Immediate Service 145°F15sec+ 3.401.11(A)(2) Comminuted Fish. Meats & Game 3-501. f 6(A) Animals -155'F 15 sea:. * 3-001.11(13)(1)(2) Por- and Beef Roast -130-F 121 min* 3-401.11(4)(2) Ratites, injected Meats - 155°F 15 590.004 H) sec. * 3-401.11(A)(3) Poultry, Wild Game, Stuffed PHFs, 27. Stuffing Containing Fish, Meat, FC -6 Poultry or Ratites-I65'F 15 sec. " 3-401.11(C)(3) Whole -muscle, Intact Beef Steaks +. FC=7 145°F 3-401.12 Raw Animal Foods Cooked in a Microwave 165°F * 3401:11(A)(1)(b) All Other PHFs -145°F 15 sec, Reheating for Hot Holding 3-403A1(A)&(D) PHFs 165'F 15 sec. 3-403.11(B) Microwave -,165` F 2 Minute Standing Time* 3-403.11(C) Commercially Processed RTE Food - 140°F* 34012-II(E) Remaining Uasliced Portions of Beef Roasts* Proper Cooling of PHFs 3-501.14(A) Cooling Cooked PHFs from 140°F to 70'F Within 2 Hours and From 70°17 to 41°F/450F R'itIim 4 Hours. * 3-50134(6) Cooling'PHFs Made From Ambient Temperature ingredients to 41°17!45°F Within 4 Hours* * Denotes criticat iarn in the 1--derai 1999 Foal Cate or 105 CMR 590.000. 20 3-50I A 4(C) PHFs Received at Temperonues According to law Cooled to 41'Fl45°F Within 4 Hours. 3-501.15 Cooling Methods for PHFs ` 23. PHF Not and Cokd Holding 3-501,16(B) 590.004(17) Cold PHFs Maintained at or below 410145' F* 3-501.16(A) Hot PHFs Maintained at or above 140°P, * 3-501. f 6(A) Roasts Held at or above 130°F. 25. Time as a Public Health Control 3-501: t4 Time as a Public Health Control' 590.004 H) Variance Requirement REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS iNSP) 21 3-801. LH(A) Unpastcur zed Pre-packaged Juices and Beverages with Warning labels* Consumer Advisory Posted for Consumption of 3-801.11(B) Use of Pasteurized Ergs* ` 23. 3-801.11(D) Raw or Partially Cooked Animal Food and Raw, Seed Sprouts Not Served. * , FG -2 3-801.11(C) Unopened Food EEkaE Not Re -served. CONSUMER ADVISORY 22 3-603.11 Consumer Advisory Posted for Consumption of 590.-OIIf) ` 23. Animal Foods That are Raw, Undercooked or , FG -2 .00.3 Na Otherwise Processed to Eliminate i Food and Food Protection FC -- 3 Patbogeas.*c'Abr1r 1^ t 25. 3-30113. Pasteurized Eggs Substitute for Raw Shell .005 ! 2E. Eggs' . nZMV1rnamcn e a Violations of Section .590.009(A) -(D) in catering, mobile food, temporary and residential kitchen operations should be debited under the appropriate sections above if related to foodborne illness interventions and risk factors. Other 590.009 violations relating to goal retail practices should be debited ander #29 - Special Requirements. (Items 23-30) Critical, mrd non-critical violations, which do not relate to the foodborne illness interventions and risk factors listed above, can be found in the following sections of the Food Code and 105 CMR 590.000. - Item I Good Retail Practices [,Fc 590.-OIIf) ` 23. 1 Manisternent and Persortnei , FG -2 .00.3 24. i Food and Food Protection FC -- 3 .004 25. Equipment and Utensils 1 FC -4 .005 ! 2E. CWater. Plumbing and Waste �! FC -5 .006 27. Physical Facility FC -6 .007 1 28. ' Poisonous or Toxic Materials +. FC=7 .008 1 29. Seciai Requirements I .009 F30- Other %' CITY OF SALEM BOARD OF HEALTH Establishment Name:S-hIQA'YN Date: --q---30-1 �) Page: � of —E3 MeA WUP 007M, Wc PIPE WIN= I�7u1 �MJ1, ..A/I. — 1._Him ISL_ 1 1 ♦�,. � �: 1 � =_; .� ....r:_W. )IRM .. _. -.. ,._.��_ .�- -- your food. Violations Related to Foodborne Illness Interventions and Risk Factors (its= 1-22) (Cont) - Im 17 18 ..__ 'Food or Color Additives 3-202.12 Additives* �- - 3-302.14 Protection from Unapproved Additives* 3-501A(5(B) 590.004(F) Poisonous or Toxic Substances 7-101.11 Identifying Information - Original Containers* 7-102.11. Common Name -Working Containers* 7-201.11 Separation - Storage* 7-202.11 Restriction - Presence and Use* 7-202.12 Conditionsof Use* 7-203.11 Toxic Containers - Prohibitions* 7-204.11 Sanitizes. Criteria - Chemicals* 7-204.12 Chemicals for Washing Produce, Criteria* 7-204.14 Drying Agms. Criteria* 7-205.11 Incidental Food Contact, Lubricants* 7-206.11 Restricted Use Pesticides; Criteria* 7-206.12 - Rodent Bait Stations* 7-206.13 Tracking Powders, Pest Control and Monitoring' 1'.0 !I is 'i * `�. - - Proper Cooking Temperatures for _ 3-501.15 PHFs 3-401.11A(1)(2) Eggs- 155`F 15 Sec 3-501A(5(B) 590.004(F) E Immediate. Service 145°F15see^ 3-401.1I(A)(2) Comminuted Fisb. Meats & Game 3.503.16(& Animals - 155°F 15 sec. * 3.401.11(B)(1)(2) Pori: and Beef Roast - 130°F 121 min* 3-401.11(A)(2) Ratites, Injected Meats -155°F 15 590.004(H) sec. * 34()1.11(A)(3) Poultry, Wild Game, Stuffed PHFs, 27. Stuffing Containing Fish, Meat, I F Poultry or Ratites -165°F 15 sec, 3-401.11(C)(3) Whole -muscle, Intact Beef Steaks I FC -7 145°F 3-401.32 Raw Animal Funds Cooked in a Microwave 165°F 3.401,11(A)(1)(b) All Other PHFs - 145'F 15 sec. Reheating for Hot Holding 3-{03& I(A)&(D) PRFs 165°F 15 sec. * 3-403.11(B) Microwave- 165` F 2 Minute Standing Tom* 3-403.11(C) Commercially Processed RTE Foal - 140°F* 3403.11(E) Remaining Unsliced Portions of Beef Roasts* Proper Cooling of PHF$ 3-501.14(A) Cooling Cooked PHFs from 140°F to 70'F Within 2 Hours and From 70*F to 410F/45'1` Within 4 Hours. * 3-SOt.14(B) Cooling PRFs Made From Ambient Temperature ingredients to 41°F/45°F Within 4 Hous* . a Den<xes critical iwax in the federal 1999 Food Code or 105 CMR 590.000. mm- 3-501.14(C) PHFs Received at Temperatures - According to Law Cooled to 41°F145°F Within 4 Hnnrs. 3-501.15 Cooling Methods for PHFs 3�01.11(B) PHF Hot and Cold Holding 3-501A(5(B) 590.004(F) Cold PHFs Maintained at or below 41'745' F* 3-501.16(A) Hot PHFs Maintained at or above 140°F. * 3.503.16(& Roasts Heid at or above 130°F. 25. Time as a Public Health Control 3-5)1;19 Time as a Public Healdr Cnntrut* 590.004(H) Variance Requirement REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS HSP 21 3-801.1](A) Unpasteurized Pre-packaged Juices and Beverages with Warning Labels* 59ailm i 3�01.11(B) _ Use of Pasteurized Ears* _ I FC -2 3-801A I (D) Raw or Partially Cooked Animal Food and Raw Seed Spniats Not Served. * Food and Foal Protection 3-801.11(C) Un ed Foal Package Not Re -served. CONSUMER ADVISORY 22 3-603.11 Consumer Advisory Posted fru• Consumption of 59ailm i 23. Animal :Foods That are Raw, Undercooked or. 1 _ I FC -2 Not Otherwise Processed to Eliminate Food and Foal Protection FC -3 Pathogens.*�'. b" f 25. 3-302.13 Pasteurized Eggs Substitute for Raw Shell .005 ! 26. 1 E * 590.009(A) -(D) Violations of Section 590.009(A) -(D) in catering, mobile fbod, temporary, and residential kitchen operations should be debited under the appropriate sections above if related to foodborne illness interventions and risk factors. Other 590.009 violations relating to good retail practices should be debited under #29 - Special Requirements. (Items 23-30) Critical, and non-critical violations, which do not relate to the foodborne illness interventions and risk factors listed above, canbe found in the following sectionsofthe Food Code and 105 CMR 5190.000. 1 Item { Good Retail Practices .FC 59ailm i 23. 1 Management and Personnel _ I FC -2 i 24. Food and Foal Protection FC -3 _004 ! 25. 1 Equipment and Utensils FC -4 .005 ! 26. Water. Plumbing and Waste _! 1 FC -5 .005 27. Physical Facifty I F 75071 28. Po sonous or Toxic Materials I FC -7 .008 r29. - Special Requirements 30 Other 5:59Marmz .. C-;