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BOBS FAMOUS FRIED CLAMS - ESTABLISHMENTS be I ce Page a3 WHO WILL BE THE NEW r JOHNNY gDAMON? ews Next Red Sox heartthrob B - TRIBUNE COMPANY TUfa NBrt6, ; PBI PI goose population stunting growth.ftes are there's a large concern that it will be." osedfor anyone who feeds Experts fear that the disease,which can only be passed from bird to human,could erns—including worries kill millions if it mutates and is able to are one reason for the de= pass from person to person. Depredation is a process that is sweep- of in the background of ing the country in advance of any avian e doing,"Peabody Health flu pandemic,Marblehead Health Director n Cameron said."jAvian in the United States,but Please see GEESE,Page Ab City Council � itM ...s a eefing Councilor says controversy over .leis ethics violation a `distraction' i A2 Friday,March 31,2006 THE SALEM NEWS Nt a , MICHAEL SFERLINWStaff photo A closed sign is posted on the front door of Bob's Famous Fried Clams at 424 Highland Ave.,Salem yesterday. Popular tried clam spot closes doors — for now By Tom DALTON are currently closed,but we do S rAi•T WRITFR thank you for your many years of patronage." ' SALEM—The city's fried food The Salem News was not able lovers are in mourning.Bob's Fa- to reach owner Arthur Velonis, mous Fried Clams,a Highland but Mayor Kim Driscoll said she Avenue landmark,has closed— spoke to him this week and was at least for now. briefed on his plans. "I almost cried," said Lucy "I talked to him,"the mayor Stewart, a longtime customer said,"and he told me Dunkin' who claims the fried scallops Donuts made an offer that was are made with a"secret"recipe.. too good to pass up." "I'm not an addict or anything Velonis wants to reopen at a ... but their food is like an new location,the mayor said. addiction." "He wants to stay," Driscoll Word spread quickly this said."We're working with him to week that Bob's had shut its find an alternative location in doors and put up a"closed"sign. Salem. We definitely want to The following message was left keep him We don't want the ne- on the restaurant phone:"We cret recipe to leave." a CITY OFSALEM, MASSACHUSETTS BOARD OF HEALTH120 WASHINGTON STREET, 4TH FLOORSALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94 , Section 305A and Chapter III , Section 5 of the General Laws, to operate a Food Establishment in the City of Salem is hereby granted to : Owner' s Name : Arthur G. Velonis Name of Establishment : Bob' s Famous Fried Clams Address of Establishment : 429 Highland Avenue Type of Establishment : FOOD SERVICE Application Date: 12/17/2001 Restrictions: Permit for Food Establishment _ 196=02 Frozen Desserts/Ice Cream Permit for the Sale .of Tobacco Products These Permits Expire December 31, 2002 This permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. HEALTH AGENT CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH gj • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 2002 APPLICATION F//OR PERMIT TO OPE_RATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT ll1 � lJC((S4 /cGtL /JTEL# g7 rT '� la ADDRESS OF ESTABLISHMENT 7 d J J ` yrJ�LfL/I C� tlU� MAILING ADDRESS (if different) //�� //� OWNER'S NAME 47-hVk C9. UZGG�/G/ S TEL#_22f, ;477 ADDRESS /761%1M CITY STATE ZIP / CERTIFIED FOOD MANAGER'S NAME(S)„ (� /rltlJL'a� CERTIFICATE#(s)a.2LS (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON AIN- JV640IA<5' HOME TEL# ev Yog DAYS/HOURS OF OPERATION: Mon.L,LTue./&LWed.j�Thu,1/-K Frit! Sat.1 Sun. TYPE OF ESTABLISHMENT ro FEE check only RETAIL STORE YES ( !O RESTAURANT (Z—p '�1CJ' /?� $40 BED& BREAKFAST YES 44 ADDITIONAL PERMITS MAKE ICE CREAM, YOGURT SOFT SERVE YES N $5 TOBACCO VENDOR YES $10 NO CHARGE FOR NON-PROFIT(such as church kitchens) PLEASE INCLUDE COPY OF TAX EXEMPTFORM 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 pians 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 be knowledge and belief, have filed all state tax returns and paid all state taxes required under the law. 1a n10 era- Signature Date SocialSecurityor Federal Identification number Revised 11/1/01 foodap2.adm Check#&DateT eye-_ �, .-.-. v . ..,. .ti•--• --•.-...--.-+.r.:.-„f-^w.-- -.�r^ay.�,:..-•- ....r,y�•.,�.,.-.-...,--........._,�,H•..,,,n.-'•--.�•+-..++w..r-+fn../.�w-^.^*✓"ia�+w�-""�.+.-,..-.-...--..-..�- . ,..y. •. -j/ THE COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM Address: 120 Washington Street, 4th Floor BOARD OF HEALTH Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel: (978) 741-1800 Fax: (978) 745-0343 Name Date Tvpe of Operatlon(s) Type of Inspection n e L //-/9-GA PPM=EP//Routine Address Risk ❑ Retail L7 Re-inspection 70�7LZr! Level ❑ Residential Kitchen Previous Inspection Telephone q, ,,yy 936( ❑ Mobile Date:/p•d%4o2-- Owner HACCP YIN ❑ Temporary ❑ Pre-operation aR 4,1i (/ iS ❑ Caterer ❑ Suspect Illness Person In Charge(PIC) Time ❑ Bed&Breakfast ❑ General Complaint e_ In: ❑ HACCP Inspector Out: Permit No. ❑'Other/577.7 /. Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. Local Law ❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/ Knowledgeable/ Duties E9/1 \ I� i3. Handwash Facilities EMPLOYEE HEALTH ` PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/ Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) El 4. Food and Water from Approved Source El16. Cooking Temperatures El 5. Receiving/Condition El 17. Reheating El6. Tags/ Records/Accuracy of Ingredient Statements El7. Conformance with Approved Procedures/HACCP Plans El 18. Cooling ❑ 19. Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20. Time as a Public Health Control ❑ 8. Separation/Segregation/ Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ❑ 21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related Items) Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions / immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/Federal Food Code.This report, when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2)(590.003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing.Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: Inspector's Signature: s y7 _��� Print: PIC's Signature: // Print: !r��.� ���-�� Page / of-a Pages FORM 734A HOBBS&WARREN - BOSTON �/ r Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) PROTECTION FROM CONTAMINATION 8 Cross-contamination FOOD PROTECTION MANAGEMENT 3-302.11(A)(1) Raw Animal Foods Separated from '.1F: 590.003(A) Assignment of Responsibility* Cooked and RTE Foods* 590.003(B) Demonstration of Knowledge* Contamination from Raw Ingredients 2-103.11 Person in Charge-Duties 3-302.11(A)(2) Raw Animal Foods Separated from Each Other* EMPLOYEE HEALTH Contamination from the Environment r 590.003(C) Responsibility of the Person in Charge to 3-302.11(A) Food Protection* require reporting by Food Employees and 3-302.15 Washing Fruits and Vegetables Applicants 3.304.11 Food Contact with Equipment and 590.003(F) Responsibility of a Food Employee or an Utensils* Applicant to Report to the Person in Charge* Contamination from the Consumer 3-306.14(A)(B) Returned Food and Reservice of Food* 590.003(G) Reporting by Person in Charge* Disposition of Adulterated or Contaminated ti3 590.003(D) Exclusions and Restrictions* Food 590.003(E) Removal of Exclusions and Restrictions 3-701.11 Discarding or Reconditioning Unsafe Food* FOOD FROM APPROVED SOURCE g Food Contact Surfaces Food and Water From Regulated Sources 4-501.111 Manual Warewashing-Hot Water 590.004(A-B) Compliance with Food Law* Sanitization Temperatures* 3-201.12 Food in a Hermetically Sealed Container* 4-501.112 Mechanical Warewashing-Hot Water 3-201.13 Fluid Milk and Milk Products* Sanitization Temperatures* 3-202.13 Shell Eggs* 4-501.114 Chemical Sanitization-temP.pH, 3-202.14 Eggs and Milk Products, Pasteurized* Concentration and Hardness* 3-202.16 Ice Made from Potable Drinking Water* 4-601.11(A) Equipment Food Contact Surfaces and 5-101.11 Drinking Water from an Approved System* Utensils Clean* 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Equipment Food- 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces and Utensils* Shellfish and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils and 3.201.14 Fish and Recreationally caught Molluscan Food Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization- Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* Game and Wild Mushrooms Approved by - .10 Proper,Adequate Handwashing Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 2-301.12 Cleaning Procedure* 3.202.18 Shellstock Identification Present* 2-301.14 When to Wash* 590.004(C) Wild Mushrooms* 11 Good Hygienic Practices 3-201.17 Game Animals* 2-401.11 Eating,Drinking or Using Tobacco* 5 Receiving/Condition 2-401.12 Discharges From the Eyes,Nose and 3-202.11 PHFs Received at Proper Temperatures* Mouth* 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-101.11 Food Safe and Unadulterated* '12` Prevention of Contamination from Hands 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from 3-202.18 Shellstock Identification* Employees* 3-203.12 Shellstock Identification Maintained* F 13. Handwash Facilities Tags/Records: Fish Products 3-402.11 Parasite Destruction* Conveniently Located and Accessible 5-203.11 Numbers and Capacities* 3-402.12 Records,Creation and Retention* 5-204.11 Location and Placement* 590.004(J) Labeling of Ingredients* 5-205.11 Accessibility,Operation and Maintenance 7 Conformance with Approved Procedures Supplied with Soap and Hand Drying /HACCP Plans Devices 3-502.11 Specialized Processing Methods* 6-301.11 Handwashing Cleanser,Availability 3-502.12 Reduced Oxygen Packaging,Criteria* 6-301.12 Hand Drying Provision 8-103.12 Conformance with Approved Procedures* •Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Y - CITY OF SALEM BOARD OF HEALTH t Establishment Name: A/35 A!7/Yl40-, C/aA-rr s Date: Page: of Item' Code C Crl(ical ItemDESCRIPTION-oF VIOLATION / PLAN OF CORRECTION I Date No' .,Reference R>.Red Items = Verified'" >I , ,., ...� :r. .� � �� .'. PLEASE PRIN,T.CIEARLY K - •• � - k ny O!/a 7`il/v,v 2 E�np/��eP /3 - 7/1/L Ph' Jrilrn" n. d PL.0 /.: p 1-1`041-I I 3 ki i i"',PWC 1,6aS f7/ is 44, ✓s v ..,,Co- _ / / t e- P 1 T LD 74. (?/2 -) 17 — i?/lrnvsP P h ,/ AO '! n k /All 14DIoa l�`PdSe �D GFFIr / Discussion With Person in Charge: Corrective Action Required: i ❑ No ❑Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to comply Exclusion with all mandates of the Mass/Federal Food Code. I understand that noncompliance may ❑ Re-inspection Scheduled ❑ Emergency Suspension y result in daily fines of twenty-five dollars or sGlpen ion/rev catio of your food permit. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other • FORM 7348 HOBBS &WARREN - BOSTON t If Violations Related to Foodborne Illness Interventions and Risk 3-501.14(C) PHFS Received at Temperatures Factors(Red Items 1-22) (Cont.) According to Law Cooled to 41*F/45°F Within 4 Hours.* PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFS 14 Food or Color Additives `Y9 PHF Hot and Cold Holding 3-202.12 Additives* 3-501.16(B) Cold PHFS Maintained at or below 3-202.14 Protection from Unapproved Additives* 590.004(F) 41°F/450F* 15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFS Maintained at or above 7-101.11 Identifying Information-Original 140°F.* Containers* 3-501.16(A) Roasts Held at or above 130°F.* 7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control 7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control* 7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement 7-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions* POPULATIONS (HSP) 7-204.11 Sanitizers,Criteria-Chemicals* 1°°21`"` 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals for WashingProduce,Criteria* Beverages Beverages with Warning Labels* 7-204.14 Drying Agents,Criteria* 3-801.11(6) Use of Pasteurized Eggs* 7-205.11 Incidental Food Contact,Lubricants* 3-801.11(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria* Raw Seed Sprouts Not Served.* 7-206.12 Rodent Bait Stations* 3-801.11(C) Unopened Food Package Not Re-served.* 7-206.13 Tracking Powders,Pest Control and Monitoring* CONSUMER ADVISORY 22 3-603.11 Consumer Advisory Posted for Consumption of TIME/TEMPERATURE CONTROLS Animal Foods that are Raw, Undercooked or 16 Proper Cooking Temperatures for not Otherwise Processed to Eliminate PHFS - Pathogens.* Effective 11112001 3-401.1IA(1)(2) Eggs- 155°F 15 Sec. 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* Eggs-Immediate Service 145°F 15 Sec.* 3-401.11(A)(2) Comminuted Fish,Meats&Game SPECIAL REQUIREMENTS Animals- 155°F Sec.* 590.009(A)-(D) Violations of Section 590.009(A)-(D) in 3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 Min.* catering,mobile food,temporary and 3-401.11(A)(2) Ratites,Injected Meats- 155*F 15 Sec.* residential kitchen operations should be 3-401.11(A)(3) Poultry,Wild Game, Stuffed PHFS, debited under the appropriate sections Stuffing Containing Fish,Meat, above if related to foodborne illness Poultry or Ratites- 165°F 15 Sec.* interventions and risk factors. Other 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail 145°F* practices should be debited under#29- 3-401.12 Raw Animal Foods Cooked in a Special Requirements. Microwave 165°F* 3-401.11(A)(1)(b) All Other PHFS- 145°F 15 Sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 17Reheating for Hot Holding (Blue Items 23-30) 3-403.11(A)&(D) PHFS 165°F 15 Sec.* Critical and non-critical violations, which do not relate to the 3-403.11(B) Microwave- 165°F 2 Minute Standing foodborne illness interventions and riskfactors listed above, can be Time* found in the following sections of the Food Code and 105 CMR 3-403.11(C) Commercially Processed RTE Food- 590.00. 140°F* Item Goad Retail Practices FC 590.00 3-403.11(E) Remaining Unsliced Portions of Beef 23. Management and Personnel FC-2 .003 Roasts* 24. Food and Food Protection FC-3 .004 Proper Cooling of PHFs 25. Equipment and Utensils FC-4 .005 3-501.14(A) Cooling Cooked PHFS from 140°F to 26. Water, Plumbing and Waste FC-5 .006 70°F Within 2 Hours and from 70°F 27. Physical Facility FC-6 .007 to 41017/45017 Within 4 Hours.* 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(B) Cooling PHFS Made From Ambient 29. SP ecial Requirements .009 Temperature Ingredients to 41°F/45°F 30. Other Within 4 Hours* *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. .� _.. .. ... _ ...�,ti^c...-.Y >p...y.�...fpv..,r..ayr ..�.,,.-v..---'.,^..n...-......w....---•r+..+y..,�.++�-^+„r.:.--^-✓...o.+•-..r•>;+..•.�....._-r"'---_-•.�- ,., ...-.. _ i . THE COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM Address: 120 Washington Street, 4th Floor BOARD OF HEALTH Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel: (978) 741-1800 Fax: (978) 745-0343 Name Date TvoTlOeration(s) T i n S /Q-a 9�O� Food Service Routine Address Risk ❑ Retail ❑ Re-inspection Z/Q 9 _ Level El Residential Kitchen Previous Inspection Telephone 'w 9y5� ! 366 ❑ Mobile -- Date:t/- Q;2- Owner HACCP Y/N ❑ Temporary ❑ Pre-operation p ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) Time ❑ Bed&Breakfast - ❑ General Complaint In: ❑ HACCP Inspector L1,/1 iivs Out: Permit No. Other ra /, El Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. Local Law ❑ FOOD PROTECTION MANAGEMENTEl2. Prevention Of Contamination from Hands El 1. PIC Assigned/ Knowledgeable i D�ties ,// LJ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 2. Reporting of Diseases by Food Employee and PIC El 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/ Excluded El 15. Toxic Chemicals FOOD FROM APPROVED SOURCE'' ( i TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4. Food and Water from Approved Source / [1 16. Cooking Temperatures ❑ 5. Receiving/Condition yr ❑ 17. Reheating ` ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ El 7. Conformance with Approved Procedures/ HACCP Plans 18. Cooling PROTECTION FROM CONTAMINATION El 19. Hot and Cold Holding---*' ❑ 20. Time as a Public Health Control a]/8. Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) CZ 9. Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate Handwashing El21. Food and Food Preparation for HSP CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories f r Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related Items) Critical (C) violations marked must be corrected [Official To Foodborne Illnesses Interventions 3 immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1-22): of Health. Non-critical (N) violations must be corrected Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/Federal Food Code.This report, when signed below C N by a Board of Health member or agent constitutes an 23. Management and Personnel (FC-2)(590.003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of Ll 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (F6-5)(590.006) establishment operations. If aggrieved by this order, you ✓ 27. Physical Facility (FC-6)(590.007) have a right to a hearing.Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: Inspector's Signatu '}y) / Print: 1611 1 PIC's Signature: �/�/�/ /N Printf E� �• page!of 4 Pages fl O l J FORM 734A HOBBSa WARREN -BOSTON r Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) PROTECTION FROM CONTAMINATION -8 Cross-contamination FOOD PROTECTION MANAGEMENT 3-302.11(A)(1) Raw Animal Foods Separated from I. 590.003(A) Assignment of Responsibility* Cooked and RTE Foods* 590.003(B) Demonstration of Knowledge* Contamination from Raw Ingredients 2-103.11 Person in Charge-Duties 3-302.11(A)(2) Raw Animal Foods Separated from Each Other* EMPLOYEE HEALTH Contamination from the Environment 2:r 590.003(C) Responsibility of the Person in Charge to 3-302.11(A) Food Protection* require reporting by Food Employees and 3-302.15 Washing Fruits and Vegetables Applicants 3.304.11 Food Contact with Equipment and 590.003(F) Responsibility of a Food Employee or an Utensils* Applicant to Report to the Person in Charge* Contamination from the Consumer 3-306.14(A)(B) Returned Food and Reservice of Food* 590.003(G) Reporting by Person in Charge* Disposition of Adulterated or Contaminated '3 590.003(D) Exclusions and Restrictions* Food 590.003(E) Removal of Exclusions and Restrictions 3-701.11 Discarding or Reconditioning Unsafe Food* FOOD FROM APPROVED SOURCE 9 Food Contact Surfaces 4,.45.. Food and Water From Regulated Sources 4-501.111 Manual Warewashing-Hot Water 590.004(A-B) Compliance with Food Law* Sanitization Temperatures* 3-201.12 Food in a Hermetically Sealed Container* 4-501.112 Mechanical Warewashing-Hot Water 3-201.13 Fluid Milk and Milk Products* Sanitization Temperatures* 3-202.13 Shell Eggs* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.14 Eggs and Milk Products,Pasteurized* Concentration and Hardness* 3-202.16 Ice Made from Potable Drinking Water* 4-601.11(A) Equipment Food Contact Surfaces and 5-101.11 Drinking Water from an Approved System* Utensils Clean* 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Equipment Food- 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces and Utensils* Shellfish and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils and 3.201.14 Fish and Recreationally caught Molluscan Food Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization- Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* DL Proper,Adequate Handwashing Game and Wild Mushrooms Approved by Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 2-301.12 Cleaning Procedure* 3.202.18 Shellstock Identification Present* 2-301.14 When to Wash* 590.004(C) Wild Mushrooms* 11 Good Hygienic Practices 3-201.17 Game Animals* 2-401.11 Eating, Drinking or Using Tobacco* 5 Receiving/Condition 2-401.12 Discharges From the Eyes,Nose and 3-202.11 PHFs Received at Proper Temperatures* Mouth* 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from 3-202.18 Shellstock Identification* Employees* 3-203.12 Shellstock Identification Maintained* 13 Handwash Facilities Tags/Records: Fish Products Conveniently Located and Accessible 3-402.11 Parasite Destruction* 5-203.11 Numbers and Capacities* 3-402.12 Records,Creation and Retention* 5-204.11 Location and Placement* 590.004(1) Labeling of Ingredients* 5-205.11 Accessibility, Operation and Maintenance 7r: Conformance with Approved Procedures Supplied with Soap and Hand Drying /HACCP Plans Devices 3-502.11 Specialized Processing Methods* 6-301.11 Handwashing Cleanser,Availability 3-502.12 Reduced Oxygen Packaging,Criteria* 6-301.12 Hand Drying Provision 8-103.12 Conformance with Approved Procedures* "Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. CITY OF SALEM *� BOARD OF HEALTH Establishment Name: &/q.i -e4/I76b5 14,1905 Date: /4-,.79-Dgz Page: of .rel L Item Code , C-Critical I)em DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date No. Referenced "R-,Red Item, -. --^,-,»--. .; c PLEASE PRINT CLEARLY m ,.R Verified' r lY1Y/ 7- 7Z17 e / i S/!o i d UD// .(//Y/ 4z- i .✓n /'iJi/,� P / it/BiJ- di1S -OS//� .5 F 7' /O ..r / O`Z y f" .RQ 0 1 , l7,1C/sf/n /,7z'1z- r / , / p. `�d /.IA.�'[1(IAiK, ,0 n� L1/ d i).P,/v �9f.�• �.7 ,SAD /r?/ 4 - G'7_PPC 'Y ISPL Z P t9/O,P.0 ��Y/US� -.r.1G'! di/O P9 G Z-�/B IWA c/.r je, -Ig,"- ,17z' --Zr ' f v- — L' /n 5 /rl _ ,o "�./ ..vif / .('hzis /cerin/, i P C"Zwi-A, /.� dr � / r 7`� �/ �iric,L.s /VaT P2111eel Discussion With Person in Charge: Corrective Actlotr Required: ❑ No O Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction / violations before the next inspection, to observe all conditions as described, and to comply Exclusion with all mandates of the Mass/Federal Food Code. I understand that noncompliance may Q1 Re-inspection Scheduled LI Emergency Suspension 1 result in daily fines of twenty-five dollars ors en 'on,/rr"eevocatibbnn of your food permit. ❑ Embargo ❑ Emergency Closure t6e " "— '/" - —� _ ❑ Voluntary Disposal ❑ Other F t � FORM 7348 HOBBB &WARREN - BOSTON R � Violations Related to Foodborne Illness Interventions and Risk 3-501.14(C) Received at Temperatures Acco Factors(Red Items 1-22) (Cont.) According to Law Cooled to 41°F/45°17 Within 4 Hours.* PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs ,-i Food or Color Additives 19 PHF Hot and Cold Holding 3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below 3-202.14 Protection from Unapproved Additives* 590.004(F) 41°F/45°F* Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above 7-101.11 Identifying Information-Original 140°F.* Containers* 3-501.16(A) Roasts Held at or above 130°F.* 7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control 7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control* 7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement 7-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions* POPULATIONS(HSP) 7-204.11 Sanitizers,Criteria-Chemicals* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals for Washing Produce,Criteria* Beverages with Warning Labels* 7-204.14 Drving Agents,Criteria* 3-80L11(B) Use of Pasteurized E s* 7-205.11 Incidental Food Contact,Lubricants* 3-801.1 I(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria* Raw Seed Sprouts Not Served.* 7-206.12 Rodent Bait Stations* 3-801.11(C) Unopened Food Package Not Re-served.* 7-206.13 Tracking Powders,Pest Control and Monitoring* CONSUMER ADVISORY 22 3-603.11 Consumer Advisory Posted for Consumption of TIMEfTEMPERATURE CONTROLS Animal Foods that are Raw,Undercooked or `16 Proper Cooking Temperatures for not Otherwise Processed to Eliminate PHFs Pathogens.* Effective 11112001 3-401.11 A(1)(2) Eggs- 155°F 15 Sec. 3-302.13 1 Pasteurized Eggs Substitute for Raw Shell Eggs* Eggs-Immediate Service 145°F 15 Sec.* 3-401.11(A)(2) Comminuted Fish,Meats&Game SPECIAL REQUIREMENTS Animals- 155°F Sec.* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 Min.* catering,mobile food,temporary and 3-401.11(A)(2) Ratites,Injected Meats- 155°F 15 Sec.* residential kitchen operations should be 3-401.11(A)(3) Poultry,Wild Game, Stuffed PHFs, debited under the appropriate sections Stuffing Containing Fish,Meat, above if related to foodborne illness Poultry or Ratites- 165°F 15 Sec.* interventions and risk factors. Other 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail 145°F* practices should be debited under#29- 3-401.12 Raw Animal Foods Cooked in a Special Requirements. Microwave 165°F* 3-401.11(A)(1)(b) All Other PHFs- 145°F 15 Sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES LIT Reheating for Hot Holding (Blue Items 23-30) 3-403.1 l(A)&(D) PHFs 165°F 15 Sec.* Critical and non-critical violations, which do not relate to the 3-403.1 l(B) Microwave- 165°F 2 Minute Standing foodborne illness interventions and risk factors listed above, can be Time* found in the following sections of the Food Code and 105 CMR 3-403.11(C) Commercially Processed RTE Food- 590.00. 140°F* Item Good Retail Practices FC 590.00 3-403.11(E) Remaining Unsliced Portions of Beef 23. Management and Personnel FC-2 .003 Roasts* 24. Food and Food Protection FC-3 .004 18 Proper Cooling of PHFs 25. Equipment and Utensils FC-4 .005 3-501.14(A) Cooling Cooked PHFs from 140°F to 26. Water, Plumbing and Waste FC-5 .006 70°F Within 2 Hours and from 70°F 27. Physical Facility FC-6 .007 to 41017/457 Within 4 Hours.* 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(B) Cooling PHFs Made From Ambient29. Special Requirements .009 Temperature Ingredients to 41°F/45°F 30. Other Within 4 Hours* *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. / CITY of SALEM a / BOARD OF HEALTH F . Establishment Name: 6.Bs Date le Page: 3 of 1/ l ltem�, Code `` C-Critical item $ DESCRIPTIONOF VIOLATION / PLAN OF CORRECTION R Date No. Reference R—Red hard _ " 3 ,� PLEA E PRINTnT CLEARLY z _ Verified - lUl Dlkl 'fZJ �� 7YJC�S f C7C ,SCC/ Pct i / 2 /?/(�P C�W/OR iN "7;4o % 2 i /S fit G/,C �n29f k� rJ7 vv G/�tG� rfii t U n t € /3 f ✓ 7—ons — TAiLe� Sia v 'odeePr/ { .rn f — /T eF a✓e - a / 1J? P f f _s �P.0�d/.-✓ ti� , �r�.� dpi 2t �,I//PPP i i7� ya .sds cpc ,� Ale yJ? V) Discussion With Person in Charge: Corrective Action Required: ❑ No ❑Yes have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ f violations before the next inspection, to observe all conditions as described, and to comply Exclusion ;E 41 ❑ Re-inspection Scheduled ❑ Emergency Suspension with all mandates of the Mass/Federal Food Cpd�. I understand that noncompliance may result in daily fines of twenty-five dollars ors suspension/revocation df your food permit. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other i FORM 734B HOBBS &WARREN - BOSTON Violations Related to Foodborne Illness Interventions and Risk 3-501.14(C) PHFs Received at Temperatures Factors(Red Items 1-22) (Cont.) According to Law Cooled to 41*F/45*F Within 4 Hours.* PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs ":14': Food or Color Additives 19 PHF Hot and Cold Holding 3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below 3-202.14 Protection from Unapproved Additives* 590.004(F) 41*F/45°F* 15,; Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above 7-101.11 Identifying Information-Original 140°E* Containers* 3-501.16(A) Roasts Held at or above 130°F.* 7-102.11 Common Name-Working Containers* ':20 Time as a Public Health Control 7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control* 7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement 7-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions* POPULATIONS (HSP) 7-204.11 Sanitizers,Criteria-Chemicals* 2T 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals for Washing Produce,Criteria* Beverages with Warning Labels* 7-204.14 D in A ents,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 7-205.11 Incidental Food Contact,Lubricants* 3-801.11(D) Raw or Partially Cooked Animal Food and r7-206.13 206.11 Restricted Use Pesticides,Criteria* Raw Seed Sprouts Not Served.* 206.12 Rodent Bait Stations* 3-801.11(C) Unopened Food Package Not Re-served.* Tracking Powders,Pest Control and i Monitoring* CONSUMER ADVISORY 22 3-603.11 Consumer Advisory Posted for Consumption of TIMEITEMPERATURE CONTROLS Animal Foods that are Raw,Undercooked or 16 Proper Cooking Temperatures for not Otherwise Processed to Eliminate PHFs Pathogens.* Effective 11112001 3-401.11A(1)(2) Eggs-155'F 15 Sec. 3-302.13 1 Pasteurized Eggs Substitute for Raw Shell Eggs* Eggs-Immediate Service 145'F 15 Sec.* 3-401.11(A)(2) Comminuted Fish, Meats&Game SPECIAL REQUIREMENTS Animals- 155'F Sec.* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 Min.* catering, mobile food,temporary and 3-401.11(A)(2) Ratites,Injected Meats-155'F 15 Sec.* residential kitchen operations should be 3-401.1 l(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections Stuffing Containing Fish,Meat, above if related to foodborne illness Poultry or Ratites- 165'F 15 Sec.* - interventions and risk factors. Other 3-401.1l(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail 145°F* practices should be debited under#29- 3-401.12 Raw Animal Foods Cooked in a Special Requirements. Microwave 165°F* 3-401.11(A)(1)(b) All Other PHFs- 145*F 15 Sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 17 Reheating for Hot Holding (Blue Items 23-30) 3-403.11(A)&(D) PHFs 165'F 15 Sec.* Critical and non-critical violations, which do not relate to the 3-403.11(B) Microwave- 165'F 2 Minute Standing foodborne illness interventions and risk factors listed above, can be Time* found in the following sections of the Food Code and 105 CMR 3-403.11(C) Commercially Processed RTE Food- 590.00. 140°F* Item Good Retail Practices FC 590.00 3-403.11(E) Remaining Unsliced Portions of Beef 23. Management and Personnel FC-2 .003 Roasts* 24. Food and Food Protection FC-3 .004 18;, Proper Cooling of PHFs 25. Equipment and Utensils FC-4 .005 3-501.14(A) Cooling Cooked PHFs from 140'F to 26. Water, Plumbing and Waste FC-5 .006 70'F Within 2 Hours and from 70*F 27. Physical Facility FC-6 .007 to 41'F/45°F Within 4 Hours.* 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(B) Cooling PHFs Made From Ambient 29. Special Requirements .009 Temperature Ingredients to 41'F/45*F 30. Other Within 4 Hours* *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. CITY OF SALEM BOARD OF HEALTH r Establishment Name: PrBr re inDvs i�mS Date: /O- Page: Of Item Code C-Critical item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION tate No. ,Reference, ;R-Red Iterti sem- ` �� Verified w.... m ,__ a t _ _ PLEASE PRIW CLEARLY d P -eZc -AiA i. 7- Loot;re . , ✓ DU C h. 4 ✓ Nnr.� S s4L -A ne ✓ / /o /r /GA9 ✓ �/�c � (Ain : t- .c n.�z t7trii / �2.t1. Discussion With Person in Charge: Corrective ActionRequlredl:T�'❑No ❑Yes t I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ [ violations before the next inspection, to observe all conditions as described, and to comply Exclusion (j with all mandates of the Mass/Federal Food Code? I understand that noncompliance may ❑ Re-inspection Scheduled ❑ Emergency Suspension result in daily fines of twenty-five dollars or su p rasion/revocation, of your food permit. ❑ Embargo ❑ Emergency Closure �` �" ❑ Voluntary Disposal ❑ Other s i FORM 7348 HOBBS &WARREN - BOSTON Violations Related to Foodborne Illness Interventions and Risk 3-501.14(C) PHFs Received at Temperatures Factors(Red Items 1-22) (Cont.) According to Law Cooled to 41°F/45°F Within 4 Hours.* PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14 Food or Color Additives 19 PHF Hot and Cold Holding 3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below 3-202.14 Protection from Unapproved Additives* 590.004(F) 41°F/45°F* F`'15..": Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above 7-101.11 Identifying Information-Original 1400F.* Containers* 3-501.16(A) Roasts Held at or above 130°F.* 7-102.11 Common Name-Working Containers* `20 Time as a Public Health Control 7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control* 7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement 7-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions* POPULATIONS(HSP) 7-204.11 Sanitizers,Criteria-Chemicals* 2L 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals for Washing Produce,Criteria* Beverages with Warning Labels* 7-204.14 Drying Agents,Criteria* 3-801.1 I(B) Use of Pasteurized Eggs* 7-205.11 Incidental Food Contact,Lubricants* 3-801.11(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria* Raw Seed Sprouts Not Served.* 7-206.12 Rodent Bait Stations* 3-801.11(C) Unopened Food Package Not Re-served.* 7-206.13 Tracking Powders,Pest Control and Monitoring* CONSUMER ADVISORY 22 3-603.11 Consumer Advisory Posted for Consumption of TIME/TEMPERATURE CONTROLS Animal Foods that are Raw,Undercooked or 16 Proper Cooking Temperatures for not Otherwise Processed to Eliminate PHFs Pathogens.* Enecle11112111 3-401.11A(1)(2) Eggs- 155°F 15 Sec. 3-302.13 1 Pasteurized Eggs Substitute for Raw Shell Eggs* Eggs-Immediate Service 145°F 15 Sec.* 3-401.11(A)(2) Comminuted Fish,Meats&Game SPECIAL REQUIREMENTS Animals- 155°F Sec.* 590.009(A)-(D) Violations of Section 590.009(A)-(D) in 3-401.1 l(B)(1)(2) Pork and Beef Roast- 130°F 121 Min.* catering, mobile food,temporary and 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 Sec.* residential kitchen operations should be 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections Stuffing Containing Fish,Meat, above if related to foodborne illness Poultry or Ratites- 165°F 15 Sec.* interventions and risk factors. Other 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail 145°F* practices should be debited under#29- 3-401.12 Raw Animal Foods Cooked in a Special Requirements. Microwave 165°F* 3-401.11(A)(1)(b) All Other PHFs- 145°F 15 Sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 17 Reheating for Hot Holding (Blue Items 23.30) 3-403.1 l(A)&(D) PHFs 165*F 15 Sec.* Critical and non-critical violations, which do not relate to the 3-403.11(B) Microwave- 165°F 2 Minute Standing foodborne illness interventions and risk factors listed above, can be Time* found in the following sections of the Food Code and 105 CMR 3-403.11(C) Commercially Processed RTE Food- 590.00. 140°F* Item Good Retail Practices FC 590.00 3-403.11(E) Remaining Unsliced Portions of Beef 23. Management and Personnel FC-2 .003 Roasts* 24. Food and Food Protection FC-3 .004 ?'18 Proper Cooling of PHFs 25. Equipment and Utensils FC-4 .005 3-501.14(A) Cooling Cooked PHFs from 140°F to 26. Water, Plumbing and Waste FC-5 .006 70°F Within 2 Hours and from 70°F 27. Physical Facility FC-6 .007 to 41*F/45°F Within 4 Hours.* 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(B) Cooling PHFs Made From Ambien[ 29. Special Requirements .009 Temperature Ingredients to 41*F/45°F 30. Other Within 4 Hours* *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. -. --�.,-. --�s�-+-.:-.•.•y.-..r .:.q.r1Y•a-Yia.,rnr .a:.....aww.•v,+n--wild-.-._ ....-. e�-ti.. v.,^•+.'.4:.tiaW "'^a-i -N w n" ^y��wxyfw*,r ':.c,--.s r THE COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM Address: 120 Washington Street, 4th Floor BOARD OF HEALTH Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel: (978) 741-1800 Fax: (978) 745-0343 Name �^� DateType of Operation(s) Type of Inspection Y Y ' /� [Food Service Routine Address G/ Risk ❑ Retail Re-inspection Levely/r/} ❑ Residential Kitchen Previous Inspection Telephone r/C ( - ❑ Mobile Date: Owner HACCP Y/N ❑ Temporary [IPre-operation ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) An% // /' Time ❑ Bed 8 Breakfast ❑ General Complaint Inspector "� �-G' CI•/C O El HACCP U/ i' Out: Permit No. El Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. Local Law ❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH ❑ 2. Reporting of Diseases by Food Employee and PIC PROTECTION FROM CHEMICALS El3. Personnel with Infections Restricted/ Excluded E] 14. Approved Food or Color Additives ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) El 16. Cooking Temperatures El 5. Receiving/Condition El 17. Reheating El6. Tags/ Records/Accuracy of Ingredient Statements El7. Conformance with Approved Procedures/ HACCP Plans El 18. Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding El20. Time as a Public Health Control ❑�8. Separation/Segregation/ Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) A9. Food Contact Surfaces Cleaning and Sanitizing ElEl 10. Proper Adequate Handwashing 21• Food and Food Preparation for HSP CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related Items) Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of Health. 590.000/Federal Food Code.This report, when signed below C N by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2)(590.003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing.Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. r 30. Other DATE OF RE-INSPECTION: Inspector's Signature:- Print. / PIC's Signature: Print: Page/of ages FORM 734A HOBBS&WARREN - BOSTON Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) PROTECTION FROM CONTAMINATION 8 Cross-contamination FOOD PROTECTION MANAGEMENT 3-302.11(A)(1) Raw Animal Foods Separated from 590.003(A) Assignment of Responsibility* Cooked and RTE Foods* 590.003(B) Demonstration of Knowledge* Contamination from Raw Ingredients 2-103.11 Person in Char e-Duties 3-302.11(A)(2) Raw Animal Foods Separated from Each Other* EMPLOYEE HEALTH Contamination from the Environment r .; 590.003(C) Responsibility of the Person in Charge to 3-302.1](A) Food Protection* require reporting by Food Employees and 3-302.15 Washing Fruits and Vegetables Applicants 3.304.11 Food Contact with Equipment and 590.003(F) Responsibility of a Food Employee or an Utensils* Applicant to Report to the Person in Charge* Contamination from the Consumer 3-306.14(A)(B) Returned Food and Reservice of Food* 590.003(G) Reporting by Person in Charge* Disposition of Adulterated or Contaminated s.3 590.003(D) Exclusions and Restrictions* Food 590.003(E) Removal of Exclusions and Restrictions 3-701.11 Discarding or Reconditioning Unsafe Food* FOOD FROM APPROVED SOURCE 9 Food Contact Surfaces "4' Food and Water From Regulated Sources 4-501.111 Manual Warewashing-Hot Water 590.004(A-B) Compliance with Food Law* Sanitization Temperatures* 3-201.12 Food in a Hermetically Sealed Container* 4-501.112 Mechanical Warewashing-Hot Water 3-201.13 Fluid Milk and Milk Products* Sanitization Temperatures* 3-202.13 Shell Eggs* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.14 Eggs and Milk Products, Pasteurized* Concentration and Hardness* 3-202.16 Ice Made from Potable Drinking Water* 4-601.1 1(A) Equipment Food Contact Surfaces and 5-101.11 Drinking Water from an Approved System* Utensils Clean* 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Equipment Food- 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces and Utensils* Shellfish and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils and 3.201.14 Fish and Recreationally caught Molluscan Food Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization- Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* +'`1tl" Proper,Adequate Handwashing Game and Wild Mushrooms Approved by Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 2-301.12 Cleaning Procedure* 3.202.18 Shellstock Identification Present* 2-301.14 When to Wash* 590.004(C) Wild Mushrooms* 11 Good Hygienic Practices 3-20].17 Game Animals* 2-401.11 Eating,Drinking or Using Tobacco* 5 Receiving/Condition 2-401.12 Discharges From the Eyes, Nose and 3-202.11 PHFs Received at Proper Temperatures* Mouth* 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-101.11 Food Safe and Unadulterated* ,,12Prevention of Contamination from Hands 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from 3-202.18 Shellstock Identification* Employees* 3-203.12 Shellstock Identification Maintained* 13 Handwash Facilities Tags/Records:Fish Products Conveniently Located and Accessible 3-402.11 Parasite Destruction* 5-203.11 Numbers and Capacities* 3-402.12 Records,Creation and Retention* 5-204.11 Location and Placement* 590.004(J) Labeling of Ingredients* 5-205.11 Accessibility,Operation and Maintenance w7; Conformance with Approved Procedures Supplied with Soap and Hand Drying /HACCP Plans Devices 3-502.11 Specialized Processing Methods* 6-301.11 Handwashing Cleanser,Availability 3-502.12 Reduced Oxygen Packaging,Criteria* 6-301.12 Hand Drying Provision 8-103.12 Conformance with Approved Procedures* *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. i .� CITY OF SALEM i BOARD OF HEALTH ' Establishment Name: " � �� c� `��1 Date: U� Page: of Item Code : C=Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION',, i, f Date , Rate y Red Item - - °� . PLEASE PRINT CLEARLY ? e o- Verified F Sti L7 n� �E �--- i � i Discussion With Person in Charge: Corrective Action Required: ❑ Nod ❑Yes have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ t violations before the next inspection, to observe all conditions as described, and to comply Exclusion with all mandates of the Mass/Federal Food Code. I understand that noncompliance may ❑ Re-inspection Scheduled ❑ Emergency Suspension result in daily fines of twenty-five dollars or suspension/revocation of your food permit. ❑ Embargo ❑ Emergency Closure r .,A ❑ Voluntary Disposal ❑ Other Y FORM 734B HOBBS a WARREN - BOSTON L J' � I Violations Related to Foodborne Illness Interventions and Risk 3-501.14(C) PHFs Received at Temperatures Factors(Red Items 1.22) (Cont.) According to Law Cooled to 41*F/45*F Within 4 Hours.* PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14 Food or Color Additives 19 PHF Hot and Cold Holding 3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below 3-202.14 Protection from Unapproved Additives* 590.004(F) 41°F/45°F* 15'a Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above 7-101.11 Identifying Information-Original 140°F.* Containers* 3-501.16(A) Roasts Held at or above 130°F.* 7-102.11 Common Name-Working Containers* 1c,20'' Time as a Public Health Control 7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control* 7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement 7-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions* POPULATIONS(HSP) 7-204.11 Sanitizers,Criteria-Chemicals* 211, 3-801.1 l(A) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals for WashingProduce,Criteria* Beverages with Warning Labels* 7-204.14 Drying Agents,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 7-205.11 Incidental Food Contact,Lubricants* 3-801.11(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria* Raw Seed Sprouts Not Served.* 7-206.12 Rodent Bait Stations* 3-801.11(C) Unopened Food Package Not Re-served.* 7-206.13 Tracking Powders,Pest Control and Monitoring* CONSUMER ADVISORY 22`' 3-603.11 Consumer Advisory Posted for Consumption of TIME/TEMPERATURE CONTROLS Animal Foods that are Raw,Undercooked or 16Proper Cooking Temperatures for not Otherwise Processed to Eliminate PHFs Pathogens.* Ellecnve 11V2001 3-401.11A(1)(2) Eggs- 155°F 15 Sec. 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* Eggs-Immediate Service 1457 15 Sec.* 3-401.11(A)(2) Comminuted Fish,Meats&Game SPECIAL REQUIREMENTS Animals- 155*F Sec.* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 3-401.11(13)(I)(2) Pork and Beef Roast- 130°F 121 Min.* catering,mobile food,temporary and 3-401.11(A)(2) Ratites,Injected Meats- 155*F 15 Sec.* residential kitchen operations should be 3-401.11(A)(3) Poultry,Wild Game, Stuffed PHFs, debited under the appropriate sections Stuffing Containing Fish,Meat, above if related to foodborne illness Poultry or Ratites- 165°F 15 Sec.* interventions and risk factors. Other 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail 145°F* practices should be debited under#29- 3-401.12 Raw Animal Foods Cooked in a Special Requirements. Microwave 165°F* 3-401.11(A)(1)(b) All Other PHFs- 145°F 15 Sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES Reheating for Hot Holding (Blue Items 23-30) 3-403.11(A)&(D) PHFs 165°F 15 Sec.* Critical and non-critical violations, which do not relate to the 3-403.11(B) Microwave- 165°F 2 Minute Standing foodborne illness interventions and risk factors listed above, can be Time* found in the following sections of the Food Code and 105 CMR 3-403.11(C) Commercially Processed RTE Food- 590.00. 140°F* Item I Good Retail Practices FC 590.00 3-403.11(E) Remaining Unsliced Portions of Beef 23. Management and Personnel FC-2 .003 Roasts* 24. Food and Food Protection FC-3 .004 `18 Proper Cooling of PHFs 25. Equipment and Utensils FC-4 .005 3-501.14(A) Cooling Cooked PHFs from 140*F to 26. Water, Plumbing and Waste FC-5 .006 70*F Within 2 Hours and from 70*F 27. Physical Facility FC-6 .007 to 41*F/45'F Within 4 Hours.* 28. Poisonous or Toxic Materials FC-7 .008 - 3-501.14(8) Cooling PHFs Made From Ambient 29. S ecial Re uirements .009 Temperature Ingredients to 41°F/45°F 30. Other Within 4 Hours* *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Q d CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94, Section 305A and Chapter III, Section 5 of the General Laws, to operate a Food Establishment in the City of Salem is hereby granted to: Owner' s Name : Arthur G. Velonis Name of Establishment : Bob' s Famous Fried Clams Address of Establishment : 429 Highland Avenue Type of Establishment : FOOD SERVICE Application Date : 12/07/2000 Restrictions: Permit for Food Establishment 152-01 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 2001 This permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. q0HEALTH 'AGENT i L , _g CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 2001 APPLICATION FOR PERMIT TO OPERATE A�FOOD ESTABLISHMENT NAME OF ESTABLISHMENT &6 �Q/✓��U/US^I ohm _d L/(�,Q�,/n ' TEL# /Jt- I�4' - 93/i, l/ ADDRESS OF ESTABLISHMENT /029 /�F �U /G/ A)ei MAILING ADDRESS ��(if //different) n OWNER'S NAME />•/7/7L//- CV t/eW�I/S TEL# / 74F 5170 -c;t97 ADDRESS fl/Y1 C CITY-'d6gay'RF STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S) t1fian Z)BI/2l7 CERTIFICATE#(s)020 /camel CMAIV (required in an establishment where potentially hazardous �food /is prepared.) EMERGENCY RESPONSE PERSON(/r (9 U�(110�(.� HOME TEL# �/7i� Y SIO �77 TYPE OF ESTABLISHMENT FEE check only RETAIL STORE YES ®O �0.., RESTAURANT ® NO #seats SA #nonsmoking i5 BED& BREAKFAST YES ® $40 ADDITIONAL PERMITS MAKE ICE CREAM, YOGURT SOFT SERVE YESNO $5 TOBACCO VENDOR YES 10 NO CHARGE FOR NON-PROFIT(suc as church kitchens) PLEASE INCLUDE COPY OF TAX EXEMPT FORM 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. Unowl GL Chapte 62C, Section 49A, I certify under the pains and penalties of perjury that I, to my e a beyf, have filed all state tax returns and paid all state taxes required under the law. '5 8gDate Social Security or Federal Identification Number ----------------------------------------------------- ---------------------------p ----------¢�-moo s� gS Revised 11/21/00 foodap2.adm Check#&Date A, s.�.�+ray.;,Ra,..r,Yb.+,,n,.w.�+,�,�.i+M�+S�SPWG,Ptan,;r16?,i,r,;x-,-:-rr---...M.,s-W✓.Z,.._-wuw,:.-a. .,P:.�.Y-.rcl-tiir.w.�rw.r•"..-�.:y�r T.w ...u..,:�....-:,.-.... ... THE,COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM Address: 9 North Street Board Of Health Salem, MA 01970-3928 FOOD ESTABLISHMENT INSPECTION REPORT Tel: (9781741-1800 Fax: (978) 740-9705 Name c Date r Type of Operation(s) Type of Inspection Aj / ❑ Food Service ❑ Routine Address ( ( ( Risk ❑ Retail ❑ Re-inspection J _ ( ?� VL Level ElResidential Kitchen Previous Inspection Telephone `.J [I Mobile Date: Owner _ El Temporary L1Pre-operation HACCP Y/N ❑ Caterer ❑ Suspect Illness Person in Chhrge(PIC) Time ❑ Bed&Breakfast ❑ General Complaint In: ❑ HACCP Inspector - El Other ' ,L Out: Permit No. Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: RED Violations (1-22) 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. Local Law ❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS . ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4. Food and Water from Approved Source ❑ 16. Cooking Temperatures ❑ 5. Receiving/Condition ❑ 17. Reheating ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 18. Cooling ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 19. Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20. Time As a Public Health Control ❑ 8. Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9. Food Contact Surfaces Cleaning and Sanitizing [121. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories BLUE Violations (23-30) Related to Good Retail Practices Number of Violated Provisions Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions Immediately or within 10 days as determined by the Board and Risk Factors(RED Items 1-22): of Health. Non-critical (N)violations must be corrected immediately or within 90 days as determined by the Board Official Order of Correction: Based on an inspection of Health. today,the items checked indicate violations of 105 CMR C N 590.000/Federal Food Code.This report,when signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of 26. Water, Plumbing and Waste (FC-5)(550.005) the food establishment permit and cessation of food establishment operations. If aggrieved by this order,you 27. Physical Facility (FC-6)(590.007) have a right to a hearing.Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: ssmmwacrca�sia as Inspector's Signa / Print•_ Fly / PIC's Signatu ,. Print: /, ).WdrZ_ Page L of 2Pages Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION AND MANAGEMENT ! 8 Cross-contamination ,1 590.003(A) Assignment of Responsibility* 3-302.11(A)(1) Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge* Cooked and RTE Foods* 2-103.1 t Person in charge-duties Contamination from Raw Ingredients 3-302.11(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other* '2 590.003(C) Responsibility of the person in charge to Contamination from the Environment require reporting by food employees and 3-302.11(A) Food Protection* _ applicants* 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility Of A Food Employee Or An 3-304.11 Food Contact with Equipment and Applicant To Report To The Person In Utensils* Chare* Contamination from the Consumer 590.003(G) Reporting by Person in Charge* 3-306.14(A)(B) Returned Food and Reservice of Food* 3 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003E Removal of Exclusions and Restrictions Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 4 Food and Water From Regulated Sources 9- Food Contact Surfaces 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing- Hot Water 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.16 Ice Made From Potable Drinking Water* concentration and hardness* 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Equipment Food Contact Surfaces and 590.006(A) Bottled Drinking Water* Utensils Clean* 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Equipment Food- Shellfish and Fish From an Approved Source Contact Surfaces and Utensils* 3-201.14 Fish and Recreationally Caught Molluscan 4-702.11 Frequency of Sanitization of Utensilsand Shellfish* Food Contact Surfaces of Equipment* 3-201.15 Molluscan Shellfish From NSSP Listed 4-703.11 Methods of Sanitization -Hot Water and Sources* Chemical* Game and Wild Mushrooms Approved by ! 10 Proper,Adequate Handwashing Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 Game Animals* ]a. Good Hygienic Practices S Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-202.11 PHF, Received at Proper Temperatures* 2-401.12 Discharges from the Eyes,Nose and 3-202.15 Package Integrity* Mouth* 3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When Tasting* 6 Ta s/Records:Shellstock F1_2 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* Employees* Ta s/Records:Fish Products 13 Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located and Accessible 3-402.12 Records Creation and Retention* 5-203.11 Numbers and Capacities* 590.004(J) Labeling of Ingredients' 5-204.11 Location and Placement* � '. Conformance with Approved Procedures 5-205.11 Accessibility,Operation and Maintenance /HACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handwashing Cleanser,Availability 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. r THE COMMONWEALTH OF MASSACHUSETTS Establishment Name /Z� � L� � �� Date Address C/Y "!—lam" 7/� li � �V Page yof L. Item No. In the space below describe all violations checked on front page. Z Z W a 3 ar N m m O 2 M a w n I O a Discussion with Management e THE IMMONWEALTH OF MASSACHUSETTS 'CITY OF SALEM Address: 9 North Street Board of Health Salem, MA 01970-3928 FOOD ESTABLISHMENT INSPECTION REPORT Te: 78 741-1800 Fax: (978) 740-9705 Name ? �j` / Date Type of Operation(s) Type of Inspection j S (� Co // ❑ Food Service ❑ Routine Address Risk L1Retail El Re-inspection/9 174 Af Level ❑ Residential Kitchen Previous Inspection Telephone ❑ Mobile Date: ❑ Temporary ❑ Pre-operation Owner HACCP Y/N ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) - _ </ Time ElBed&Breakfast ElGeneral Complaint ❑ HACCP Inspector In: ❑ Other r Out: Permit No. Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: RED Violations (1-22) 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. I Local Law ❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities r' EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4. Food and Water from Approved Source ❑ 16. Cooking Temperatures ❑ 5. Receiving/Condition ❑ 17. Reheating ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 18. Cooling ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 19. Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20. Time Asa Public Health Control q(1� 8. Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) CpLIL(J�J, 9. Food Contact Surfaces Cleaning and Sanitizing ❑ 21. Food and Food Preparation for HSP 10. Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories BLUE Violations(23-30) Related to Good Retail Practices Number of Violated Provisions Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions Immediately or within 10 days as determined by the Board and Risk Factors(RED Items 1-22): of Health. Non-critical (N)violations must be corrected immediately or within 90 days as determined Eby the Board Official Order of Correction: Based on an inspection of Health. today,the items checked indicate violations of 105 CMR �C N 590.000/Federal Food Code.This report,when signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of 26. Water, Plumbing and Waste (FC-5)(590.006) the food establishment permit and cessation of food establishment operations. If aggrieved by this order,you 27. Physical Facility (FC-6)(590.007) have a right to a hearing.Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(59o.om) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: 5:59JIrrspec -&14 d. Inspector's Signatu : Pri �r'Z PIC's Signatur . Print: / �/O , /� Page/of Pages Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION AND MANAGEMENT 4-8, Cross-contamination 1 590.003(A) Assignment of Responsibility* 3-302.11(A)(1) Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge* Cooked and RTE Foods* 2-103.11 Person in charge-duties Contamination from Raw Ingredients 3-302.11(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other* j 2 590.003(C) Responsibility of the person in charge to Contamination from the Environment require reporting by food employees and 3-302.11(A) Food Protection* applicants* 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility Of A Food Employee Or An 3-304.11 Food Contact with Equipment and Applicant To Report To The Person In Utensils* Charge* Contamination from the Consumer 590.003 G Reporting by Person in Charge* 3-306.14(A)(B) Returned Food and Reservice of Food* 3 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003E Removal of Exclusions and Restrictions Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 4 Food and Water From Regulated Sources ;"9,. Food Contact Surfaces 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.16 Ice Made From Potable Drinking Water* concentration and hardness* 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Equipment Food Contact Surfaces and 590.006(A) Bottled Drinking Water* Utensils Clean* 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Equipment Food- Shellfish and Fish From an Approved Source Contact Surfaces and Utensils* 3-201.14 Fish and Recreationally Caught Molluscan 4-702.11 Frequency of Sanitization of Utensilsand Shellfish* Food Contact Surfaces of Equipment* 3-201.15 Molluscan Shellfish From NSSP Listed 4-703.11 Methods of Sanitization -Hot Water and Sources* Chemical* Game and Wild Mushrooms Approved by '.10 Proper,Adequate Handwashing Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 Game Animals* Good Hygienic Practices 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-202.11 PHFs Received at Proper Temperatures* 2-401.12 Discharges from the Eyes,Nose and 3-202.15 Package Integrity* Mouth* 3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When Tasting* 6 '.. Tags/Records:Shellstock 1112 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* Employees* Ta s/Records:Fish Products 13. Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located and Accessible 3-402.12 Records Creation and Retention* 5-203.11 Numbers and Capacifies* 590.004(J) Labeling of Ingredients* 5-204.11 Location and Placement* 7. Conformance with Approved Procedures 5-205.11 Accessibility, Operation and Maintenance /HACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handwashing Cleanser,Availability 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. THE COMMONWEALTH OF MASSACHUSETTS Establishment Name j� -; Cr7, 75 Date c Address C� J +.; q �� — �� Page of Item No. In the space below describe all violations checked on front page. COW C.A. \ PC �BJ,,-ii_ OM7 Std �S ��i cJc�a\i D ),--, G'1 S S ! > U( v � 6� ��� 17 //;-1 z / z W K C 3 tl tl1 m M O 2 m a w n Z 0 O 4 Discussion with Management v - '"`"�"„"°r'^+•"`�..•+....... '�" ,Cw'/"'^"t��-.w...w*q+�n*w+..�=-vF�-,-.-.+.n.asM�^'w.,...,,w�^'�"x�.y`a+Y.3Jrb/^'+r+:�;.La.•.'4mew+'3«�,.ir••....r•. ......,,.:. , ..;�- A TELE COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM Address: 9 North Street Board of Health Salem, MA 01970-3928 FOOD ESTABLISHMENT INSPECTION REPORT Tel: (978) 741-1800 Fax: (978)740-9705 Name Date Type of Operation(s) Type of Inspection .j,yj ,6 �G/7//Q�/J "-;i� ��jp� © Food S� T ice IPRoutine Address ��079 / /G„d wP RiskIEZ ❑ Retail ❑ Re-inspection /'r/ Level ❑ Residential Kitchen Previous Inspection Telephone � l/3 ❑ Mobile Date: Owner / ElTemporary ElPre-operation rI evr HACCP Y/N ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) ElBed&Breakfast ElGeneral Complaint Time El /hi/l,�Gh Cdd C CP Inspector In. El Other 7�� Out: Permit No. Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: RED Violations (1-22) 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. Local Law ❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additives .. ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15. Toxic.Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4. Food and Water from Approved Source ❑ 16. Cooking Temperatures ❑ 5. Receiving/Condition ❑ 17. Reheating ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 18. Cooling ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 19. Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20. Time As a Public Health Control ❑ 8. Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ❑ 21. Food and Food Preparation for HSP 1:110. Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories BLUE Violations (23-30) Related to Good Retail Practices Number of Violated Provisions Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions Immediately or within 10 days as determined by the Board and Risk Factors(RED Items 1-22): of Health. Non-critical (N)violations must be corrected immediately or within 90 days as determined by the Board Official Order of Correction: Based on an inspection of Health. today,the items checked indicate violations of 105 CMR C N 590.000/Federal Food Code.This report,when signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of 26. Water, Plumbing and Waste (FC-5)(590.006) the food establishment permit and cessation of food establishment operations. If aggrieved by this order,you 27. Physical Facility (FC-6)(590.007) have a right.to a hearing.Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: s:5W� m,6-14 de Inspector's Signature: Print: PIC's Signature: Print: Page / o(,2 Pages Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION AND MANAGEMENT (,.8 Cross-contamination 1 ', 590.003(A) I Assignment of Responsibility* 3-302.11(A)(1) Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge* Cooked and RTE Foods* 2-103.11 Person in charge-duties Contamination from Raw Ingredients 3-302.11(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other* 2'; 590.003(C) Responsibility of the person in charge to Contamination from the Environment require reporting by food employees and 3-302.11(A) Food Protection* applicants* 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility Of A Food Employee Or An 3-304.11 Food Contact with Equipment and Applicant To Report To The Person In Utensils* Charge* Contamination from the Consumer 590.003(G) Reporting by Person in Charge* 3-306.14(A)(B) Returned Food and Reservice of Food* 3' 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003E Removal of Exclusions and Restrictions Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE _ Food* 4 , Food and Water From Regulated Sources =a.9 Food Contact Surfaces 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.16 Ice Made From Potable Drinking Water* concentration and hardness* 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Equipment Food Contact Surfaces and 590.006(A) Bottled Drinking Water* Utensils Clean* 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Equipment Food- Shellfish and Fish From an Approved Source Contact Surfaces and Utensils* 3-201.14 Fish and Recreationally Caught Molluscan 4-702.11 Frequency of Sanitization of Utensilsand Shellfish* Food Contact Surfaces of Equipment* 3-201.15 Molluscan Shellfish From NSSP Listed 4-703.11 Methods of Sanitization-Hot Water and Sources* Chemical* Game and Wild Mushrooms Approved by F 10 Proper,Adequate Handwashing Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 Game Animals* '11 Good Hygienic Practices 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-202.11 PHFs Received at Proper Temperatures* 2-401.12 Discharges from the Eyes,Nose and 3-202.15 Package Integrity* Mouth* 3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When Tasting* 6,z Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* Employees* Ta s/Records:Fish Products 13 Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located and Accessible 3-402.12 Records Creation and Retention* 5-203.11 Numbers and Capacities* 590.004(J) labeling of Ingredients* 5-204.11 Location and Placement* 9 Conformance with Approved Procedures 5-205.11 Accessibility,Operation and Maintenance /HACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handwashing Cleanser,Availability 8-103.12 Conformance with Approved Procedures* 6-301.12 1 Hand Drying Provision *Denotes critical item in the federal 1999 Food Code or 105 CMA 590.000. 'r. .tiA.-.. ..... ;r, ^4' ,�'i ".rN:, rx raved ."4j°„� �!' �. l:'�^'l"AtirAa;^I... FYr'7 ti��..,TM ^+q J1Nv-•. . t .�; THE COMMONWEALTH OF MASSACHUSETTS City of Salem Establishment Name s dui ojif � Q/ ��,�,� Date 15 Address 41079 �/ ��H Q' 'qle. Page '2- of Item No. In the space below describe all violations checked on front page. Ain) ri L C inspection of this establishment was conducted in accordance with the State Sanitary Code for Food Establishments,Cha ter X, 105 CMR 590.000.The followingviolations were observed: J P IT 1, 'ed i e de E z >r .e /r / f r , _ � 0 Discussion with Management 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 Chapter X. I understand that noncompliance may result in daily fines of twenty-five dollars. S` TOy DATE TIME AM P a,is, 6 a ;i�M FROM AREA CODE HP b\7'Q-C/KKC„Vl� N0. O�' OF Na EXT. E''. M FAX a E p 'S cjp�- MEs ° � 'EA n� I1 0 E SIGNE a iPHONED C.&L RUUURNEDE]JI SEEYOVO ❑ WA IN WIU C&L ❑ URGENT❑ ' 'U6Yc N /alo 1713K a ;r CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT - Tel:(978)741-1800 Fax:(978)740-9705 COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94 , Section 305A and Chapter III , Section 5 of the General Laws, to operate a Food Establishment in the City of Salem is hereby granted to: Owner' s Name : Arthur L. Velonis Name of Establishment : Bob' s Famous Fried Clams Address of Establishment : 429 Highland Avenue Type of Establishment : FOOD SERVICE Application Date : 04/12/2000 Restrictions: Permit for Food Establishment 218-00 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 2000 This permit is not transferable and must be reissued upon change of ownership or location. In accordance with the State Sanitary Code, all plans of renovations, improvements, equipment changes must be approved by the Health Department. HEALTH AGENT WED APR 7 2000 CITY OF SALEM BOARD OF HEALTH CITY OF SALEM Salem, Massachusetts 01970-3928 HEALTH DEPT, JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT ,,�" Tel:(978)741-1800 Fax:(978)740-9705 2000 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT &'/h 9 6/Y70vS Z!&f :--d nelAW-4 TEL#�7��f 93(00 ADDRESS OF ESTABLISHMENT `1 Ilf?;/�Wd Ft✓C MAILING ADDRESS (if different) OWNER'S NAME/� 7T L#L ZV I/e-Ioaji-S TEL#9)fl-��o X977 ADDRESS.!!46Wi.)#,n LtwiF Aijbov,L--x 116 CERTIFIED FOOD MANAGER'S NAME(S) �R+tti l Jc,eJ41 CERTIFICATE#(s)AoKoaao keha'y-1 czpIC It;) (required in an establishment where potentially hazardous food is prepared.) 97f1-4.7o-fit 77 EMERGENCY RESPONSE PERSONA&hu(L- V,5�"/ s TEL#978-7&4-j5W ESTABLISHMENT'S DAYS &HOURS OF OPERATIONSa,J-Wed )yca-S:va T w.4--lirT TYPE OF ESTABLISHMENT a)9\-06 FEE check only RETAIL STORE YES NO $40 RESTAURANT W NO #seats_ #nonsmoking_ 40 ADDITIONAL PERMITS MAKE FROZEN DESSERTS YES NO $5 TOBACCO VENDOR YES NO $10 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. 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. i - - - -_'--==-Pfirsaant-ai atftehapte -— -- —- — - -- best knowledge and belief, have filed all state tax returns and paid all state taxes required under the law. &o?rco o�-3 50 5 S Signatur Date Social Security or Federal Identification Number ------------ - ---- - - --------------------------------------------------- Revised 10/20/98 foodap2.adm Check#&Date����� ^3v CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tei:(978)741-1800 Fax:(978)740-9705 COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94, Section 305A and Chapter III, Section 5 of the General Laws, to operate a Food Establishment in the City of Salem is hereby granted to: Owner' s Name : Arthur L. Zetes Name of Establishment : Bob' s Famous Fried Clams Address of Establishment : 429 Highland Avenue Type of Establishment : FOOD SERVICE Application Date : 03/15/2000 Restrictions: Permit for Food Establishment 60-00 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 2000 This permit is not transferable and must be reissued upon change of ownership or location. In accordance with the State Sanitary Code, all plans of renovations, improvements, equipment changes must be approved by the Health Department. J _Z7- - - 3FEW MAR 1 4 91VO dtry� CITY OF SALEM HEALTH DEPT. CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 2000 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT E095 6§&&25fkNDftW5EL# ADDRESS OF ESTABLISHMENT /2!4Z47 Apt'. > j MAILING ADDRESS (if different) OWNER'S NAME— ADDRESS I(e 2 /ybRFbL)( � SI r si4—/1A Ds rn CERTIFIED FOOD MANAGER'S NAME(S) F21 kA( rPEVCV E CERTIFICATE#(s);?6962ZO Mlr'i -PrLy- /0! (t 220 2493 (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON <7r— 6T-4--q z �S TEL 0I \Z-)7-2 ESTABLISHMENTS DAYS & HOURS OF OPERATION40� m=LJ8J ll- I�1:'�5 1 1=!J� TYPE OF ESTABLISHMENT r FEE check only RETAIL STORE YES NO �� $40 RESTAURANT ES NO #seats-.!0nonsmoking25— 40 ADDITIONAL PERMITS MAKE FROZEN DESSERTS YES NO $5 TOBACCO VENDOR YES NO $10 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. 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. ��anttovl(3L=-@hapter62C�S-eetion,49A;W-cerEifyx�nder#f�alr�sand�erraHri�nf�pe .-_ —' best knowledge and belief, have filed all state tax returns and paid all state taxes required under the law. ez-WW 2,P Ignature �— at Social Security or Federal Identification Number ---------------------------------------------------------- ---�-t------- ----- -------------------------------------------- Revised 10/20/98 foodap2.adm Check#&Date-:73-----)3J' ��Oy THE,`OMMONWEALTH OF MASSACHUSETTS - . CITY OF SALEM Address: 9 North Street Board Of Health Salem, MA 01970-3928 FOOD ESTABLISHMENT INSPECTION/ REPORT Tel: (978) 741-1800 Fax: (978) 740-9705 Name rJe / �dwn01/1 �/ec �'/ ice Date Type of ODerationlsl Type of Inspection �✓ C7 (! // 2 VFood Service ❑ Routine Address ' b� / f�UP. Risk ❑ Retail 1-Re-inspection Level ❑ Residential Kitchen Previous Inspection Telephone ,1yy_ v3�p� Z'W ❑ Mobile Date: � Owner El Temporary ElPre-operation ��/�,� HACCP Y/N ❑ Caterer ❑ Suspect Illness El Bed&Breakfast El General Complaint Person in Charge(PIC) Time ❑ HACCP Inspector In: ❑ Other Out: Permit No. Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with; RED Violations (1-22) 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. Local Law ❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4. Food and Water from Approved Source ❑ 16. Cooking Temperatures ❑ 5. Receiving/Condition ❑ 17. Reheating ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 18. Cooling ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 19. Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20. Time As a Public Health Control ❑ 8. Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ❑ 21. Food and Food Preparation for HSP E110. Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories BLUE Violations(23-30) Related to Good Retail Practices Number of Violated Provisions Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions Immediately or within 10 days as determined by the Board and Risk Factors(RED Items 1-22): of Health. Non-critical (N)violations must be corrected immediately or within 90 days as determined by the Board Official Order of Correction: Based on an inspection of Health. today,the items checked indicate violations of 105 CMR _C1 N 590.000/Federal Food Code.This report,when signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of 26. Water, Plumbing and Waste (FC-5)(590.006) the food establishment permit and cessation of food establishment operations. If aggrieved by this order,you 27. Physical Facility (FC-6)(590.007) have a right to a hearing.Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(59o.00a) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: SSW/naL'ecWm514.Ox Inspector's Signature: / = Print: PIC's Signature: Print: Page of 1 Pages Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION AND MANAGEMENT ;8 Cross-contamination �1 590.003(A) Assignment of Responsibility* 3-302.11(A)(1) Raw Animal Foods Separated from 520.003(B) Demonstration of Knowledge* Cooked and RTE Foods* 2-103.I 1 Person in charge-duties Contamination from Raw Ingredients 3-302.11(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other* 2 590.003(C) Responsibility of the person in charge to Contamination from the Environment Ivl j require reporting by food employees and 3-302.1 l(A) Food Protection* applicants* 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility Of A Food Employee Or An 3-304.11 Food Contact with Equipment and Applicant To Report To The Person In Utensils* Char e* Contamination from the Consumer 590.003(G) Reporting by Person in Charge* 3-306.14(A)(B) Returned Food and Reservice of Food* 3 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003E Removal of Exclusions and Restrictions Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* E4 Food and Water From Regulated Sources 9- Food Contact Surfaces 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.16 Ice Made From Potable Drinking Water* concentration and hardness* 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Equipment Food Contact Surfaces and 590.006(A) Bottled Drinking Water* Utensils Clean* 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Equipment Food- Shellfish and Fish From an Approved Source Contact Surfaces and Utensils* 3-201.14 Fish and Recreationally Caught Molluscan 4-702.11 Frequency of Sanitization of Utensilsand Shellfish* Food Contact Surfaces of Equipment* 3-201.15 Molluscan Shellfish From NSSP Listed 4-703.11 Methods of Sanitization -Hot Water and Sources* Chemical* Game and Wild Mushrooms Approved by 10 Proper,Adequate Handwashing Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 Game Animals* lI' Good Hygienic Practices 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-202.11 PHFs Received at Proper Temperatures* 2-401.12 Discharges from the Eyes,Nose and 3-202.15 Package Integrity* Mouth* 3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When Tasting* ,-.6 Tags/Records:Shellstock 12- Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* I Employees* Ta s/flecords: Fish Products13 Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located and Accessible 3-402.12 Records Creation and Retention* 5-203.11 Numbers and Capacities* 590.004(7) Labeling of Ingredients" 5-204.11 Location and Placement* E7`'I Conformance with Approved Procedures 5-205.11 Accessibility,Operation and Maintenance /HACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handwashing Cleanser,Availability 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. ., �,h'F�^4:�i' ..k.«snrR`�Fj.�'"9h'�n" „M;k+:w.,r4•i;+c ...'v��rY.?:k�i+.�$'.<:Gr�. , z r • THE COMMONWEALTH OF.MASSACHUSETTS City of Salem Establishment Name /✓Db s ��,oGid Fif'o/ � Date Address S/ac� �� C/ /'dP, Page ,_,z of -? Item No. In the �s-pacee below describe all violations checked on front page. A(n) /`/JWlf Pry///P Age—inspection of this establishment was conducted in accordance with the State Sanitary Code for Food Establishments Chapter X, 105 CMR 590.000.The following violations were observed: aa �S a -/ 04 PN P Discussion with Management 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 Chapter X. I understand that noncompliance may result in daily fines of twenty-five dollars. THE COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM Address: 9 North Street Board of Health Salem MA 01970-3928 FOOD ESTABLISHMENT INSPECTION REPORT Tel: (978) 741-1800 Fax: (978) 740-9705 Name / r Date T e of O eration s Type of Inspection 'O'Zl Food Service Routine Address ���� / / �UP Ris 7) Retail L1 Re-inspection V,797 H/ h W/7a Level ❑ Residential Kitchen Previous Inspection Telephone ❑ Mobile Date: ^/ /Z/ ❑ Temporary ❑ Pre-operation Owner �/r�/fir Ue/U�/� HACCP Y/N 1-1Caterer ❑ Suspect Illness Person in Charge(PIC) Time 1:1 Bed&Breakfast El General Complaint ❑ HACCP Inspector -rSe_ n z In: El Other N/p /„/G Out: Permit No. Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) Violated. Non-compliance with: RED Violations (1-22) 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. Local Law ❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4. Food and Water from Approved Source ❑ 16. Cooking Temperatures ❑ 5. Receiving/Condition ❑ 17. Reheating ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 18. Cooling ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 19. Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20. Time As a Public Health Control ❑ 8. Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) V9. Food Contact Surfaces Cleaning and Sanitizing ❑ 21. Food and Food Preparation for HSP E110. Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories BLUE Violations (23-30) Related to Good Retail Practices Number of Violated Provisions Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions / Immediately or within 10 days as determined by the Board and Risk Factors(RED Items 1-22): of Health. Non-critical (N)violations must be corrected immediately or within 90 days as determined by the Board Official Order of Correction: Based on an inspection of Health. today,the items checked indicate violations of 105 CMR 590.000/1'ederal Food Code.This report,when signed below ' C N. 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590.004) order of the Board of Health.Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of 26. Water, Plumbing and Waste (FC-5)(590.006) the food establishment permit and cessation of food establishment operations. If aggrieved by this order,you 27. Physical Facility (FC-6)(590.007) have a right to a hearing.Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: S:SWln;reclFwm6-14 Ca Inspector's Signature: y Print: / PIC's Signature: Print: Page / or-7 Pages i ,I Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION AND MANAGEMENT 8, Cross-contamination I x 590.003(A) Assignment of Responsibility* 3-302.1 l(A)(1) Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge* Cooked and RTE Foods* 2-103.11 Person in charge-duties Contamination from Raw Ingredients 3-302.11(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other* 2 590.003(C) Responsibility of the person in charge to Contamination from the Environment require reporting by food employees and 3-302.11(A) Food Protection* applicants* 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility Of A Food Employee Or An 3-304.11 Food Contact with Equipment and Applicant To Report To The Person In Utensils* Charge* Contamination from the Consumer 590.003(G) Reporting by Person in Charge* 3-306.14(A)(B) Returned Food and Reservice of Food* L. 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003E Removal of Exclusions and Restrictions Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 4' Food and Water From Regulated Sources 9 " Food Contact Surfaces 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing- Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.16 Ice Made From Potable Drinking Water* concentration and hardness* 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Equipment Food Contact Surfaces and 590.006(A) Bottled Drinking Water* Utensils Clean* 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Equipment Food- Shellfish and Fish From an Approved Source Contact Surfaces and Utensils* 3-201.14 Fish and Recreationally Caught Molluscan 4-702.11 Frequency of Sanitization of Utensilsand Shellfish* Food Contact Surfaces of Equipment* 3-201.15 Molluscan Shellfish From NSSP Listed 4-703.11 Methods of Sanitization-Hot Water and Sources* Chemical* Game and Wild Mushrooms Approved by F,_0 Proper,Adequate Handwashing Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 Game Animals* €11'; Good Hygienic Practices 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-202.11 PHFs Received at Proper Temperatures* 2-401.12 Discharges from the Eyes,Nose and 3-202.15 Package Integrity* Mouth* 3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When Tasting* 6 Tags/Records:Shellstock li 12t Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* Employees* Ta s/Records:Fish Products F13 Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located and Accessible 3-402.12 Records Creation and Retention* 5-203.11 Numbers and Capacities* 590.004(J) Labeling of Ingredients* 5-204.11 Location and Placement* 7; Conformance with Approved Procedures 5-205.11 Accessibility,Operation and Maintenance /HACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handwashing Cleanser,Availability 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. •t... f. ,y "vM'�r�:('t.� ���L+'M�"It y�y _ ^�..M"!rr }..}�,,. I., ..rf ,. THE COMMONWEALTH OF MASSACHUSETTS City of Salem Establishment Name db S �G/�r✓D!/s �i Pad C,/6%/�J4� Date �1701444J Address Z47 ��G �h d ,�jJ�� Page �L of\ Item No. In the space below describe all violations checked on front page. A(n) o,�a!j �Pp�/// !P inspection of this establishment was conducted in accordance with the State SanjtarVCode for Food Establishments,Chapter X, 105 CMR 590.000.The following violations were observed: d ' 49 e14-1 ell 96-4 11 I'll en e S. �k .j +' ..._ P Discussion with Management 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 Chapter X. I understand that noncompliance may result in daily fines of twenty-five dollars. .r+y.Yhr'"�5a,,.... .+.w*/y.e+..s•,H„'�sy'�+*rV7I�.N4tf'�`R'^1'i�17,�''1:wu,,+F`I'7}t'Tvb`d�gM'F'hf"hr'yad" .*"`'T.A,,....Y .. .� ...rn..-.tFryN.RMM'.rr...,y..,. , THE COMMONWEALTH OF MASSACHUSETTS City of Salem BOARD OF HEALTH FOOD ESTABLISHMENT INSPECTION REPORT Establishment Name j n Date y o0 Address Time: In Out �� v Telephone ?/n _ 9366 , Type of Establishment: Purpose: Food Service ❑✓ r�w°a p, Owner's Name Retail Food Routine U _ Residential Kitchen Follow-up Person in Charge 7, Mobile Unit Complaint Temporary Food Service Investigation Inspector's Name Catering Other U Based on an inspection today,the Items checked below indicate the violated provisions of 105 CMR 590.000. Each item is followed by the applicable section of the Massachusetts regulation. Non-critical violations are marked under column"N"and critical violations are marked under column"C". Descriptions of each item appear on the back of this form. Each violation checked requires an explanation on the narrative page(s). This report serves as official notice of violated provisions and official notice to correct said violations. Food N C Sanitary Facilities N C 1. Food Supply .00229. Water Source .015 2. Food Containers .00211' 30. Sewage .016 31. Cross-Connections .017 Food Protection 32. Toilets/Handwashing .018 & ,019 3. PHF Temperatures .00433. Insects/Rodents .021 4. Facilities. Hot 8 Cold Storage .00434. Plumbing .017 5. PHF Re-service .00635. Toilet Rooms .018 6. Spoiled/Damaged Foods .00336. Handwashing Areas 019 7. Food Protected .00337. Garbage/Refuse .020 8. Food Thermometers •00438. Outside Disposal .020 9. Cross Contamination .00539. Outer Openings 021 10. PHFs thawed, cooked i3 cooled .00540. Pesticide/Rodenticide Application 021 11. Food Handling .005 12. Dispensing Utensils .0061Physical Facilities 41. Floors .022 Personnel 42. Walls, Ceiling .022 13. Employee Infections .008 43. Lighting .023 14. Employee Hygiene .009 44. Ventilation .024 15. Employee Clothing .010 45. Dressing Rooms .025 Equipment i Utensils Other 16: , Equipment/Uter)sil Clean E Sanitized .013 46. Toxics .026 17. Food Contact Surfaces .013 47. Premises .027 18. Non-Food Contact Surfaces .013 48. Living Areas .027 19. Food Contact Surfaces Clean .013 49. Linen .027 20. Non-Food Contact Surfaces Clean .013 50. Pets .027 21. Wiping Cloths .013 51. Bulk Foods .031 22. Dish/Warewashing Facilities .013 52. Salad Bars 032 23, Pre-Scraped. Soaked .013 24. Wash/Rinse Water .013 No. of 13 Critical Items Violated 25, Thermometers/Test Kits .013 These items require immediate attention. 26. Equipment/Utensil Storage .014 27. Single Service Articles ,014 Received by: Inspected b i 28. Single Service Re-Use 012 X SMOKING LAW COMPLIANCEYES_NO_NA Reinspection of Critical Items FORM 7MA a Hoees s WARREN'" CHOKE SAVER COMPLIANCE_YES_NO_NA Reinspection of Noncritical Items THE COMMONWEALTH OF MASSACHUSETTS City of Salem Establishment Name / Date Address Page ? of a Item No. In the space below describe all violations checked on front page. A(n) we,— a,.-.-�, ,/g,/ inspection of this establishment was conducted in accordance with the State Sanitary Code for Food Establishments,Chapter X, 105 CMR 590.000.The following violations were observed: Sc.P.o�.0 .E C,L w.' LIT7(L�.S• / % /= mac' .rl a./nI ✓ 42 4z Discussion with Management 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 Chapter X. I understand that noncompliance may result in daily fines of twenty-five dollars. �v nr,,, �„V�'�f1'r•�6�,'q,��"'(h`+^,.R+-"e(A.h-,-�w,r.��,'�+I���'�Ai.�jqA"'qr,,.�{'f4y��w.,:�tt4.�•,r.11t'"p.'�"r"'-l ,r,.�,,. • THE COMMONWEALTH OF MASSACHUSETTS City of Salem Establishment NameDate I�(� Address z �1 Page of A 4W 11i la-id AveH .,2, Item No. In the space below describe all violations checked on front page.n� Ain) r Ge.� D-1 /'/aa S 1pspacfioa of this establishment was conducted inaccordance with the State SanitaryCode for Food Establishments,Chapter X, 105 CMR 590.000.The followin 'c Latier//�we�e observed: r 7 /7e P /a CL,a A,*, ek,d O r NA2,o-& Y � e.vi et ✓BQ u),otl Aiief swloac O v �2 7"�r✓Y70vxl�P✓ Gf 40 P S O 2 r fv ie Olc� M. ooem4 s°F tlot)jer ly Pldeenq! Lmt-k, 1- �lua r Jor -fa wa 7. r G/-e/ c P Aye arr �ih� 5� u /fav io. e H J 0 won Or 'r 5 ' ,5 I o G o Play f du led. / , -_5Olues/ O esf S vi 5 s u e an a.s of C'Csl; . U 1i ✓ X10 k5 v re-s �D U A-tt•-r Discussion with Management I have read this report,have had the opportunity to ask questions and agree to c=W=Pa q-gfnre th neM incnectLn,t6 observe all conditions as described,and to comply with all mandates of Chapter X. I understand that noricomplianc7may result in daily fines of twenty-five dollars. i h 3 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Fax:(508)740-9705 MEMORANDUM Date: 3-/7-D O To: /�a-cld 13!'�/Ce Lice r /meq / `e,d C,Gia,� t From: J . S6aH- i RE: ��65 /Ya Ar -Cw,- y,e jour;s 1;lq Al e•-7 �a /-e CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fm:(978)740-9705 COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94, Section 305A and Chapter III , Section 5 of the General Laws, to operate a Food Establishment in the City of Salem is hereby granted to: Owner' s Name : Arthur L. Zetes Name of Establishment : Bob' s Famous Fried Clams Address of Establishment : 429 Highland Avenue Type of Establishment : FOOD SERVICE Application Date : 12/10/98 Restrictions: Permit for Establishment 3-99 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 1999 This permit is not transferable and must be reissued upon change of ownership or location. In accordance with the State Sanitary Code, all plans of renovations, improvements, equipment changes must be approved by the Health Department. HEALTH AGENT 3 Ire DEC 71996 CITY OF SALEM BOARD OF HEALTH Ci TTY OF SALEM Salem, Massachusetts 01970-3928 HEALTH DEPT. JOANNE SCOTT, MPH, RS,CHO - Q(� NINE NORTH STREET HEALTH AGENT / / Tel:(978)741-1800 Fax:(978)740.9705 1999 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT BfJBS [r'h=113 FR/ED e[�JTEL ADDRESS OF ESTABLISHMENT �Z4 1� /0,7 Pt C//rusVe MAILING ADDRESS (if different) OWNER'S NAME L- Ave, TEL#_ZIII"892 ZSr]Z ADDRESS 11o7 dI g1-eLLe;C_e'YdYNPSC���14-���� 7 CERTIFIED FOOD MANAGER'S NAME(S)ct b&0 7tV L ���5 CERTIFICF.TE#(s),/QZ_JQVQ (required in an establishment where potentially hazardous food is prepared.) EMERGENCYyRESPONSE,PERSON �I— ,'�o �( L ( �S TEL#�����Z I t ESTABLISHMENT'S DAYS & HOURS OF OPERATION St1 fix/_ TYPE OF ESTABLISHMENT FEE check only RETAIL. STORE YES NO $40 RESTAURANT NO #seats,00 nonsmoking 540 ADDITIONAL PERMITS MAKE FROZEN DESSERTS YES NO $5 TOBACCO VENDOR YES NO $10 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. 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 'hat I, to my best knowledge a—ndd belief, have filed all state to r turns and paid all state taxes required under the law. -274 21110,Signature Date Social Security or Federal ldentifiEbVbri Number ----------- --------- -------'-/----p---------------------- ------ Revised 10/20/98 foodap2.adm Check#&Date r I e ,... L.r ie.�....... ...r...r ,,r._�✓i.�4a'r..,nlrl'T1M'..li.. Y"' /Y ^r. {ti..ln... r..�t+rw.i r -thM1�FT } "'� Sr THE COMMONWEALTH OF MASSACHUSETTS City of Salem BOARD OF HEALTH FOOD ESTABLISHMENT INSPECTION REPORT Establishment Name S /Q/ owu< �p� ��CJ/j1�d Date///�7p*/_ Address Y�9 /j�Gfj r6 ,0e. Time: In �Out Telephone r/r/5/ 9.3�� ' Type of Establishment: Purpose: Owner s Name ��ui' �C PS Food Service Routine Retail Food Residential Kitchen f=ollow-up iN PersoEinCharge 'I'/G//7 �Pd�//y �.r� /h�li Mobile Unit ComplaintTemporary Food Service InvestigationInspeame �SC �, /G/z Catering d. Othe, ❑ Based on an Inspection today,the Items checked below indicate the violated provisions of 105 CMR 590.000. Each item is followed by the applicable section of the Massachusetts regulation. Non-critical violations are marked under column"N"and critical violations are marked under column"C'. Descriptions of each Item appear on the back of this form. Each violation checked requires an explanation on the narrative page(s).. This report serves as official notice of violated provisions and official notice to correct said violations. Food 8 C Sanitary Facilities N C 1. Food Supply .002 29, Water Source .015 2. Food Containers .002 30. Sewage 016 31. Cross-Connections 017 Food Protection 32. Toilets/Handwashing 018 8 .019 3. PHF Temperatures .004 33, Insects/Rodents .021 4. Facilities. Hot d Cold Storage .004 34, Plumbing .017 S. PHF Re-service .006 <ID Toilet Rooms .018 & Spoiled/Damaged Foods .003 36. Handwashing Areas .019 7. Food Protected .003 37. Garbage/Refuse 020 <JCP Food Thermometers .004 38. , Outside Disposal .020 9. Cross Contamination .005 39. Outer Openings .021 10. PHFs thawed, cooked b cooled .005 40. Pesticide/Rodenticide Application .021 11. Food Handling .005 12. Dispensing Utensils .006 Physical Facilities 41. Floors .022 Personnel 42. Walls, Ceiling .022 13. Employee Infections .008 43. Lighting .023 14. Employee Hygiene .009 44, Ventilation .024 15. Employee Clothing .010 45. Dressing Rooms .025 Equipment& Utensils Other 16. Equipment/Utensil Clean 8 Sanitized .013 46. Toxics .026 17. Food Contact Surfaces .013 47. Premises .027 Non-Food Contact Surfaces .013 48. Living Areas .027 Food Contact Surfaces Clean .013 49. Linen .027 20. Non-Food Contact Surfaces Clean .013 50. Pets .027 21. Wiping Cloths •013 51. Bulk Foods .031 22. Dish/Warewashing Facilities .013 52. Salad Bars 032 23, Pre-Scraped, Soaked .013 24. Wash/Rinse Water .013 No. of 13 Critical Items Violated _ 25. Thermometers/Test Kits .013 These items require immediate attention. 26. Equipment/Utensil Storage .014 27. Single Service Articles .014 R cel led by: f n ted by 28. Single Service Re-Use .012 F�i+�L r 0 SMOKING LAW COMPLIANCE--YES-NO-NA Reinspec' n of Critical Items FORM 733A H&w Hoses a WARREN TM CHOKE SAVER COMPLIANCE-YES-NO-NA Reinspection of Noncritical Items � .. . .. . .........i�r..."`i7.n.J".""r.�...^�ei.,M'h,.�-.�YC'!•i^"f`r'�'...e4..v'e�•.n.y. ,� -^�.`w..,-�.w'-: .,q . +. .., -� THE COMMONWEALTH OF MASSACHUSETTS City of Salem / Establishment Name �✓d d s �A/1�/Du 4 "d�l PO ��/hcS Date Address L/ey /fr 71"Iewd /9o/E . Page / of Item No. In the space below describe all violations checked on front page. A(n) inspection of this establishment was conducted in accordance with the State Sanitary Code for Food Establishments,Chapter X, 105 CMR 590.000.The following violations were observed: r e � o � . s d e D e 's G �S / f Prc I. r O P T i Discussion with Management e 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 describ d,an tocomply wi h all mandates of hapter X. I understand that noncompliance may result in daily fines of twenty-five dollars. THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF FOOD ESTABLISHMENT INSPECTION REPORT Establishment Name /� 'S Pd,,�T//J/-l6 Piic'C/ �',,�.jitS� Date Address y 9,5-e �j�f J Time: In Out Telephone -/V//- el2u.101, Type of Establishment: Purpose: n Food Service Routine Owner s Namey�fj`/y �� CS Retail Food Residential Kitchen Follow-up Person in Charge-//d��u• �C,��-s Mobile Unit Complaint Temporary Food Service Investigation Inspector's Name Tase ,0,o e Catering Other Based on an Inspection today,the Items checked below indicate the violated provisions of 105 CMR 590.000. Each item is followed by the applicable section of the Massachusetts regulation. Non-critical violations are marked under column"N"and critical violations are marked under column"C". Descriptions of each item appear on the back of this form. Each violation checked requires an explanation on the narrative page(s). This report serves as official notice of violated provisions and official notice to correct said violations 11 Food III C �-t Sanitary Facilities N C 1. Food Supply .0021 F 29, Water Source .015 2. Food Containers .002 30. Sewage .016 31. Cross-Connections .017 Food Protection 32. Toilets/Handwashing .018 & .019 3. PHF Temperatures .004 33, Insects/Rodents .021 4. Facilities Hot d Cold Storage .004 34. Plumbing .017 5. PHF Re-service .006 35. Toilet Rooms .018 6. Spoiled/Damaged Foods .003 36. Handwashing Areas .019 7. Food Protected .003 37. Garbage/Refuse .020 8. Food Thermometers .006 38. Outside Disposal .020 9. Cross Contamination .005 39. Outer Openings .021 10. PHFs thawed• cooked ii cooled .005 40, pesticide/Rodenticide Application .021 11. Food Handling .005 12. Dispensing Utensils .006 Physical Facilities 41. Floors .022 Personnel 42. Walls, Ceiling .022 13. Employee Infections .008 43. Lighting .023 14. Employee Hygiene .009 44. Ventilation 024 15. Employee Clothing •010 45. Dressing Rooms .025 Equipment i Utensils Other 16. Equipment/Utegsil Clean b Sanitized 013 46. Toxics .026 17. Food Contact Surfaces .013 47. Premises .027 18. Non-Food Contact Surfaces .013 48. Living Areas .027 19. Food Contact Surfaces Clean .013 49. Linen .027 20. Non-Food Contact Surfaces Clean .013 50. Pets .027 21. Wiping Cloths .013 51. Bulk Foods .031 22. Dish/Warewashing Facilities .013 52. Salad Bars .032 23. Pre-Scraped, Soaked .013 24. Wash/Rinse Water .013No. of 13 Critical Items Violated _ 25. Thermometers/Test Kits .013 These items require immediate attention. 26: Equipment/Utensil Storage .014 27. Single Service Articles .014 R ceived by In's ected l y. 28 Single Service Re-Use .012 1 2 - e� �•�� �+�s`I'� SMOKING LAW COMPLIANCE-YES-NO-NA Reinsp)C roof Critical Items FORM 734A H&w Hoess a WARREN"" CHOKE SAVER COMPLIANCE_YES_NONA Reinspection of Noncritical Items FOOD Full Item Descriptions C1 Food Source, approved, wholesale 2 Containers, properly labelled FOOD PROTECTION C3 Potentially hazardous foods at proper temperatures: 140'F or above,45°F or below,OT rapid cooling of cooked foods within 4 hours C4 Facilities to maintain product temperature C5 Unwrapped and potentially hazardous foods not re-served 6. Damaged, spoiled, returned foods segregated 7 Food protected during storage, preparation, display, dispensing, service, transportation 8 Thermometers provided, conspicuous, accurate 9 No cross-contamination 10 Potentially hazardous foods properly thawed, cooked, and cooled 11 Food handling minimized 12 Dispensing utensils stored PERSONNEL 13 Employees with infections restricted C14 Hands washed and clean; good hygienic practices 15 Clean clothes, hair restraints EQUIPMENT & UTENSILS C16 Equipment, utensils sanitized(automatic and manual methods) 17 Food contact surfaces:designed, constructed, installed, maintained, located 18 Non-food contact surfaces:designed, constructed, Installed, maintained, located 19 Food contact surfaces clean, tree of all cleansers 20 Non-food contact surfaces clean, free of all cleansers 2/ Wiping cloths; clean, use restricted 22 Dish/Warewashing facilities: designed, constructed, maintained, installed, located, operated 23 Pre-flushed, scraped, soaked 24 Wash/Rinse water clean, temperature 25 Accurate thermometers, chemical test kits provided; instructions posted 26 Storage, handling of clean equipment/utensils 27 Single service articles, storage, dispensing 28 No reuse of single service articles SANITARY FACILITIES Water source; approved, not a cold under pressure C30 Sewage and waste water disposal C31 No cross-connections, back siphonage, backflow C32 Toilets 8 Handwashing: number, accessible, design, installed C33 No Insects or rodents; harborage prevented 34 Plumbing; installed, maintained 35 Toilet rooms enclosed, self-closing doors, fixtures good repair, clean, signs 36 Handwashing areas supplied with soap and towel dispensers, proper waste receptacles 37 Garbage and refuse: containers covered, adequate number, insect/rodent resistent, frequency, clean 38 Outside area: dumpster covered, construction, clean 39 Outer openings protected 40 Pesticides and rodenticides, proper application PHYSICAL FACILITIES 41 Floors constructed, maintained,'clean 42 Walls, ceiling attached equipment; constructed, maintained, clean 43 Lighting provided as required,fixtures shielded 44 Rooms and equipment vented as required 45 Dressing, locker areas provided, clean OTHER C46 Toxics properly stored, labelled, used 47 Premises litter-free, unnecessary articles, cleaning maintenance equipment property stored. Authorized personnel 48 Living/sleeping quarters and laundry separate 49 Linen properly stored 50 No pets or other large animals except guide dogs 51 Bulk foods stored, labelled, dispensed 52 Salad bar operations prepared, refrigerated, displayed, protected ..a nws i .A-yr,p'jfa,�,,,"tif:.ARn�.-iFa'✓"".r`a•ar v�>� , ,x E.ien�-vr-•PritrW4-.�-::::,,,.>...;Lsa.. THE COMMONWEALTH OF MASSACHUSETTS City of Salem Establishment Name �y,Q�s /�f,S Date Address /�9 ✓/J /G�rl /�ve, Page of -2 Item No. In the space below bbeeelow describe all violations checked on front page. A(n) inspection of this establishment was conducted in accordance with the State Sanitary Code for Food Establishments,Chapter X, 105 CMR 590.000.The following violations were observed: S d Discussion with Management 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 Chapter X. I understand that noncompliance may result in daily fines of twenty-five dollars. - Y y CITY OF SALEM BOARD OF HEALTH Salem,Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Fax:(508)740-9705 COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94, Section 305A and Chapter III, Section 5 of the General Laws, to operate a Food Establishment in the City of Salem is hereby granted to: Owner' s Name: Arthur L. Zetes Name of Establishment : Bob' s Famous Fried Clams Address of Establishment : 429 Highland Avenue Type of Establishment : FOOD SERVICE Application Date: 12/29/97 Restrictions : Permit for Establishment 27-98 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 1998 This permit is not transferable and must be reissued upon change of ownership or location. In accordance with the State Sanitary Code, all plans of renovations, improvements, equipment changes must be approved by the Health Department. HEALTH AGENT DEC 2 2 1997 CITY OF SALEM BOARD OF HEALTH Cl i Y OSALEM Salem, Massachusetts 01970-3928 14h"p1 TLI F) P7, JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fax:(978)740-9705 1998 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT SQ[%L_F,Q ��fJ$ Ce1gP -STEL# 4!7RP-?yV-9 ADDRESS OF ESTABLISHMENT ytz 9 1y/4i 1agd MAILING ADDRESS(if different) OWNER'S NAME � /J /�, Z�/ L 5 _TEL /�`_ �7�� ADDRESS�Gl� /Vi9R /IL�G ) ice, _C� /47!1-01g0 !y�A6 EMERGENCY RESPONSE PERSONSl>�A ,6nt Y_7�' ,��_TEL 4_f3l I -le� I�_p EST'ABLISHMENT'S DAYS 8c HOURS OF OPERATION_5t —Qn //--?_ g S/ TYPE OF ESTABLISHMENT �� / FEE check only' 1 RETAIL STORE YES ' « $40° ` �, , �' "' �� yx (i RBSTAURANT ra ES +NO #Seats' #nohsmokmg '2 g' MOBILE UNIT t 7 YES 4P16se fill out additional foriq $40 a' TEMPORARY YES Please fill out additional form $40 OTHER YES $ ADDITIONAL PERMITS MAKE,FROZEN DESSERTS YES $5 TOBACCO VENDOR YES O $10 q6 #Q,od Please pay total with one check This permit is not transferable and must be reissued upon change of ownership. 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 Health Department. 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 nd p id all state taxes required under the law. /y/7 7 ® Signature Date Social Security or Federal Identification Number foodav'-.adm ' tf%: 13. F a r 'Il z y K yzx.Za'k r CX X r CITY OF:SALEM B ARD'OF.HEALTH Sale^i`, Massachusetts 0197Q3928 .k JOANNE sCOTf,MPH;RS,CHO _ NINE NORTH STREET -.HEALTH AGENTTel:(508)741-1800 - .. - - • . ...Fax:(508)740-9705 COMMONWEALTH OF MASSACHUSETTS PERMIT TO. OPERATE A FOOD ESTABLISHMENT' _ In. accordance with regulations promulgated under authority of Chapter 94, Section305A and Chapter III, Section 5 .of the 'General Laws, to. operate a Food Establishment in the City of Salem is hereby,. granted ,to: Owner' s: Name: Arthur L. Zetes Name of Establishment: Bob' s Famous Fried Clams' Address. of Establishment: 429 Highland .Avenue, Type of Establishment : FOOD SERVICE Application Date: 12/10/96 Restrictions :' Permit for Establishment 32-97 r Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 1997 This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code, all plans of renovations, improvements, equipment changes must be approved by the Health Department. HEALTH AGENT f A � + i I t a1` . �,F- DEC 5 1996 CITY OF SALEM BOARD OF HEALTH ' S DEFT. Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO _ NINE NORTH STREET HEALTH AGENT "` "' Tel:(508)741-1800 Fax:(508)740-9705 1997 APPLICATION FOR PERMIT Tis OPERATE A FOOD ESTABLISHMENT NAMEOF'ESTABLISI-IMENT_ Q RLO�a4RDSTEL# 067 -!1 �6�p ADDRESS OF ESTABLISHMENT X29 �t�LLJICL4- 362:L ILINi:;.ADDRESS(if different) _ T _ OV4ER'S NAME_ �n�- F, z S -- TEL 3 tf. ADDRr'SS__ l� Q �12_�I� EMERGENCY RESPONSE PERSON_ �� y� S 'IFI 4__ I�JiI _ ESTABLISHMENT'S DAYS&HOURS OF OPERATION ft-_ aJ 5-fl—;? _�-AuR TYPE OF FS_ABLLSHME[dT3 oZ FEF, check only I.ETA1L STORE YES NO S40 RESTAURANT C::TS) NO . sects_a i-noasmioking 2,g $d0 ✓ vIUBiLE UNIT TES IVO Please. hll o:;t additional form $40 TE MPORARY YES NO Please till oet additional form $40 OTHER YES 40 ' ' $ ADDITIONAL PERMITS MAKE FROZEN DESSERTS YES 140 $5 !oBACCOVENDOR YES NO $10 _ -rz` . .. 4. . .. 0r Please pay total with one check This permit is not transferabl-and must be reissued upon change of ownership. 1w,hecord'ance with the State Sanitary Code, before any renovations,improvements,or equipment changes are made,all plans for such must be submitted to and approved by the Health Department. Pursuant to MGL Chapter 62C, Section 49A, I certify under the pains and penalties of perjury[hat 1,to my best knowledge and bejief,have filed all state tax returns and paid all state taxes required under the law. YZ Signature Date Social Security or Federal Identificatio7i Number focdep2.adm - 4 6 3 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Fax:(508)740-9705 COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94, Section 305A and Chapter III, Section 5 of the General Laws, to operate a Food Establishment in the City of Salem is hereby granted to: Owner' s Name: Arthur L . Zetes Name of Establishment : Bob' s Famous Fried Clams Address of Establishment : 429 Highland Avenue Type of Establishment : FOOD SERVICE Application Date : 11/16/95 Restrictions : Permit for Establishment 20-96 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 1996 HEALTH AGENT ux NOV 14 1995 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Fax:(508)740-9705 1996 APPLICATION FOR PERMIT TO OPERATE�7A FOOD ESTABLISHMMENTT NAME OF ESTABLISHMENT D�9$� ftys �l?I E4-74,7n/ D1�1�jTEL �L ADDRESS OF ESTABLISHMENT 9 �/ ! 4,7nI74VL� �K%YY) MAILING ADDRESS(if different) OWNER'S NAME 5 TEL ADDRESS�l �/�/—'D Ave! �GC�19V3LkJc�/ I1 EMERGENCY RESPONSE PERSON! j rF `l� TEL# 5a/iy1G' m- n the TYPEAOFSTOR BLISHMENT ? NO ��eats�1 #nonsmokin K FEE check only ^ SAIL STORE � YES NO n � y .... $ RET a, $25 .. T U ® T gZ MOBILE UNIT YES NO Please fill out additional form $25 TEMPORARY YES NO Please fill out additional form $25 OTHER YES NO $ ADDITIONAL PERMITS FROZEN DESSERTS YES NO $5 TOBACCO VENDOR YES NO $10 1 Please pay total ,V:tL one check This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,all plans of renovations, improvements,equipment changes must be approved by the Health Department. 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. Signature Date Social Security or Federal Identificatio Number foodap.edm i ",�t�CLEAN SWEEP w t North and South h Specializing in Hood & Duct Cleaning LI 635 Willow Street • South Yarmouth, MA 02664 • (508) 394-8322 Name CL 7M P Date �t ,c)rt / 7 i/ 19 j j MAR 22 1999 Address F/I fe j e Cast. Or No. CITY OF SALEM R 7' , u 7 HEALTH DEAT, Del. To vY1-IC t 9/r-/- /-/ Via SOLD BY CASH C.O.D. CHARGE ON ACCT. PAID OUT K /�2 tr'J'.!'tJ�t e' t:1•F7 -!'f/ /d�-'o lJ�"Cr /f G�t J'� i!7'� fc'I y'CFlt,'✓ E� hJ�d.fj ,f',..rZc'� pia 2 -& i re1'6"r /n/CG z� Cr TAX �~ TOTAL 2Zvr i All claims and returned goods MUST be accompanied by this bill. Ree'd by BOB'AND XAOLIS FRIEDZ FOOD 00. CLAMS 429 HIGHLAND AVENUE $ALBA. MA 41970.1741 BOB'S FAMOUS FRIED CLAMS BAKED PLATES • SPECIALS Boneless Chicken +Haddock+ Scallops •Shrimp with Baked Potatoes and Cole Slaw SANDWICHES - ROLLS BASKETS PLATES TUNA with French Fries OR Onion Rings CLAM CLAM FRANKFORT SHRIMP SHRIMP HAMBURG SCALLOP SCALLOP CHEESEBURG COMBINATION SEAFOOD SALAD CHICKEN HADDOCK HAMBURGER CHICKEN BITS HADDOCK BITS CHEESEBURGER CLAM FLOUNDER LARGE ROAST BEEF SHRIMP SMELT SMALL ROAST BEEF SCALLOP FISH AND CHIPS (HADDOCK) FRANKFORT HADDOCK CHICKEN (1/2) CHICKEN (BONELESS) HADDOCK BITS BONELESS CHICKEN HADDOCK FLOUNDER (with Bob's Potatoes) GRILLED CHEESE SMELTS CHICKEN BITS BLT Large Ketchup or Tartar Extra HAMBURG (2) CHEESPc. Cheese or Tomato - Extra ROAST BEEF {2} ROAST BEEF CONTAINERS FLAVOR CRISP CHICKEN SIDE ORDERS Halt Pint Pint Quart 9 Pcs. 15 Pcs. 21 Pcs. COLESLAW CLAMS 1 PIECE CHICKEN Cup 1/2 Pint Pint SHRIMP 1/2 CHICKEN BREAST CLAM CHOWDER SCALLOP PIECE HADDOCK- 1/2 LB. 1/2 Pint Pint Quart HADDOCK BITS 1 LB. HADDOCK GREEKSALAD CHICKEN BITS 1 LB. FLOUNDER Small & Large BABY SHRIMP 1 LB. SMELTS SOUPS FRENCH FRIES 1/2 BONELESS BREAST Minestrone Chicken ONION RINGS ALL DAY SPECIALS BOB'S DRINKS Includes French Fries& Cole Slaw FAMOUS FRIED CLAMS CHIPS, ETC. BAKED HADDOCK MILK SHAKES BAKED SCALLOPS 429 HIGHLAND AVENUE FRAPPES BAKED CHICKEN BITS SALEM, MA 01970 MILK FRIED SCALLOPS ROUTE 107 NORTH TEA FRIED JUNIOR CLAM COFFEE FRIED FLOUNDER (978) 744-9366 HOT CHOCOLATE FRIED HADDOCK BITS ORDERS TO GO SOFT DRINKS FRIED CHICKEN BITSICE CREAM CUPS FRIED BABY SHRIMP SUNDAY thru WEDNESDAY FRIED SMELTS 11:00 a.m. to 8:00 P.M. PLUS 5%STATE MEAL TAX FRIED CLAM STRIPS THURSDAY,FRIDAY,SATURDAY 11:00 a.m.to 9:00 P.m. I —_ ce i e 1� unrt --� J eK_ Tsk __ jvuC�in �T dL�r Unde uve IZtI _l� toN wrap 5—/ Sur wic4 nl+ - - til - -- - J— nr o� —7i —`:`'7 �� rw I � � i i I I � III ' _ I v , I BOB 'S FAMOUS FRIED CLAMS BAKED PLATES • SPECIALS Boneless Chicken •Haddock•Scallops •Shrimp with Baked Potatoes and Cole Slaw SANDWICHES - ROLLS BASKETS PLATES TUNA with French Fries OR Onion Rings CLAM CLAM FRANKFORT SHRIMP SHRIMP HAMBURG SCALLOP SCALLOP CHEESEBURG COMBINATION SEAFOOD SALAD CHICKEN HADDOCK HAMBURGER CHICKEN BITS HADDOCK BITS CHEESEBURGER CLAM FLOUNDER LARGE ROAST BEEF SHRIMP SMELT SMALL ROAST BEEF SCALLOP FISH AND CHIPS (HADDOCK) FRANKFORT HADDOCK CHICKEN (1/2) CHICKEN (BONELESS) HADDOCK BITS BONELESS CHICKEN HADDOCK FLOUNDER (with Bob's Potatoes) GRILLED CHEESE SMELTS CHICKEN BITS BLT Large Ketchup or Tartar Extra HAMBURG (2) PC. Cheese or Tomato - Extra CHEESEBURG (2) ROAST BEEF CONTAINERS FLAVOR CRISP CHICKEN SIDE ORDERS Half Pint Pint Quart 9 PCs. 15 PCs. 21 PCs. COLESLAW CLAMS 1 PIECE CHICKEN Cup 1/2 Pint Pint SHRIMP 1/2 CHICKEN BREAST CLAM CHOWDER SCALLOP PIECE HADDOCK - 1/2 LB. 1/2 Pint Pint Quart HADDOCK BITS 1 LB. HADDOCK GREEK SALAD CHICKEN BITS 1 LB. FLOUNDER Small & Large BABY SHRIMP 1 LB. SMELTS SOUPS FRENCH FRIES 1/2 BONELESS BREAST Minestrone Chicken ONION RINGS ALL DAY SPECIALS BOB'S DRINKS Includes French Fries& Cole Slaw FAMOUS FRIED CLAMS CHIPS, ETC. BAKED HADDOCK MILK SHAKES BAKED SCALLOPS 429 HIGHLAND AVENUE FRAPPES BAKED CHICKEN BITS SALEM, MA 01970 MILK FRIED SCALLOPS ROUTE 107 NORTH TEA FRIED JUNIOR CLAM COFFEE FRIED FLOUNDER (978) 744-9366 HOT CHOCOLATE FRIED HADDOCK BITS ORDERS TO GO SOFT DRINKS FRIED CHICKEN BITS SUNDAY thru WEDNESDAY ICE CREAM CUPS FRIED BABY SHRIMP FRIED SMELTS 11:00 a.m. to 8:00 p.m. PLUS 5%STATE MEAL TAX FRIED CLAM STRIPS THURSDAY,FRIDAY,SATURDAY 11:00 a.m.to 9:00 p.m. pi THE COMMONWEALTH OF MASSACHUSETTS TOM OR CITY OF SALEM HEALTH DEPARTMENT - 9 NORTH STREET SALEM, 10,33. 02970 FOOD ESTABLISHMENT INSPECTION REPORT Establishment Name "013 /, 0 S Date _l06 91 Address apq Zba.W11,0 Timer In �3 Out Telephone Type of Establishment: Purpose: Owner s Name Food Service Routine Retail Food Fallow-up ResiPerson in Cha Mobile obilUnit nit Kitchen V Complaint Temporary Food Service Investigation inspector's Name y lffacz Catering Other Based on an inspection today, the items checked below indicate the violated provisions of 105 CMR 590.000. Each item is followed by the applicable section of the Massachusetts regulation. Non-critical violations are marked under column"N"and critical violations are marked under column"C". Descriptions of each item appear on the back of this form. Each violation checked requires an explanation on the narrative page(s). This report serves as official notice of violated provisions and official notice to correct said violations. Food NC Sanitary Facilities N C 1. Food Supply .002 29, Water Source 015 2, Food Containers .002 30, Sewage 016 31. Cross-Connections 017 Food Protection 32. Toilets/Handwashing .018 $ .019 3. PHF Temperatures .004 33. Insects/Rodents -021 4. Facilities. Hot $ Cold Storage .004 Plumbing .017 5. PHF Re-service .006 Toilet Rooms .018 6. Spoiled/Damaged Foods .003 Handwashing Areas .019 Food Protected .003 37, Garbage/Refuse .020 8 Food Thermometers .004 38. Outside Disposal .020 9. Cross Contamination .005 39. Outer Openings 021 10. PHF's thawed, cooked $ cooled .005 40, Pesticide/Rodenticide Application 021 11. Food Handling .005 12. Dispensing Utensils .006 Physical Facilities 41. Floors .022 Personnel 42. Walls, Ceiling -022 13. Employee Infections .008 43, Lighting .023 14. Employee Hygiene .009 44. Ventilation .024 15. Employee Clothing .010 45. Dressing Rooms .025 uipment& Utensils Other i Equipment/Utensil Clean $ Sanitized .013 46. Toxics .026 17 Food Contact Surfaces .013 47. Premises .027 18. Non-Food Contact Surfaces .013 4g, Living Areas .027 19. Food Contact Surfaces Clean .013 49. Linen .027 20. Non-Food Contact Surfaces Clean .013 50. Pets .027 r • 21. Wiping Cloths .013 51, Bulk Foods .031 22. Dish/Warewashing Facilities .013 52. Salad Bars .032 23. Pre-Scraped, Soaked .013 24. Wash/Rinse Water .013 No. of 13 Critical Items Violated 25. Thermometers/Test Kits .013 These items require immediate attention. . 26. Equipment/Utensil Storage .014 A 27. Single Service Articles .014 R eiv y, Inspecte 28 Single Service Re-Use _012 / � . FORM 734A HOBBS&WARREN,INC.1985 l Full Item Descriptions Food C1 Food Source, approved, wholesome , 2 Containers, properly labelled Food Protection C3 .Potentially hazardous foods at proper temperatures: 140OF or above, 45OF or below, OoF; rapid cooling of cooked foods within hours C4 Facilities to maintain product temperature , C5 Unwrapped and potentially hazardous foods not re-served 6 Damaged, spoiled, returned foods segregated 7 Food protected during storage, preparation, display, dispensing, service, transportation 8 Thermometers provided, conspicuous, accurate 9 No cross-contamination 10 Potentially hazardous foods properly thawed, cooked, and cooled 11 Food handling minimized , 12 Dispensing utensils stored Personnel C13 Employees with infections restricted C14 Hands washed and clean; good hygienic practices 15 Clean clothes, hair restraints Equipment & Utensils C16 Equipment; utensils sanitized (automatic and manual methods) 17 Food contact surfaces: design, constructed, installed, maintained, located 18 Non-food contact surfaces: design, constructed, installed, maintained, located 19 Food contact surfaces clean, free of all cleansers 20 Non-food contact surfaces clean, free. of all cleansers 21 Wiping cloths; clean, use restricted , 22 Dish/Warewashing facilities: designed, constructed, maintained, installed, located, operated 23 Pre-flushed, scraped, soaked I 24 Wash/Rinse water clean, temperature 25 Accurate thermometers, chemical test kits provided; instructions posted 26 Storage, handling of clean equipment/utensils 27 Single service articles, storage, dispensing 28 No re-use of single service articles Sanitary Facilities C29 Water source; approved, hot&cold under pressure C30 Sewage and waste water disposal C31 No cross-connections, back siphonage, backflow C32 Toilets & Handwashing: number, accessible, design, installed C33 No insects or rodents; harborage prevented 34 Plumbing; installed, maintained 35 Toilet rooms enclosed, self-closing doors, fixtures good repair, clean, signs 36 Handwashing areas supplied with soap and towel dispensers, proper waste receptacles 37 Garbage and refuse: containers covered, adequate number, insect/rodent resistant, frequency, clean 38 Outside area: dumpster covered, construction, clean 39 Outer openings protected 40 Pesticides and rodenticides, proper application Physical Facilities 41 Floors constructed, maintained, clean 42 Walls, ceiling, attached equipment; constructed, maintained, clean 43 Lighting provided as required, fixtures shielded 44 Rooms and equipment vented as required 45 Dressing, locker areas provided used, clean Other C46 Toxics properly stored, labelled, used 47 Premises litter-free, unnecessary articles, cleaning maintenance equipment properly stored. Authorized personnel 48 Living/sleeping quarters and laundry separate 49 Linen properly stored 50,. No pets or other live animrals except-guide'. ogs '' 1 51 Bulk foods stored, labelled, dispensed 52 Salad bar operations prepared, refrigerated, displayed, protected Establishment Name Date Id-11-91 . / 415 Page 2-Of \3 77 r� • /�i On OEM 1Wr/ r ri G i /./rr / w7m,W,MIA 711 ry 0. ,G raf/ • a / / / r .ir - .ii !Oi /�I •i /.I.YZAI . i P / l / � ' _ r. � � AGF [ id r • _ / r .J/// u � s,71c i : ��s ii ���/�►/q� f THE COMMONWEALTH CF MASSACHUSETTS CITY OF SALEM HEALTH DEPARTMENT - 9 NORTH STREET, SALEM, MASS. 01970 Establishment Name Date ,&.35 '�,9mad; ��,i� C�.am s Address qR 9 1/-,��t�� IVO �U� Page 3 of 3 Item No. In the space below describa all violations checked on front page. S /&/ f 6"er 0,f- ddi� A2S r-_13Z- ti MO 07- C&Z-2) (94 '7:9 SE are 2 167v zl�� -air- 't Ceoas'Z- aod gale cl 164 — 2 m ,— m - m 0 m -- A n a Discussion with Management ,1 Y � i � 7 fi �� { O/yp I '1 J�,11V1\ \ ��+..J � j�""h,.. �.rl� � V �A/`l� �.l'4K. }.,tom{ I I , I „ I .4 I I I NUMBER FEE THE COMMONWEALTH OF MASSACHUSETTS I 89-95 $25.00 City of Salem I I Board of Health of PERMIT TO OPERATE A FOOD ESTABLISHMENT I Permit No. 89-95 Dec. 22 19 94 ` In accordance with Regulations promulgated under authority of Chapter 94,Section 305A and Chapter 111, I Section 5 of the General Laws a Permit is hereby granted to: Bob's Famous Fried Clams Whose place of business is 429 Highland Avenue Type of business and any restrictions Pnnd Service To operate a food establishment in Salem/1 (City or Town) Permit Expires Dec. 31 19 95 Copy Board This Copy To Be Retained By local d^'^.y.lx ,tr of Board of Health Health MPH,RS,CHO FORM 738 Rev.1986 HEALTH AGENT — - — Z .As CITY OF SALEM HEALTH DEPARTMENT BOARD OF HEALTH _. .._ Salem, Massachusetts 01970 ?' ` Application for Permit to Operate a.Food.:Establishpm'e/nt Date Name of Establishment �SO B rS rAvXt)VS FRIED OLA-M5- TELEPHONE# Z!J 5- `� 6 Business Address V y d V Mailing Address(if different) AA Name&Title of Applicant -t1241-1'U1R L,- P7 Address of Applicant Name of Owner(if different froth applicant) If corporation partnershi give name;title&home address of officers.or partners. iiame Title (� Home Address ?TX 9 r P P so YK e' State of. Name&Address Incorporation of Local Agent 6 7 7 Z Emergency Response Person: Name D' `HT:-bO zEi` S Home Phone Type of Establishment Fee Duration of Permit Amount To Be Paid Retail Food F1 Annual Food Service Caterer ❑ Temporary ❑ Mobile Food* ❑ Residential ❑ Seasonal ❑ TOTAL: —� Dates of Operation if not Annual: PAYMENT IS DUE WITH APPLICATION • Applications for mobile food units or pushcarts must include a list of the handwash and toilet facilities available on each route. Attach separate sheet. Additional Information Water Source Sewage Disposal Days & Hours of Operation rnnu ry Nnn..c . ...moo... w , ••• If Restaurant: y Number of Seats -2 Number of Non-Smoking 5 eli" Person Trained in Anti -CChoking Procedures(if 25 scats or ore).' Yes " No SignatuAjoeApplicant Pursuant to M.G.L.Ch.62C.sec.49A,I certify under the penalties of perjury that 1,to my best knowledge and belief,have riled all state tax returns and paid all stato"raxcs°ret{uired under taw.' Social Security Number or Federal Identification Number Signature of Individual or Corpo ate ame.. by Corporate Officer(if applicable) FOR BOARD OF HEALTH USE ONLY Date:Rcccived Date Inspected Approved By . . Permit 9 Issued This permit is not transferable and must be reissued upon change o£-ownership from the Health Departmeat.....All improvements and equipment replacernat in Food Establishment must be approved by,_the Health Department prior to installation, in-accordance with the Masa. Dept:-of Public Health Sanitary Code, Chapter. B. Applicangs_for Wbile Food Unit or Pushcart permits shall list the handwash and toilet' facilities available `oti each route on the back of this form. The permft' fee'is $25.00 which may be paid by check made payable' to the City of Salem or.paid-in cash at the Board of Health Office. Food Establishment permits expire. on the 31st of December or one year from the date issu d. Applicant Signature NUMBER FEE THE COMMONWEALTH OF MASSACHUSETTS 85-95 $2.00 ........ ........C i tY.............of.....---'-........-----Salem---.......... Board of Health STORE LICENSE—MILK AND-CREAM This is to Certify that.......Bob's--- amous... ried- Clams----------------------------------------------„-.-_.-----. NAME residing at--------------------------------'------------------ --------------------------.and having a place of business at.-...492--Highland--Avenue in the-- city .........of. .. Salem ... ---------------- -------------------...._----------------has been granted A LICENSE TO SELL MILK AND CREAM and is subject to the Provisions of the Laws of The Commonwealth of Massachusetts, relating thereto, and upon such terms and conditions, and to the rules and regulations established by the Board of Health, of the-----City o{ Salem _----_governing ............ :"31,-T995 the sale of Milk and Cream and shall remain in f re until �� g1�X ...., unless previous to that time is suspended or revoke . License Issued--... Dec.....22..... ..__.....19...94 C _.-: � ..........._.. _ __ ------- ----- . MPH,RS_,CHO HEALTH AGMT INSPECTOR OF MILK POST THIS LICENSE IN A CONSPICUOUS PLACE THIS LICENSE SHALL NOT BE SOLD. ASSIGNED OR TRANSFERRED. FORM d44 ( H&W H09BS8 WARREN rrn OVER l /y 5 Z � testWi+t CITY OF SALEM HEALTH DEPARTMENT 80,�R0 OF HEALTH Salem, Massachusetts 01970 ROBERT E BLENKHORN 9 NORTH STREET HEALTH AGENT (617) 741-1800 Date: APPLICATION FOR LICP.NSE TO SELL MILRICREAH Name of Establishment: 2013F '( E.L> OLf'YY75 Address/Phone Number: 1 l�J �Q �► 4ye r This license is not transferable and must be renewed annually from the Salem Health Department, in accordance with provisions of Chapter 94, Section 40 of the General Laws, FEE: $2.00 per annum PLEASE PRINT NA.M 0'r :°PLICANT HOME ADDRESS Il�zRuti' ��77� S f NUMBER FEE THE COMMONWEALTH OF MASSACHUSETTS 62-94 $25.00 City of Salem Board of Health of PERMIT TO OPERATE A FOOD ESTABLISHMENT Permit No. 62-94 _ � � Jan. 27 1994 In accordance with Regulations promulgated under authority of Chapter 94, Section 305A and Chapter 111, Section 5 of the General Laws a Permit is hereby granted to: Bob's Famous Fried Clams - Arthur L. Zetas Whose place of business is 429 Highland Avenue Type of business and any restrictions Food Service I To operate a food establishment in Salem (City or Town) Permit Expires Dec. 31 119/.+`-94,,x, C.H.O. Copy Board This Copy To Be Retained By local of Board of Health Health HEALTH I N FORM 738 Rev.1986 • cosZ • � �� :i t::.... is f.:is hi Ua.0 I�p��^nlaf �., CITY OF SALEM HEALTH DEPARTMENT V!An J - Iqo,` BOARD OF-HEALTH _ . Salem, Massachusetts 01970 1 ;, CITY OF SALEM -: TH DEPT. Application for Permit to Operate a:Food:Fsta Ais ment Date s Name of Establisttinent°: . - I Fs it , _.. Business Address Mailing Address(if different) Name&Title of Applicant A-e 77-,tyJ R L . ZECTE Address of Applicant �� 7 R ISN-A, Ake Name of Owner(d diffuent from appli' . lfcbrporatiori r partnershi oamei.title&home address of officers.or partners. amc Tide Home Address f�o77-t Y L .2f �s State of Name do Address Incorporation of Local Agent O� Home EmergencyuResponse Person Name Phone Type of Establishment .. Fee Duration of Permit Amo intTo Be Paid Retail Food ❑; Food Sere« � �L Caterer ❑ Temporary ❑ Mobile Food* ❑ Residential ❑ Seasonal ❑ TOTA�� Data of Operation if not Annual: PAYMENT IS DUE WITH APPLICATION • Applications for mobile food units or pushcarts must include a list of the handwash and toilet facilities available on each route. Attach separate sheet. Additional Information Water Source Sewage Disposal Days& Hours of Operation (o•u) _ If Restaurant: Number of SeatsNumber of Non-Smoking ` Pdr: n.Trained in Anti-Choking rocedures(if 25 scats'. ore) Ya No TS ignat of Applicant tn.. { , Pursuant to M.G.G Ch.62C=sec.49A,leettify under the penalties of perjury that t,to my bat knowledge and belief,have filed all state taz returns'and paid ulfttate lazes required iumctlaw e. _ Social Security Number or Federal Identification Number Signature of Individual or corp? tc Mame.;, y y _ Corporate Officer(if applicable) FOR BOARD 0 HEALTH USE ONLY I)ate;Received Y9"`i "' ;t u ri e rz,Appmval,8 Permit l Issued Psis-peeimft.is not traifsf¢rable and must be reissued upon change of ownership from the Hettlth:Departmeat. -All improvements and equipment,:replacemelt= in mood Establishment mast.-be -approved.by:-the:.Health Department, .priorto installation, iti"accordance with ' ; the Mass: ,Dept:-of-Public Health Sanitary Cade, Chapter.X. tggl3r�nts.46iMobile.Food unit or Pushcart permits shall list the handwash and MIUI*"faci hies available ori'eadi route on the back of this form. The-permit,fewis $25.00 which may be by check made payable' to the City of Salem .or.paid-iu, cash at the Board of Health Office. Food Establishment permits'expire. on the 31st of December or one year from the date issued. Applicant Signature �}k u i k! t}P U,. �y# �A I'll! N ;4 s'+ NUMBER FEE THE COMMONWEALTH OF MASSACHUSETTS 65-94 $2,'00 ................City.............-_of--------------•-.._ ....................----- a .......... Board of Health STORE LICENSE—MILK AND :CREAM . This is to Certify Arthur L. Zetes ( ; tnsiding,at ..................................................................... ---Land,having a,^ti place of business at---A2R..High1and_Av.emiE.........................................----------------------------------------- in Y..... .. ...... ................... ....................................................Ias been granted -A-LICENSE TO SELL MILK AND -CREAM -and is'subject iiithe-Piiiiie-ions of thita-vis of The Commonwealth of Massachusetts, relating thereto, and upon such terms and conditions, and to the rules and regulations established by the Board of Health,of the___'QJtV-----------Of................_§p1qm.... Dec4iEgii7­3.1.4....f9.9.4....governing the sale of NM and Cream and shall remain in force until J1xxf .Axk pxs& s=A2xx_.., unless previous to that time is suspended or revoked. Ucense Issued...... .....I_----- 4C-.H-Q.. ------------------------------------------- HEALTH AGENT IN9PECOR OF MILK POST THIS LICENSE IN A CONSPICUOUS PLACE THIS LICENSE SHALL NOT BE SOLD. ASSIGNED OR TRANSFERRED. FOR,M 444HeDw , Howss.&Wa m"' (OVER) rtiJ �r+lrya CTTY OF SALEM CITY ,OF SALEM HEALTH DEPARTMENT 7-7EALTH DEPT. BOgRD OF HEALTH Salem, Massachusetts 01970 R06ERT E. SLENKHORN - 9 NORTH STREET HEALTH AGENT. (617) 741-1800 Bate;_�f APPLICATION FOR LICENSE TO SELL MILK/CREAM Name of Establishment: Address/Phone Number: �9 T MI6 r' � • 7TH '3� This license is not transferable and must be renewed annually from trhe ,'Salem Health Department, in accordance with provisions of Chapter 94, Section 40 of the General Taws. i FEE: $2.00 per annum PLEASE PRINT WliE OF APPLICANT Ai t�'TH LzR L �� 5 HONE ADDRESS z4R� 1�yt�.�/.l._.1@")yl(j ' V of o� PHONE t 11�0l�ORTANT MESSAGE FO DATE �".�"J TIME M heos o,J OF PHONE AREA CODE NUMBER EXTENSION O FAX O MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASECALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOU;R�CALL WILL FAX TO YOU MESSAGE SIGNED rY- FORM 4009 -. MADE IN U.S.A. � , . _a � - _-- - --- - . _ I CITY OF SALEM { BOARD OF HEALTH Establishment Name: Date: Page: of Item Code C—Critical Item DESCRIPTION OF VIOLATION/ PLAN OF CORRECTION .Date No. Reference R-Red Item .Verified PLEASE PRINT CLEARLY a t' i w it r r k,l j I1 0 /A ',;Xr47 a'l _h) 1 /,LIC A 3H4 a All A - -.1 .: v L` I , iii ' '/ i .^ t� �1 ,_ I : + � � J �71�ficr0ov11 � L "A5 I . '�'. 1�r/ r � ,f `� I;;li 1 �' �l4 _ '17rj (-77 11 s ^ (A A I P t,l[k` SI 1 hl '11 ` 4 I -h 74�C4 I c) I Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ violations before the next ec ins tion, to observe all conditions as described, and to Exclusion p ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your,food permit. _ ❑ Voluntary Disposal ❑ Other: "y v Fir 3-501.14(C) PHFs Received at Temperature, Violations Related to Foodborne Illness Interventions and Risk .According to Law Cooled to Factors(Items 1.22) (Cont) 41"F/45'F Within 4 Hours- x PROTECTION FROM CHEMICALS 3-5111.15 Cailin�Methods for PHFs --- t9 PHP Hol and Gold Holding 14 FoodColor Additives 3_3-,S01.16(B) Cold PHFs Maintained at or below 3-2(12.12 Additives* 390.004(F) 3-302.14 Protection from Unappro ed Additives"' _ 41°/45°F IS PoisonousiorToxicSubstances 3-501-INA) Hot PHFs Maintaiuedatorabove -101.11 -`- Z 140'1-',RcxSte Held at of above iiQ°FCnntaueri" 50L16(A) 7 10111 Comm,t vtame N vki r C nuc tinar "� x-20 -�-- -- �TTime as a Public Health CoMro! --- - ---- 7o i 19 iro..as a Public Health('_ontrol'* r '0 1.11 4c a tuon Snug � - —..- - -- - --0 - @ - 9(1.n0.1(H) V r.as?ec Re nittment --yy ;-202.11 kc---- -<t Pr un r ant,d c _ _� --- ---- --- -- ---,—__._1 i2 (,minion of ik REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-703 t I Toxic t o n tine: ProKN!w[)' - 204 l tl POPULATIONS"NS�Hs� �—�- , 5unurcxs Cmc,+ Churuc�s �- - �� 1° C.humeals for U nhi� li xh, c (nr.n a^` rl� , wt?i 1-1 t �) UnP wrcmized Pre, pec}tied Juices:utd 7 104.14 Dr'l eucr.(nae i a 5W «1(B) -1205,1 t lined nt tl k axl ta;6malm' --WI j i(D) Raw or Puiiall,,(-',K)k Am d inal Rxad and v I '611 R":and1 ;rP neulea. Cruuti ' R 3612 Roil r B itsranons m 5c d7ittants ti<.t Served. 206 i � � _tit ; _ NSA R -scitie`t^ _� CONSUMER ADVISORY '2 1:U� t r 1 rso; rai so+s r'osl 1 » C rnr uu :tim k4 i TiMEITEMPERATURE CONTROLS 1 gb-T-..—____.._-.-_ Proper Cocking lemraratures fior A,.n,tal 1 xxl ha ire Rww. Unauux,kcd o: �PHF s j Not ?tl<rt S, t'ritc5w d to Nimina,.e >z r li5c. 1 nun StiN,1iwiv trw t2zv. Shell tn ,natedl,ch, tt,; k(,ai,7vI 1 _1 t -, SPECIAL REQUIREMENTS i3.-40 ._1_.1._13),1 z >_' ."I P, .- t.n i rsn._. ..----- _ a ci SecLio j '. t}.tki9r�t fig ja :il.l t(Alt � d 81c : Ir jce a19 �rs ; � t t , �_ i i y ntCrrlt LX,I:ilc tIUNt lempvrarr alld 1 3 401.11(A ? - 1 Poc n Wild Gam °+tiffe !{'j 1F, �I j i rcmdi u ql l.itehen of t:tions should hc. � � f � ,.,1. .y Crnt..tt,❑,r i ..!_ M. _e, f i ..tit d under ilio 311:.e pr;atc,eetians j _..- ( i.i� , ) f ,. ,iti I0. .;. Ct.{\ d.S - iwo v('11'.;'x ;S Rtt .t[.1, fS,i c 3ttteT r '.41 1i ci .i l' t1.. —0 ....-�. :_ r ,. :\ti iV , S:,:n,li C1;' j ul lrt , EI f�Yr( , 1 LL -t" + e?Ch�7trnt tae t#:4 t i3lcfir^g i VIOLATtC7NS RELATED TO(°.00D i�l~`7.AIt ills 17 �r1- 7 i Nl iF i j A _ _ (Jfeins >) 3011 tt 3.11r1fX .�__i, tlll tsi l�- j 1 ' .i < J joi it i Mfr al"u, , s r, r --rru; d n I j r 'aOV' �r'M bP i 1.#?i3.1 LC) 1 Com,7ea',is ;e I9tx_z ..ti `t 1,.l',xvi t{, F'. I0 on 4 ;-_Item r Good Retaii Practrecs -- 'fr3.,1 1 t 1 1z m i nrh,. m{ic.a P�,r ,r »u, 13�rt � -_,- _ _ i FC ,,5 BOAOft t pp. G 2 1 -.-Z Pr�nar rM it tkkd aPt GcT nJrcr 00 24 r oce t Proper Cooling of PHFs FC --a 00 4 25 c ratn�rd U I4 , PHI frn t _ oC+6 _ r,t l-1Vimir 2 R wr t;cui Fwar a;,y4 a F ,ltty_ 91 11!5^ 1L fltiu How"• i Z� 'ois r i Or <; ter ai t C r 308 _._. _ .0 _._ ._ __. - _...._ _ ..._ ` .,3-(1I.14(}3j 1104wPI-IF LSauc Etom irnbiznt i i ratar tr Within-1 ltrx;r Massachusetts Department of Public.Health---' Salem Board of Health 120 Washington Street,0 Floor Division of Food and Drugs Salem,.MA�1,170-352 FOOD ESTABLISHMENT INSPECTION REPORT •el. (978) 741_1800 ax (978) 745-0343 Namer � ( dD t Type of Operation(s) Tvne of Insoection �j C ( �Food Service Routine Address / J RiskElRetail Re-inspection DJ /" 1 n ^ Ye Level ❑ Residential Kitchen Previous Ins action 11, Telephone ` ❑ Mobile Date:�(3 t Iy Owner I _ HACCP Y/N ❑ Temporary ❑ Pre-operation ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) Time e/ _ ❑ Bed&Breakfast ❑ General Complaint inspector In. / Permit No. ❑ HACCP P Out: ❑Other Each violation chec ed requires an explanation on the narrative ages)and a citation of specific provisions)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) Elaction as determined by the Board of Health. -Fool_PROTECTION MANAOEMEN7_- El 12. Prevention of Contamination from Hands El 1. PIC Assigned/Knowledgeable/Duties ' ❑ 13. Handwash Facilities EMPLOYEE HEALTH. - -- •n= t y El 2. Reporting of Diseases by Food Employee and PIIIC C'° PROTECTION FROM CHEMICALS [114.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ._ _.,m...____ ❑ 15.Toxic Chemicals FOOD FROM.APPROV1i SOURCEE3.4. Food'and Water from Approved Source L12EEMPERATURE CONTROLS(Potentially HazardousFoods)73 ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans [118.Cooling PROTECTION FROM CONTAMINATION - • '"� ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REOUIREMENTS FOR_14IGHLY SUSCEPTIBLE POPULATIONS(HSP) 21. Food and Food Preparation for HSP El 10. Proper Adequate Handwashing El 11.Good Hygienic Practices 1QONSUMER.ADVISQRY �_ ar.�,x_ , _ ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR of c ealth. 590.000/federal Food Code. This report,when signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an "'s,-24. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (Fc-a)(5so.00s) cited in this report may result in suspension or revocation of the'food establishment permit and cessation of food 26.Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you .-27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address PER29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: S:Mmpe o1 14E Inspector's SignaG�v • Print: I PIC's Signatur: C D S Print: Page�oL�Ia . 1 Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 8 Crass-contamination 1 590.003(A) Assig meat of Responsibility* 3-302.11(A)(1) Raw Animal Foods Separated from Cooked and RTE Foods* 590.003(B) Demonstration of Knowledge* Contamination from Raw ingredients 2-103.11 Person in charge-duties 3-302.1.1(A)(2) Raw Anururl Foods Separated from Each Other* EMPLOYEE HEALTH Contamination from the Environment 2 590.003(C) Responsibility of the person in charge to 3-302.11(A) Food Protection* require reporting by food employees and 3_302.15 Washing Fruits and Are etables a ilic:mts* 3-304.11 Food Contact with Equipment and 590.003(F) Responsibility Of A Food Employee Or An Utensils* Applicant To Report To The Person to Contamination from the Consumer Charge*e* 3-306.14(A)(B) Returned Food and Reservice of Food* 590.003 G) Reporting b Person in Charge* Disposition of Adulterated or Contaminated 3 590.003(D) Exclusions and Restrictions* Food 590.003(E) Removal of Exclusions and ResMetions 3-701..11 F�4Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 590.004(A-B) Compliance with Food law* 4-501..1 I I Manual Warewashing-Hot Water 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 3-202.93 Shell Eg s* Sanitization Tem eratures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.16 Ice Made From Potable Drinkin Water* concentration and hardness. 4-601.11(A) Equipment Food Contact Surfaces and- , 5-'L01.11 Drinkin Water from an Approved System* Utensils Clean* _590.006(A) Bottled Bets t Water* 4-602.11 Cleaning Frequency of Equipment Ment Food 590,1g}6{B} Water Meats Standards in 310 CMR 22.0 q P Contact Surfaces and U nsi k Food- Shellfish and Fish From an Approved Source to , is 4-702.11 Frequency of Sanitization of Utensils and 3-201.14 Fish and Recrealianx'liy Caught Molluscan Food Contact Surfaces of Equipment* Shelli 4-703.11 Methods of Sanitizafipn-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* 10 Proper,Adequate-Handwashing Authority Game andMushroomsApprovedby 2.301,11 - Clean Condition-Handsand:Arms* Re ulafo 3-202.18 Identification Present* 2-301.12 Cleanin Procedure* 590.004(0 Wild Mushrooms* 2-301.I4 When to Wash* 3-201.17 Game Animals* 11 Good Hygienic Practices g Receiving/Condition 2401.11. Eating,Drinking or Using Tobacco* 3-202.11. PHFs Received at Proper Temperatures* 2401.12 Discharges From the Eyes, Nose and 3-202.15 Package Irate it * Mouth* 3-101.11 Food Safe and Unadulterated* 3-301.'12 Preventing Contamination When Tasting* Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* - 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained'* Em to ees* Tags/Records:Fish Products 13 Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located and Accessible 3-402.12 Records,Creation and Retention* 5-203.11 Numbers and Capacifies* 590.004(7) Labeling of Ingredients' 5-20411 Location and Placement* 9 Conformance with Approved Procedures 5-205.11 Accessibility,Operation and Maintenance /HACCP Pians Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handwashin Cleanser,Availability 8-103.12 Conformance with A. roved Procedures* 6-301.12 Hand-Drying Provision "Denotes critical item in the federal 1999 Food Caie or l(15 CbIR 590.000. CITY OF SALEM ;� I BOARD OF HEALTH Establishment Name: J /OS � '/L'�J�j }—�L c d c (moi! Date: R 11�/_—_ Pagers of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION onto No. Reference R-Red Item 'Qverified r T PLEASE PRINT CLEARLY t ( &, IlUir/1AS ren � d A!� rr J✓ � JU V •- 4--�- .�' k. j! CSS S/ YJo .(� J - 9 f Sic Pot— i a - I l .f 1P Q / l e r i?� s " Jr7 ' Q , r SP I l n. -P ' c six, aCl ten/ Discussion With Person in Charge: Corrective Action Required: ❑ No Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion p ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: i� 3-501,40 PHFs Received at Temlx;rntures - Violations Related to Foodborne illnessi interventions and Risk According to Law Cooled to Factors fltens 1-22) (Cont,) 41'F/45'F Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 Coolin Methods for PffFs 14 Food or Color Additives 19 PHF Hct and Cold Holding 3202.12 Additives* 3-501,.16(B) Cold PHFs Maintained at or below �_._. _ _ 590.004(F) 41'145°Ft- 3-302.14 *3-302.14 Protection from Unapproved_1.ddinves" i- ...,._ _._.....__.___._.._.. SOl.lb(A} Hot PHFs Maintained at or above ig Poisonous or Toxic Substances 7-10111 Identifying Information-Original IdOa F. 3-501.I6fA7 Roasts Held of or above 130'17. Containers* 7-102.11. Common Name-Working Containers* 20 Time as a Public Health Control 7201.11 Separauxin-Storae* 3-50IA9 Time as a Public Health Control' 7-202.11 .Restriction-Presence and Use* 590.004(H! Varianceuiremem 7-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Coutainers-Prohibitions* POPULATIONS HSP 7-204.11 Sanitizers.Criteria-Chemicals* 23 3-801.II(A) Unpasteurved Pre-packaged Juices and 7-204.12 Chemicals for WashinE Produce,Criteria* Severaees with Warning Labels* 7-204.74 Drying eats,Criteria° 3-801.1 IIB Use of Pasteurized E 7-205,11 Incidental Food Contam Lubricants$ 3-301..11(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria* Raw Seed Sprouts Not Served 7-206.12 _ Rodent'Bait Staticros* 3-801.11(C) Unaptned Food PaukaLe Not Reserved. 7-206.13 Tracking Powders,Pest Control and Monitoring* CONSUMER ADVISORY TIAAEti EMPERATURE CONTROLS 22 3-603.11 1 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods That are Raw.Undercooked or Not Otherwise Processed to Eliminate PHFs Padto?ens.*txxew,rnrzmt 3-40i,11A(1)(2) Eggs- 155'1715 See. Eees-immediate Service 145'Fl5sec^ 3-302.13 1 Pasteurized Eggs Substitute for Raw Shell 3.401.11(A)(2) Comminuted Fish.Meats&Game E Animals-155'F 15 sec.* SPECIAL REQUIREMENTS 340111(B)(1)(2) Pork and Beef Roast- 130'F 121 mitt* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 3-401.11(A')(2) Ratites,Injected Meats-155'F 15 Sec s catering,mobile Rmd,temporary and 3401.1I(A)(3) Poultry,Wild.Game,Staffed PRFs, residential kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Paul or Ratites-165'F 15 sec, * above if related to foodborne illness 3-401 AI(CW) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 1450F* 590.009 violations relating to goal retail 3-401.12 Raw Animal Foods Cooked in a practices should be debited under#29- Microwave 165'F* Special Requirements. 3-401a(A)(I')(b) I All Other PHFs- 145'F 15 sec. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-'W3.Ii(A)&(D) PHFs 16ST 15 sea* (Items 23-30) 3-403.11(B) Microwave- 1W F 2 Minute Standing Criticaiwid non-critical violations,which do not relate to the Time* foodborne illness interventions and risk factors listed above,can be 3-403.11(C) Commercially Processed RTE Foal- found in the following sections-of the Food Cade and 105 CMR 140°F* 590.000. 3-403.11(E) Remaining Unsliced Portions of Beef Item ( Good Retail Practices , PC 540.060 Roasts* 23. 1 Management and Personnel I-FC-2 .403 18 Proper Cooling of PHFs 24 i Food and Foci Protection I FC-3 .004 1 25. 1 Equipment and Utensils ( FC-4 .005 3-501.14(A) Cooling Calked PHFs from 140`F to ! 2& 1 Water.Plumbing and Waste i FC-5 .006 ; 70`F Within 2 flours and From 70`17 27. ' Physical Facili + FC-6 007 to 4 FF/45'F Within 4 Hours. * L28. 1 Poisonous or Toxic Materials FC 7 .008 3-501.14(.8) Cooling PRFs Made From Ambient 29. Serial A uiremams 0.09 7 Temperature Ingredients to 4I'F/45'F ' 301 Other Within 4 Hours* 'Denotes critical ream in the federal 1999 FwW Cale or 105 00R X90.000. ; cr "'o "A r �+, M" "A -------- N Q CERTIFICATE OF ALLERGEN AWARENESS TRAINING r=�� W 0 ;t CIO r r- Name of Recipient: Cosme Dos Santos Date of Completion: 8/8/2012 ;r< Date of Expiration: 8/8/2017 �(A w a, L L L r�V I lssned By: The above-nainedperson is hereby issued lbi_r cerli/ica/e 0 for completing an allergen awareness tiainingpp6gianl 0 9)J t eroguized by the Massacbusetts Department of Public Health - ,�6eLrlTcshire-� �C¢ in accordance with 105 CjVJR 590.009(G)(.3)(a). I_—�S ''�AHEC Arca,Health 6d,walion Ccntcr t0 Pittsfield,hfassachnsetts v '; This rert�rate zui/l be vn/id Jbr fz'e,e(5)years�iom dace of�omplction. ntivvv.mxfiiodallei gVtraininb oro r�y f� + ea Rug 17 12 09: 15a Rob Martel 978-35G-0986 P. 3 Massachusetts Department of Public Health Salem Board of Health Division of Food and Dru g s 120 Washington Street,4'"Floor Sa le 70.352 FOOD ESTABLISHMENT INSPECTION REPORT el. (978)741-180 -0343 Name I D t 7 e of Operation(s) TVDe of Inspection C I�.rzC d S Food Service Routine Address a ^ / �� Risk ❑ Retail 'Re-inspection A Level ❑ Residential Kitchen reviou ns action Telephone ❑ Mobile Date:�13,P Owner I HACCP YM ❑ Temporary ❑Pre-operation ❑ Caterer ❑Suspect Illness Person in Charge(PIC) Time ❑ Bed& Breakfast ❑General Complaint In: ❑ HACCP Inspector ( Out.tar I Permit No. ❑Other Each violatioff checked requires an explanation on the narrative age(s) and a citation of specific provision(s)violated. Noncompliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC [:114.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals FOOD FROM APPROVED SOURCE ❑ 4. Food and Water from Approved Source TIMEITEMPERATURE CONTROLS(Potentially Hamrdous Foods) ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑18.Cooling PROTECTION FROM CONTAMINATION ❑ 19.Hot and Cold Holding ❑ 8.Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) El 10. Proper Adequate Handwashing El21. Food and Food Preparation for HSP ❑ 11. Good Hygienic Practices CONSUMER ADVISORY ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today,the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code. This report, when signed below 23, Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection 1-004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils cited in this report may result in suspension or revocation of FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 7. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: 5'S9JIMpec(FGTIfi-iJ.b]C Inspector's Signatn Print: PIC's Signator : j _ Print: Pageof P ges Aug 17 12 09: 14a Rob Martel 978-356-0986 p. l DATE : AUGUST 17, 2012 TO : SALEM BOARD OF HEALTH FROM : ROB MARTEL BOB'S FAMOUS FRIED CLAMS 400 HIGHLAND AVE SALEM, MA 01970 RE: CERTIFICATE OF ALLERGEN AWARENESS TRAINING DEAR SIR; PLEASE FIND ATTACHED FAX OF CERTIFICATE OF AWARENESS TRAINING FOR COSME DOS SANTOS AS REQUESTED BY THIS OFFICE. THANK YOU , ROB MARTEL SENT BY FAX ONLY 3 TOTAL PAGES Massachusetts Department of Public Health Salem Board of Health 120 Washington Street,4'" Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name Do Tvve of Operation(s) Tvoe of Inspection _ r( Food Service [Routine Address 1 rO ( Risk Retail ElRe-inspection `I Level ❑ Residential Kitchen Previous Inspection Telephone _ ❑ Mobile Date: Owner HACCP Yli ❑ Temporary ❑ Pre-operation 7 r 2 ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) Time ❑ Bed&Breakfast ❑General Complaint Inspector �' In. 1(;I° \ Permit No. El HACCP Out: ❑ Other Each violation checked requires an explanation on the narrative page(s) and a citation of speciflc 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. FOOL)PROTECTION MANAGEMENT - , , _ ,j ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties f EMPLOYEE HEALTH ❑ 13. Handwash Facilities ` PROTECTION FROM CHEMICALS ''' •s • a ' +^ �Y� '❑ 2. Reporting of Diseases by Food Employee and PIC _ '�" El 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded .__ ___ _ - _ ❑ 15.Toxic Chemicals FOOD-FROM SOURCE-�..' '�_ - x� .� ��•. -.�--.�..�� ❑ 4. Food and Water from Approved SOOrca TIMEITEMPERATURE CONTROLS(Potentially Hazardous F.-d-0 ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling PROTECTION FROM CONTAMINATION - " � C ,19. Hot a d COId Iding El 8. Separation/Segregation/Protection YY❑ 20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing [REQUIRE 1. Food andKO HIGHLY USCionEOr HSP POPULATIONS(HSP)'. ❑ 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices -0O22.Posting of Con ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today,the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code. This report,when signed below C_Ti- by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2)(5so.0 order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-4)(590.0054))) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (Fc-5)(000.000) the food establishment permit and cessation of food 26. Water,Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: I S:ssoinspecrFo,me-ia.aa 12 Inspector's Signature: Print PIC's Signature• 5 • i-- Print: DS - Page- ) of_19ges v i Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 8 Cross-contamination 1 590.003(A) Assn menf of Res onsibiht * 3302-II(A)(1) Raw Animal Foods Separated from Cooked and RTE Foods* 590.003(6) -Demonstration of Knowled. e" Contamination from Raw ingredients 2-103.1.1. Person in charge-duties 3-302.1.1(A)(2) Raw Anirnrd Foods Separated from Each Other* EMPLOYEE HEALTH Contamination from the Environment 2 590.003(0) Responsibility of the person in charge to 3-302.11(A) Food Protection* require reporting by food employees and 3-302.15 Washing Fruits and Vegetables applicants* 3-304.11 Food Contact with Equipment and 590.003(F) Responsibility Of A Food Employee Or An Utensils* Applicant To Report To The Person In Contamination from the Consumer Charge* 590.003 G) Reporting b Person in Charge* 3-306.14(A)(B) Retuned Food and Rtedor C of Food* 3 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003(E) Removal of Exclusions and Restrictions 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 4 Food and Water From Regulated Sources FT Food Contact Surfaces - 590.004(A B) Compliance with Food Law* 4-501.111. Manual Warewashing-Hot Water 3-201.12 Food ma Hermetically Sealed Container* Sanitization Temperatures* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization Tem ratures* 3-202.t4 Eggs and Milk Products.Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.16 ice Made From Potable Drinking Water* concentration and hardness. *. 5-101.11Drinking Water frorn an A roved System* 4-601..11(A) Equipment Food Contact Surfaces and 590.006(A) Bottled Drinking Watcr* Utensils Clean` 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11. Cleaning Frequency of Equipment Food Shellfish and Fish From an Approved Source Contact Surfaces and.Utensils* 4-702.11 Frequency of Sanitization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of Equipment* Shellfish* - 4-703.11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* 10 Proper,Adequate Handwashing Game and Witt Mushrooms Approved by Re MatoAuthor' 2-301.11 - Clean Condition-Hands and Arms* 3-202.18 Shellstock Identification Present* 2-301..12 Cleaning Procedure* 590.004(0) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 Game Animals* tl Good Hygienic Practices 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-202.11 PHFs Received at Proper Temperatures* 2-401.1.2 Discharges From the Eyes,Nose and 3-202.15 Package Integrity- Mouth* - 3-101.11 Food Safe and Unadulterated* 3-30'1.12 Preventing Contamination When Tasting* 6 Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590D04(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* Em to s` Taga/Records:Fish Products 13 Handwash Facilities 3=402.11' Parasite Destruction' Conveniently Located and Accessible 3-402.12 Records,Creation and Retention* 5-203.11. Numbers and Capacities* 590.004(n Labeling of Ingredients; 5-204.11 Location and Placement* Conformance with Approved Procedures 5-205.11 Accessibiht ,Operation and Maintenance /HACCP Plans Supplied with Soap and Hand Drying 3-502.11. Specialized Processin Metbods* Devices 3-502.12- Reduced oxygen packaging,criteria* 6 301.11 Handwashing Cleanser, Availability 8-103.12 Conformance with A. roved Procedures* 6-301.12 Hand Drying Provision *Denotes critical item in the rederal 1999 Food Cade or 105 CMR 590-000. CITY OF SALEM BOARD OF HEALTH Establishment Name: 9.vJl J,S ,�Yt > C (I c Date: -1(?t [(.,L-- Page: of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Reference R-Red Item - vied PLEASE PRINT CLEARLY o< LIJO Ur I(¢c,,.J _ AII o d" An el 4M - 4 AAC n V C/�J Q S (k G c/ k a S- I)K 11/0 ) c In/ ,/o ktr '% AAJ r5 IrtK N ko SfCJS L �l e t4a,,e j ' L e-A --Lo, I tA I �,tfn {, ✓ ,2 S 1M<�, Discussion With Person in Charge: Corrective Actio Requi ❑ .No s have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction t violations before the next inspection, to observe all conditions as described, and to Exclusion ❑ 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 foodpermit. C �1�9 S� ❑ Voluntary Disposal ❑ Other: 3-501.14(C) PHFs Received at Temperatures Violations Related to Foodborne Illness interventions and Risk According to Law Cooled to Factors(Mears 1-22) (Cont.) 41°F/45°F Within Hours. * PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14 Food or Color Additives ,19 PHF Not and Cold Holding --- 3-501.16(B) Cold PHFs Maintained at or below 3 202.12 __ Additives* 590.004(1) 410/450 F* 3-302.14 Protection from Unapproved Additives* 15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above 140`F. 7-101.11 Identifying Information-Original 3501.16(A) Roasts Held at or above 130°F. Containers* Time as a Public Health Control 7-102.11. Common Name-Working Containers* 20 3-501.19 Time as a Public Health Contral° 7201.11 Separation-Storae* 590.004(H) VarianceRuirement 7-202.11 .Restriction-Presence and Use* 7-202.12 Conditions of 1Jse* 7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS HSP 7-204.11 Sanirizers.Criteria-Chemicals* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals for Washing Produce,Criteria* 7-204.14 Drying Agents.Criteria* Beverauzes with Warning labels* 7-205.11 incidental Food Contact,Lubricants* 3-801.11(8) Use of Pasteurized E*es* 7-206.11 Restricted Use Pesticides,Criteria* 3-801..I i(D) Raw or Partially Cooked Animal Food and Raw Seed Sprouts Not Served, 7-206.12 1 Rodent Bait Stations* 3-801.11(C) Uno ned Food Packa Not Re-served. 7-206.13 Tracking Powders,Pest Control and Monitoring* CONSUMER ADVISORY _ 71 ME1'FEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods That are Raw.Undercooked or PHFs Not Otherwise Processed to Eliminate 3-40i.11A(i)(2) Eggs- 155°FISSee. PatOens'* tle1 Eggs-Immediate Service 145°F15sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell -3.401.11(A)(2) Comminuted Fish.Meats&Game Eggs* Animals-155*F 15 sec.* 3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 tale* SPECIAL REQUIREMENTS _ 3.401.11(A)(2) Ratites,Injected Meats-155°F 15 590.009(A)-(D) Violations of Section 590.009(A)-(D)in see.* catering,mobile food, temporary and 3-401.1 l(A)(3) Poultry,Wild Crame,Stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, - debited under the appropriate sections Poultry or Ratites-165OF 15 sec. * above if related to foodborne illness 3-40111(C)(3) Whole-muscle,intact Beef Steaks interventions and risk factors. Other 145OF* 590.009 violations relating to good retail 3401.12 Raw Animal Foods Cooked in a practices should be debited under#29- Microwave 165°F* Special Requirements. 3401,11(A)(1)(6) All Other PHFs-145°F 15 sec. 17 Rsheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403AI(A)&(D) PHFs 1657 15 sec.* (Items 23-30) 3-403.11(B) Microwave- 165°F 2 Minute Standing Critical.and non-critical violations,which do not relate to the Time* foodborne illness interventions and risk factors listed above,cawbe 3-403.11(C) Commercially Processed RTE Food- found in the following sections of the Food Code and 105 CMR 140°F* 590.000: 3403.11(E) Remaining Unsliced Portions of Beef Item I Good Retail Practices J .FC 590.000 Roasts" 23. 1 Management and Personnel FC-2 .003 18 Proper Cooling of PHFs 24, 1 Food Food Protection FC 1 3 .004 I 25. Equipment and Utensils i FC-4 _005 3-501.14(A) Cooling Cooked PHFs from 140°F to 2e. Water.Plumbing and Waste j FC-5 .006 70'F Within 2 Hours and From 70°F 70- Phi sisal Facility :.FC-6 .007 to 41°F/45'F Within 4 Hours. *. i 28. Poisonous or Toxic Materials i FC-7 .008 3-501.14(B) Cooling PHFs Made From Ambient 29. -Special Requirements Temperature Ingredients to 41°F/4.5*F 30. 1 Other Within 4 Hours* Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. CITY OF SALEM _ BOARD OF HEALTH Establishment Name: (�� f f"s Te I I—IZ4-e) C � Date: Page: of Item Code C—Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date' No. Reference R-Red Item Verified PLEASE PRINT CLEA LY Ole i ,r ..: gtj 'Uro i 1 n:. • w L o _ ,),- �( I,� tXJ -( Q. Gt I ('S'C� � /SIN �- `/�/1•� it � - .)J � Ir I ,. t'' l O t Discussion With Person in Charge: CorredtiveActlon Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance El Employ Restriction/ inspection, to observe all conditions as described, and to Emersion violations before the next ins p �❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of theNass/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. ❑ Vo�untary Disposal ❑ Other: a 3-501.14(0) PHFs Received at Temperatures Violations Related to Foodborne illness Interventions and Risk According to few Cooled to Factors(ftmis'1-22) (Cont.) 41'F/45'F within 4 Hours. PROTECTION FROM CHEMICALS 3_501.15 Coolie Methods for PHFs ng 14 Food or Calor Additives 19 CHF Hof and Cold Hotd 3-501.16(B) Cold PRFs Siainwat at gr below 3-202.12 TAdditives* 590.004(F) 41°745°F* 3-302.14 Protection from Unapproved Additives* 3-50L16(A) Hot PRFs Maintained at or above Ig Poisonous or Toxic Substances 1400F. * 7-101-I1 Identifying Information-Original 3-501.16(A) Roasts Held at or above, 130'F. Containers" ?A Time as a Public Health Control 7-102.11. Common Name-Working Convuriers* 7-201.11 Separation-Storage* - 3-501.19 Time as a Public Health Control* 7-202.11 .Restriction-Presenc.eand Use* 590.004(H) Varianceuiremant 7-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTISLE 7-203.11 Toxic Containers-Prohibitions* POPULAT1DN5 HSP 7-204.11 Sanitizers.Criteria-Chemicals* 7-204.12 Chemicals for WashingProduce,Criteria* 21 3-8Q1.11(A) Unpasteurized Pre-packaged Zuices and .Beverages with Warning Labels* . 7-204.74 'a Agents.Criteria' ^,-$01.118 Use of Pasteurized Eggs* 1-205.11 Incidental Food Contact,Lubricants* 3-801.1 I(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria* Raw geed Sprouts Not Served, * 7-206.12 - Rodent Bait Stauoas* 3-801.11(C) Unopened Food Pack re Not Re-served. 7-206.13 Tracking Powders, Pest Control and Monitoring* CONSUMER ADVISORY TIMEISEMPERATIIRE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw.Undercooked or 16 Proper Cooking Temperatures for Not OtherwiseProcessedto Eliminate PHFs *fw"Nrff 3-40f.11A(1)(2) Eggs- 155'F 15 Sec. Pate ens. E Immediate Service 145'Fl5seca 3 302.13. Pasteurized Eggs Substitute for Raw Shell E * 3-407.11(A)(2) Comminuted Fish.Meats&.frame _ Animals-155'F 15 sec.* SPECIAL REQUIREMENTS 3-401.11(11)(i)(2) Pork and Beef Roast-130OF 121 miu* 3-401.11(A)(2) Ralites,Injected Meats-155'F IS 590.009(A)-(D) Violations of Section 590.009(A)-(D)in Sec.* catering, mobile Food,temporary and 3-40).11(A)(3) Poultry,Wild Came,Stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Poultry or Ratites-165°F 15 sec.* above if related to foodborne illness 3-301.11(0)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 145T* 590.009 violations relating to good retail 3401.12 Raw Animal Focxls Cooked in a practices should be debited under#29- Microwave 165 F* Special Requirements. 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* 17 Reheating for Hot Holding VIOLA77ONS RELATED TO GOOD RETAIL PRAC77CES 3-403AI(A)&(D) PHFs 165"F 15 sec. * (Items 23-30) 3403.11(B) Microwave 165'F 2 Minute Standing Critical,mid non-critical violations,which do not relate to the Time" ,foodborne illness interventions and risk.factors listed above, can be 3-403.11(C) Commercially Processed RTE Food- ,fbund in the following sections of the Food Cnde and 105 CA.'R 140*P 590.000. 3403.1I(E) Remaining Unsiiced Porrious of Beef ftem 1 Good Retail Practices FC 590.000 j Roasts" j 23 _ 1 Management and Personnel- FG-2 _003 1R Y Proper Coaling of PHFs i 24. 1 Food and Food Protection FC-3 .044 25. 1 Equipment and utensils I FC-4 005 j 3-501.14(A) Cooling Cooked PHFs from 140'F to 126. 1 Water.Plumbing and Waste I FC-5 906 70'F Within 2 Hours and Front 70'F 27. { Phvsical Facility I 1 FC-6 .0()7__j to 4 VF145'F Within 4 Hours.* - L28. Poisonous or Toxic Materials FC-7 .008 3-501.14(B) Cooling PHFs Made From Ambient 29. eciat Requirements .003 Temperature Ingredients to 41'F/45'F 30 i Other Within 4 Hours" 'Dznotes eziticat item in the fbderal 1999 FwA Cale or M CNIR 590.000. L CITY OF SALEM ' /BOARD OF HEALTH Establishment Name: �4-,A, r! J Date: :];?Al Page: �/ of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date.- No. Reference R-Red Item Verified PLEASE PRINT ABLY J1, t) v tI lel c'1 )7 , Discussion With Person in Charge: 76orrective Action Required: ❑ .No ly Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee 'striction/ Exclusion violations before the next inspection, to observe all conditions as described, and to spection Scheduled o Emergency suspension i 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 b Embargo ❑ Emergency Closure t� your food permit. p Ll Dis osal 0 Other: 3-501.14(C) PHFs Received at Temperatures Violations Related to Foodborne Illness Interventions and Risk - According to law Cooled to Factors(Hems 1-22) (Cont.) 41°F/45°F Within 4 Hours. PROTECTION FROM CHEMICALS3-501.15 Cooling Methods for PHFs 14 Food or Color Additives 19 PHF Hot and Cold Holding 3-501.16(B) Cold PHFs Maintained at or below 3202.12 Additives* 590.004(F) 41°!45°F * 3-302.14 Protection from Unapproved Additives* 3-501.16(A) Hot PHFs Maintained at or above 15 Poisonous or Toxic Substances 7-101.11 Identifying Information-Original 140°F. *3-501.16(A) RoastsHeld at or above 130°F. Containers* 7-102.11. Common Name-Working Containers* 20 Time as a Public Health Control 7-201.1.t Separation-Storage* 3-501.19 Time as a Public Health Control* 7-202.11 .Restriction-Presenceand Use* 590.004H) Variance Requirement - 7-202.12 Conditions of Use* 7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanitizers.Critetia-Chemicals* POPULATIONS HSP 7-204.12 Chemicals for Washing Produce;Criten .a* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and Bevera es with Warning Labels* 7-204.14 Incite tats.Criteria* 3-801.11(B) Use of Pasteurized E 7-205.11 Incidental Food Contact,Lubricants* 3-801.11(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria* Raw Seed S uts Not Served* 7-206.12 Rodent Bait Stations* 3-801.11(C) Uno ned Food Packs Not Re-served. 7-206.13 Tracking Powders,Pest Control and Monitoring* CONSUMER ADVISORY - TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods That are Raw.Undercooked or PHFs Not Otherwise Processed to Eliminate 3-40i.11A(1)(2) Eggs- I55"F 15 See. pathogens'*E"Iv" 0 E Immediate Service 145'F15sec, 3-302.13 Pasteurized Eggs Substitute for Raw Shell 3401.11(A)(2) Contaminated Fish.Meats&Game Eggs* Animals-155°F 15 sec.* 3401.11(2)(1)(2) Pork and Beef Roast- 130°F 121 nun* SPECIAL REQUIREMENTS 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 590.009(A)-(D) Violations of Section 590.009(A)-(D)in sec * catering, mobile foot,temporary and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Poultry or Ratites-165°F 15 sec. * abrve if related to foodborne illness 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 145°F r: 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Cooked in a practices should be debited under#29- Microwave 165°F* Special Requirements, 3-401.11(A)(1)(b) All Other PHPs-145°F 15 sec. 17 Reheating for Not bolding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403A I(A)&(D) PHFs 165°F 15 sec. * (items 23-30) 3-403.11(B) Microwave- 165`F 2 Minute Standing Critical mid non-critical violations,which do not relate to the Time* foodborne illness interventions and tisk factors listed above, can be 3-403.11(C) Commercially Processed RTE flood- found in the following sections of the Food Code and 105 CMR 140°F* 590.000, 3-403.11(E) Remaining UnslicedPortions ofBeef nem J Good Retail Practices .FC 590.000 Roasts* 23. Managiernent and Personnel FC-2 .003 1g Proper Cooling of PHFs 24. _ Food and Food Protection FC-3 004 3-501.14(A) Cootie Coked PHFs from 140°F to 25. Equipment and Utensils FC-_4 .00- 5 Cooling 26. Water.Plumbing and Waste FC 5 .006 t 70°F Within 2 Hours and From 70°F 27. Physical FaciU FC-6 .007 to 41°F/45°F Within 4 Hours. * 26. Pcisonous or Toxic Materials ` FC-7 .006 3-501.14(2) Cooling PHFs Made From Ambient 29. Special R uireme ns 009 Temperature Ingredients to 41°F/4.5°F 30• I Other Within 4 Hours* s:��eromutzax 'IX-notes critical iter in the federal 1999 Foal Code or 105 CMR 590.000.