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Home My WebLink AboutANDREA'S KITCHEN - FOOD Andrea's Kitchen 1 395,Cap' N Lijah's Centerville l9q-02(v-vofv I Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. L BARNSTABLE, $ F.P.(Thomas)Lee :MA&S, Daniel Luczkow,M.D.,Alt. 200 Main Street, Hyannis, MA 02601 are. Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 1139 Issue Date: 01/01/2022 DBA: ANDREA'S KITCHEN OWNER: ANDREA PINTO Location of Establishment: 395 CAP' N LIJAH'S ROAD CENTERVILLE MA 02632 Type of Business Permit: COTTAGE FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: $75.00 Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE- FOOD: MOBILE-ICE CREAM: GQ,� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BA tstitstA F.P.(Thomas)Lee c , 200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D.,Alt. Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 1139 Issue Date: 07/01/ DBA: ANDREA'S KITCHEN OWNER: ANDREA PINTO Location of Establishment: 395 CAP' N LIJAH'S ROAD CENTERVILLE MA 02 2 Type of Business Permit: COTTAGE FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: $75.00 Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: ( � FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS H SEATING: PERMIT IS NOT VALID NLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: l- Iles l`?S, oL 1 - sec , For Office Use nitials: Town of Barnstable Date Paid rI I � Amt I'd BARNMBLE, : Inspectional Services nec, ,' ,,� Check# 3& Public Health Division Thomas McKean, Director 19 0'2_� _ fit?tP 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 t s • APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE j� NEW OWNERSHIP V RENEWAL NAME OF FOOD ESTABLISHMENT: ADANeL.'S R; 61P1 n 1 ADDRESS OF FOOD ESTABLISHMENT: "1 ca!R 1'1 eL i�G y1�S 001 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: QVN0(et-"k A u e 0 G er r,a' l - C p wn TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (�Q9� - 3q o TOTAL NUMBER OF BATHROOMS: L WELL WATER:YES NO V ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V SEASONAL: DATES OF OPERATION:_/_/_ TO NUMBER OF SEATS: INSIDE: N/A OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? NI A IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REOUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:Wpplication FormsTOODAPP 2020.doc OWNER INFORMATION: 1 FULL NAME OF APPLICANT n,A,Q, L. V;n r0 SOLE OWNER: YES NO D.O.B OWNER PHONE# SOLE OWNER:& 509- 3 LI_ 3 BIOS ADDRESS CORPORATE OWNER: CORPORATE ADDRESS: 1 PERSON IN CHARGE OF DAILY OPERATIONS: rec� Pr/b=t'l� List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date as /202KT. rc rea r,�, �� 06� 2-57 12025' 2. w 06 l 22l 90 a, SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asi). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January I st to Dec.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1 st. Q:\Application Forms\FOODAPP REV3-2019.doc L ' Proposed Menu Items: Chocolate Chip Cookies Guava filled Cookies Shortbread Cookies Milk Chocolate truffles Dark Chocolate truffles Caramels Sourdough Bread Milk Bread Sweet Portuguese Bread Cupcakes Celebration Cakes Pastries(Scones&Puff Pastry) Red Berry Jam I assert that I have completed(or caused to be completed)this page and the Site Plan Review Application and that, to the best of my knowledge,the info tion submitted here is true. 6/9/21 tgnature of Applicant Date Andrea Pinto Printed Name of Applicant APPLICATION FOR SITE PLAN REVIEW ANR Plan LOCATION: Site Plan Business Name: Andrea's Kitchen Assessor's Map# 194 Parcel# 194-026-006 APPLICANT Property Address: 395 Capn Lijahs Rd Name: Andrea Pinto Centerville,MA 02632 Address:395 Capn Lijahs Rd Centerville, MA 02632 OWNER OF PROPERTY Telephone: 508.364.3405 Name: Andrea Pinto Email: andrealayce(a gmail.com Address: 395 Capn Lijahs Rd Centerville, MA 02632 Telephone: 508.364.3405 AGENT/ATTORNEY Email: andrealayce(a,gmail.com Name: Address: ARCHITECT/DEVELOPER/CONTRACTOR/ENGINEER Telephone: Name: Andrea Pinto Fax: Address: 395 Capn Lijahs Rd Centerville, MA 02632 Telephone: 508.364.3405 ZONING DISTRICT CLASSIFICATIONS Email: andrealayce(a)gmail.com District RC Overlay(s) Lot Area Sq. Ft. Two Ac. Fire District STORAGE TANKS(HASMAT/FUEL OR WASTE OIL) Setbacks(ft.) Existing Proposed Front Side Rear Number Number Size Size Above Ground Above Ground Number of Buildings Underground Underground Existing 1 Proposed Contents Contents Demolition no TOTAL FLOOR AREA BY USE: Basement Existing (Sq.Ft). Proposed (Sq.Ft). UTILITIES Residential Sewer- ❑ Public X Private Size-2500 gal #of Bedrooms Restaurant Water-X Public ❑ Private Retail Office Electric- ❑ Aerial X Underground Medical Office Gas-X Natural ❑ Propane Commercial(specify Wholesale(specify) Grease Trap- ❑ Size gal Institutional (specify) Sewage Daily Flow * gal Industrial(specify) All Other Uses On Siteil Gross Floor Area PARKING SPACES CURB CUTS Required Existing Provided 4 Proposed On-Site 4 To Close Off-Site Totals Handicapped * GP or WP areas restrict wastewater discharge to 330 gallons per acre per day into on-site system. Subdivision Plan Old King's Highway Regional Historic District File# Approved? ❑ Yes ❑ No Hyannis Main Street Waterfront Historic District File# Approved? ❑ Yes ❑ No Listed in National and/or State Register of Historic Places? ❑ Yes ❑ No Previous Site Plan Review File# Approved? ❑ Yes ❑ No Previous Zoning Board of Appeals File# Approved? ❑ Yes ❑ No Is the site located in a Flood Area(Section 3-5.1) ❑ Yes ❑ No In Area of Critical Environmental Concern? ❑ Yes ❑ No Is the Project within 100' of Wetland Resource Area? ❑ Yes ❑ No Site sketch—informal presentation ❑ Yes ❑ No Site Plan prepared,wet stamped and signed by a Registered PE and/or PLS. ❑ Yes ❑ No Parking and Traffic Circulation Plan ❑ Yes ❑ No Landscape Plan and Lighting Plan ❑ Yes ❑ No Drainage Plan with calculations and Utility Plan ❑ Yes ❑ No Building Plans,(all floor plans,elevations and cross sections) ❑ Yes ❑ No Note that all signage must be approved by Code Enforcement Office at the Building Department Lot area in sq.ft. 87,120 sq. ft. Total Building(s)footprint 5,093 sq. ft. Maximum Lot Coverage as%of Lot 17 % GROUND WATER PROTECTION OVERLAY DISCTICT REQUREMENTS: DISTRICT: Lot Coverage(%) Required Proposed Site Clearing(%)Required Proposed PRINCIPAL BUILDING ACCESSORY BUILDINGS) ❑ Yes ❑ No Number of floors 3 Height: ft. Number of floors Height: ft. FLOOR AREA: FLOOR AREA: Basement 862_sq. ft. Second 1394 sq. ft. Basement sq. ft. Second sq.ft. First 1496 sq. ft. Attic sq.ft. First sq. ft. Attic sq. ft. Other(Specify) sq.ft. Please provide a brief narrative of your proposed project: I would like to make the below items listed under"menu"for sale to the public.My company will offer for customers to either pick up from my location(see overhead map)or I can deliver.The vehicle I would use to deliver can be either my personal vehicle(Jeep Grand Cherokee),OR I do have a commercially registered vehicle if necessary(Toyota Prius). I would not use the entire house as the cottage kitchen,but rather only the downstairs kitchen which has a dedicated entrance from the exterior of the home and a pathway from the location where customers can park. 1 have 4-5 parking spots available at the house for parking. As far as employees,I will be the only person working for this business. If for some reason I become ill,the business will pause all services. The goal is to eventually apply for a wholesale permit from the state in order to distribute as a wholesaler. Please see proposed menu on next page. I lo'X Town of Barnstable .I BAPUNWM Site Plata Review BA d 11 E 1 1639. ft ` 200 Main.;Street, H anni-s,MA 02601 � . www.to n.bar-nstab e.nta.ns Office: 508-862-4679 June 17, 2021 Andrea Pinto 395 Cap'n Ujahs Pd. Centerville, MA 02632 SPR,051-21 Andreas Kitchen 395 Cap'n l_ijahs Rd., Centerville, Map/Parcel- 19410261606 Zoning; RC/AP Proposal: Applicant is proposing to add.a cottage kitchen facility to the lower level for baited goods to be sold to the public.There is a dedicated entrance from the exterior to this location as well as parking..The public will be able to pick-up goods and applicant proposes a delivery possibility as well. Dear Ms. Pinto and Agi�iho; At the informal site plan review meeting held on June 15, 2921 it was determined.by the Building Commissioner that the above proposal is approvable, The Site Plan review Committee made the following preliminary comments: m Brian Florence: Applicant must deliver products, no public at the site o Applicant to comply with Nome Occupation Ordinance§240-46, Hobert Duffy: Plumbing and Gas Inspector Grease interceptor(interior)will be required as well as.a mop sink. It was suggested that'a commercial dishwasher be used but.a 3 bay sink may be an alternative. Restroom set up is acceptable. • Nathan Collins: Assistant Town Engineer Confirmed that there will be no seating at the site. 0 Jeff Carter: Deputy Director Inspectional Services. o A building permit will be required. • COMM Fire: Michael Grossman Need to determine whether or not grease laden vapors are produced. This will dictate what type of hood is required; type 1 or type 2 which would require a suppression system. COMM Fire will work with building to see if sprinklers will be required. I l F 1 I I � DaveStanton:Chief Health Inspector BOWd of Health supports cottage kitchens, a cottage food permit is required, Katherine SOtO will be your Health Inspector An exterior grease trap is not required for this type of permit. A residential dishwasher is acceptable as long as temperature is correc l onmtored; Katherine will advise. Applicant must obtain all other applicable permits, licenses and approvals required. SincerelyAl Zian iorence, Cao Chairman Cc: Site Plan Review Con rnittee ck -, SITE PLAN REVIEW STAFF MEETING Scheduled for 2:00 — 4:00 June 15, 2021 Planning & Development Department Via Zoom, details below INFORMAL AGENDA SPR 046-21 Verizon Wireless (Alex Murshteyn) 3195 Main Street, Barnstable Map/Parcel: 2991024 Zoning: VB-A, RF-2/AP and OKH Proposal: Applicant wishes to replace parts and antennae's on existing tower. ****Postponed from 06/08/2021**** T:10-SITE PLAN REVIEW\3195 Main Street, Barnstable SPR 050-21 Verizon (Chuck Bruttomesso) 215 Old Falmouth Rd., Marstons Mills Map/Parcel: 100/071 Zoning: RF/GP Proposal: Verizon is planning on changing out their antenna from 12 to 15. These antennas have a centerline of 140' above the ground. T:10-SITE PLAN REVIEW1215 Old Falmouth Rd., Marstons Mills SPR 051-21 Andreas Kitchen 395 Cap'n Lijahs Rd., Centerville. Map/Parcel: 194/0261006 Zoning; RC/AP Proposal: Applicant is proposing to add a cottage kitchen facility to the lower level for baked goods to be sold to the public. There is a dedicated entrance from the exterior to this location as well as parking. The public will be able to pick-up goods and applicant proposes a delivery possibility as well. T:10-SITE PLAN REVIEW1395 Cap'n Liiah's Rd., Centerville SPR 052-21 Electrify America 793 lyannough Rd., Hyannis Map/Parcel: 293/024 Zoning: HB, B/GP Proposal: Applicant is proposing to modify 4 existing parking spaces by adding 4 Electrical Charging stations as well as accompanying stalls, transformer and switchgear. Landscaping will shield all electrical equipment and an underground electrical line will be added for the transformer. Existing 1 landscaping, 5 parking stalls. and 105 linear feet of curbing will be demolished. TAO-SITE PLAN REVIE1M793 Iyannough Rd., Hyannis Join Zoom Meeting: https://zoom.us/j/3301000010?pwd=ZDFNZi9gOHFLd3RjcnNVUGwrZzVhZz09 Meeting ID: 330 100 0010 Passcode: MGL143 2 �FTME Tp� TOWN OF BARNSTAB_LE .,,. .:HEALTH INSPECTOR'S Establishment Name: Date: -. Page: ..of r P` OFFICE HOURS PUBLIC HEALTH DIVISION , 8:06-9:30A.M. `- BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3 : �� HYANNIS, MA 02601 MON.-FRI. No Reference R-.Red Item PLEASE PRINT CLEARLY 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name Date( 7,gA, Tyne of Type of Inspection v �- Ooeration(s) Routine Address r //� Risk Food Service a-ins a N '�`` �� Level Previous Inspection -I Telephone esidential Kitche Date: Mob le Pre-operation Owner HACCP YIN Temporary Suspect Illness S Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP L In: t Other Inspector JC� Out: PVM- Each violation checked'requir s an explanation on the narrative page(s)and a citation of specific provision(s)violated. Aa 4 6 Violations Related to Foodborne Illness Interventions and Risk Factors(Red Itemsl Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ �7 ,}, �L �� j FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands C/ I/�tif �C- l '( O ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS yl1 rt.7 PD ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food'or Color Additives W b �1'G•„�%�72_�r ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals V`�- FOOD FROM APPROVED SOURCE TIMEITEMPERATURE 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 4 _ l tD , � O PROTECTION FROM CONTAMINATION ❑ 20.Time Asa Public Health Control der ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) S G:.et/IGA4 ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP IV � �y e ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY vu Ye_ ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories p Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 2c.1 Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ElNo El 'Yes Non-critical(N)violations must be corrected immediately or Overall Rating 1 la(o within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Sche spension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils B=One critical violation and less than 4npn-critical violations 9 (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to anon-cri 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8npn-critical violations=C. w 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signatu Print - 31.Dumpster screened from public view �Q Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N v` #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease.Trap Size .Variance Letter Posted. Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination - 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties Cooked and RTE Foods. 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 1 g Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* * 2 590.003(C) Responsibility of the Person-in-Charge to Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-102.11 Common Name-Working Containers* 3-501.16 A Roasts Held At or Above 130°F* Require Reporting by Food Employees and Contamination from the Environment * ( ) 7-201.11 Separation-Storage*Applicants* 3-302.11(A) Food Protection* P g * 20 Time as a Public Health Control 3-302.15 Washing Fruits and Vegetables 7-202. 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* * 11 Restriction-Presence and Use Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations Raw Seed S routs Not Served* 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and P 3-201.13 Fluid Milk and-Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg--e rruzoor 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Cough[Molluscan Contact Surf aces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources g, P �' 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11' Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail practices 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirem nould be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* F18 Proper Cooling of PHFs following sections of the Food Code and 16 CMR 590.000 * 18 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification* ( ) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers an P d Ca pacifies* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. -FTHE Tp,, TOWN OF BARNSTABLE. HEALTH INSPECTOR'S Establishment Name: Date: _ -Page: 1 of Z l OFFICE HOURS r o PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified a;. `0� HYANNIS, MA 02601 soa-862�Rsaa No Reference R Red Item PLEASE PRINT CLEARLY - 'F°""A`' FOOD ESTABLISHMENT INSPECTION REPORT Name Date Type of Tyoe of Inspection 0� Ooeration(sl Routine Q Address 31 lit �� /f /f o _ Risk Food Service Re-inspection Y ' yr- �- 1�� `�� Level Ret Previous Inspection Telephone esidential Kit n re-o eratlon ) Owner HACCP Y/N Temporary Suspect Illness w Z L '� (o F_ Caterer General Complaint Person in Charge(PIC) �; Time Bed&Breakfast HACCP Othe JV& SG(�(NI` i e In: /t „^ r I r fTV Inspector �I/L.J� Out: 1 Each violation checked r'quires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ ,P�A.4 L i ij p -.,c. Action as determined by the Board of Health. ,Allergen Awareness 590.009(G) ❑ ` FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands \^ � C D i ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities4t V` r Lk EMPLOYEE HEALTH PROTECTION FROM CHEMICALS "--I' I. f)/) I J f-rLy ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) / ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures J V( ❑ 5.Receiving/Condition ❑ 17.Reheating �S vuAlt" ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling i c i �f 's�� U �, ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding VLJ Q CW1U -G klfle PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control �I.cilU9 D W Z ❑ 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 Items) Total Number of Critical Violations l� Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No I[] Yes Non-critical cal(N)violations must be corrected immediately or Overall Rating --�' within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils B=One critical violation and less than 4 non-critical violations 9 (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) receipt within 10 days of recei t of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector' �natur Pri 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N r � . - Tom'• Violations related to Foodborne Illness :<: Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination L14. Food or Color Additives Law Cooled to 41°F/45'F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45'F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) * 2 590.003 C Responsibility of the Person-in-Charge to Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F ( ) Require Reporting by Food Employee and Contamination from the Environment 7-102.11 Common Name-Working Containers* 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* * 20 Time as a Public Health Control 3-302.11(A) Food Protection 7-202.11 Restriction-Presence and Use* 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* * Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashing-Ho[Water 7.206.12 Rodent Bait Stations * 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served Y P 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg crive 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-401.11(B)(1)(2) Pork and Beef Roast 130°F 121 min* F 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source EEs* 4-702.11 Frequency of Sanitization of Utensils and Food see* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 Shellfish 3-401.11(A* 3 Poultry,Wild Game Stuffed PHFs SPECIAL REQUIREMENTS )O fi 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 see*Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11 C 3 Whole-muscle Intact Beef Steaks 145°F* kitchen operations should be debited under ( )O P Game and told Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* g 8 3 403.11(C) Commercially Processed RTE Food-140°F 12 Prevention of Contamination from Hands .. Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices PFC-4 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel .003 Tags/Records:Fish Products p 24. Food and Food Protection .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils .005 * P3-402.12 Records,Creation and Retention Y' Within 4 Hours* 26. Water Plumbm and Waste .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF.HE*off TOWN OF BARNSTABLE HEALTH INSPECTOR'S 'Establishment Name: Date: Page: - of Z r, p�w OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. = 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ;'a q: m� HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY .o ' 508-862A644 rED 1% ' FOOD ESTA 3LISHMENT INSPECTION REPORT Name Date T e o Tvae of Inspection fbl n pt '� Operations) Routine �v`4u Lt Address Risk '-(" Food Service Re-inspection _ �� L revel R Previous Inspection Telephone (Residential KitchB Dat e-o eratio Owner HACCP Y/N Temporary Suspect Illness ,V Caterer General Complaint 1 Person in Charge(PIC) Time Bed&Breakfast HACCP (/j`G , I c� In: Other Inspector S Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. 1 Sf Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ OPC a:�Ai- 11 " Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands /I I!1 .. t. CL/ ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS J D"A/L G CL A-, ❑2.Reporting of Diseases by Food Employees and PIC' ❑ 14.Approved Food or Color Additives a 9; 140 ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals Uk / c /,,,IFOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) / ❑ 01 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures . �� ❑5.Receiving/Condition ❑ 17.Reheating 16,j ' ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling r/n Lin ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding L� 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 a _ ❑ IKD 10.Proper Adequate Handwashing CONSUMER ADVISORY T I " ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations , A14 l Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ® Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4non-critical violations g )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8 non- itical violations=C. n 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Sign ur Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N i Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003 A Assi nment of Responsibility* 8 Cross-contamination '•'_ Law Cooled to 41°F/45°F Within 4 Hours* ( ) $ _ 14 Food or Color Additives 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 - PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*7-102.11 Common Name-Working Containers 590.004(F) 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants** 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control '°` 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(1)) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 15 0.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized,Eggs*. 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*'. y P 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* * $$ Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* Equipment 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef°ti° 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590 006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-40 1.11(B)(1)(2).Pork and Beet Roast-130"F 1'21 min Eggs* 4-702.11 Frequency r f cesSanitizationquof Utensils and Food 3-40 1.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* $ $ �' 590.009(A)-(D) Violations of Section 590.009(A)-(D)in.cater- Sources* 10 Ratites-165°F 15 sec* ing,mobile food,temporary and residential ; Game and Wild Mushrooms Approved By Proper,Adequate Handwashing l 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23.30) 3-202.15 Package Integrity* $ $ 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Convenient] Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* y 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products P 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .005 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback5-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 3. � f j Ole Ito CL 01 N m 71 ki c F jig, 10" $:'fir W ha WM Piro it tu , r AYS 40 iF 4zz �¢ i Tt I F z J °L k , Al � � a Aw II1�1 iE �iyli k tY n,I"� a If, 7 2 e 4 �y } S b � jjF�,££,�p'y Rom. it►' '*,",µ�* .a. .�.• � ir, ,(5 „ r ud� dm �gv _ - { Yr 3 Item # Quantity C.S.I. Section 11400 � HOBARTJ Al20 = 701 S Ridge Avenue,Troy,OH 45374 MIXER p 1-888-4HOBART•www.hobartcorp.com a STANDARD FEATURES MODEL ■ 1/3 H.P. Hobart Designed Fixed Speed Motor ❑ A120— 12-Quart All Purpose Mixer ■ Gear-Driven Transmission Specifications,Details and Dimensions on Inside and Back. ■ 15 Minute Timer ■ Three Fixed Speeds ■ Open Base ■ Large, Easy-To-Reach Controls ■ #12 Taper Attachment Hub ■ Manual Bowl Lift ■ 12-Quart Stainless Steel Bowl, "B" Flat Beater, "D" Wire Whip, Cord and Plug ACCESSORIES ❑ Stainless Steel Bowl ❑ "B" Flat Beater ❑ "C" Wing Whip ❑ "D" Wire Whip ❑ "E" Dough Hook - ❑ "P" Pastry Knife ❑ Bowl Splash CoverF n° T ❑ 9" Vegetable Slicer ' „ w ❑ Meat Chopper Attachment b ao F-7519—A120 Mixer Page 1 of 4 Al20 HOBART MIXER 701 S Ridge Avenue,Troy,OH 45374 1.888-4HOBART•www.hobartcorp.com SOLUTIONS/BENEFITS A120 MIXER CAPACITY CHART '/3 H.P. Hobart Designed Motor Recommended Maximum Capacities - dough capaci- Durability ties based on 70°F. water and 12% flour moisture. ■ Heavy-duty to meet the most demanding operations AGITATORS PRODUCT SUITABLE FOR A120 OPERATION 15-Minute Electric Timer CAPACITY OF BOWL(QTS.LIQUID) 12 Convenience, Ease of Use, Consistency Egg Whites D 1/4 pts. ■ Supports recipe mixing times Mashed Potatoes B&C 10 lbs. ■ Simplifies operation Mayonnaise(Qts.of Oil) B or C or D 4/2 qts. ■ Provides accurate results and eliminates Meringue(Qts.of Water) D 3/4 pts. overmixing Waffle or Hot Cake Batter B 5 qts. Three Fixed Speeds Whipped Cream D or C 21/2 qts. Flexibility, Reliability, Consistency Cake,Angel Food (8-10 oz.cake) C or I 7 ■ For incorporating, blending, mixing ingredients Cake, Box or Slab B or C 12 lbs. ■ Supports consistent results and thorough mixing Cake,Cup B or C 12 lbs. Cake,Layer B or C 12 lbs. Gear-Driven Transmission Cake, Pound B 12 lbs. Durability, Reliability Cake,Short(Sponge) C or I 8 lbs. ■ Ensures consistent performance and minimum Cake,Sponge C or 1 61/2 lbs. downtime with positive drive under heavy loads Cookies,Sugar B 10 lbs. Dough,Bread or Roll Hobart Attachments (Lt.-Med.)60%AR § ED 13 lbs. Durability, Flexibility Dough, Heavy Bread 55%AR § ED — ■ Hobart manufactured accessories are designed Dough Pie B&P 11 lbs. for long-term usage under heavy-duty Dough,Thin Pizza 40%AR Conditions (max.mix time 5 min.) §$ ED — ■ Large array of attachments provide multiple Dough, Med.Pizza 50%AR §$ ED — uses for recipe and product processing Dough,Thick Pizza 60%AR §$ ED — Dough, Raised Donut 65%AR ED — Dough,Whole Wheat 70%AR ED — Eggs&Sugar for Sponge Cake B&C or 1 5 lbs. Icing, Fondant B 7 lbs. Icing,Marshmallow C or 1 VA lbs. Shortening&Sugar,Creamed B 9Y2 S. Pasta,Basic Egg Noodle (max.mix time 5 min.) ED — NOTE:%AR(%Absorption Ratio)-Water weight divided by flour weight.Capacity depends on moisture content of dough.Above capacities based on 12%flour moisture at 70OF water temperature. § If high gluten flour is used,reduce above dough batch size by 10%. $ 2nd speed should never be used on 50%AR or lower products. USE OF ICE REQUIRES A 10%REDUCTION IN BATCH SIZE. 1 gallon of water weighs 8.33 lbs. NOTE:Attachment hub should not be used while mixing. Page 2 of 4 F-7519—A120 Mixer s•tchenA®•d® Project COMMERCIAL Name -•!e Item # A 2000 North M-63, Benton Harbor, MI 49022 Quantity n 855-845-9684 web:www.kitchenaidcommercial.com Available at O email: commercial@kitchenaid.com Approval m KSMC895 Commercial 8-Quart Bowl Lift SMUMIDRWITH BOWL GUARD D �. NSF CERTIFIED FOR COMMERCIAL USE • OUR MOST POWERFUL,QUIETEST AVAILABLE 1.3HP high- efficiency DC motor'is designed to run longer and delivers optimum torque with less heat buildup.Easily handles recipes requiring longer mixing,kneading and whipping times. • LARGE CAPACITY easily mixes recipes with up to 16 cups of 4 flour, 13 dozen cookies or kneads dough for 8'/a loaves of bread in a single bowl. �--- • POWERCORE®TECHNOLOGY delivers consistent power va while reducing heat buildup for long-lasting performance • COMMERCIAL BOWL-LIFT DESIGN 00 �d • ROBUST METAL CONTROL KNOBS �,._ Cn 00 • ALL-METAL precise gear and housing design produces a smooth,quiet sound. _ • SPEED CONTROL PROTECTION reduces the risk of D accidentally turning on the mixer when wiping it clean. All • STAINLESS STEEL BOWL GUARD provides added safety,to � ' W . i' I keep objects from entering the mixer during operation. rt n$' • DISHWASHER SAFE stainless steel Flat Beater, 11 Wire KSMC895DP Eliptical Whisk and Spiral Dough Hook. r 500 Watts 1.3HP High-Efficiency 4 MOTOR DC Motor*. � )_ 120 V,60 Hz Converted +•+rsza,�.. � to d S,000x per Second ( z NSF COMMERCIAL ) Yes z ' CERTIFIED CAPACITY 1 8-Qt/7,6L KNOB STYLE Heavy-Duty Metal I 7 X ATTACHMENT HUB Fits All KtchenAid•Attachments High-Performance Control KSMC8950B KSMC895WH C CONTROL PANEL ASF—Advanced Sensory Feedback (15,000x per second) Brushed Stainless Steel _ BOWL I with Commercial"J"Style Handle " BEATER Dishwasher Safe—Stainless Steel " O DOUGH HOOK Dishwasher.Safe—Stainless Steel Spiral 7 _ 1 � WHIP Dishwasher Safe—Stainless Steel 11-Wire Elliptical' r WARRANTY 2-Year Hassle.Free w C c �L us AM00 9RICA ® O DESIGNED AND ASSEMBLED IN THE U.S.A. KSMC895ER 'Motor horsepower for our mixer motors was measured using a dynamometer,a machine laboratories routinely use to measure the mechanical power of motors.Our 1.3-horsepower(Hl)motor reference reflects the horsepower rating of the motor itself and not the mixer's horsepower output to the mixer bowl. KSMC895 Commercial 8-Quart Bowl Lift SFT&N [0) R1 E IRWITH BOWL GUARD Accessories Included 91 i1� 1 MODELS MODEL# s STAND MIXER UP KSMC895DP Stand Mixer-Dark Pewter 883049332888 KSMC895ER Stand Mixer-Empire Red 883049332864 KSMC8950B Stand Mixer-Onyx Black 883049332871 KSMC895WH Stand Mixer-White 883049332857 MODEL# ACCESSORIES , UPC" i�o `:'. t KSMC8QBOWL 8-Quart Bowl 883049288246 KSMC7QBOWL 7-Quart Bowl 883049254623 KSMC5QBOWL 5-Quart Bowl 883049288253 KSMC7QDH Stainles_.Steel Dough Hook 883049254456 KSMC7QEW Stainless Steel Elliptical Whisk 883049254449 KSMC7QFB Stainless Steel Flat Beater 883049254647 PACKAGING DIMENSIONS ;I,r?a (Y1q �yG,j:oss,Weightwith�o.,trtP,2<kaging,,,, ,PepthwithoutPads ing -- ' WdthwidroutPadkagfn *, . HeightwithoutPackaging Qty KSMC895 25.5 Ibs 11.5 kgs 14.6 in 37.1 cm 13.3 in 33.8 cm 16.5 in 41.9 cm 1 �, ,..�-ter ^-fir- ,. . ., �, �: a .p„„,qh''--':> Z Z Accessories Gross Weight without Pad;agmg Depth without-Packaging Width without Packaging `Height without Packaging Qry J KSMC80BOWL 2.8 Ibs 1.2 kgs 8.1 in 20.6 cm 9.8 in 24.8 cm 12.5 in 31.8 cm 1 Q Y Q Q KSMC7QBOWL 2.61bs 1.2 kgs 7.5 in 19.1 cm 9.8 in 24.8 cm 12.5 in 31.8 cm 1 > O KSMC50BOWL 1.7 Ibs 0.8 kgs 6.3 in 15.9 cm 9.8 in 24.8 cm 12.5 in 31.8 cm 1 Z KSMC70DH 0.8lbs 0.4 kgs 4.0 in 10.2 cm 3.3 in 8.3 cm 6.8 in 17.2 cm 1 KSMC70EW 0.6lbs 0.3 kgs 6.0 in 15.2 cm 3.5 in 8.9 cm 7.0 in 17.8 cm 1 KSMC7QFB 1.1 Ibs 0.5 kgs 6.5 in 16.5 cm 1.3 in 3.2 cm 7.3 in 18.4 cm 1 Model Bross N+eigl't firth Packaging " Depth w th Paackaging `W 8th�w th Padkaging` `f Height=with P*agirig�1^• y •, ";; r . th, t wa e�»w Qt KSMC895 30 5 Ibs 13.8 kgs 17.3 in 45.9 cm 13 3 in 33.8 cm 19 4 in 49.3 cm 1 Z Z Acces"s"dr(es - nV Gross`'Yleighi with Packaging w h 'a Qap'th;wrthPaekaging Wictkwit( Packagil g; Height, rth'ackagiog' Qty = O J Y KSMC8QBOWL 3.3lbs 1.5 kgs 8.5 In 21.6 cm 10.3 in 26.1 cm 11.5 in 29.2 cm 1 Q U Q � KSMC7QBOWL 3.1 Ibs 1.4 kgs 8.5 in 21.6 cm 10.3 in 26.1 cm 11.5 in 29.2 cm 1 > LL KSMC5QBOWL 2.3 Ibs 1.0 kgs 8.5 in 21.6 cm 10.3 in 26.1 cm 11.5 in 29.2 cm 1 O Z KSMC7QDH 1.0Ibs 0.5 kgs 4.6 in 11.8 cm 4.6 in 11.8 cm 7.4 in 18.7 cm 1 3 KSMC7QEW 0.8lbs .04 kgs 6.8 in 17.2 cm 6.3 in 15.9 cm 6.1 in 15.6 cm 1 KSMC7QFB 1.4lbs 0.6 kgs 6.8 in 17.2 cm 6.3 in 15.9 cm 6.1 in 15.6 cm 1 Y U Y Q U . ax e fUl�de� n rt s WeighT with Pa mg Pth»rth Packaging y Width with Packaging Height with Padkagmg Qt y j KSMCB95 30.5lbs 13.8 kgs 17.6 in 44.7 cm 13.6 in 34.5 cm 20.0 in 50.8 cm N 1 Q 0 0 911 0 • • •• •I :� •.:� /�AOTAK High-temp Undercountord .. Glass Washer � � � Model #: DSP4DPS Hsu x X . Product Details yk F • 18/10, AISI 304 stainless steel construction } • Wash and rinse temperature thermometers • Stainless steel lower and upper rotating wash arms • Stainless steel lower rotating rinsing and upper fixed • Extractable control panel for easy maintenance • Rinse aid dispenser • Detergent pump • Automatic tank loading • Door-opening safety device • Thermocontrol device ensures water reaches set point for every rinse cycle, even when used non-stop • Security thermostat Not suitable for installation in non-commercial or residential applications. Included Accessories Size 1 baskets for dishes 23-3/4"W x 25"D x 32-1/4"H 1 cutlery container 1 generic basket Cycle Period: 2 Minutes Certifications Capacity: C SUS 30 Baskets per hour LISTED WMM31MDMASHERS ANSIMSF3 13CA MOTAK reserves the right to make changes to the design or specifications without prior notice. .•o MOTAK 1 305 KaTom Drive, Kodak,TN 37764 1 800-541-8683 1 www.katom.com MOTAK 100TAK High-temp Undercounter Glass Washer Model #: DSP4DPS Plan View Specifications 2970m 2500in 1378 DSP4DPS o _ _ Voltage 208V/lph/60Hz H Washing Pump 650 W� N Wash Tank Elements 2000 W -- S S o Rinse Tank Elementsstltl 3000 W L E Total Rating 3650 W S E -�i- --A- L-- - $ Maximum Current Intensity 20 A k Front A Side (door open) Plates Clearance 11.81-in. Work Height 12.40-in. 16.54 w....am Tank Capacity 4-gal. A Maximum height of drain from floor Boiler Capacity0.8-gel. E� ;S iE E 'Waterintet 3/4"G Pump Delivery _ 2601t/min L Electric input 208 V 60Hz Water Connection 131°F S Drain 32 mm 1 1/4"G ( — •- __ Water Consumption Per Cycle 0.6-gal. m Water Consumption Per Hour 19 gal Water Pressure t 20±5 psi _.a .. Water Hardness 5-10 TH(°F) 23.70 in Rinsing Water Temperature 179 -194°F Rear Water Inlet 3/4"G Water Outlet 1-1/4 G Net Weight 95 lbs. Gross Weight 1 106 tbs. Packing Size 24 80"W x 28.37"L x 44.09"H Noise Level <70 dB(AJ ;�. m� ' MOTAK reserves the right to make changes to the design or specifications without prior notice. MOTAK 1 305 KaTom Drive, Kodak,TN 37764 1 800-541-8683 1 www.katom.com 1 I V I A K EODSERIES tuffbafaffilif E28D4 Technical data sheet for E28D4 ON THE SK2731N / SK2731U STAND Full Size Digital / Electric Convection Oven on a Stainless Steel Stand STANDARD FEATURES • 4 460mm x 660mm/18"x 26"full size sheet pan capacity • 4 400mm x 600mm tray capacity 80mm tray spacing • Compact 810mm width �® Digital display Time and Temperature controls • Large easy view 3/4"/20mm high displays • Electronic thermostat control • Electronic timer • Manual mode and Program mode • 20 programs with 3 stage cooking and stage end alarms • Steam injection mode and manual injection • Twin bi-directional reversing fans • 5.6kW heating power • Vitreous enamel oven chamber • Plug-in continuous oven door seal qW • Safe-Touch vented drop down door • Stay-Cool door handle • Heavy-duty door hinges • Easy clean door glass system • Dual halogen oven lamps a • Twin dia. 180mm full stainless steel oven fans • Anti-skid 50mm dia.76mm high adjustable stainless E28D4 steel feet Unit shall be a Moffat electrically heated Turbofan convection oven.The oven shall have a one piece porcelain enameled oven chamber,stainless top and sides and • 4 oven wire racks supplied safe touch vented easy clean drop down door.Oven shall have capacity for four full • 100%recyclable packaging size sheet pans.The oven shall have°.8kW heating elements.The oven shall have twin bi-directional single reversing fans:and feature a single halogen oven lamp.The oven shall be controlled by an electronic control having separate digital displays and ACCESSORIES adjusting knobs for time and temperatire functions.The oven control shall allow both manual and programmed operating modes with programmable steam injection • Turbofan SK2731N Oven Stand and 3 stage cooking.Oven shall be abbe to be bench mounted on 76mm feet or mounted on oven stand models SK2731N or SK2731U.Unit shall be supplied in suits 400mm x 600mm trays and GN 1/1 pans 100%recyclable shipping packaging. • Turbofan SK2731U Oven Stand SK2731N Unit shall be a Moffat Turbofan stainless steel oven stand.The stand shall be suits 460mm x 660mm/18"x 26" pans constructed from stainless steel tube with castors,with front castors having dual swivel and wheel locks.It shall be fitted with 6 tray runners suitable for up to 600 x 400 trays and GIN 1/1 pans.The stand shall be fully compatible with,and support, Turbofan Convection Oven models E27,E28,and E31.Unit shall be supplied in 100%recyclable shipping packaging. SK2731U Unit shall be a Moffat Turbofan stainless steel oven stand.The stand shall be constructed from stainless steel tube with castors,with front castors having dual swivel and wheel locks.It shall be fitted with 6 tray runners suitable for up to 12 half size sheet pans or 6 full size sheet pans.The stand shall be fully compatible with,and support,Turbofan Convection Oven models E27,E28,and E31.Unit shall be supplied in 100%recyclable shipping packaging. 2ODSERIES tuffbafafff E28D4 E28D4 Full Size Manual/Electric Oven Internal Dimensions Convection Oven on a Stainless Width 695mm Steel Stand Height 355mm Australia Depth 4.0mm CONSTRUCTION Volume 0.116m3 www.moffat.com.au Vitreous enamel fully welded oven chamber Oven Rack Dimensions New Zealand Stainless steel front,sides and top exterior Width 650mm www.moffat.co.nz Stainless steel oven fan baffle and oven vent Depth 460mm www.turbofanoven.com Removable 4 position chrome plated wire side racks Nett Weight(E28D4) Oven racks chrome plated wire(4 supplied) Australia Stainless steel frame drop down hinged door 69.5kg Moffat Pty Limited 5mm thick door outer glass Packing Data(E28D4) 5mm thick low energy loss door inner glass 86.5kg Victoria/Tasmania Heavy-duty counterbalanced door hinges 0.55m3 740 Springvale Road Wear resistant powder coated welded door handle Width 870mm Mulgrave,Victoria 3170 Stainless steel control panel Height 755mm Telephone+61 3-9518 3888 Aluminised coated steel base and rear panels Depth 835mm Facsimile+61 3-9518 3833 CONTROLS vsales@moffat.com.au Electronic controls with Digital Time and Temperature display, SK273 1 N/U Stainless Steel Stand Manual or Program modes All stainless steel welded frame oven stand for Turbofan New South Wales Large 20mm high LED displays E27,E28 and E31 Series model ovens Telephone+61 2-8833 4111 Two individual time and temperature setting control knobs 6 position tray runners standard nswsales@moffat.com.au ON/OFF and Oven Lights key 4 76mm diameter wheel swivel castors standard with g Y Timer Stag/Stop key 2 front castors with dual swivel and wheel lock South Australia Steam injection key Welded 38mm and 32mm square tube front and rear frames Telephone+61 3-9518 3888 Programs select key Welded rack supports/side frames vsales@moffat.com.au Top frame oven supports suit Turbofan E27,E28 and E31 Actual temperature display key Queensland Adjustable buzzer/alarm volume Series oven mounting Telephone+61 7-3630 8600 Thermostat range 5D-260°C Supplied CKD for assembly on site gldsales@moffat.com.au Timer range from 180 minutes in countdown mode External Dimensions(SK2731N/U Oven Stand) Western Australia Timer range up to 999 minutes in time count mode for Width 610mm holding,slow cooking Height E80mm Telephone+61 8-9413 2400 Over-temperature safety cut-out Depth E.50mm wasales@moffat.com.au CLEANING Nett Weight(SK2731N/U Oven Stand) New Zealand Stainless steel top and sides continuous exterior panel 19.5kg Vitreous enamel oven chamber Packing Data(SK2731N/U Oven Stand) Moffat Limited Fully removable chrome plated oven side racks 22kg Christchurch Removable stainless steel oven fan baffle 0.11m3 45 Illinois Drive Full stainless steel oven fans Width 830mm Easy clean door system with hinge out door inner glass(no (Zone Business Hub Height qO0mm tools required) 1 52mm Rolleston 7675 Removable plug-in oven door seal(no tools required) Depth 52 Telephone+64 3-983 6600 Supplied CKD for assembly on site 76mm high stainless steel feet for easy access underside Facsimile+64 3-983 6660 SPECIFICATIONS INSTALLATION CLEARANCES sales@moffat.co.nz Electrical Requirements Rear 25mm Auckland 230-240V,50/6OHz,1P+N+E,5.8kW,25A LH Side 25mm Telephone+64 9-574 3150 No cordset supplied RHSide 25mm sales@moffat.CD.nz Water Requirements(optional) r CLEARANCE FROM SOURCES HEAT Cold water connection a/a"BSP male 80psi maximum inlet pressure/20psi minimum inlet pressure A minimum distance of 300mm from the appliance sides s required External Dimensions Width 810mm J��J-7 Height 662mm including 76mm feet Se '..su -t Depth 762mm IS09001 �e,omm,�,x� ,@mm�n �w,�„x- ,a ,��a ,umm,.u• Quality FT I � Management Standard Designed and manufactured by IS09001 All Turbofan products are designed and =� manufactured by Moffat using the internationally recognised IS09001 quality management system,covering k R design,manufacture and final inspection, ensuring consistent hid quality at all times. In line with policy to continually develop and improve its products,Moffat Limited reserves the right to change specifications and design without notice. ® 0 Copyright Moffat Ltd AN.TFN.S.1901 an Ali Group Company 'A 9 lo G R O U P The Spirit of Excellence