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CRAIGVILLE BEACH SNACK BAR - FOOD
�Luke Gem SfYi� b> ed qI�G ct 9� IKE Town of Barnstable BOARD OF HEALTH 4 John T.Norman Board of Health Donald A.Gaudagnoli,M.D. �utYsrtE F.P.(Thomas)Lee y MA 02601 Daniel Luczkow,M.D.,Alt. 200 Main Street, Hyannis, 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, 3056, 146, 189 and 189A; Chapter 111,Sections 5 and 127A:, a permit is hereby granted to: Permit No: 279 Issue Date: 05/18/2022 DBA: CRAIGVILLE BEACH ASSOC. SNACK BAR OWNER: CRAIGVILLE BEACH ASSOCIATION Location of Establishment: 915-B CRAIGVILLE BEACH RD CENTERVILLE MA 02632 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 0 OutdoorSeating: 24 Total Seating: 24 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE- ICE CREAM: Q� FROZEN DESSERT: $30.00 Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: ..-.- • Initials: Town of Barnstable For Office Use Only-Date Paid`4 BAMSTA,JNLE, : Inspectional Services •`� Public Health Division Check# Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE'���� NEW OWNERSHIP � RENEWAL ��� � 7K NAME OF FOOD ESTABLISHMENT: 4 a ADDRESS OF FOOD ESTABLISHMEN J i 9141_ MAILING ADDRESS(IF DIFFERENT FROM ABOVE)• ),Ile 07"3- d�rv3� ff 1� E-MAIL ADDRESS:n/� 17 C�/ D CO�o�3 �• r�d G7'� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO ✓...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: V DATES OF OPERATION:(//j/ TO /J- / 696.D NUMBER OF SEATS: INSIDE: 1_L OUTSIDE;,gO 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? NO IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? � 5 TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) / v 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*** REQUHRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-8624644 Q:\Application FormsTOODAPP 2020.doc L _ ,OWNER INFORMATION: o�� FULL NAME OF APPLICANT �ja oC(4 �d n SOLE OWNER: �NO D.O.B -� OWNER PHONE# ADDRESS `` CORPORATE OWNER: Ci' e CORPORATE ADDRESS: �"I P �� 3 PERSON IN CHARGE OF DAILY OPERATIONS: 2P.6 Oj 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 SIGNAT OF PLICANT 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.townofbarnstablc.us/healthdivision/applications.asp. 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.31s`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FonnsTOODAPP REV3-2019.doc April 4, 2022 Re: CBA Snack Bar,915E Craigville Beach Road,Centerville, MA 02632 Good morning Dianna, Enclosed is the permit application as requested. I appreciate the waiving of any late fees. Since we will not be opening until June 18th(June 25th is the actual beach opening), I won't be ready for a health inspection until the beginning of June, if that works for you. Any day you say is fine. Please let me know if there is anything you need from me at this point. I will be sending you the Servsafe certificate for the second person in the meantime. Thank you for all help and consideration. Nancy nancyb66888@gmail.co I CN€t Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagngli,M.D. BARNSTASM : Paul J.Canniff,D.M.D. MAn 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstablems 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: 279 Issue Date: 05/01/2020 DBA: CRAIGVILLE BEACH ASSOC. SNACK BAR OWNER: CRAIGVILLE BEACH ASSOCIATION Location of Establishment: 915-B CRAIGVILLE BEACH RD CENTERVILLE, MA 02632 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 0 OutdoorSeating: 24 Total Seating: 24 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - --- -- — - - -- — MOBILE-FOOD: MOBILE-ICE CREAM: Gr'� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: � w F For Office Use Initials:� Town of Barnstable K � Date Paid $Off✓ _ ,W,,,W",E, : Inspectional Services s 9 ``� Public Health Division Check QED MAC a Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT QG DATE J NEW OWNERSHIP RENEWAL 5 NAME OF FOOD ESTABLISHMENT: L P Snack � al�h6, 6.po �-' ADDRESS OF FOOD ESTABLISHMENT: lavi � MAILING ADDRESS(IF DIFFERENT FROM ABOVE): orlvv�� E-MAIL ADDRESS: r)Q� �� ��� a me l G�L� 63,4 TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER: YES_NO ✓... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: J DATES OF OPERATION:_/" TO %/-2 /,:' NUMBER OF SEATS: INSIDE: _C2 OUTSIDE: _,g_4 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? /y3 z) 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*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q: Application FormsTOODAPP 2020.doc here, uji 11 be-. nD il)&,-er OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: YES/NO D.O.B - 3 - OWNER PHONE # -5-Oe ` `7 7 ( -- J',-9D-3 ADDRESS ' 3 ka/L e , Inn CORPORATE OWNER: CORPORATE ADDRESS: e /kn q 9a? PERSON IN CHARGE OF DAILY OPERATIONS: 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 141 ALA I.— �1.-1va'a".d Po 0) �-1 2. (i11� Brown 010 4 � SIGNATU 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 littp://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. QAApplication FormsWOODAPP REV3-2019.doc is q MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include copies of your employees' food protection manager training certificates (at least two) and food allergen awareness training certificate (at least one.) In addition, please include the required fee amount (see fees at bottom of this page). Make check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax copies of your employees' food protection manager training certificates (at least two) and food allergen awareness training certificate (at least one.) In addition, you must mail the required fee amount (see box below). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. FEES: Bed &Breakfast Permit= $55; Food Service Permit 0-49 seats=$250; 50 or more seats$300; Continental Breakfast= $30; Retail Food (only TCS Foods) =$20; Retail Food Store—Less than 8,000 S.F. _ $100, more than 8,000 S.F. =$285; less than 1,000 S.F.; Retail Food Combo/Limited Prep. - $200.00; Cottage Food Industry= $75; Mobile Truck=$50; Mobile Ice Cream Truck= $35; Frozen Dessert License=$30; Additional non-refundable Fee for New Establishment or New Ownership= $100-$500(see staff), Late Fee = $10 Q:\Application FormsTOODAPP REV3-2019.doc rt €r Town of Barnstable BOARD OF HEALTH u Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. RAR RZAB E, John T. Norman '$� + 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate 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: 279 Issue Date: 05/15/2019 DBA: CRAIGVILLE BEACH ASSOC. SNACK BAR OWNER: CRAIGVILLE BEACH ASSOCIATION Location of Establishment: 915-B CRAIGVILLE BEACH RD CENTERVILLE, MA 02632 Type of Business Permit: FOOD SERVICE An nual: Seasonal: YES IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE- FOOD: J MOBILE-ICE CREAM: G�� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: I PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE i Restrictions: - �_0* rosy For Office Use Only: Initials: o� Town of Barnstable --- - -- Date Paid r Amt Ed BARNSTABLE, : Inspectional. Services 0 # prEOMAy Public Health Division Check Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office. 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE �_�� _�C� NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: l: /� V/ Avc� �1 ; ADDRESS OF FOOD ESTABLISHMENT; U! _ r u a✓ � MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: & TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (M)77(-- TOTAL NUMBER OF BATHROOMS: d WELL WATER:YES NO i-/ ...'(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: V DATES OF OPERATION:b—1 1 M6 TO r NUMBER OF SEATS: INSIDE: 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? / �Y IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? / r TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) XFOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) G 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) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL,MOBILE &_NEW FOOD ONLY' REQUIRED TO CALL HEALTH DIV FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q Upplication Fornis\F00DAPPRL;V2018.doc A Z V - �i qS f PLEASE CALL 508-862-4644 OWNER INFORMATION: D FULL NAME OF APPLICANT SOLE OWNER: YES/N D.O.B OWNER PHONE# -7-7 ADDRESS -,�. /Y1 A o k� � Tl(���O CORPORATE OWNER: - FEDERAL ID NO.: CORPORATE ADDRESS: ( 1 y� • I I„� ��� PERSON IN CHARGE OF DAILY OPERATIONS: d Food Protection Managers AND at least 1 Allergen Awareness Certified Staff List(2) Certified g ( ) g 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. E Certified Food Managers Expiration Date Allergen Awareness Expiration Date Ivo/qlcu VYUA(I :r /4 Id SIGNATURE OF APPLICANT DATE I ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile hocks 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. 1 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/healtlidiyision/ai)p]ications.asp, OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited, TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. i NOTICE: Permits run annually from January Istto Dec.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE CONTLETED APPLICATIONS)AND REQUIRED FEES BY DEC l st. E i Q:kApplication FormsTOODAPPREV2018.doc i PERMIT NO: TOWN OF BARNSTABLE 06/12/18 279 BOARD OF HEALTH PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94, Section 395A and Chapter 111,Section 5 of the General Laws,a permit is hereby granted to: CRAIGVILLE BEACH ASSOCIATION D/B/A: CRAIGVILLE BEACH ASSOC. SNACK BAR Whose place of business is: 915 CRAIGVILLE BEACH RDX B , CENTERVILLE, MA 02632 Type of business and any restrictions: FOOD SERVICE ESTABLISHMENT To operate a food establishment in the TOWN OF BARNSTABLE RESTRICTIONS IF ANY: SEATING: 0 ANNUAL: SEASONAL: YES TEMPORARY: F E E S BOARD OF HEALTH RETAIL FOOD STORE: Paul J. Canniff, D.M.D, Chairperson FOOD SERVICE ESTABLISHMENT: $250.00 Junichi Sawayanagi RESIDENTIAL KITCHEN FOR RETAIL SALE: Donald A. Guadagnoli, M.D. RESIDENTIAL KITCHEN FOR BED+BREAKFAST: MOBILE FOOD UNIT: Permit expires: TOBACCO SALES: 12/31/18 �/° FROZEN DESSERT: Thomas A. McKean, RS, CHO CATERER: Director of Public Health i HE Town of Barnstable 2�1 Op1 1p� Regulatory Services i, i saxrrsrne�e, * Richard V. Scali, Director C� �- BARNSTABI,E MASS. i639• 10� t + n�aa"sns`i ui`s os V�Viu mtirwieavis'ru! Public Health Division Thomas McKean, Director 200 Main Street, Hyannis,MA 02601O Office: 508-862-4644 X Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISIIMENT DATE: C"env-L��-(� CavA p )jku�ro 5 4sso c• NAME OF FOOD ESTABLISHMENT: 6yly I yi t ID 'J" 4-s5 o r ,50 ac k S ADDRESS OF FOOD ESTABLISHMENT: 0)p 5 Gra 6u me PeAck Qj, 6t44 y U L l_b MAILING ADDRESS(IF DIFFERENT FROM ABOVE): P105 W, � ke, a0 I e1r V1 ll.Y 6Z&3 2 E-MAIL ADDRESS: U CCC. © r r TELEPHONE NUMBER OF FOOD ESTABLISHMENT: NUMBER OF SEATS*: INSIDE: _ OUTSIDE:a CO TOTAL: * Note: If-indoor seating provided, see Licensing regarding Common Victuallers Lic se n �� TOTAL NUMBER OF BATHROOMS: U — I(I �'� n' J CP�.�r �'`�-�" ANNUAL OR SEASONAL OPERATION: S 0)4 0- TYPICAL HOURS OF OPERATION MON-FRI: D CD TO O DAYS CLOSED EXCLUDING HOLIDAYS (I.E. MONDAYS) _ Q IF SEASONAL: APPROXIMATE DATES OF OPERATION: �/I/ &TO__!�Jj I /1(7 ***REMINDER*** SEASONAL ESTABLISHMENTS MUST CALL FOR INSPECTION PRIOR TO OPENING TYPE OF ESTABLISHMENT: PLEASE CHECK ALL THAT APPLY FOOD SERVICE RETAIL FOOD BED & BREAKFAST CONTINENTAL BREAKFAST *IF SEATING: ALSO,MUST OBTAIN RESIDENTIAL KITCHEN A COMMON VICTUALLER'S LICENSE MOBILE FOOD FROM LICENSING DIVISION. TOBACCO SALES FROZEN DAIRY DESSERT MACHINES CATERING OUTSIDE DINING (OVER) Q\Application Forms\Foodappldoc ***REMINDER*** IF OUTSIDE DINING,YOU MUST BE APPROVED BY THE HEALTH DIVISION AND LICENSING,AND MEET ALL OF THE OUTSIDE DINING CRITERIA IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? CONTACT INFORMATION: Ct, l S i Ia JA Ca UA n kU t`ftA ((f0 n 1 FULL NAME OF APPLICANT V1 `t" �" J / SOLE OWNER: �/NO D.O.B r 1 t� ea O s5 oZ. cc1 ADDRESS f 5 CfQ(oGff tj AeaC� Loa . CQJAleyv�CL�2 PHONE # (� - IF APPLICANT-ISA PARTNERSHIP,FULL-NAME AND HOME ADDRESS OF ALL - PARTNERS: IF APPLICANT IS A CORPORATION:. FEDERAL IDENTIFICATION NO. Oq -600 L�917 STATE OF INCORPORATION: V►'�� 5� ��� "� FOOD SERVICE ESTABLISHMENTS CONDUCTING FOOD PREPARATION (EXCLUDES RETAIL FOOD ESTABLISHMENTS THAT DO NOT PREPARE FOOD AND CONTINENTAL BREAKFAST): EFFECTIVE JANUARY 1, 2004, EACH FOOD SERVICE ESTABLISHMENT IS REQUIRED TO HAVE AT LEAST TWO CERTIFIED FOOD PROTECTION MANAGERS. AT LEAST ONE CERTIFIED FOOD PROTECTION MANAGER IS REOUIRED TO BE ONSITE DURING ALL HOURS OF OPERATION.***PLEASE PUT THE NAME OF THE.ESTABLISHMENT ON EACH OF THE CERTIFICATES*** LIST THE NAMES OF YOUR CERTIFIED FOOD PROTECTION MANAGERS (I.E. SERVSAFE.) q 1. EXPIRATION DATE: 2. EXPIRATION DATE: / Iaf EFFECTIVE FEBRUARY 1, 2011 EACH FOOD ESTABLISHMENT THAT COOKS, PREPARES, OIL SERVES FOOD INTENDED FOR IMMEDIATE CONSUMPTION EITHER ON OR OFF THE PREMISES SHALL HAVE AT LEAST ONE CERTIFIED FOOD ALLERGEN AWARENESS TRAINED STAFF MEMBER. *** PLEASE PUT THE NAME OF THE ESTABLISHMENT ON THE CERTIFICATE*** LIST THE NAME OF YOUR CERTIFED FOOD ALLERGEN AWARENESS TRAINED STAFF. 1. EXPIRATION DATE: ^tea SIGNATURE OF APPLICANT AND DATE Q:Wpplication For7ns\Foodapp3.doc • ��s rMocv� �-�-� � LcS U,GI rMIN #t}sp4i y i �" J+ 1 cr 3 r' (t '•. i 4i .F.• 3 t / tr.M•t' > 1 t��' t'i ,. t k k. i •�;' p;..l 1 k, �, .? y�. rr 7 �,Y4:r 7.'y �' o iYy�` �'1\\' t1 11, kt .,..1+ ::� r a. � i',�.r' i '.is, .:,yy' •5}�`�',�,f�%YI :i { 'y.� , � yr"r�4 � ;roc'm%';'xis, 4o-ro �'t<•i �• L e FSsI 7 =L' , Cl�u�;.'�y`i,,t.P �' .i t�, x1'1, r,.ya 4dlS ,'�I •�t "ti r�tx. tkd • Ip, �. � � rp ''+:,�y"��'. .J�� '� (,.� -jai, �+•,r..l'�i_.:r/ ;5 ff��}, ?�: �7,r n r a k, sYL- ,r hKt•`:5 4'#c." 4y n rh ` i' fi t •. f J�C (.tp a1 t„ is a t y 4r Y. .. �k•, t? 7. t>s �y�,�,w•'f i r�.2� .p.� r � �'�'t' j3'��.;, F -rl .� I I �{ , ,x+)J t ?a� h r � ��� t k` ! 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'i CBA Snack Bar featuring Four Seas I•ce Cream 915 .Craigville Beach Rd, Centerville MA 02632 z, rl 0 l�' r i N .-� �� pt E i. ,J fy _�'UfgSrJ•M�j ev'y�r '+! �!�., \ •ra,� }h �, 15ry ��: of �� lF �'V .�1 •iyt`t ��F�� S�lY� rl(1 ;�}.�✓1 J F 1 ��� ��y��� 1 pt �.F � �.�t r �1f /� .�' S' aX5 �+i aV.l •t; '�M" F + �j' ��f f s fir',. •. wr , j d � N"11 1 �Ir^ ?Dm� ,jl�r'{v 4�56,k�'n"'17, VIL. y !, 1 �q�_ ti e• +II ! v J ME CBA Snack Bar featuring Four Seas Ice Cream 915 Craigville Beach Rd, Centerville MA 02632 Y ;r� • 1 Town of Barnstable Geographic Information System r-V,lI rl&`/ IVIGy G 1,LV 1 J 226161 226153 O #29 #17 726004CNID / M6009 �261 261 #1006 L/ J R #932 62 I2�6008001 / / / =6160CND #� 226163 226005 #946 / / /// �#25 #41rd #974 226007 6/ #966 ( l 226159 ,AW165 # 1 #17 t y V � 226166 h #16� 226171 p Ili #20 rr-6112E7 l / z26tse `.8157 y #10 14 206013 ® f FACH�� # y OrRl H #997 2261701 Z 226175 #B48 2.5.1 #915 225030 225003 In�AU� #879 225031 #865 #873 225004 #861 2250DS #857 4 0 64 Feet DISCLAIMERS:This map is for planning purposes only.it is not adequate for legal Map:225 Parcel 001 Selected Parcel E bowdary determination or mgWatory interpretation. Enlargements beyond aacale of owner.CHRISTIAN CAMP MEETING Total Assessed Value:$2919800 w _ 1-=100'may not meet established map accuracy standards The parcel lines on this map Go-Owner. Acreage:245 acres Abutters _ are only graphic representations of Assessor's tan parcels They are not We property boundaries and do not represent accurate relationships to physical features on the map Location:915 CRAIGVILLE BEACH ROAD Buffer such as building locations. 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Town of Barnstable Geographic Information System —-- - 2'16161 236153 O #29 #17 ?Z6004CND / 7/' z6008 #932 '�16162 33 226DO8001 22616�D # _ / •#25 226163 msom 2?60D6 #946 / �// #41Ed #W9 #974 Z%Do, r #966 l ( l 226t , #'17 226165 226166 h #16r 2•r6171 p ® h6m #20 /t 226167 #12 OR 2 l� r �- O, _6168 M6173 208013 ® I CRA,Cv,LCEBceaC i#��. y1®6169 #9 W 010 #997 ® "-'-� 22El j 2?6175 �� y #848 25001 JJJ#915 i P 225030 y 2250AfAaz #s7s 2250313 #86o53 #87 225004 #881 225006 #857 0 64 Feet DW AIMEAS:TIus nW is kr ptmui+9 Paper wn/-pis not adeWEde for legt Map:225 Patcet 001 N Selected Parcel boundary determination or replatory inmpu=on. Enlargements beyond a safe or OVTer_CHRISTIAN CAMP MEETING Total Assessed Value:$2919800 1'=lW may not meet es b&hed map mracy standards The parcel Gees on this map Co-Owner. Acreage:245 acres Abutters are only graphic repres,:maGons oT ASSesoYsiax pmrehi They are not true properly bowtdames and do not represent acmrare relm mtshipsto physical leames m the map Location:915 CAAIGVILL.E BEACH ROAD such as buGding torsions Buffer I I `gyp THE rok, TOWN OF BARNSTABLE - - HEALTH INSPECTOR'S Establishment Name: Date: Page: l of OFFICE HOURS PUBLIC HEALTH DIVISION 8:o0-9:30A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified Mbsq: �0� HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �DlEn MPS° 508-862-4644 - FOOD ESTABLISHMENT INSPECTION REPORT Name a6r�1 Date Type of Type of Inspection Operati n Routine .Address Y-13 Risk Cood Serv' Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen 7General q Mobile Owner HACCP Y/N Temporary Caterer aint Person in Charge(PIC) Time Bed&Breakfast In: ,1" Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Lz, e', - f 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) ❑ ' Action as determined by the Board of Health. Allergen Awareness - 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands 3� ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS r ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color AdditivesJfq6 i= ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) J ❑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 Get/ 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 Z ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories ! a I Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations n , �Q Critical(C)violations marked must be corrected immediately. (blue&red items) •jv�/ Corrective Action Req fired: ❑ 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 in ction today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. Embargo❑ 9 ❑ Emergency Closure. ❑ Voluntary Disposal ❑ Other: 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 g ardless of the number of critical, results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 6=One critical violation and less than non-critical violations re 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 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) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Sign re Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N aervice P PIC's Si n tur Print frozen Out :#Seats Observed Dessert Machines: side Dining Y N g Self Service Wit Srovided Grease Trap Size Variance Letter Posted Y N Dumpster Screen o Y N -• _,-�,.,.�,.•-,,,, -r^r_'•>s:.r-- --_-..:..ti•.�.,.- ......T _. ��-r--w ..,- .. ._. T.--.t-•"Y..•. ,�-v--._.-.. . -�°. �... -�✓-� µ ,,.�..,��-.. _�r,..-. Violations related to Foodborne Illness Viola tion 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 Cooked and RTE Foods.* * 1.9 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives " Contamination from Raw Ingredients 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 15 Poisonous or Toxic Substances (� EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004 * 3-501.16(A) Hot PHFs Maintained At or Above-140°F Other 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F * 7-201.11 Separation-Storage* - Applicants 3-302.11(A) Food Protection* - 20, Time as a Public Health Control 7-202.11 Restriction-Presence and Use* - 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.203.11 Conditions of Use 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils * ( ) q 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 in)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g .Disposition of or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE * 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 3-761.11 Discarding or Reconditioning Unsafe Food 4 Food and Water From Regulated Sources g 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 Warewashing-Hot Water 7.206.12 Roden[Bait Stations* * 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served 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 Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 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 Not Otherwise Processed to Eliminate Equipment ( )O Pathogens*590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meals&Game g * eff cave truzoa 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 Shel�sh and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130*F 121 min Eggs* 4402.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS r 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 temporary and a ide in cater- Ra[i[es-165°F 15 sec* 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 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 * 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 3-201.17 - Game Animals Requirements. g Receiving/Condition - 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHFs 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* 3-403.11 C Commercially Processed RTE Food-140°F* (]Blue Items 23-30) 3-202.11 Package Integrity O y Critical and non-critical violations,which do not relate to the Foodborne * 12 Prevention of Contamination from Hands 3403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated O g illness interventions and risk factors listed above,can be found in the 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs S Tags/Records:Shellstock _ P 9 following sections of the Food Code and 105 CMR 590.000 13 Handwashing Facilities 3-202.18 Shellstock Identification* 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Conveniently 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* - Tags/Records:Fish Products 5-203.11 Numbers and Capacities* 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 * 5-205.11 Accessibility,Operation and Maintenance 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. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 1 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:¢90Formback6-2doc *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. �FIME r TOWN OF BARNSTABLE '/y��/',{//�/) HEALTH�NSPECTOR,s Establishment Name: C MEDatekj/q/ga age: of 'Y t`r OFFICE HOURS �P PUBLIC HEALTH DIVISION a 8:00-9:30 A.M. BARNSTABLE. ' 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified M639•� .0� - HYANNIS,MA 02601 - MON.-FRL No Reference R-Red Item - PLEASE PRINT CLEARLYAm„l fO M s 508-862-4644 FOOD ESTABW.SMMENT INS CTION REPORT bf6 Name Date T e ofyR e of Insaection , 'A ° , er Routine Address Risk " ervic- Re-inspection v ' Level et ' Previous Inspection Telephone Residential Kitchen Date: Mobile a-opera i Owner ACCP Y/N Temporary S ness . Caterer General Complaint Person in Charge(PIC) ime Bed&Breakfast HACCP In: Other - , MInspector lr Each violation checked requires anv explanation on the narrative ages)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ HMO (11A 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) ❑ ' FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities y EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ./1 F ❑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 TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ra ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding /J°� PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control l:/ ZVI > ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) a/` ❑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 i Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations (p 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 Yes- within 90 days as determined b the Board of Health. Overall Rating Voluntary Compliance y ❑ ry p ❑ Employee Restriction/Exclusion I❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ go Embar checked indicate violations of 105 CMR 590.000/Federal Food Code. Emergency Closure ❑ Voluntary Disposal Other: ❑ 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 B=One critical violation and less than 4non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (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. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 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. i l iti vo 4 to 8 non critical 29.Special Requirements (590.009) within 10 days of receipt of this order. violation, l 19ns- ,? ' 30.Other DATE OF RE-INSPECTION: Insp c 's Signature 31.Dumpster screened from public view 0 **Aki Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N plt3As Si na e 7 Print: #Seats Observed _ Frozen Dessert Machines: Outside Dining Y N 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 Coaling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved 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 Pelson 7-102.11 Common Name-Working Containers -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 7-201.11 Separation-Storage* ' Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils * ( ) 9 590.003(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 ( ) P 4-501.111 Manual Warewashing-Hot 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 Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 7202.13 Shell Eggs* Sanitization Temperatures* TIMEIrEMPERATURE 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 Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System * gg Not Otherwise Processed to Eliminate Equipment 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg-dve mnom 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 of Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces 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 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* 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 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* foodborne illness interventions and risk factors. 2-301.14 When to Wash* * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 1 T Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g• g g 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* 3-403.11 C Commercial] Processed RTE Food-140'F* Blue Items 23-30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11 Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated B) g 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 3-202.18 Shellstock Identification* 3-501.14(A) 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 and Capacities* 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* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 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. I °F. rok TOWN OF BARN.STABLE . HEALTH IN$PECTOR's Establishment Name: (2;t��h P-Bate: Page: of ti PUBLIC HEALTH DIVISION i , OFFICE HOURS 8:00-9:30A.M. BABNBTABLE. ` 200 MAIN STREET o 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified Mp39: �•� - - HYANNIS,MA 02601 _ MON.-FRI. No Reference R-Red Item PL SE PRINT EA 508-862-4644 p'FON1P'' F OD ESTABLISHMENT INSPE TON REPORT 7. Name Date Tvoe of Tyne of Inspection r Routine i Address / k Fo d e _ Re-inspection Level Retai Previous Inspection Telephone Residential Kitchen D Mobile re-operation ' Owner HACCP Y/N Temporary ss _ Caterer General Complaint Person' e PIC) Time Bed 8 Breakfast HACCP Other Inspector c Each violati n checked requires an ex lanation on the Harrpiepage(s)and a citation of s ecific rovision s violated. q P P P O Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked ma ose an imminent health hazard and re uire immediate corrective TO 590.009 F Yp q Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM.CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ii ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals ,tP� 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 ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY - f( ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations i Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: No ❑ Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. OveralLRating EEmb Compliance y ry p ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled El Emergency Suspension C N Official Order for Correction:Based on an inspection today,the ite sochecked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 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. Equipment and Utensils 590.005 q P )( ) cited in this re 25.E ui (FC-4 B=One critical violation and less than 4Hon-critical violations 9 port 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 (FC75)(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 no critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. tion,4 to 8 non-critical v' latio C. 30.Other DATE OF RE-INSPECTION: I ctor'. Signatur 1 Print. 31.Dumpster screened from public view. Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N re/ #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's ig ai \ Print: Self Service Wait Service Provided Grease Trap Size. Variance Letter Posted. Y ` Dump ster Screen? Y N �( + ` r n sP.y,[�y�r/T,f.t�r�,• .,+J` ��.^G� r`•..-Y�-r ._ _ Y _ s Y 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 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* 3-501. 6(590.0016( Other* A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g * 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use - 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* - 590.003(G) Reporting by Person in Charge* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7.203.11 Toxic Containers-Prohibitions* ( ) q 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 Rearese d 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* 4-SOLI l l Manual Wazewashin 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 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products 4-501.112 Mechanical Wazewashing-Hot Water Monitoring _ 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 1 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* ce Conntration 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 Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective uuzooi 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 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 of Sanitization of Utensils and Food 3-401.11(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 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* Proper,Adequate Handwashing 10 ing' mobile food,temporaryand residential Game and Wild Mushrooms Approved By 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 * 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 3-201.17 Game Animals 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* 3-403.11 C * (Blue Items 23.30) 3-202.15 Package Integrity ( ) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11 Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 3-101.11 Food Safe and Unadulterated (E) g 8 Tags/Records:Shellstock L5-203.11 4(E) Preventing Contamination from Employees* 18 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 3-202.12 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products Numbers and Capacities* 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°17/45°17 25 5 . Equipment and Utensils FC-4 .00 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 2 . Water,Plumbing and Waste FC-5 .00 590.004(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 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 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.