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HomeMy WebLinkAboutLAMBERT'S RAINBOW FRUIT CO - FOOD LAMBERT'5 RAINBOW FRUIT CO.aa9 f A I 1000 W.Main Cent. �► Town of Barnstable BOARD OF HEALTH 8 t John T.Norman Board of Health Donald A.Gaudagnoli,M.D. aAWNSTABLF. : F.P.(Thomas)Lee,. a 9 200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D. Alt. 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: 765 Issue Date: 01/01/2022 DBA: LAMBERT'S RAINBOW FRUIT OWNER: LM FRUIT& PRODUCE, INC. I Location of Establishment: 1000 W. MAIN STREET CENTERVILLE„ MA 02632 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 10 Total Seating: 10 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: Gi A 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: 2018 August approved variance for one toilet for patrons w/o traveling through food prep area. Picnic tables approved from "grandfathered" variance. No inside seating allowed. f Mom- O Initials: Town of Barnstable For Date Paid s 6t, ,„BM . Inspectional ServicesCad }' Public Health Division Check# Thomas McKean,Director V-510A-m 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 �A7PPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE (�' NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: Loss n �,] 4� ADDRESS OF FOOD ESTABLISHMENT: I� �-�J{ Y� Jt. . l QYC(Ut�l MAILING ADDRESS(IF DIFFERENT FROM ABOVE): � E-MAIL ADDRESS:�IG� jT`(!CU( Q ,• C( G�71 D� ,� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER: S_NO v ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS:INSIDE: OUTSIDE: 10 TOTAL: 1,b 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. _ 1S WAIT STAFF PROVIDED FOR OUTSIDE DINING? _ IS AN AIR CURTAIN PROVIDED AT WATTSTAFF SERVICE DOOR(S)? 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*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-8624644 Q:\Appfication FormsTOODAPP 2020.doe i OWNER INFORMATION: FULL NAME OF APPLICANT �t SOLE OWNER: SS NO D.O.B o _ OWNER PHONE# —nq" ADDRESS CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: 1) 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 Aller2ca Awareness Expiration Date 21� ZS e� 7LICANT ice, GN 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 508-8624644 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 1st to Dec.31"each calendar year. 1T IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC Ist. Q\Application FormsTOODAPP REV3-2019.doc .1a Town of Barnstable BOARD OF HEALTH a John T.Norman Board of Health Donald A.Gaudagnoli,M.D. DIX Paul J.Canniff,D.M.D. MASS 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: 765 Issue Date: 01/01/2021 DBA: LAMBERT'S RAINBOW FRUIT OWNER: LM FRUIT& PRODUCE, INC. Location of Establishment: 1000 W. MAIN STREET CENTERVILLE„ MA 02632 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 10 Total Seating: 10 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: 2018 August approved variance for one toilet for patrons w/o traveling through food prep area. Picnic tables approved from "grandfathered" variance. No inside seating allowed. i A y J0- 06 KWEr For Office Use Initials: Town of Barnstable Date Paid Amt Pd$ BABD•SPABM ; Inspectional Services a`e� Public Health Division ArEC MAY Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A KOOD ESTABLISHMENT DATE— � NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: �,� .E (L \\Q A& MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: Z• V� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO V ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: // SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: to 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? _ 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 QAApplication FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF LICANT 1" k\I�) SOLE OWNER: ES NO D.O.B OWNER PHONE # ADDRESS CORPORATE OWNER: Cl I CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: -� `` d- -��" 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 17 /)l 2. `� / /� 17 -�b ze-et/—� SIGNATURE OF APPLICANT DATE I ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openine!! 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.asp. I OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. I NOTICE: Permits run annually from January 1st to Dec.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1 st. Q:\Apphcation FormsTOODAPP REV3-2019.doc d BOARD OF HEALTH Town of Barnstable ~ John T.Norman Board of Health Donald A.Gaudagnoli,M.D. . BARNSTABL& Paul J.Canniff,D.M.D. MASS 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: 765 Issue Date: 12/10/2019 DBA: LAMBERT'S RAINBOW FRUIT OWNER: LM FRUIT& PRODUCE, INC. Location of Establishment: 1000 W. MAIN STREET CENTERVILLE, MA 02632 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 10 Total Seating: 10 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: 2018 August approved variance for one toilet for patrons w/o traveling through food prep area. Picnic tables approved from "grandfathered" variance. No inside seating allowed. f ' For Off Initials: ��"�'°"yti� Town of Barnstable Date Paid Amt Pd$- r . .� . 3 . ,,,MR,B,E, : Inspectional Services '�E ►``� Public Health Division heck#Thomas McKean,McKean,Director j3 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 }} APPLICATION FOR PERMIT TO OPERATE AsFOOD ESTABLISHMENT DATE V NEW OWNERSHIP RENEWAL- ` NAME OF FOOD ESTABLISHMENT:J A l i �1/5WL( lI\�. � ADDRESS OF FOOD ESTABLISHMENT: i M0 L&�� aTt `1C.0 t/► 1 MAILING ADDRESS(IF DIFFERENT FROM �,�A,B�O�V,,E): E-MAIL ADDRESS: �L di—AL- m/aAIZ• TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO—Z.. (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: (/ SEASONAL: DATES OF OPERATION:_/ /_ TO NUMBER OF SEATS: INSIDE: OUTSIDE: 5 TOTAL: b 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? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) '1//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 QAApplication FormsTOODAPP 2020.doc C` v 6WNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: ES NO D.O.B bl OWNER PHONE# a ADDRESS Ql CORPORATE OWNER: LfiTA `�1 tc CORPORATE ADDRESS: 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 2. S TURE 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/api)lications.asi). 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 Ist. p QAApplication FormsTOODAPP REV3-2019.doc I Bellaire, Dianna From: Scali, Richard Sent: Monday, September 16, 2019 11:50 AM To: 'zzm69@hotmail.com'; 'lynn.lambert@comcast.net' Cc: McKean, Thomas; Flynn, Margaret; Florence, Brian; Duffy, Robert; Bellaire, Dianna; Zulkiewicz, Jane; Cabot, Jaime Subject: RE: Lambert's Rainbow Fruit-1000 West Main St. Hyannis From: Scali, Richard Sent: Monday, September 16, 2019 11:39 AM To: 'zzm69@hotmail.com' Cc: McKean, Thomas; Flynn, Margaret; Florence, Brian; Duffy, Robert; Bellaire, Dianna; Zulkiewicz, Jane; Cabot, Jaime Subject: Lambert's Rainbow Fruit-1000 West Main St. Hyannis Dear Matt, Lynn (or Neal), This is the only email on file for Lambert's so I am trying to reach you with information. Pursuant to our information, currently you have a permit with the Health Dept for 10 outside seats. You do not currently have a Common Victualler's license for eating on the premises. Our WM staff provided you with an application to apply for a CV hearing. Our observations show that you have currently 8-16 seats inside, and 7 picnic tables and 2 benches outside. You would need to update your Health Dept permit and also consult with the Plumbing inspector in the Building Dept to update your plan. Once you have this corrected,you should apply to Licensing for permission to have seating. If you have any questions or need more assistance, we are happy to help you. Richard Scali Richard V. Scali, Esq. Licensing Director Town of Barnstable 200 Main St. Hyannis, MA 02601 508-862-4778 508-778-2412 fax 1 I I Town of Barnstable � BOARD OF HEALTH Paul J Canniff,D.M.D. Board Of Health l l _ Donald A.Gaudagnoli,M.D. a.AaeNMULE, John T. Norman 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate ro,ra. Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment h In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 30516, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 765 Issue Date: 12/26/2018 DBA: LAMBERT'S RAINBOW FRUIT k OWNER: LM FRUIT& PRODUCE, INC. Location of Establishment: 1000 W. MAIN STREET CENTERVILLE MA 02632 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 10 Total Seating: 10 FEES (� FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - - MOBILE-FOOD: MOBILE-ICE CREAM: C�� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions,: 2018 August approved variance for one toilet for patrons w/o traveling through food prep area. Picnic tables approved from "grandfathered" variance. No inside seating allowed. v pFtHEInitials: p„ Town of Barnstable For 0 Date Paid Amt Pd$ p 9 MAS& Inspectional Services �. ff �AT16�s`0 Public Health Division 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 Z V NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: 1000 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: may6iie--LA AVVIA(I TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS:_ WELL WATER: YES NO VI.. (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: t v 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? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) 1/ 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) 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:\Application FormsTOODAPPREV2018.doc y1 PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT L PLC lit SOLE OWNER: a /NO D.O.B ` OWNER PHONE # o,6� � llltl� ADDRESS ` 00� ACASA, P� �`\�QT /VI, �02a CORPORATE OWNER: FEDERAL ID NO. : nq— b� CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: 8Ae�) 1 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 Expiratiou Date r en Awareness Expiration Date 2. oj�T, A m ;J Lom ha X/ eURE OF AP CANT 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.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. NOTICE: Permits run annually from January 1 st to Dec.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1 st. Q:\Application FormsT00DAPPREV2018.doc °FINE r, TOWN OF BARNSTABLE. HEALTH INSPECTOR'S Establishment Name: Date: Page of '9 OFFICE HOURS PUBLIC HEALTH DIVISION - 8 00-9:30A.M. i BARNSTABLE. ` 200 MAIN STREET 3.30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 67q: �•� HYANNIS, MA 02601 - - MON.-FRI. No Reference: R'-Red Item_ CLEARLY., - - 508-862-4saa PLEASE PRINT �FOM"+°' FOOD ESTABLISHMENT INSPECTION REPORT Name ` Date Type of T Inspection L 'p outine _ _ _rin. Address fii n S ' Risk Food Service spection ' Level .e ai Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary . Suspect Illness Caterer General Complaint Person in Charge(PIC) L'� Time Bed&Breakfast HACCP ( 1 -(LF �.11f/U Other In: Inspector Out: _ Iq Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. f Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items-1 Anti=Choking 590.009(E) ❑ Gr' Violations marked may pose an imminent health hazard and require immediate corrective . Tobacco 590.0019(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 l -- EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives I U.t� 1 , t"Id ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals r �• I / �D FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) iol ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating 1 ❑ 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 Le ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) �. y ❑ 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 ,� v t`'? & Violations Related to Good Retail Practices(Blue Items) Total Number of Critical ViolationsV V Critical(C)violations marked must be corrected immediately. (blue&red items) r - Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating �j 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 6=One critical violation and less than 4Aon-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 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. . violat to 8Aon-critical violations C. 29.Special Requirements (590.009) within 10 days of receipt of this order. = 30.Other DATE OF RE-INSPECTION: Inspec is 'gnature P,�n , 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N U #Seats Observed Frozen Dessert Machines: Outside Dining Y N ICs ignature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted_ Y N - Dumpster Screen? Y N _ - ` { -TM'".a •�-.�..,�--.-•was.-,.k..--,--�---a..-�.-.,r-.-.r rns. .:-....��.,..,,-,.-,.r.,,.,....,.•.�...-.-••--,..<._ .,z-.-+. �. r-,- ...-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) Assignment of Responsibility* 8 Cross-contamination 1q 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 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* Time as a Public Health Control Applicants* 3-302.11(A) Food Protection* P g * 20 ' 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* 3-304.11 Washing Fruits and Vegetables 7-202.11 Restriction-7.202.12 Conditions of Use Presence and 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) I 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* q 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 Warewashing-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 Pe 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 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 HFs Proper Cooking Temperatures for P 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 5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP y Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eb rn-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 3-401.11(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* 3 401.11(A.)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g y 590.009(A)-(D) Violations of Section temporary and - ide in cater- * Ratites-165°F 15 sec* in mobile food,tem o and residential Sources g, P �Y 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 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 24101.11 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 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 foodbome 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 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 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 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products p 5-20411 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 i 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:590Forrnback6-2doc *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. °p THE T TOWN OF BARNSTABLE. HEALTH INSPECTORS Establishment Name: Date: _ Page of. t OFFICE HOURS PUBLIC HEALTH DIVISION soo 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 ,e,y.a HYANNIS, MA 02601 sos-8s2 a MAC, $ MO -FRI. No Reference- R :Red Item PLEASE PRINT CLEARLY 94, . 64a FOOD ESTABLISHMENT INSPECTION REPORT - Name Date Type o T akief Inspection p outine 1.2Q IqO Address n + Risk Food Se ice Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Dater Mobile Pre-operation I Owner HACCP Y/N Temporary Suspect Illness {3 Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP Y ,I , o St Other In: �Qy✓1 � . Inspector Out: U1 Each violation checked requires 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) Lf q-J= Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ �` 3�. 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 Chi ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) 11 1 ❑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 C 14 F ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) I is ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP vt ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY / ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories I(V 11 F Violations Related to Good Retail Practices{Blue Items) Total Number of Critical Violations U Critical(C)violations marked must be corrected immediately., (blue&red items) Corrective Action Required: ❑ No El 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 checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ 9 ❑ 9 y ❑ rY P ❑ 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 anon-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 Physical Facility 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.Ph y ty (FC-6)(590.007) aggrieved by this order,you have aright to a hearing. Your request must violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation,4 to 8 non- I Ica violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Sign a Prin. 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 Sigvnatur Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N ,.�a..-...+r-. :`°�'t'`t''rir�'�.".. .��"'�'.;lC�'i;z+..r;..r. s,r. :.ter--�F:. .r .^rti.Y?�;-., .• r*R�.., "w.iL��j--.:.."�`"�..^Y,^�.=.�i„"r,GY°'o - :--..'t...'►`�'"e'�'3" .. _'°"`� 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* ( ) g14 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 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 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 Anima]Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers* 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 7-202.11 Restriction-Presence and Use* O P ty3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 3-304.11 Food Contact with Equipment and Utensils* 7.202.12 Conditions of Use* 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* 590.003(E) I Removal of Exclusions and Restrictions Disposition ofAduIterated 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* q 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 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 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 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils an Eggs d Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.1](A)(2) Comminuted Fish,Meats&Game Pathogens* Ef 1-1iu200r 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 4-702.11 Frequency of Sanitization of Utensils and Food Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 3-40 1.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 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* g g �' 590.009(A)-(L1) Violations of Section 590.009(A)-(D)in cater- Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Ratites-165°F 15 sec*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. 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 Requiremenpractices s should be debited under#29-Special 5 Receiving/Condition 2-401.11 1 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 Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.11 Package Integrity ( ) y 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 Handwashin 9 Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°17 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 Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) * 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 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 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. Op THE T TOWN OF BARN.STABLE._, ,. -. .-HE?44TH INSPECTOR's Establishment Name: - Date: - .-,..Page.: .� Of. o OFFI&:HOURS _. PUBLIC HEALTH DIVISION = 1300 m s;aoA.M. BARNSTABLE. = 200 MAIN STREET s.so-a:so P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. �.. MON. PLEASE PRINT CLEARLY,.. -FRI. A 1639• .e HYANNIS, MA 02601 508-852-4644 No Reference ,.R Red;Item 'EOMp�a FOOD ESTABLISHMENT INSPECTION REPORT '. . Name /I Date �e of Woe of Inspection Y .- _ -O outin Address �/�/� ' Risk ood Servi Re-inspectionZ. / n ( Level Retail _ Previous Inspection Telephone. Residential Kitchen Date: Lai Mobile Pre-operation -P Pt ,> i /) Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACC"P In: Other her / Inspector Out: �' V // (� /> :' Each violation checked "quires an explanationon 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) ❑ ' Action asAetermined.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. G✓ e C ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Cotor.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 ( � Cl"(_0 ❑ 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 _ r ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) J , ct- ❑ 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 - 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 within 90 days as determined b the Board of Health.- Overall Rating e y y - - � ❑ 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 Food Code. ❑ Embargo ❑ 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 - 9 A-Zero critical violations and no more than anon-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 4von=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 6von-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 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 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have aright to.a hearing. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation erved,7 to 8 non-critical violations. If 1 critical refrigeration.. 29.Special Requirements (590:009) within 10 days of receipt of this order. violatio ;4 tq 8 non-critical violations=C. InspM�� re 30.Other DATE OF RE-INSPECTION: C/< 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 PIVS ature Print: Self Service Wait Service Provided Grease Trap Size-- Variance.Letter Posted. Y.-. N Dumpster Screen? Y N ,y �.w.. - > ,. .. .-..�.-r. � .. •....Afe,l--+.+„t-�-- .�. ..r+-..+v-•. ,."lam-. -...-.r"1..� tiq. r�.-, ... "� • '-`.... 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) Assignment of Responsibility* 8 Cross-contamination 1 q 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.* * 18 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 EachIdentifying * 590.004(F) - * ( )O P 7-101.11 Identi m Information.-Original Containers 2 590.003(C) Responsibility of the Person-in-Charge to Other*.... .,. g g * 3-501.16(A): Hot PHFs Maintained At or Above 140°F* 7-201.11 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 7-202.11 Restriction-Presence and Use 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* 3-302.15 Washing Fruits and Vegetables * 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(3) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed 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 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 * 4-501.111 Manual Warewashing-Hot Water 1.206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 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* 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 Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-lO1.T1 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* EJfecnve///nom 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 rf ces of qui 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 .t' 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 residuiaial Sources g, P ruTY 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 3-201.17 Game Animals* 1t 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�1.12 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 Commerciall 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 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* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashin 9 Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 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 s Within 4 Hours* 23. Management and Personnel FC 2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities 24. Food and Food ProtectionUF3 .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste .006 590.004(J) Labeling of Ingredients' Supplied wfth Soap and hand Drying Devices 27. Physical Facility .007 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 1 Specialized Processing Methods* 1 130. 1 Other 9-502.12 lReduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Fofmback6-2doc '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. p*IHE r TOWN OF BARN..STABLE:. ;-. u ,HEALTH.INSPECTOR'S Establishment Name: - atPage:.. OFFICE HOURS Date: of. ap ° PUBLIC HEALTH DIVISION = a0o=930A.M. BARNSTABLE. ` 200 MAIN STREET 3.30-4:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date•Verified MASS. MON.-FRI. .aas•..`0g HYANNIS,MA 02601 5oa-asz asaa No Reference.: .R-Redrltem EARLY :,. 'ED"""`' FOOD ESTABLISHMENT INSPECTION REPORT I LEASE PRINTCL Name. ` Date" e o Ins action Address Risk r Re inlspection a ns " u Level Retail Previous Inspection ©(� G/w�� 2, I TolophonC Rc3idcntial Kitchcn . Date: Mobile Pre-operation Owner HACCP Y/N Temporary.. Suspect Illness Caterer General Complaint b Person in Charge:(PIC),' Time Bed&Breakfast HACCP - Other' In: Inspector. Out: .. tl checked requires ' p - n the narrative page(s)'and a citation of specific provision(s)violated., Violations Related toFoodborneIllness interventions and Risk Factors(Red Items) Anti-Choking 1590.009(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) ❑ I y 9 � FOOD PROTECTION MANAGEMENT. ❑ 12:Prevention of Contamination from Hands J ❑ 1.PIC Assigned/Knowledgeable/-Duties ❑ 13.Handwash Facilities ` r EMPLOYEE HEALTH PROTECTION FROM CHEMICALS: : �iL ❑ 2.Reporting of Diseases by'Food Employees and PIC ❑ 14.Approved Food or Color Additives �9 ❑ 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 ❑ 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 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories : Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 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 within 90 days as determined b the Board of Health. Overall Rating.; y y ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled .. ❑`Emergency Suspension C N Official Order for Correction:Based on an inspection today,-the items _.. ._ ❑ g ❑ - ` 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 Orion-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 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.violation;4 to 8��critical violations29.Special Requirements (590.009) within 10 days of receipt of this order. =C. 30:Other DATE OF RE-INSPECTION: Inspector's S' n Print: 17 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N p, #Seats Observed Frozen-DesseitMachines: Outside Dining Y N PIC's,6gQtZWe 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 Law Cooled to 41*F/45*F Within 4 Hours* ( ) g14 Food or Color Additives 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-20212 - Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 19 PHF Hot and Cold Holding _ g 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 Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers 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 Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* * (� po ty3-302.15 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 ( ) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(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* q 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* 4-501.111 Manual Warewashing-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 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* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water*' Concentration and Hardness* 163-401.11A.(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 * Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* ( * Eggs-Immediate Service 145°F 15 sec Not Otherwise Processed to Eliminate Equipment 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg cn°e inrzooi 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 p 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 1•, - 4-702.11 Frequency rf ces 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 't S _. 3-201.15 Molluscan Shellfish from NSSP Listed r Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Croper,al 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* ( )( ) p 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 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 g 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 8 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 * 13 Handwashing 3-501.14 A 3-202.18 Shellstock Identification Facilities ( ) Cooling Cooked PHFs from 140°F to 70°F 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 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 1 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. 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. `pp VIE A TOWN OF BARNSTAB;LE, - , _ .;.. „HEALTH INSPECTORS Establishment Name: L�/Itij;lX Date: Page: of Wa OFFICE HOURS PUBLIC HEALTH DIVISION 609-9:30A.M. BARNSTAB�E. � 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �b .659. .0� HYANNIS, MA 02601 MON.-FRI. No Reference. :R:,-.,Red Items; PLEASE PRINT CLEARLY OrFD MAC s FOOD ESTABLISHMENT INSPECTION REPORT 508-862-4644 Name 1 Date y Z3 Tvpe of Type of Inspection Routine Address Lo (Z �.t Risk Food Servi Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation /n Owner HACCP YIN Temporary Suspect lllnes It�C / Caterer eneral Complaint Person in Charge(PIC) Time Bed&Breakfast db I_ In: Other Inspector Out: aAr -r v �D &zt Each violation checked requires 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) ❑ ?i Q Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ /^� /� Q ` � Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ �� / / 1 FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ` il? ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals _1 FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) I CT 1 ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling T ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ,e ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ' I ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP \Q, tr♦ ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY (y^ �•/ ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories y XWO �/�, Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations p�t'V {3 �I �i/llJ to CAA Critical(C)violations marked must be corrected immediately. (blue&red items) v ` 1 Corrective Action Required: ❑ No ❑ Yes (j1\ d Non-critical(N)violations must be corrected immediately or within 90 days as determined by the Board of Health. Overall Rating Voluntary Compliance Employee Restriction/Exclusion Re-inspection Scheduled❑ ry p ❑ ❑ p ❑ e gency uspensl n C N Official Order for Correction:Based on an inspection today,the items Embargo Emergency Closure Voluntary Disposal checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g ❑ 9 y ❑ ry P ❑ Other: sj 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 viola�ins 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 25.Equipment and Utensils B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. (FC-4)(590.005) cited in this report may result in suspension or revocation of the food Q 26.Water,Plumbingand Waste if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically no hot (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 u t(Of= 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. �;/ be in writing and submitted to the Board of Health at the above address g [ov rr y 29.Special Requirements (590.009) s o within 10 days f receipt of this order. violation,4 to 8 non-critical violations=C. BPS 30.Other DATE OF RE-INSPECTION: Inspector's Si ure _r Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N 6_61_44111� #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC s gnature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N l 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 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 t 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 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* g g 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees 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* 20 Time as a Public Health Control Applicants 3-302.11(A)� Food Protection* 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 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* 3 590.003(D) Exclusions and Restrictions* Contamination from the Consumer 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals far Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g ( ) 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 Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 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* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. L16 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* Ej/ecnve r/uzoor I 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 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 3-201.15 Molluscan Shellfish from NSSP Listed Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 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* 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 3-201.17 Game Animals* 11 Good Hygienic Practices 77 Reheating for Hot Holding practices should be debited under#29-Special Requirements. $ 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 * (Blue Items 23-30) _ 3-202.15 Package Integrity (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* 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 3-202.18 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 Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* * 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 I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 1 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. sh INE TOWN OF BARNSTABLE HEALTH wsPECTOR,s Establishment Name: Date: U L I. . Page of OFFICE HOURS P ° PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTARLE. 200 MAIN STREET ,„A 3:30-4:30P.M.MON.-FRI. Item Code C Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ss. g = ,6 HYANNIS, MA02601 5oe-86246aa No Reference � R Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT Name ' Date g Tvue cf Type of Inspection {v O s Routine ) Address Risk Food Se e-inspec _ t Level Retail -Previous Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness ^� AM Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP Other Inspector n J Out:Iw Y_r l Jv Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. / I Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ / ` �� f� 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 n 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 1n It ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals / _ � � _1 /v• �r FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ,�/[J��� �t C.VJ ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures �N u� -A ❑ 5.Receiving/Condition ❑ 17.Reheating ✓ �A't'. ❑ 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 b aA ,] ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY t 1t�/' t'�❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories1 1 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Non-critical(N)violations must be corrected immediately or Corrective Action Required: ❑ No Yes within 90 days as determined b the Board of Health. Overall Rating Y Y � ❑ 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 Food Code. ❑ Embargo ❑ 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 anon-critical violations. F=3 or more critical violations. n no critical violations observed, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 9 or more non-critical violation 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 non-critical violations s=F. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-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 4 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=C. refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. at Print: 30.Other DATE OF RE-INSPECTION: Inspector's Si I� - 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 Sigpature� (�( Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N (//v///,1►/,A/ Dumpster Screen? Y N (J ti; ,�.. N-.,-• '•---`-„�._ ....�:., �• - �_.,«...r-..wr...--+•_...r-.�--'� •..�.,-.t..�.Y_� `"..... -. .�.. ..�,w>_ 'w.� , .. -,.� .. ...r-�.• _ t_ � . . �,. .,,.ti�j'-...`w..-..�.-�r..�-��-�..+`�--L.r.._.•- _.".....-r-�-��."-�.+"-...:v .`��'^.a...�-�.�...r..%..... _.. 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 L 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 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding 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* 7-102.11 Common Name-Working Containers* 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* * 7-201.11 Separation-Storage* 20 Time as a Public Health Control 3-302.11(A) Food Protection 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* 3-302.15 Washing Fruits and Vegetables 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* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) I 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 Warewashing-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 Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* * 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 Warewashing-Hot Water Monitoring* P g 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 5-101.11 Drinking Water from an Approved System* 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* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg cri,-e uu200t 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* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* aces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009 A Chemical ( )-(D) Violations of Section 590.009(A)-(D)in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 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* I 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 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 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodbome 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* 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 3-203.12 Shellstock Identification Maintained* y Convenientl 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 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 .004 5-205.11 Accessibility,O eration and Maintenance Temperature Ingredients to 41°F/45'F 25: Equipment and Utensils FC-4 .005 3-402. Records,Creation and Retention* P Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied witthhSoap and hand Drying Devices 2 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability HACCP Plans 6-301.12 Hand Drying Provision 28. Poisonous Facility Special Requirements .00 Toxic Materials FC-7 .008 3-502.11 Specialized Processing Methods* 30. 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. °p IKE ram, TOWN OF BARNSTABLE HEALTH INSPECTOR-s Establishment Name: ' Date: ( 2 Z/ Page: / of_L ti OFFICE HOURS 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 V... `0l HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY 508�62-4644 'FD MP P FOOD ESTABLISHMENT INSPECTION REPORT Name I l l J / Date IZ•Z,I Tvoe of Inspection � l l Routine' Address Risk Food S Re-inspectionMDO / Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness S Caterer General Complaint ^ Person in Charge(PIC) Time Bed&Breakfast HACCP (i In: LO" Other `n i a _d_ Inspector Out: Each violation checked req ires an explanation on the narrative page(s)and a citation of specific provision(s)violated. f Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ ,1 o Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Ob Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ C /1 FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities v EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 1 / ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals v 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 .41 ' A (/f LW �K (_ ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18. oling f, J � ® ❑ 7.Conformance with Approved Procedures/HACCP Plans 9.Hot and Cold Holding , lit/ )A r� c _ PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑8 Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) V 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY G ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Lo ✓� (,� °� ����-G�'-� /'�'/ Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) q 'I 21 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. 11T FE ❑ 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 590.000/1'ederal 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 B=One critical violation and less than 4 non-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 o la 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 i non-critical. . f 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 a non critical violations. If 1 critical refrigeration. )( ) violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Sig t re Print: 31.DumpsteJ screened from public view ffeA71441 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 /A� ee� Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N /w yl ham.. Dumpster Screen? Y N U 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 t 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 6 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 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 79 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 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 IdentifyingInformation-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* Require Reporting by Food Employees and Contamination from the Environment 7-202.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F* Applicants* * 7-201.11 Separation-Storage* 20 Time as a Public Health Control 3-302.11(A) Food Protection 590.003 F Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* * ( ) p° y3-302.15 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 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(13) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 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 Warewashing-Hot Water , 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* 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* I Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. L16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* I 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* 8g Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* E$ecnve///Wool 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 P 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* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 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 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and 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 3-201.17 Game Animals* 11 Good Hygienic Practices L 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 34A3.11(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) 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* 16 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 * 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 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 .004 5205.11 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. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. 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. aIKE To TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: cam- Date: Page: of 2- p`o OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. sneNsrnsLe. = 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MONHYANNIS,MA 02601 508-808-8 -FRI.62-4644 NO Reference R-Red Item PLEASE PRINT CLEARLY �ptFu MPS s FOOD ESTABLISHMENT INSPEICTION REPORT b SO/ 1 Z hh -AD Name f�- Date Tvoe of T Inspection i o outine Address Risk Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP 3 b4ld In: Other Inspector 1 Out: v v v c1r� Each violation checked requires 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) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT 1 Prevention of Contamination from Hands jn / ❑ 1.PIC Assigned/Knowledgeable/Duties 13.Handwash Facilities al J EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals I FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) UV.mil V ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures � ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ -ooling ❑ 7.Conformance with Approved Procedures/HACCP Plans 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑8 eparation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) `(.v ►1 v 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 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 El 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) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 6 non crib violations g if no critical violations observed,4 to boon-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 i non-critical. . f critical water,sewage back-up,infestation of rodents or insects,or lack of 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. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to Snon-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Sign a 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 Signatu�Wd re , 1V .� 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* $ 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- 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 590.004(F) 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* 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 Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 3-302.11(A) Food Protection* 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* 3-302.15 Washing Fruits and Vegetables 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 * ( ) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions 3 590.003(D) I Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition ofAdulterated 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 Warewashing-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 Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Pe 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. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(l)(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,Meals&Game Pathogens* Effective 1o12001 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) 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 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 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 P 11 Cl 301- . ean Condition-Hands and Arms* the appropriate Regulatory Authority 2 3-401.12 Raw Animal Foods Cooked in a Microwave PPriate sections above if related to P 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome 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 17 Reheating for Hot Holding practices should be debited under 929-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* 3-403.11 * (Blue Items 23.30) 3-202.15 Package Integrity (C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbome 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 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 I 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 29. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 1 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. oaT ►oy TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: �V^ /. / / J�Date: % '?� Page: 3.: � of OFFICE HOURS � . ° PUBLIC HEALTH DIVISION 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 'A sv HYANNIS, MA 02601 soa as2 asaa No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT - - Name- Date Type of !XpMf Inspection outine - Address Risk e-inspection �/ Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness At Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP k In: Other / s 7 Inspector v Out: AA Lo en- Each violation checked requires 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) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ �/ t / Z FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands j r > s ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities (,�- EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ;3� 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) V /� ❑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.C nformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PR CTION FROM CONTAMINATION ❑20.Time As a Public Health Control 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 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 B=One critical violation and less than 4non-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. 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 o la 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 i non-critical. . f critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) 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. � 28.Poisonous or Toxic Materials FC-7 590.008 9 violation,4 to Snon-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Sign 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 � lA__ o 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 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 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 po ty7-102.11 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 3-302.15 Washing Fruits and Vegetables Use 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* 7-202.11 Restriction-Presence and* 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 Sanitizzrs,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 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 * 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 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* TIME/TEMPERATURE 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* I 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 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 vuzoor 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* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* aces 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* 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 8. P ary 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 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 3-202.15 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 foodbome 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 * 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification g 590.000 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 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 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* 1 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 I 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. r r TOWN OF BARNSTABLE HEALTH wsPEcroR s Establishment Name: Date: Page: of p ti OFFICE HOURS : BARNSTABLE, PUBLIC 2 0 MAIN LST DIVISION 3:30-430 A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:30-4:30 P.M. HYANNIS,MA 02601 MON.-464 No Reference R Red Item PLEASE PRINT CLEARLY 508�62-0644 rFD MP�P FOOD ESTABLISH M QIT 1 PE 'TI N REPORT _ Name i "e'el 7k�Arg e of ns ec ion C M_ _ er Routin Address ood ervic R .i spection v RetaiL� Previous n ati n Telephone It, rFV Residential Kitchen Date: P�J v r Mobile Pre-ope 41 I((�� Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP C Other �-- Inspector 22Lt &2ZO WlJ Each violation checked requires an explanation on the narrative pa e(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) ❑ r, 1117 Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ I FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands = iff❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities i L EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 4 ❑ 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 n ❑6.Tags/Records/Accuracy of Ingredient Statements 18.Cooling ❑7.Conformance with Approved Procedures/HACCP PlansM1 19.Hot and Cold Holding f r OTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control Separation/Segregation/Protections REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS HSP) I 9� 711' J 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP + ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY I� u ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Itemsl Total Number of Critical Violations 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 it ❑ 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 B=One critical violation and less than 4 non-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 o la 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 i non-critical. If no critical water,sewage bads-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 8non-critic vi ions. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. olatio 4 to 8 non-critical violate s= W 30.Other DATE OF RE-INSPECTION: Ins or's S gnature rin 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N ZZY 9 Seats Observed Frozen Dessert Machines: Outside Dining Y N PI 's Si t ri t: 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 k PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* $ Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) jDem,nstration 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 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 15 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* 7-102.11 Common Name-Working Containers* 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* 7-201.11 Separation-Storage* PP 3-302.11(A) Food Protection* 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(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 590.003(E) Removal of Exclusions and Restrictions 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 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* 4-501.111 Manual Warewashing-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 HermeticallySealed Container* * Raw Seed Sprouts Not Served Sanitization Temperatures 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 Warewashing-Hot Water Monitoring* 3-202.13 Shell Eggs* I Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 1$ Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* = Concentration and Hardness* 3-441.11A(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* sg cnvc innom 4 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* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 5g0,009(A)-(D) Violations of Section temporary and - ide in cater- 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 AutWildhority 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 Req irem nos]d 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 * 3-301.12 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 foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3403.11(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 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F to 70°F 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 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 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 .004 * 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 1 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. PyoFT ro TOWN OF BARNSTABLE . HEOTHr INSPECTOR'S Establishment Name: Date: i Page:E HOURS of 3- PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. ' 200 MAIN STREET 3:30-4:30 F.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MON67q• �0� HYANNIS,MA 02601 -08-862-4644 No eference R-Red Item • PLEAS PRINT CLEARLY 508-864 p'F FOOD ESTABLISHMENT INSP " TON REPORT Name Da t Type o n ctio Routine Address Rid oo&Servic -' spection 4' Level RE Previous Inspection 9 Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: VI Each violation checked require 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) ❑ f Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ AA 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 Tv ❑ 13.Handwash Facilities 1 EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 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 TIMElrEMPERATURE CONTROLS(Potentially Hazardous Foods) ri ❑4.Food.end Water from Approved Source ❑ 16.Cooking Temperatures U ❑ 5.Receiving/Condition ❑ 17.Reheating y 1 i ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ll ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding i 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 f!' ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Itemsl Total Number of Critical Violations C violations marked must be corrected immediate) blue&red items ( ) y ( ) � Corrective Action Required: ❑ Critical No ® Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined by the Board of Health. Overall Rating ❑ 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 B=One critical violation and less than 4 non-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 o la 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 i non-critical. . f critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) 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. 28.Poisonous or Toxic Materials FC-7 590.008 9 violation,4 to Von-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspe i a Print: 77 /f)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 S" atu Print: ` Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N C r I Dumpster Screen? Y N 1 , i Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) i 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* F8 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 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 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* g7-102.11 Common Name-Working Containers* 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* * 7-201.11 Separation-Storage* 20 Time as a Public Health Control 3-302.11(A) Food Protection 590.003 Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* * � P Y3-302.15 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 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* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(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* q 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* 4-501.111 Manual Wazewashing-Hot Water 17.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* * Raw Seed Sprouts Not Served * Sanitization Temperatures 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* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 16 3-401.11A(1)(2) Eggs-155*17 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* El/°"°e mnooi a 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) 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 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 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* 3-401.11 A 1 All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )ro) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under 929-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165*17 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2401.12 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 PreventingContamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the fvodborne * 12 Prevention of Contamination from Hands 3-403.11E 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 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 16 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F to 70°F i 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 1 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008 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:590Fo1mback6-2doc *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. F THE - -- TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name:' Date: Page: of Pao ~o OFFICE HOURS PUBLIC HEALTH DIVISION 8:00 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 .639• o� HYANNIS,MA 02601 _ MON.-FRi. No Reference R-Red.Item PLEASE PRINT CLEARLY p'EDh1�` FOOD ESTABLISHMENT INSPF4CTjON REPORT 508-8624644 Name Dat Type of Type of Inspection r OReration(s) Routine Address Risk Food Service Re-inspection Level Retail Previous Inspection ! Telephone Residential Kitchen Date: „ n Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: 44 Each violation checked requires 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) ❑ 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 UIJ EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑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) �y ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling O ❑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) y ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY - A i ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations " LIZ Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: No ❑ es 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. B=One critical violation and less than 4npn-critical violations re 9 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 o la 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 i non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) 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. 28.Poisonous or Toxic Materials FC-7 590.008 9 violatio to 8npn-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. I � 30.Other DATE OF RE-INSPECTION: Inspe to ' Sig Prin 31.Dumpster screened from public view /P Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI 's Sig re P'nt: 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 4 590.003(A) jAssignment of Responsibility* 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 590.004(F) EMPLOYEE HEALTH t 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 j Other* g7-102.11 Common Name-Working Containers* 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* 3-302.11(A) Food Protection* P Storage* 2 rime me as a Public Health Control 7-201.11 Separation-Stora e Restriction-Presence and Use* 3-302.15 Washing Fruits and Vegetables 7-202.11 590.003(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* 3 590.003(13 Contamination from the Consumer) 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 3-701.11 Discarding or Reconditioning Unsafe Food FOOD FROM APPROVED SOURCE * 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 g routs Not 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed SP 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package age Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 163-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of - . A Clean Utensils and Food Contact Surfaces of * Animal Foods That are Raw,Undercooked or' 5-101.11 Drinking Water from an Approved System* 460111( ) Eggs-Immediate Service 145°F 15 sec Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg ctiw 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 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency r f 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 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 8 590.009(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* 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 3-202.1 Package Integrity* 3-403.11( ) rn 3-301.12 Preventing Contamination When Tasting* C Comerciall y Processed RTE Food-140°F* Blue Items 23-30) 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3 403.11(E) Remaining Unsliced Portions of Beef Roasts* Critical and non-critical violations,which do not relate to the foodborneillness 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 * 3-501.14 A 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°F ConvenientlyLocated 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* * 23. Mana ement and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours 9 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 1 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 1 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 596.09,0. *Denotes critical item in the federal 1999 Food.Code or 105 CMR 590.000. THE T� Town of Barnstable 6ARNSTAIIE. b�: A,$g Board of Health fo 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Paul Canniff,D.M.D.. FAX: 508-;90-6304 John T.Norman Donald A.Guadapoli,M.D. September 5, 2018 Mr. Matthew Lambert ,. _L-ambert's=Rainbo_w,F_r_uit 1000 West Main Street Hyannis, MA 02601 RE: Variance to Operate a Food Establishment with One Restroom Facility Outdoor Picnic Tables, 100 West Main Street, Hyannis Massachusetts Dear Mr. 'Lambert, You are granted variances to provide only one restroom -for patrons (and a separate restroom for employees) at Lambert's Rainbow Fruit, 1000 West Main Street Hyannis, Massachusetts. The variances granted are as follows: • Section 322-4 Toilet Facilities To provide one restroom for patrons, in lieu.of the requirement to provide separate male and female toilet facilities for patrons where/when seats are provided. • Section 322-4 Toilet Facilities To provide one restroom for employees, in lieu of the requirement to provide separate male and female toilet facilities for employees. These variances are granted with the following conditions: (1) The walkway to the restroom shall be made accessible to patrons without traveling through any food preparation areas. As discussed with the Health Inspector onsite and at the public meeting of the Board of Health, a few additional barriers need to be installed to ensure patrons have no access nor exposure to the food preparation areas. (2) Signage shall be posted to indicate the designated entry-way and walkway to the public restroom. Q:\WPFILES\Restroom Variance Lamberts Fruit 2018.docx I ; ' (3) Indoor seating for patrons is not authorized. Only outdoor seating at the existing picnic tables, are authorized. These variances are granted because the owner testified the restroom is accessible to patrons without traveling through any food preparation areas. He also testified that picnic tables have been in existence at this site for approximately forty years. The Board is of the opinion one restroom is sufficient for the existing outdoor picnic table seats provided onsite on a seasonal basis. The second restroom is sufficient for the limited number of employees. Sincerely yours, C� a Cani , Chairman Q:\WPFILES\Restroom Variance Lamberts Fruit 2018.docx 4-j L"40 WE C Town of Barnstable Regulatory Services Department + BAENBTABM • ,3 200 Main Street,Hyannis MA 02601 tQ i639 �� tQ RFD MAr 0 APPLICATION FOR OUTSIDE DINING/SIDEWALK CAFE100 -Ci LOCATION ''dd��� !"�3 Property Address: WJ M1� (.JT Name of Establishment: APPLICANTS NAME: �` ,� (111 � Phone# SEATING FACILITIES/EQUIPMENT Total#of Seats Existing #of Restrooms Provided. Size of Grease Trap Total#of Seats Proposed Air Curtains(Yes or No) (Total means overall numb-,r of seats indoors and outdoors) Hose Bib (Yes or No) Screens (Yes or No) Brief Description of Seating Arrangement,Type of Furniture Proposed,Hours of Operation,Projected Opening and Closin a es h M Uwe the undersigned certify that the above information on which Uwe provided is correct. Uwe have read and fully understand the procedures as established by the Town of Barnstable in accordance with Chapter II, Article 8,Section 2 of the,General Bylaws and the Board of Health Regulation#14,and further understand that failure to comply with said procedures may result in the immediate revocation of this permit. Signature of Applicant (s): Date: i Date: G i IMPORTANT-PLEASE REMEMBER TO INCLUDE: 3 Copies of the Neatly Drawn Sketch Plan of the Outside Dining Area Showing Separation Distances to Curbing,Trees,Rubbish Containers and any other Obstacles in Pedestrian Walkway r 3 Copies of Pictures o-the Proposed Outside Dining Location(Front and Side Views) 1 Copy of the Menu THIS SECTION BELOW IS FOR OFFICIAL USE ONLY Town Manager Approval: Public Health Division: Licensing Board Approval: Certificate of Insurance: License Agreement: Comments: I BOARD OF HEALTH REGULATION,PART H,SECTION 1.00,#14,Requirements a through n (a) The applicant shall file a written request for outside dining or for an outside cafe on a form prescribed by the Town and shall submit plans of the proposed dining area. The seating capacity shall be determined by the Board of Health after a determination is made whether requirements"b"through"n" below will be met and after a visual inspection is conducted by an agent of the Board of Health. A replacement food establishment permit shall be issued by the Board of Health indicating"outside dining"is permitted and listing the overall seating capacity,only after it is determined by an agent of the Board of Health that all of the requirements"a"through"n"of this Regulation#14 are met. (b) A menu shall be submitted to the Board at the time of application. (c) The dining area must be appurtenant and contiguous to the restaurant property. The dining area must be mentioned on the described premises as in the case of a Common Victualler's License. (d) Sufficient restrooms,both for customers and employees,must be furnished counting the additional outside seating as required by the State Plumbing Code and Town of Barnstable Health regulations. (e) A grease trap shall be of sufficient capacity,based upon 15 gallons per seat,as required by the State Environmental Code,Title V,and Town of Barnstable Health Regulations. A grease recovery device may be installed to supplement an existing inground grease trap,after receiving the approval of the Board of Health. (f) All entrance and exit doors used by food service personnel and customers must be screened and , provided with air curtains meeting National Sanitation Foundation standards. All windows or openings used for the transfer of food will be screened and provided with air curtains. Food cannot be stored or kept ' outside. All food must be prepared inside the facility's kitchen and kept inside until served. (g) A drainage system designed to eliminate odors will be required for all outdoor dining areas. Hose bibs with vacuum breakers must be available for washing down the dining area. I (h) Trash dumpsters shall be situated no closer than 50 feet from an outdoor dining area. If such a dumpster is in the line of sight from the dining area,it must be hidden from view. The area around the dumpster and stockade must be kept clean and free of litter. Dumpsters must be closed with adequate covers designed to prevent entrance of rodents and birds and sealed to control odors. (i) The patio or other ground surface must be of constructed of material readily cleanable and not susceptible to dust,mud,or debris.- (Brick,tile,and concrete are examples of acceptable materials). � I (j) Table tops must be smooth,non-porous,easily cleanable and durable;and readily maintained in a i clean and sanitary condition. I I I (k) Food service personnel must constantly police the dining area for waste paper,garbage and other trash. Placement clips,cup holders and other such devices must be utilized to prevent blowing paper. Covered trash receptacles must be provided in close proximity to the dining area and must be emptied as ` needed to prevent overflowing. (1) Strict clean-up practices must be adhered to. Waitstaff and buspersons must clean up after each patron as in indoor dining. Each establishment must abide by all regulations contained in Article X, Minimum Sanitation Standards for Food Service Establishments,of the Commonwealth of Massachusetts, Department of Health Sanitary Code. (m) Outside food handlers must have easy access to handwash sinks and cleaning cloths. Facilities for preparation and disposal of sanitizing solutions must be accessible. (n) Hair nets or other effective hair restraints,such as hats covering exposed hair,shall be worn by all FOR MAIL-IN APPLICATIONS outside food or drink handlers. Beards and mustaches must be neatly trimmed. Please mail a completed application form to the address below. Please include: 3 Copies of the Neatly Drawn Sketch Plan of the Outside Dining Area Showing Separation Distances to Curbing,Trees,Rubbish Containers and any other Obstacles in Pedestrian Walkway 3 Copies of Pictures of the Proposed Outside Dining Location(Front and Side Views) 1 Copy of the Menu Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED APPLICATIONS Our fax number is(508)790-6304. Please fax a completed application form. Please include: 3 Copies of the Neatly Drawn Sketch Plan of the Outside Dining Area Showing Separation Distances to Curbing,Trees,Rubbish Containers and any other Obstacles in Pedestrian Walkway 3 Copies of Pictures of the Proposed Outside Dining Location(Front and Side Views) 1 Copy of the Menu For further assistance on any item above,call(508)862-4644 I To get an outside dining/sidewalk cafe application form, click here. To be able to access this form, your computer must have Acrobat Reader. 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S"1t"p�!'//iftt tin fslt IleAse TOWN OFBARNSTABLE LOCATION `OHO V SEWAGE# ola// VILLAGE ASSESSOR'S MAP&PARCEL ? q— INSTALLER'S NAME&PHONE NO, SC.O B SEPTIC TANK CAPACITY eX 1 S'E 1000 C-r-r K rc 11t /OQQ Seel c LEACHING FACILITY(type)crw Vi 10 I S-00 y r %J NO.OF13EDROOMSG .k L>C-r ,0VV_ 1 F} 0�_Lf OWNER_ , ( L� PERMIT DATE: /I i COMPLIANCE DATE:3/J/h Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility AJ _Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) 4 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) _Feet FURNISHED BY. �.(p� CA,-- A k0 T^S?CL U3 coo ►_ as- cao .3 c to : Ir tjato �'ozox 3 L tow = Q*0 r'Cn SQw b % 0 is c -i S c O 1ra 1 :al Oro a fA0— r 1 of 1 6/22/2018, 11:56 AM LAMBERTS KITCHEN CATERING MENU Specializing in Business Conferences, Family Occasions or Just Your Office Lunch 1000 West Main Street,Centerville,MA 02632•508-778-4066 Hours:Mon-Sat 8 am to 7 pm,Sunday 8 am to 5 pm SOUPS BY THE QUART/GALLON PARTY PLATTERS $10.99 per quart BASIC PLATTER $64.99(Serves 15-18) Chicken Noodle Chicken Rice LAMBERT'S SPECIALTY $74.99(Serves 20-25) Italian Wedding Bell Chili Lean Roast Beef,Honey Baked Ham,Oven Roasted Gr.Chicken&Corn Chowder Chicken Vegetable Turkey,American Cheese,and Imported Swiss. Tomato Bisque Beef Stew ASSORTED ITALIAN $74.99(Serves 20-25) Hungarian Mushroom Kale Lean Roast Beef,Imported Ham,Genoa Salami, Clam Chowder Tuscan Sausage Mortadella,Capacola,Provolone Cheese,and American Cheese. COLD SALADS GRAND BUFFET $84.99(Serves 30-35) In a Decorative Bowl•Priced per lb.(3lb minimum) Lean Roast Beef,Honey Baked Ham.Oven Roasted Turkey,Bologna,Genoa Salami,American Cheese, Cole Slaw $5.99 lb. and Imported Swiss. Cranberry Chicken Salad $10.99 Ib. MEDITERRANEAN PLATTER $74.99(Serves 20-25) Chicken Salad $9.99 Ib. Pita Bread,Hummus,Tabouli,Grape Leaves,Sliced Buffalo Chicken Salad $10.99 lb. Tomato,Cucumbers,and Spinach Dip Tuna Salad $10.99 lb. CHEESETRAYS Italian Tuna Salad . $10.99 lb. Small(Serves 20-25) $69.99 Seafood Salad $9.99 lb. Large(Serves 30-35) $89.99 Country Ham Salad $9.99 lb. Special You Pick Your Cheese Farmer Egg Salad $6.99 lb._ VEGETABLE TRAYS Bacon/Cheddar Potato Small(Serves 20-25) $59.99 (Twice Baked) $8.99 lb. Large(Serves 30-35) $69.99 Macaroni Salad $7.99 Ib. Assortment of Fresh Vegetables from Our Market Greek Pasta Salad $8.99 lb. Accompanied with Homemade Dip Edamame Salad $8.99 lb. FRUIT BOWL Tom/Mozz Basil $9.99 lb. One Size Only Prices may vary with season Cucumber Salad $8.99 lb. Large(Serves 30-35) $59.99 Green Bean Salad $8.99 lb. An Assortment of Fresh Fruits from Our Market Vegetable Salad $8.99 lb. Accompanied with Homemade Dip I. Red Bliss Potato $5.99 lb. i Chicken Caesar Salad S10.99 lb. HOT MEALS TO GO! FULL AND 1/2 TRAYS Bleu Cheese Cole Slaw $8.99 lb. Antipasto Salad $9.99 lb. Call for Pricing! Tortellini Salad $9.99 Ib. Chicken(1/2 Tray:6 pieces,Full Tray: 10 pieces) Lobster Salad Market Price-Just Ask! Scampi,Piccata,Parmigiana,Marsala,Alfredo, Cacciatore, Pesto,Goat Cheese&Sausage,Chi-Chi FRESH SALAD BAR Lasagna:Made with 3 Different Cheeses Meatballs-Italian or Swedish Greek Meatloaf Eggplant Parmigiana Caesar Pot Roast Sausage&Peppers Garden ` Stuffed Peppers Pasta-Plain Cobb ':o:, s BBQ Chicken Thighs $8.99 lb. Antipasto ::: �`® " BBQ Ribs $10.99 lb. Mixed Greens Quiche $12.99 ea.(and up) Chicken Pie(1/2 tray) $19.99 ea. SANDWICH PLATTERS Your Sandwich,Your Way SIDES by the each/lb. Your Choice of Bread: Crab Cake $4.99 ea. Pain D'Avignon,sliced&Roll-ups! Stuffed Quahog $4.99 ea. Boarshead Deli Meat&Cheese Tilapia Cake $4.99 ea. Cut and Served on a Tray XXLG Twice Baked Potatoes $4.99 ea. Stuffed Seafood Portabella $8.99 ea. FINGER ROLLS ASSORTMENT Stuffed Zucchini $6.99 lb. $2.9Sperpiece Grape Leaves $8.99 lb. Tabouli $8.99 lb. Chicken Salad , Chicken Cranberry FULL TRAYS AND 1/2 TRAYS price by the lb. Tuna Salad Italian Tuna Old Fashioned Macaroni&Cheese Egg Salad Macaroni&Cheese with Ham Ham Salad Lobster Macaroni&Cheese,Market Price-Just Ask! Lobster Salad Market Price-Just Ask! Mashed Potatoes Everything Mashed Garlic Mashed Wild Rice Rice Pilaf Fresh String Beans BAKERY Butternut Squash Sauteed Fresh Vegetables From Cookies,Pies,Breads,Muffins,Cheesecakes Twice Baked Potatoes Zucchini&Summer and Our Gourmet Cakes! You Choose Fresh Vegetables Tray Indulge! 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Page 1 of 1 O O } l .1 . t d El say something https://photos.google.com/share/AF 1 QipOgzj VyufFsOHxyFukhOd6_K3N-wsQdwJlkB5o2... 8/28/2018 Photo - , oogle Photos Page 1 of 1 977 OR f k EGG S HDWI , RERE io .\ta�,Oca i I ' 1 f i I r I Say something https://photos.google.com/share/AF 1 QipPuCBI-Jg7iMi2Xkj Okj 8Dnp2H7Xx8Kn48N2soV... 8/28/2018 Photo - Google Photos Page 1 of 1 EGG lb a A a Owl AN U . n HER s. r, w - zrt ✓F- Y ' C 0� Say something https://photos.google.com/share/AF 1 QipPk8exvgmPukjxlQvXnZ_VtNZdzm5YB3cAnXH... 8/28/2018 Photo - Google Photos Page 1 of 1 aarewt��' t / 1 k I I AugV6 ♦�� F (� t L L � Say something https://photos.google.com/share/AFlQipPk8exvgmPukjxlQvYnZ VtNZdzm5YB3cAnXH... 8/28/2018 I Photo - Google Photos Page 1 of 1 i � y , A Say something https://photos.google.com/share/AF 1 QipPuCBI-Jg7iMi2XkjOkj 8Dnp2H7Xx8Kn48N2soV... 8/28/2018 Photo - Google Photos Page 1 of 1 ! a rah it 1 t• �_ �y ,�.e "^'f Y • y •' ter" i 1 �1 C 1 �n C V \� \� V sc� https://photos.google.com/share/AFIQipPuCBI-Jg7iMi2XkjOkj8Dnp2H7Xx8Kn48N2soV... 8/28/2018 �I f •Photo - Google Photos Page 1 of 1 It j lii p RESTROOMS 1 1 1 �30Z)n Il I �Q l l \ iI �; 1` M j =1 n #1 ty, c �- t�SfUA— I"clt� Say something https://photos.google.com/share/AFIQipPk8exvgmPukjxlQvXnZ VtNZdzm5YB3cAnXH... 8/28/2018 MAI- �o/i- s No. l b .5 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpIitation for ]Disposal 6pstem Coustruftiou permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /CD 6 Uj e4+ Meri., 4- - Owner's Name,Name,Address,and Tel.No. Assessor's Map/Parcel a G t/�'G�Vl .W !/Cvv%�-Q Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. a0 k CJ 6 q (5T 6 Z a Type of Building: G Dwelling No.of Bedrooms Lot Size 0 0 0 sq.ft. Garbage Grinder Other Type of Building ZwO&f- rndif.P k No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) //7 a gpd Design flow provided gpd Plan Date i? 7 r�(� j) Number of sheets Revision Date Title Size of Septic Tank X 1 Type of S.A. JA-yy,-tZ)yj /V,J V Description of Soil A(>O r. no Cs C_._ Nature of Repairs or Alterations(Answer when applicable) (H 1�4 \k s+irsv--,K_ a,rc)��.c� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date c� I Application Approved by Date Application Disapproved by Date for the following reasons Permit No. �W — O 5 Date Issued 3—1 N-1 tK y\ n , _ __.. •. . _ .. _ .vim kA No. o` C r .b J �� :v a: Fee j(S'0 THE COMMONWEALTH OF MASSACHUSETTS, Entered in computer: PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Yes u 2pplitation for Nsposal 6pstem (Construction 3permit Application'for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete'System ❑Individual Components Location Address or Lot No. /00 d W MC,j S>f- Owner's Name,Address,and Tel.No. Assessor's Map/Parcel C-t� kcAm Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms�n Lot Size� v 0 D 0 sq.ft. Garbage Grinder( v w Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 17 gpd Design flow provided gpd Plan Date 7 I `�U )) Number of sheets Revision Date Title Size of Septic Tank 9 X 1 �/0 a(J (x6,1 Type of S.A. . s�o ,m (/ w Description of Soil Co,.J u*. . A6, r--1 a bZNO tcN& ✓ram Ll 11r_%SkT_V Nature of Repairs or Alterations(Answer when applicable) A J( ��� -� Date last inspected: e Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date J gyp` Application Approved by Date Application Disapproved by Date for the following reasons ' Permit No. D U B 1- 055 Date Issued 3-(W- I . .- ------ --------- -------------------------------------------------------- --------------------------------------------------- - 11 % THE COMMONWEALTH OF MASSACHUSETTS i BARNSTABLE,MASSACHUSETTS Certificate of Compliance - THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(v ) Upgraded( ) Abandoned( )by at c�a t awn �. ��t �,�, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. �o I I -b SS dated Installer Designer s k((A l #bedrooms {„ SUA e f nn f 1/L?i'4' Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will function as des ? ed. Date ��� t i Inspector { i � No. C90 - b SS Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pste Construction Permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at , O C3 d C-) M G k t and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with z Title 5 and the following local provisions or special conditions. / i Provided:Construction must be completed within three years of the date of this permit.Date 3 �'-( Approved by - ' i Town of Barnstable OF SHE Regulatory Services - ,wRrisrAat.e Thomas F,Geiler, Director � MASS.�639• Public Health Division A �4 . jfD"A0�p Thomas McKean,Director 200.Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: 31 I Sewage Permit# 2O C Assessor's Ma \Parcel 1 a Designer: EQ ({�—►J J�. � rS,pE Installer: SC,�s1-r ►.t, Fit_ Address: q�3 R-o�vzeeA Address: 113 pt_'b leA9j-46-c7ir1. R:I>. &wTHR:5 RL , HA vzl;"7 j N 4'/4-emu�S P4 A. 62" 1 On . `�.�1\,A , 1 :5 �.(, 1N�1� was issued a permit to install a (date) (installer) septic system at ��� ti^ based on a design drawn by (address) - S le P Hct► A. 14AAvj. Pe- dated I I I I (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the f distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e, greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. 4 9� (Installer's Signa�e � AL (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE -WILL NOT BE ISSUED UNTIL BOTH.THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Revised.doc � I � •�� � I� j i ! I I j j ! � j I h' ► I Co T die. . 4 •� I It I i j 1 F r ► I I ' � i i I I j i I � ► I I � j I � - ! 1 __. I � I ; - i x � � � I 1 � I !•• 1 I .;.-!_. I I -i - r ! � i � ' I i I .,3,�� — — - • _ � — -- ---- � I � _ ! a� � 1 I I' ---- --- ------- -- --- —�__ �—_ __ I _T_T_ • - - — � ---_ Vag 0 ato oe b° ®atone k''°hao ,�ia9 b � 006 c b°�b k,i°ben o° be at b° �b e at b° ato°® i b° at° o� be { SECOND FLOOR PLAN Oil 61 E l a'oA � c o° °o1 bo 90 a� °O b°lb M� oe be b° �b ,. oe . ago b° °o® b° a� oa be SECOND FLOOR PLAN o o Zo �). ' STEPHEN 41. ��zs No.........Z..-........ ............... THE COMMONWEALTH OF MASSACHUSETTS p BOARD O HEALTH . Avillicamin for Uiivasal Mario Tunairurmin Wrutit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal system t . ...............................��..-�. . Location• dress or L No. (sl er Aa ess .:.�.-_... -. � Installer _....---•----------------------••--•--•-............. ........ ............._.....-•----- U Type of Building/ adares5 � v Size Lot----------------------•-....Sq. feet Dwelling,—No. of Bedrooms. � .��z�z�� x ansion Attic YP g -- tto � °`IQb:-of persons ( ) Garbage Grinder p., Other�T e of Building�_ p, Showers Cafeteria Otherfixtures ..........................---•-••--•-•-••----------•-----•-•---•---•-•-•-•-••................. ............. ....•---.......:...................... r W Design Flow._._f.�.— -�tl� gallo p erson per day. Total daily flow...............1--� �. 1 ...._.....gallons. W Septic Tan Liquid capaclt ._._.._.....gallo s ngth--------- ----- Width............. Diameter................ Depth................ Z Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area-_--.---.--.-._----sq. ft. Seepage Pit No......T--------- Diameterr..................... Depth below inle _•-----•----•----- To al lea ing area_..._.----------_-sq. ft. Other Distribution box (d/) Dosing tank ( ) d� C�a:- ���.z/7y a Percolation Test Results Performed by............................... - ----------------••-------•---...._..----- Date................... f�a Test Pit No. 1................minutes per inch Depth of Test Pit__.._......_..._:_.. Depth to ground water..................... Test Pit No. 2..:.............minutes per inch Depth of Test -Pit.................... Depth to ground water........................ y Description of Soil _.....Q'._.._.__-- a M 1.r...... - U --•............................•------------•••----•---•...-_-•----------•--------•---------- -•--••----------•--- W --- x ------------- U afore of Repairs or Alterations—Answer when applicable............. ..............._______ greemen .............................................................................................. .........-•--•-------•-----•-•------•---••--•---•------- The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with _the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in -- _operation until a Certificate of Compliance has been issued by th board f health. - Sign ...�! Application Approved By _ a e ............. Application Disapproved for the following reasons:.................. Da e % •-- Permit No.......... Date " Issued...2.., ... ....:.. .... I Date �' r... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ OF....... . . Z ..................... Trr#if irabr of &Utplianu HI :` TO CE .-IFY hat.the Individual Sewage Disposal System constructed ( or Repaired by.. -- -- : at. 11 : Instr .....---- .s 1 has been installed in accordance with the provisions of Article.XI of The Sr�i'te Sanitary, e as d ibe th application for Disposal Works Construction Perm C ' Hint IVo.._._..._. ..:_... dated-•--• `!f. THE ISSUANCEOF TEAS CERTIFICATE SMALL NOT BE.CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SAV-Sr-ACTORY... DATE........ ............................................................ Inspector.................... .............. •--------•--•--...-•-----••------...---•-•----...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 14 . No.-. OF......... .. ........ ............. FEE._. �t��.� � �z•�� �aa,� tx.rfii�a� rri�Permission is hereby granted... '.. !�... to Const or epaY>y, ( ) n Individu wag D •-- at No. .:� ,� g ?os' S tern . ... as shown on the application for Disposal Works Constructio Street ._r..... n Per No.-= Dated---,P' .?2 ram . DATE_..,....................... ................... Board of Health ...................... FORM .:1255 .,HOBBS.-& WARREN, INC., PUBLISHERS 'I y -. s.... UN'� �.L� .. ,p` .�� �q 9� d" � � / ��:� �'�.- � �,, ��� �� . i i I No--qL-A THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE llp iratinrt for Disposal nrkii Tonatrnrtign .e . rnitt Application is hereby made for a Permit to Construct ( ) or Repair System at: (,� an Individual Sewage Disposal ...........................cation-Address ------------••-------•- / ........................... o. ��5 -�� • 6 . Address ................... __(� Installer ---...-•---•---•-------•-----� ��f Type of Building Address �� Dwelling—No. of Bedrooms..........,..--•-------- Size Lot._ ,�...1/2 - Sq. feet ___--_-•.-•_Expansion Attic ( ) Garbage. Grinder ( ) a Other—Type of Building ............................ No. of persons.......... Showers ( ) — cafeteria Other.fixtures ...................--- -------- --------------------------------------) W Design Flow_.•_--.-•-.----,----------------------------gallons per person per day. Total daily flow.._- -------------------------------Tank—Liquid Width-----•••-•-••...:-Diameter----------•.••_. Depth....... Disposal Trench—No._ -•--• Width_•---�............. Total Length._._-•--._ Seepage Pit No---------�_.-- Diameter-,--` Depth below inlet_._...6-r-••••- g • Total leaching area______________:._.-_Sq. ft. Other Distribution box ' . Total leaching area..................s ft, ( ) Dosing tank ( ) q• a Percolation Test Results Performed ng tank --•----------......................•--•.. Date Test Pit No. 1----------------minutes per inch Depth of Test Depth to w Pit... Test Pit No. 2________________minutes per inch _._.___- De p ground water...................... . a Depth of Test Pi __t-_-_--_-_---_-._.___ Depth to ground water...__.._.__._.____.._._. 0 Description of Soil------ -----•. -------- •------- --•-----------------------------------••••--•----••••••--••-.. W - ---------------•-----------•------- -------------------------------------------- ......------------------------------ U Nature of Repairs or Alterations—Answer when applicable____ p � � .. Agreement: ------------------- The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further a rees n t system in operation until a Certificate of Compliances s-b en iss ue board of health. the b g o to place the y. Signed = A Application Approved By ...-_.. -- Application Disapproved for the following reasons: ----.......:- --------------------------------...................................................... ------------------------------- --- PermitNo. �` ..............- .................... Aoo/�................. Issued 9/ ..............ire THE COMMONWEALTH OF MASSACHUSE77S BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Cruxrc�lt�xxcce THIS IS' TO CERT IF1 That the Individual Sewa e Dis Disposal System con_srructed ( or by ...... �� �_ , ��<'�� ��.. ar ............................ 9 smiler....................... ' epalre ( has been installed in ccord, ace with the provisions of TITLE 5 oThe State Environmental Code as described in the a pplication for D s, 1_usal ti%nrks Construction Permit No. --..-.-� r_7 THE ISSUANCE OF THIS -ERTIFICATE SHALL NOT BE CONSTR�}UED AS A GUARA . .. ll L� ��_.. dated ...... 1..fj 7,�!� r SYSTEM WILL FUNCTION SATISF:ACTORY. t .r r.. EE THAT THE DATE.. ...`. ........................... Inspector .............. THE COM,'�A(--)N WEALTH OF MASSACHUSETTS - % BUARD OF . T ., L BARNSTABLE' HEALTH No. . ' TOWN fY FEE. Permission to Construct is he grante a......•••. ........... .... �i.�r exxnif ` ( ) or Repair =: c(.�7 an Individual Sewa Disposal System at No....__. as shown on the application for street ! s�>< ---- j Di,posa: Works Construction f?ermit No.. 1 �� � r � -Dated_ ? ' % ,7 � ,J / �k DATE_ �f :- i - <._.....1.... Board of Health' FORM 38508 H088S&WARREN,INC.;PUBLISHr, i v� ` y Nv COCA COLA THERMOMERR INSTALLATION INSTRUCTIONS I� CODE T102 6y 1 � IO U 9%2 �lA C C O E C OI O Q. O 4- C Figure No. 1 Figure No. 2 co co MOUNTING THERMOMETER TO WALL � bo There are two methods of mounting your thermometer. For best temperature results select location where the thermometer is not exposed to direct sunlight. METHOD 1. SCREW MOUNT — THIS IS THE PREFERRED METHOD T There are two slots provided on the back of the thermometer (See Figure No. 1 . With screws provided, drive a� the top screw 13/16" below the top of the thermometer, leaving the 'screw head out from the mounting surface D approximately 3/32". Be sure to keep the screws on a vertical line in relation.to each other, 9-1/2" apart. Hang the thermometer on the two screws, using both slots in back. -t� CU Q METHOD 2. TAPE, MOUNT C N The adhesive tape is adequate to mount this thermometer if the instructions below are followed. However, rough or irregular surfaces (brick, cement block, etc.) or improperly prepared surfaces can cause unsatisfactory. results. Failure to properly clean surface or attempting to place adhesive tape on rough surface will result in Thermometer not adhering to surface, U) APPLICATION: U Tape mounting requires that both surfaces, the back of the thermometer and the mounting surface, be ab- solutely clean and free of loose particles or grease. It is recommended that the surface be cleaned just prior to the application of the tape and/or mounting the thermometer. It is also advised that the temper- ature for mounting the thermometer is 70 degrees or higher. With the tape provided, remove protective- cover from one side. DO NOT touch adhesive after removing protective cover. Apply one piece of tape at the top and one piece at the bottom of the thermometer back, pressing the tape firmly to the back. (See Figure 2). Remove the second protective cover from the tape and position the thermometer in the desired location on the mounting surface. Press thermometer firmly to the surface for a few seconds. Your thermometer is now ready for many years of service. TOWN OF BARNSTABLE LOCATION /OG0 6tas7- 444,,,,seAj cry, SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO.x9C//�U&.)�Vi' 0aXX5'7 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS_ PRIVATE WELL O9] . BLIC WAT _ - BUILDER OR OWNER �S r /nJ �J .�C1rT DATE PERMIT ISSUED: 5,;;//719 DATE COMPLIANCE ISSUED: ���� VARIANCE GRANTED: Yes No I F --------------- _ .......... __-__''_ -----___-_____-� 142 Corporation Street __-. _............. Hyannis, Mac3. 775-0828 __. --_ '--__ __--___-__-__________-__-_______-_---_--_-_^�_�-�_�__--___ \ \ | ' | � � � � �^/ *�. . x-* �-�� - � | � � , ' � - � ' ' | ` � LAMBERT'S COMPLAINTS/PIGS/RECORDS REQUESTS IN ATTIC .rati _ ru - A e i \ cpssi I I / { tr lot 11 �Z 1 s r A `A k; -ice � r._,�1 '' �`��.. yJ_ • _ .. � � #:• ',e a (W l v > o F tottoli Fv �Qry� dial �I�,�'t"-��Q�� .� �?. �.5►�"" j:7 �i f•i � L301 ♦ �,_,fie t .. � � �� .q�' ti..`r � y 7�`+"�`- "( - t*din ' fit „y ►. � f r 12, lofst xe 1. . �Op w °wand T < abdI -.I 79L) ��N`tENTS'1 GALLON(3• '� °'' f 5 f - �-- _ 4 R. Y Top- Not -w-MOM l r .J .. III �. 3� t � I I Y ( I w • z1 big M 1 P i a t t t i t � i V .. � t. _ f �• �r �� ,.. Tom'. 1 > 1 t- . w f • `r t e ��: ��►� ,'ir CJ i f OCT-10-2000 10:34 BARNSTABLE CTY 'LAB 15083756612 P.02 11 4DThe Commonwealth of sachusetts Executive Office of Health an man Services Department of Public Health Division of Food and Drugs 305 South Street, Jamaica Plain, MA 02130-3597 ARGEO PAUL CELLUCCI (617) 983-6700 (617) 524-8062-Fax GOVERNOR JANE SWIFT LIEUTENANT GOVERNOR WILLIAM 0.O'LEARY SECRETARY HOWARD K.KOH,MD,MPH COMMISSIONER October 2,2000 First Class and Certified Mail Return Receipt Requested Receipt No. 7099 3400 0005 9954 5142 Matthew Lambert Lambert Fruit Co. D.b.a.M&M Fruit and Produce Co.,Inc. 1000 West Main Street ; Centerville,MA 02632 Re:Notice of Agency Action Refusal to Issue a License for Food Processing and/or Distribution at Wholesale Order to Cease and Desist Wholesale Operations Dear Ms.Lambert_ For the reasons set forth in the attached Notice of Agency Action,the Department of Public Health (Department)is refusing to issue a license for food processing and/or distribution at wholesale to Lambert h Fruit Co., d.b.a.M&.M Fruit and Produce Co.,Inc.Furthermore,the Department is issuing an order to cease and desist wholesale operations at Lambert Fruit Co.,d.b.a.M&M Fruit and Produce Co_, Inc. This action is subject to the adjudicatory provisions of M:G.L. c. 30A and will be governed by the Standard Adjudicatory Rules of Practice and Procedure, 801 CMR 1.0 1 et se4. Pursuant to 801 CMR 1.01(6)and 105 CUR 500.017(H)(2)you have a right to request an adjudicatory hearing by filing a written request for a hearing within ten(10)dMs of receipt of this notice.The request for a hearing must meet the requirements of 801 CMR 1.01 (6)of the Adjudicatory Rules,copy annexed hereto, and must be filed with Tracy Miller,Deputy General Counsel,Department of Public Health,250 Washington Street, Boston,MA 02108-4619. The failure to timely make a written request shall constitute a waiver of the right to a hearing. Furthermore,respondents are required,pursuant to 801 CMR 1.01(6),to file an answer to the agency action. I_ OCT-10-2000 10:34 BARNSTABLE CTY LAB 15083756612 P.03 Page two October 2,2000 Please be advised that whether or not you request a hearing,Lambert Fruit Co., d.b.a.M& M Fruit and Produce Co.,Inc. must immediately cease and desist wholesale operations. Any communication with the Department regarding this matter,whether written or oral must be through Ms.Miller at the address listed above,or by telephone at(617)624-5220. If,and as long as you are represented by counsel in this matter, all communications with Ms. Miller should be made through your counsel. Sincerely, DIVISION OF FOOD AND DRUGS PAUL J. TIERNEY Assistant Director, Food Protection Program Enclosures Cc: Tracy A.Miller,DGC7NIDPH Centerville$oH Lamber cdLener.doc OCT-10-2000 10:35 BARNSTABLE CTY LAB 15083756612 P.04 COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH DIVISION OF FOOD AND DRUGS The Department of Public Health, Petitioner V. NOTICE OF AGENCY ACTION Lambert Fruit Co_,d.b.a. M&M Fruit and Produce Co.,Inc.and Matthew Lambert, Respondents REFUSAL TO ISSUE A LICENSE FOR FOOD PROCESSING AND/OR DISTRIBUTION AT WHOLESALE AND ORDER TO CEASE AND DESIST WHOLESALE OPERATIONS I. ACTION Pursuant to M.G.L.c. 94, § 305C and 105 CMR 500.017(13),the Department of Public Health (Department)refuses to issue a license for food processing and/or distribution at wholesale to Lambert Fruit Co.,d.b.a.M&M Fruit and Produce Co.,Inc.(Lambert Fruit). This refusal is based on the Department's findings, set forth,more fWly below,that Lambert Fruit and its owner Matthew Lambert(Lambert)failed to satisfy the requirements of 105 CMR 500.000 and operated the facility without a license. Pursuant to M.G.L. c. 94, § 305 C and 105 CMR 500.010 (D)and 500.012 (B)the Department orders Lambert Fruit to immediately cease and desist operation of the wholesale operation at 1000 West Main Street, Centerville,MA,based on the Department's finding that the facility has no license to operate and that it fails to satisfy the requirements for licensure. Pursuant to 105 CMR 500.017 li (IT) (2),Respondents have the right to an adjudicatory hearing to i challenge the Department's action. This right may be claimed by submitting a written request for such a hearing to the Department within ten(10)days of the Respondents' receipt of this Notice(See, 801 CMR 1.01 (6)). Respondents shall also file an answer to the charges contained in this notice,which meet the requirements of 801 CMR 1.01 (6) (d). The request shall be sent to Tracy Miller,Deputy General Counsel, 250 Washington Street,Boston, MA 02108-4619. Failure to timely file such a request shall constitute a waiver of the right to a hearing. OCT-10-2000 10:35 BARNSTABLE CTY LAB 15083756612 P.05 Please note whether or not Respondents request an adjudicatory hearing,Lambert Fruit mast cease and desist wholesale operations immediately. U_ JURISDICTION This notice is issued pursuant to M.G.L. c. 94, § 305C, 105 CMR 500.000,M.G.L.c. 30A, and 801 CMR 1.00. III. PARTIES A. The Petitioner is the Department of Public Health.The Department is responsible for the enforcement of the above referenced provisions of the Massachusetts General Laws and the Code of Massachusetts Regulations. 13. Respondents are: (a)Lambert Fruit,located at 1000 West Main St., Centerville,MA;and,(b) Matthew Lambert,the individual owner and the responsible contact person listed on the initial application. IV. PROCEDURE Any hearing requested by Respondents is subject to the adjudicatory hearing provisions of M.G.L.c. 30A and the Standard Adjudicatory Rules of Practice and Procedure, 801 CUR 1.01.Any Notice of Claim for an adjudicatory hearing shall be filed with the Department in accordance with the requirements of 801 CMR 1.01 (6). V. FACTS A. On August 8,2000, a Division of Food and Drug(DFD)inspector visited Lambert Fruit to conduct an inspection for initial licensure.At that time,Lambert Fruit was informed that it was a wholesale operation operating without a current,valid license from the DFD. The inspection report is attached as Exhibit A and is incorporated herein as part of this action. At the time of this inspection,the inspector cited Lambert Fruit for 9 violations.The inspector,having found Lambert Fruit operating without a license,formally notified Lambert Fruit that continued operation in the absence of a license may subject it to legal action and administrative penalties. The inspector provided a license application to Respondents. B. On August 11,2000,the Department received an application for licensure for Lambert Fruit,d.b.a. M&M Fruit and Produce Co.,Inc.In addition to the application,the applicant submitted a Plan of Correction,dated August 9, 2000 indicating that violations cited at the August 8,2000 inspection had been corrected, or would soon be corrected.-The correction plan is attached as Exhibit B and incorporated herein. 2 OCT-10-2000 10 -35 BARNSTABLE CTY LAB 150e3756612 P.06 C. The Department conducted a second licensure inspection on September 8, 2000. The firm was Operating at this time. As reflected in the inspection report dated September 8,2000,the inspector cited the facility for twenty-nine(29)violations. Lambert Fruit was issued another Order to Correct. The inspection report and Order to Correct are attached as Exhibit C and incorporated herein. D. As of October 2,2000,the Department has not received a Plan of Correction from Lambert Fruit as required in the Order to Correct issued on September 8,2000. VI. GROUNDS: A. FOR REFUSAL TO ISSUE A LICENSE FOR FOOD PROCESSINGAND/OR DISTRIBUTION AT WHOLESALE 1. Pursuant to M.G.L. c. 94, §305 C and 105 CMR 500.017 (13)(1)(c),the Department is authorized,based on the violations cited in the inspection reports noted above,to refuse to issue a license based on the applicant's failure to comply with the provisions of the Department's regulations. The specific sanitary violations cited in the inspection reports of August 8" and September 8, 2000 constitute violations of 105 CMR 500.000 and are sufficient bases to refuse to issue a license to Lambert Fruit. 2. Pursuant to M.G.L.c. 94, § 305 C and 105 CMR 500.011 (A),no person shall operate a food processing operation without a valid license granted by the Department. 105 CMR 500.012 (C) and 105 CMR 500.017(B)(1)(f)provide that operation of a facility without a license is a basis for refusing to issue such a license.Respondents' operation of Lambert Fruit without a license constitutes a violation of the above stated regulations and is a basis to refuse to issue a license. 3. Each of the above stated grounds constitutes a separate and independent basis for the refusal to issue a license to Lambert Fruit B. FOR ISSUANCE OF A CEASE AND DESIST ORDER Pursuant to 105 CMR 500.010(D)and 500.012 (B),the Department is authorized to issue a cease and desist order to any person engaged in a food processing operation without a license. Respondents'operation of the facility without a license is a basis to issue a cease and desist order. C. FOR ASSESSING ADMINISTRATIVE PENALTIES 1. Pursuant to M.G.L. c_ 94, § 305C, 105 CMR 500.012 (B)and 105 CMR 500.017(E)(1)(d)and (2)(b)(5)the Department is authorized to assess administrative penalties for failing to comply w`th a cease and desist order.Failure to comply with this order to cease operations shall subject Respondents to penalties of$500.00 per day for each day of non-compliance. 2. Pursuant to M.G.L. c. 94, § 305C, 105 CMR 500.012(D),and 105 CMR 500.017(E)(1)(f)and (2)(b)(6)the Department is authorized to assess administrative penalties of$500.00 per day for each day that a person operates a facility without a license. Operation of Lambert Fruit, 3 OCT-10-2000 10:36 BARNSTABLE CTY LAB 15083756612 P.07 subsequent to the issuance of this action, shall subject Respondents to penalties of$500.00 per day for each day of non-compliance. WHEREFORE,the Department refuses to issue a license for food processing and/or distribution at wholesale to Lambert Fruit. ` WHEREFORE,the Department hereby orders Lambert Fruit and Lambert to immediately cease all wholesale operations at Lambert Fruit at 1000 West Main Street, Centerville MA. WHEREFORE,the Department shall seek administrative penalties against Lambert Fruit and Lambert for any violations of the order to cease and desist and for operating the facility without a license commencing from the date of service of this action. Dated: October 2,2000 DEPARTMENT OF PUBLIC HEALTH By: P UL J. , Assistant Directo , otection Program Division of Food and Drugs Department of Public Health cc: Tracy Miller,Deputy General Counsel 4 TOTAL P.07 OCT-10-2000 10:34 BARNSTABLE CTY LAB 15083756612 P.01 4WARNSTABLE COUNTY DEPARTMENT OF HEALTH & ENVIRONMENT �• SUPERIOR COURTHOUSE P.O. BOX 427, BARNSTABLE, MA. 02630 A s s ' 'Telephone #508-362-2511, ext. 6613 FAX#508-362-2603 FAX TRANSMITTAL DATE. To: �/I/L/j? CC: dl�md FROM: W4 3 #Pages(including this cover sheet) MESSAGE: la�ac�W d awe yru doc:Fax Form j<ffjje:?�jte COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, SS. SUPERIORtO'OURT NO. 1772C�V00384 PATRICIA A. CAHILL Plaintiff, V. M.R.C.P. Ri1L.l= 30(a) AND RULE 45 LM FRUIT & PRODUCE, INC. Defendant. A TRUE COPY ATTEST TO: Keeper of Records Town of Barnstable Board of Health Process server&Disinterested Person 200 Main Street Hyannis, MA 02601 GREETINGS: YOU ARE HEREBY COMMANDED in the name of the Commonwealth of Massachusetts in accordance with the provisions of Rule 30(a) and Rule 45 of the i Massachusetts Rules of Civil Procedure to appear and testify on behalf of the plaintiff, Patricia A. Cahill before a Notary Public of the Commonwealth, at the offices of MARTIN,MAGNUSON, McCARTHY & KENNEY, 101 Merrimac Street, 7th Floor,Boston, Massachusetts, on the tad day of May, 2018, at 10:00 a.m. and to testify as to your knowledge, at the taking of the deposition in the above entitled action. You are further required to bring with you the following: A copy of any and all correspondence, reports, citations, violations, inspections, and other documents whether paper, digital, electronic, or any other form, that is within your possession, custody, and/or control and in any way related to any business located at 1000 W. Main Street, Centerville, MA 02362, including but not limited to LM Fruit&Produce, Inc. (also known as Lambert's or Lambert's Rainbow Fruit) from March 18,2014 to present. i Hereof, fail not as you will answer your default under the pains and penalties of the law in that behalf made and provided. I You may comply with this subpoena by mailing a complete certified copy of I the records mentioned above to Attorney Stephen M. O'Shea at the address listed below at least one day prior to May 2, 2018 A certification form has been included for your convenience. ; wC Gtr !vl 2 Stephen M. O'Shea (BBO No. 559236) (Notary Public: Kathryn E. Price (BBO No. 689292) Attorneys for the Plaintiff, My Commission Expires: J� Patricia A. Cahill Martin, Magnuson, McCarthy & Kenney 101 Merrimac Street Boston, Massachusetts 02114 (617) 227-3240 sosheato.mmmk.com kprice(c,mmmk.com Dated: 1 I 1 i • I COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, SS. PATRICIA A. CAHILL ) Plaintiff, ) V. ' ) LM FRUIT&PRODUCE,INC. ) ' Defendant. ) SUPERIOR COURT NO. 1772CV003 84 RECORD CERTIFICATION I, Sharon Crocker,Keeper of the Records,under oath,do depose and say that the attached records, numbering 55 pages (Inspections p IA, 1B, 2-26, and Other p 1-28), are a true, accurate, and complete copy of my original records kept in the usual course of business. SUBSCRIBED AND SWORN TO UNDER THE PAINS AND PENALTIES OF PERJURY THIS FIRST DAY OF MAY 2018. Keeper of Records Town of Barnstable-Board of Health TOWN OF BARNSTABLE HEALTH. _ _ LIST OF DOCUMENTS LAMBERT/LM FRUIT & PRODUCE INSPECTIONS PAGE(S) LIST OF FOOD CODES Inspect 1-A DATED 2/11/14 Inspect 1-13 DATED 7/10/14 Inspect 2 DATED 1/21/15 Inspect 3 DATED 8/04/15 Inspect 4 DATED 3/09/16 Inspect 5 DATED 9/01/16 Inspect 6 DATED 3/20/17 Inspect 7 DATED 7/25/17 Inspect 8-9 DATED 7/26/17 Inspect 10 DATED 8/17/17 Inspect 11 DATED 10/15/17 Inspect 12 DATED 11/02/17 Inspect 13-16 DATED 11/29/17 Inspect 17 DATED 12/20/17 Inspect 18-20 DATED 12/21/17 Inspect 21 DATED 1/03/18 Inspect 22-23 DATED 1/11/18 Inspect 24 DATED 1/26/18 Inspect 25 DATED 2/02/18 Inspect 26 OTHER: PAGE(S) Letter dated 10/28/15 P1 Letter dated 6/03/15 P2 Citizen Request Management dated 10/25/17 P3 Citizen Request Management dated 08/16/17 P4 Citizen Request Management dated 07/27/17 P5 Citizen Request Management dated 07/21/17 P6 Citizen Request Management dated 12/23/16 P7 Citizen Request Management dated 08/30/16 P8 Citizen Request Management dated 08/01/16 P9 Citizen Request Management dated 03/25/16 P10 Citizen Request Management dated 07/09/14 P11 Food Permit for Year 2018 P12 Food Application for Year 2018 P13-14 Food Permit for Year 2017 P15 Food Application for Year 2017 P16-17 Food Safety Training Certificate P18 Citizen Request Management dated 12/23/16 P19-21 Foodborne Illness Complaint Worksheet P22-23 Citizen Request Management dated 11/23/16 P24 Food Permit for Year 2016 P25 Email interoffice dated 1/30/15 P26 Food Application for Year 2015 P27-28 Q:\Legal\RECORDS REQUESTS\Ct Case Lambert v Patricia Cahill 5-2-18 Atty Martin Magnusun McCarthy-Bos\List of Documents sent to Atty 5-1- 18 Case Lamberts v Patricia Cahill May 2 2018.docx i E 3 i i i i 1�j ; J ir • 1 . 1 r I _ yT- r 7 r _ _ do + , yi i 1 ---- --------^--� ' ` , tom'=----- ----7` i � I f F p 7. — T—IL P 22 o aigelsweg io uMol (1 idap y_�eaN + S/CIALE DRAWN 8V APfftav"ev DRAWING NVM®ER g ALIIANENE 10 5455 :> MADE IN U S.A ARCHITECTS'STA ND ARO FORM ACCESS COVERS MUST INSPEC!'ON 9' MINIMUM. DES I GN CIS / l E,r? / A GENERAL N I! S 111 {{{ BE TO FINISH GRADE PO Wi',y 3 ' 21 MAXIMUM COVER DESIGN FLOW: T 10. / FIRST 2 ' TO 3'R OF F; MIN 2' OF PEASTUNE 4500 SF SUPERMARKET AT 97 GPD/1000 SF i . THIS PLAN IS FOR THE DESIGN AND CONSTRUCT, JN -�� - - M1 1 -�T= � BE LEVEL EOL'ALS 437 GPD OF THE SEWAGE DISPOSAL SYSTEM ONLY. 4' DiAM P1Pf _ v — j _ ___ OR FILTER FABRIC L _ �=-=- -- -=•_ S WAREHOUSE EMPLOYEES AT 15 GPD/EMPLOYEE_ `•- ,i/4' - 1 1/2` D/A. EQUALS 75 GPD 2. VERTICAL DATUM IS ASSUMED, FOR BENCH MARKS DOUBLE WASHED STONE 6 BEDROOMS AT 1 10 GPD/BEDROOM SET. SEE SITE PLAN. EFFLUENT' 11 +� 4 95 8 EQUAL S 660 GPD F!L TER �8.QZJ �L.�_. —_— L I I H-20 TOTAL FLOW FOUALS ! !72 GPD 3. ALL CONSTRUCT ION ME-7r SAND MATtRiALS AND CONVERT EXISTING EXISTING 13 INFILTRATOR 30.'0 CHAMBERS EXISTING L 3 OUTLET MAINTENANCE OF THE SEPTIC SYSTEM SHALL 1000 GALLON TANK 1000 GALLON , 500 GAL H-20 D-BOX W/4 ' STONE AROUND2 'M x t� l x 2 d SEPTIC TANK REQUIRED: CONFORM TO MASS. D.E. P. TITLE 5 AND LOCAL TO A GREASE TRAP SEPTIC TANK SEPTIC TANK 1 172 GPD X 200% - 2344 GAL. BOAPO OF HEALTH RFGUI_A T"IONS EXTEND BOTH TEES 6' CRUSHED STONE OR COMPACTED BASE SEPTIC TANK PROVIDED: EXISTING i000 GAL. PLUS A NEW 1500 GAL - 2500 GAL TOTAL 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER PROF I L E NO T TO SCALE AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER j GREASE TRAP REOU!RED: THAN 3 ' IN DF_P TH SHALL BE CAPABLE OF W i T•h- �/ 24 HOUR KITCHEN FLOW - 4,37 GAL STANDING H-20 WHEEL LOADS. VV _P!R FENCE GREASE TRAP PROVIDED: 1 D00 GAL - 5. A1.L SEWER PIPE S.HA1 BE .S!'HEDUL E 40 PVC OR -___-P/R FENCE APPROVED EQUAL ' - --- SOIL ABSORPT r ON SYSTEM REOUI RED y EDGE OF'CiRAVEC ` ' —— DESIGN PERC PATE f 5 M I N/I NCH Fes•, �vENr SOIL TEXTURAL CLASS - 1 6. SEPTIC TANK AND D-BOX SHALL BE REINFORCED N 84 4 54•F !8�'85 L PRECAST CONCRETE OR APPROVED POLYETHYLENE. rP.2� o EFFLUENT LOADING NG RATE - 0. 74 GPD/SF PrI� BOTH SHALL BE WATERTIGHT, D-BOX SHALL BE WATER ��nc�'�_ i 1 , 2 GPD / 0. 74 GPD/SF - i 584 S.F. REQU'1 RED �_ _---- --T } TESTED FOR LEVEL WHEN THERE I S MGRE THAN ONE ~'� PROVIDED: 13 INFILTRATOR 3050 CHAMPFRS OUTLET. —� W74 ' STONE AROUND, A- 1648 S.F. ��0 648 S.F x 0, 74 - 1220 GPD 7, BEFORE CONSTRUCTION CAL; •D l G-SAFE-. 1-888-DIG-SAFE AND THE LOCAL WA TER DEPT. 13 INFILrRAr0R J050 FOR LOCATION OF UNDERGROUND UTILITIES. O -- 40 MIDI CHAMBERS w/4" STONE AROUND �f 7 J /'� ^ -r POLY LINER SG I L ! ES P 1 � iJfi A �� ExrsrlNc .. , J I 8. SEPTIC ,SYSTEM INSTALLER SHALL NOTIFY THE EACH PiT5 SLPO (��r INDICArES INDICATES �pB STOCKADE ENCLOSUREP r PERCOLATION �- OBSERVED DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION rEST - GRSUNDNATER OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE NEW 1500 GALLON TP .1 P.13149 TP •2 CONSTRUCTION INSPECTIONS, S£P'iC TANKr ^ HORIZON TEXTURE COLOR HORIZON TEXTURE COLOR t•,) J' -------r-- 101.5 0' — f 0 i.5 EXISTING LOAMY 10YR LOAMY IOYR T- -_ _-A_._ A - 1000 GALLON \-BM. CORNER CONCRE"£ `� SAND 3/3 �� v SAND 3/3 IOO.0 8•_ — 100.0 SEPTIC TANK APRON. EL-IOJ.9I B a LOAMY IOYR p LOAMY IOYR f SAND 6/4 O SAND 6/4 t— �L J `z 36' .... .. 98.5 30' 99.0 E C J MED COARSE IOYR C! MFD COARSE 10YR �P SAND 6/4 t' SAID 6/4 \ \ - CONVERT EXISTING QCl- I000 GALLON SEPTIC �G 54- - 28 TANK TO GREASE TRAP Dp� \ cry ROlI7E '--KITCHEN OUTLET OCUS RE-ROUTE SECOND FLOOR- \�� APARTMENTS TO SECOND TANK \` NO PATER I NO WATER 91 I.S 4i 44--�_._.._._._.�� 89.5 120= ��— _ v S DATE: OECEMBER lJ, 2010 E� TEST BY. 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