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Home My WebLink AboutPAPA JOHN'S PIZZA - FOOD (2) #„"PAPA J' S T 12- ^ I Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. ru� r�asc� S F.P.(Thomas)Lee, 200 Main Street Hyannis, MA 02601 IDaniel Luczkow,M.D. Alt. �fQ AlA't 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: 710 Issue Date: 01/01/2022 DBA: PAPA JOHN'S OWNER: KAY-JENS PIZZA, LLC Location of Establishment: 215 W. MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q/ _ FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: APPROVED 06-11-2003- 1.) A GRD shall be installed in accordance with State Plumbing Codes. 2.) The menu is restricted to pizzas, breadsticks, cheesesticks and chicken strips. 3.)The variance is non-transferable will be voided if the establishment has a change in use, ownershipor leased to party other than applicant. For Office lice Only: Initials: Town of Barnstable 1 _ s Inspectional Services Date Paid ��v��d$ O��— snaxASM p ►�� Public Health Division check# $ �O 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 l NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: k4 -jery /'►� Twe-. A,& A0j&Jo4�-j ADDRESS OF FOOD ESTABLISHMENT: Z l S LyeS-� /Lg.,-P S-1Rw--t y,?Aw,"s Ag, W,90/ MAILING ADDRESS(IF DIFFERENT FROM ABOVE): P.0 8 oy- - A E-MAIL ADDRESS: E'- TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (10-1b 22-r- TOTAL NUMBER OF BATHROOMS: CA WELL WATER:YES N04 ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: 0_ OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICE SE 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 DOORS)? / TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) X FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL.MOBILE &NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q\Application FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT Cl.�C lJ � J 2- SOLE OWNER: YES 0 /D.O.B 11 96 OWNER PHONE # .5-g& 3,6a-5-;6 6 7 ADDRESS 3 Y �,/.tox�s e �Q�✓e wed' /3g S-4b/e-A,0�66��,�x+; CORPORATE OWNER: n� [ / /►� �4 096l� CORPORATE ADDRESS: o?/S� IN�S�/"/�'i� STl�+�� /7'r 4/�N:S /•z�A peal . �/ 1^ PERSON IN CHARGE OF DAILY OPERATIONS: ffv e.1A JA 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 1. 44A)IA M f-T'1,vgiv- ,t?, O L o 1. eAl AMIPL-r✓Q- Q � / 0 X l 20 X4 2. C4,41 M eT.LV _ r, 1 / at /12024 SIGNATURE OF APPLIC DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openina!! 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. NOTICE: Permits run annually from January 1 st to Dec.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q\Application FormsTOODAPP REV3-2019.doc �s 0 Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BAmNsrABL&, : Paul J.Canniff,D.M.D. MAS6 F.P. Thomas Lee Alternate �o � 200 Main Street, Hyannis, MA 02601 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: 710 Issue Date: 01/01/2021 DBA: PAPA JOHN'S OWNER: KAY-JENS PIZZA, LLC Location of Establishment: 215 W. MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 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: Q FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: APPROVED 06-11-2003- 1.) A GIRD shall be installed in accordance with State Plumbing Codes. 2.) The menu is restricted to pizzas, breadsticks, cheesesticks and chicken strips. 3.) The variance is non-transferable will be voided if the establishment has a change in use, ownershipor leased to party other than applicant. I For Office Us Initials:Town of Barnstable tt //��'-�� Date Paid t Amt Pd$04.-1V (+ BARMSPABLE, : Inspectional Services 1 i- vMASS. Check# I IJ Public Health Division °rEo ter" 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 _j2.jX6L-4o-yo NEW OWNERSHIP RENEWAL �C NAME OF FOOD ESTABLISHMENT: k4)e"J6tjs AM4 TNC, U&4 P"4 ADDRESS OF FOOD ESTABLISHMENT: a21 r WP-(S4- Af# J SMt�f &4A NI'3 MAILING ADDRESS(IF DIFFERENT FROM ABOVE):P do x 742 W eli- ZSAKA-�-FAk -�q, a 4,�F E-MAIL ADDRESS: l:, A C 7:4y&✓'e_ Cam CAfT. JUCY- TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (S-Ok - r60 TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO-X— ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: X _ SEASONAL: DATES OF OPERATION: /_/_ TO NUMBER OF SEATS: INSIDE: OUTSIDE:TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. dd IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? rT IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? N TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT l�►��t+'�d f clluz1bv'o- J9 SOLE OWNER: YE� 0 D.O.B ,?OWNER PHONE itSv R- 36,7 S"6 l(? l� ADDRESS_ Otis 61t.114/A4-s4h/e A4.o,24;- a.l;w 4u&j odox Z�.Z CORPORATE OWNER: hip o�� CORPORATE ADDRESS: h 5- We, 144N PERSON IN CHARGE OF DAILY OPERATIONS: E77 o G� ` / e- 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 I. , /ffC'nyq ! / l3 /,2a21 1. f kdA ent,� 2-/ 4 2. %�'�' � (�/4'So?�/fiL1e4.W oZ/ lv /to,Z 'T';t-AAr/f1 02//6/`;w 1 KU M, l /2 SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asy. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE CON1PLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPP REV3-2019.doc + vi5ec +0 CA6 vary rYlci t l2d $ t 2--ZoZo --&b i Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BARN Bum � Paul J.Canniff,D.M.D. 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate q i6 � 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: 710 Issue Date: 01/01/2020 DBA: PAPA JOHN'S OWNER: KAY-JENS PIZZA, LLC Location of Establishment: 215 W. MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 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: cQ� 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: APPROVED 06-11-2003- 1.) A GRD shall be installed in accordance with State Plumbing Codes. 2.) The menu is restricted to pizzas, breadsticks, cheesesticks and chicken strips. 3.) The variance is non-transferable will be voided if the establishment has a change in use, ownershipor leased to party other than applicant. pt Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. RAPNSTAUL& Paul J.Canniff,D.M.D. 26 #� 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: 710 Issue Date: 12/10/2019 DBA: PAPA JOHN'S OWNER: KAY-JENS PIZZA, LLC Location of Establishment: 215 W. MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 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: QA 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: 15�47 For Offs Initials: Town of Barnstable Date raid MA,'� Inspectional Services '� •�`� Public Health Division �s —oor 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 6 1 NEW OWNERSHIP RENEWAL)C NAME OF FOOD ESTABLISHMENT:_k,4y-) .r /`oZM lee- 654 306u ,`Z ZA ADDRESS OF FOOD ESTABLISHMENT: 07l 1.l�' ''/A'%� S'l'�� 17 i S At. 02-e0I MAILING ADDRESS(IF DIFFERENT FROM ABOVE): /� 6c,, . 7eA 44,5/We/Gf� oa66� E-MAIL ADDRESS: G:MCTL.Vt, doaltS N&�-/— TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (,-5—qj ?7 - me) 6e TOTAL NUMBER OF BATHROOMS: _ WELL WATER: YES_NO_X... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: . SEASONAL: DATES'OF OPERATION:_/ / TO NUMBER OF SEATS: INSIDE: OUTSIDE iLLLER'S TOTAL: SEATING: MUST OBTAIN A OMMON VIC LIC E 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 SF CE DOOR(S)?1 1 TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE _RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BtD&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:\Application FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: YEV& D.O.B Il l OWNER PHONE# �SD?' 341d- T"? �� ADDRESS .3K J�VJ54----- pRise,W,ep�A4R 54plcA 0Ot91 /I44eAS/w/,�4 �I��. CORPORATE OWNER: CORPORATE ADDRESS: o? Z S d't— /"�G+� tS �.Pil� UX CLA,,At/S /of c�, PERSON IN CHARGE OF DAILY OPERATIONS: z14 cT L -mle u . 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 , ' r , 1. 1!7 l— Z rA-�vqrj- 'o?l 2. -,Azl-4 d R; OQJe a'A' p2/ t o QO•� r' • 5�r�d'"�B �j 9C ��`cSG`IA►1� ho) /A M j ao SIGNATURE OF APPLICA DATE ***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 508-8624644 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.townofbarnstabla.us/bealthdivision/`applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.31'each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPP REV3-2019.doc I Town of Barnstable BOARD OF HEALTH r Paul J Canniff,D.M.D. Board OI Health Donald A.Gaudagnoli,M.D. BARNISMAUM John T. Norman MAS' F.P. Thomas Lee Alternate 200 Main Street, Hyannis, MA 02601 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: 710... Issue Date: 12/20/18 DBA: PAPA JOHN'S OWNER: KAY-DENS' PIZZA, LLC, HAROLD & CAROL MCILVANE Location of Establishment: 215 W. MAIN STREET HYANNIS MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 -FEES --- FOOD SERVICE ESTABLISHMENT: $250.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: --- - MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: q d � ofIKE For Office Us Initials: Town of Barnstable n Date Paid ✓ Ant pd$ Inspectional Services �. �, y 1639.. Public Health Divisioncad .,.,., . Thomas Mcgeau ,*Director { LA 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fag: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE a Al Xdr0G NEW OWNERSHIP RENEWAI)( NAME OF FOOD ESTABLISHMENT: A e."J.p .Z ,4- afi GINS 04,ZZ4 ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): /! 6 Ax 79.2 Rce. 0a66� E-MAIL ADDRESS: ( ,M C 3:Ly 4&,2 (0 dov ST, cio�l TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO ...(ANNUAL WATER ANALYSIS REQUIRED) . ANNUAL: < SEASONAL:., w DATES OF OPERATION: �TO NUMBER OF SEATS: INSIDE:, OUTSIDE TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICE SE 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 DOORS)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE . , , rs 40 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 FommsTOODAPPREV2018.doc . ...... ...- f .......... . - PLEASE CALL 508-862-4644 OWNER INFORMATION: // � 1 FULL NAME OF APPLICANT f-f�`+Ao c-Z4 ye sV- J� SOLE OWNER: YES/ht0) ``��D.O..B 4 o 94 3 OWNNER PHONE# S6S- 3d�—,��66 7 1' ADDRESS XAzy-, iAe- ✓/2i V2 1.�-eS��S L�f' /�u Do��i /u��'s /�.Od >` 21�i2 LI�S��`41 `7 t CORPORATE OWNER: FEDERAL ID NO. : 02 CORPORATE ADDRESS: a?I S GGl'gS�-I;q o,�6161 PERSON IN CHARGE OF DAILY OPERATIONS: List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff 7 All FOOD ESTABLISHMENTS must have 1 Ce g, F- d P-,F e�tion M x4ger PER SHIFT. f� n� ... f� .. y *.*ATTACH COPIES OF CERTIFICA S *"The'" ea t> I v. 'bik 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. WCA fel 6fwo, SIGNATURE OF APPLICAN DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to ouenins!! 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 htty://www.townofbarnstable.us/bealthdivision/aunlications.aso. 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.31'each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. AApplication FormsTOODAPPREV2018.doc pp THE Tpk, TOWN OF BARNSTABLE - HEALTH INSPECTOR,s Establishment Name: Date: Page: ( ,.of ti OFFICE HOURS P ° 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 ,63v. �0� HYANNIS,MA 02601 nnoN.-FRI. No Reference R,Red Item PLEASE PRINT CLEARLY 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT l 3 61z- Name , foU Date Tvue of T e of Inspection �CO' /"lS/�+h s -lToutin Address �. Risk ion Level Retail Previous Inspection - ,- `-e1- Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Cp CJ Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other ' Inspector Out: �� 4-1 C, Each violation checked r uires 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) ❑ C. .- <� Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 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 A\ , Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: Non-critical(N)violations must be corrected immediately or ❑ No TO Yes within 90 days as determined by the Board of Health. Overall Rating Voluntary Com❑ ry Compliance p ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items Embar o checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 9 ardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-critical violations re if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up, infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 t 8 non- ''cal violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's (gnat re 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' ur Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y. N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 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 1 g 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. 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers*ll Identifying Information-Original Containers* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 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-Stara e Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and 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* 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 P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMErfEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(l)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted far 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 Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg cave 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* 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) Ratites,Injected Meats-155°F 15 sec* f 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 temporary and a ide in ca[er- Sources* Ratites-165°F 15 sec* 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. 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 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g, g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) g 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 Facilities 3-202.18 Shellstock Identification* 3-501.14(A) g Coolin Cooked PHFs from 140°F[0 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 1 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 11 008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other her 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. oFTHEr TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: Date: Page: . I of �. 4 OFFICE HOURS Aa E° PUBLIC 0 MAN STREET EEVTSION 3:30 s 30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:30-4.30 P.M. MON.-FRI. .639. �0� HYANNIS,MA 02601 No Reference . R-Red Item . PLEASE PRINT CLEARLY p s 508-862-4644 'EO"""` FOOD ESTABLISHMENT INSPECTION REPORTHZ(AAC _ Name f Date b Type of Type of Inspection i4l ZZ Ooemtion(sli e�ne Addres / Risk ood Service previous Inlsnection f Level Retai P Telephone a Residential Kitchen Date: }//I GL Mobile Pre-operation K� cL Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP /,I r In: Other IV Inspector Out:f)m ) Each violation checked requi es 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) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Ln 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 J / JVVTI C�y f7/{^t d ClQ EMPLOYEE HEALTH PROTECTION FROM CHEMICALS r 3 ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives 3 ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals t ,- FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) de / ❑ Ap 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures C_ - ❑ 5.Receiving/Condition ❑ 17.Reheating S 3 ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding L 3 PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control i 3 6 ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP l CYO/1 S ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY y �l ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories �,1v2n) I `��j ace I Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations ��/// r� v Critical(C)violations marked must be corrected immediately. (blue&red items) �\ I Corrective Action Requi ed: No Yes Non-critical(N)violations must be corrected immediately or Overall Rating �---_ ❑ ❑ Y� 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 4npn-critical violations 9 (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violatiuns and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations obse id to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to/8 non- itical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's S ature Print: 31.Dump er screened from public view p I Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's S4 ature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N 1 . ,... ., '.rt �.« .. +-"! --,�. .: >,:,�. ,,.i1� -'+.-w....,.�.+�.-r.-�-_+r-. -•--„+� +--•-`---.-...�-�.�r--...� .y.-`.�.� .� --.�"`^^k- .. -.J � .- .-. `w-.r �' s .r ...... ...5..,.-+:_"`"v.^e--.-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.) .G FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment P Storage* 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Stora e Applicants* 3-302.11(A) Food Protection* 7-202.11 Restriction-Presence and Use* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 1590.003(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* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and Unopened 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11C ( ) P ened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMErfEMPERATURE 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* 3-401.11 A(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* Eggs 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ell-s,.e 1112001 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 Surf aces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-HoLWater and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential HE Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail practices shu 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requ iemenos ld 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 Commerciall Processed RTE Food-140°F* (Blue Items 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* 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/ 6-301.11 1Handwashing Cleanser,Availability 28. 1 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 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. °FINE Iq, TOWN OF BARNSTABLE - _ HEALTH INSPECTOR's Establishment Name: Date: Page: of PUBLIC HEALTH DIVISION OFFICE HOURS8:00-9:30A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 1639. .0� HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �AEED MAC° 508-862-4644 - FOOD ESTABLISHMENT INSP CTION REPORT q Name A. - D`�� Date 3 10 e o T e of ns ection ou d i. Address "7 i t� S-�� Risk ood Se ection !� Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation C5 Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector OQ-1 Out: fI -L4/ .Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. C��/��, 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 rAm ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS G ❑ 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) C� ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating l ❑ 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 i 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 t 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 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 8non-critical violations. If 1 critical refrigeration. violation,4 to 8non- l violations C. 29.Special Requirements (590.009) within 10 days of receipt of this order. cr'� a = 30.Other DATE OF RE-INSPECTION: Inspector's Signatur 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 Signatu 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.) a FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS { 3-501,14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g g 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables ° 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements Reporting.by Person in Charge* Contamination from the Consumer 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* . 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and * 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 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* 3-401.11 A(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 Equipment Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved-System'k * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* ebnve 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) I Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and 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- Sources* Ratites-165°F 15 sec* 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. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.1](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 Requirements. radicsshould be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.1](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 Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y 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 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 FG-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 tO98 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 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. oFINE rok TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: a "D � Date: ` Z Z/. Page: of / v� do OFFICE HOURS BAR-NSTABLE. ) PUBLIC B200 MAN STREET EEVT 3:30-4:30 P.M. DIVISION : 0- :3A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified N. HYANNIS, MA 02601 MO s-FRI' No Reference R-Red Item PLEASE PRINT CLEARLY A'FD1AP'p FOOD ESTABLISHMENT INSPECTION REPORT Name � `S Date N S►hAL I STt e o Type of Inspection l�l w O Rou' D�- Address I t;�J O•�- Risk ood Service e-ins e Level _17rewous Inspection Telephone Residential Kitchen Date: fH Mobile Pre-operation fat Owner HACCP YIN Temporary Sus Caterer eneral Complain / Person in Charge(PIC) Time ii Bed&Breakfast r Ol L• C[cln=) � In: 3 tb Other Inspector Out: 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) ❑ _ cl i FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS //�� ,�, n ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives - LY,t(&t- ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals n F, �/ n FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) A (�-C� ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ✓S" /� /� ❑ 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 / K 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 L 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 o? 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 9 re ardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4non-critical violations 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 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot C=2 critical violations and less than 9 non-critical. If If critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to anon-cri 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to anon-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's S' nature - 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 S ture Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted, Y N Dumpster Screen? Y N v / Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 3 19 PHF Hot and Cold Holding 2-103.11 Person-in-Chaz e Charge Duties -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) 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* Other* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F * 7-201.11 Separation-Storage Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions*590.003(E) Removal of Exclusions and Restrictions7A 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reser of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Disposition of or 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 Warewashin Hot Water € 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed 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* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 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- mme is sec Animal Foods That are Raw,Undercooked or 5-101.11 DrinkingWater from an Approved S stem* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP Y Not Otherwise Processed to Eliminate Equipment* ( )( ) Pathogens 590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meats&Game * eff-n-innooi 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 Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 1p 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 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* Requirements. 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) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity 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 TagsiRecords: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 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*17 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 5-20411 Location and Placement* Temperature 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 128. 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. vl� y°FINE Tokti _ TOWN OF BARNSTABLE HEATH INSPECTOR'S Establishment Name: v ^ S Date: `( L L Page:_�of PUBLIC HEALTH DIVISION OFFICE HOURS S 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 M $ HYANNIS,MA 02601 MON.-FRi. No Reference -R-Red,Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT 508-8624644 Name Date Z Z Tvpe of Lwqsj Inspection C� l Risk ood Se Address 1 J �_ O s ou b�� `!D �� .. W Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: p�9 Mobile Pre-operation _r`x�-` 6?_ d4 I UD D Owner HACCP Y/N Temporary Suspect Illness / ( �� Caterer General Complaint ��Q'wl r - r �� G Person in Charge(PIC) �-��v -rI� � Time.,z �j, Bed&Breakfast HACCPOther f '� In: Inspector �� Out: L`.6b 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) `�❑ ( d v�� L� �'�^t S+Action as determined by the Board of Health. Allergen Awareness 590.009(G) ' 4vt c r FOOD PROTECTION MANAGEMENT ❑�evention of Contamination from Hands � ✓ i , _ Q 1.PIC Assigned/Knowledgeable/Duties / �C � r y(�y❑ 9 9 3.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS �jrt� ❑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) W"Pc rN ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 18 Cooling �./'�/ ��`_�, � �_ J ff1A de ❑6.Tags/Records/Accuracy of Ingredient Statements . }� /`� /�( ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding (ALA' J i PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control , ( � qb_ t ❑ 8.S aration/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) v G� .Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP 3 El 10.Proper Adequate Handwashing CONSUMER ADVISORY rQ t 3 K- ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical ViolationsL &a-m � " tljy �(t ❑ No Critical(C)violations marked must be corrected immediately. (blue&red items) ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating a Corrective Action Required: 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 Embar o checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ 9 ❑ Emergency Closure ❑ Voluntary Disposal Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 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 regardless of the number of critical, results in an 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 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 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 = 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8non-critical violations C. 30.Other DATE OF RE-INSPECTION- Inspector's Signatu a Print: 31.Dumps 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 /k Dumpster Screen? Y N �/✓1 �- QW t 1 Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 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 b Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F Applicants* g y3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* A 7.202.12 Conditions of Use Applicant To Report P To The Person In Charge*g 3-304.11 Food Contact with Equipment and Utensils* * 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* from the Consumer ge* 7-203.11 Toxic Containers-Prohibitions 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reted of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or 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 ( ) P 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a HermeticallySealed 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 Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS * 4-501.114 Chemical Sanitization-Temp., H. Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.14 Eggs and Milk Products,Pasteurized P�•P 16 P 9 P Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 4-601.11(A) Clean Utensils and Food Contact Surfaces of F.ggs-Immediate Service 145°F 15 sec* 5-101.11 Drinking Water from an Approved System* Not Othcrwisc Proccsscd to Eliminate 590.006(A) Bottled Drinking Water* Equipment* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ery ctsw 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment 3-001.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* Shellfish and Fish From an Approved Source 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,Poultryor 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g * 590.009(A)-(D) Violations of Section temporary and e ide in cater- Sources* Ratites-165°F 15 sec 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* the a ro riate sections above if related to Regulatory Authority 3401.12 Raw Animal Foods Cooked in a Microwave PP P 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 3-202.18 Shellstock Identification Present* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec* practices should be debited under#29-Special 3-201.17 Game Animals* 11 Good Hygienic Practices L 17 Reheating for Hot Holding Requirements. 5 Receiving/Condition 2-001.11 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) Commercially Processed RTE Food-140'F* Blue Items 23-30) 3-202.15 Package Integrity* Critical and non-critical violations,which do not relate to the foodbome 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness tnterventions and risk actors listed above,can be and in the 3-101.11 Food Safe and Unadulterated* f f° 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 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°17 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 SuppliedWithin 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 with Soap and hand Drying in Devices 590.004(J) Labeling of Ingredients' 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 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. °p tHE T TOWN OF BARNSTABLE, HEALTH INSPECTOR's Establishment Name: Tl � y�S Date: Page;. of., 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 MAC HYANNIS,MA 02601 r{ / MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �p i639•s�0 508-862-4644 FFD MP'� FOOD EST BLISHMENT INSPE ION REPORT Name ate T e o f Ins ection r a Routin Address isk Food Sery spe on Al r ItLevel Previo I cti n� Telephone Residential Kitchen Date: Mobile Pre-ope it Owner HACCP Y/N Temporary Suspec I ess Caterer General Complaint Person in Charge(PIC) Time Bed 8 Breakfast HACCP<'01v- y,Ivi h4.4 Zo th 01run 1 12 J In' Other j Inspector Each violation checked requires an explanation on the narrativ page(s)and a citation of specific provision(s)violated. 4 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) r C- FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 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 TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating i ❑ 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) i ❑ 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.Advisones 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,theRemy. ❑ 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 o 6 non-critical violations if no critical violations observed,4 to von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-criti violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 vio n,4 to 8 non-critical vVaf s=C, 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: I ctor' ig ur Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC' ign re 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) fAsignments of Responsibility* 8 Cross-contamination 14 Food or Color Additives _ Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) emonstration 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* * 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* Applicants 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* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003 D Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* ( ) REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( � Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* • 4-501.411 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 3-201.13 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. 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 Equipmenl 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* effwe�e uuzoot 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* c 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 Foo 3-40L11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and ` 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 10 Proper,Adequate Handwashing Ratites-165°F 15 sec*3-401.11 )(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* (C 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 �� Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g, g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* - 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 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 foodborne 12 Prevention of Contamination from Hands 3-101.11 Food Safe and Unadulterated* f 3-003.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 13 590.004(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* Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140IF 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 3402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices Within 4 Hours 27. Water,Plumbing and Waste FC-5 .006 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 129. 1 special Requirements 009 3-502.11 Specialized Processing Methods* 30. 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. y pp(ME row TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: Date: C� �( Page:, of q OFFICE HOURS PUBLIC AR EST 2 0 MAIN STREET SION 3:30-a:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. PLEASE PRINT CLEARLY. �p .aw•p0� HYANNIS,MA 02601 50e-862-4644 No Reference R-Red Item rFD^"0� FOOD ESTABLISHMENT INSPECTION REPORT Name -nlDat a of T s ecti n outinevie v Address , Risk od Service coon Level 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 In: Other Inspecto Out: 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) ❑ A In 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 \ �" EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives A. ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals b, i� •l 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 C ^� ❑ 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 `,� El 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) �/ 9 ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP j ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisies Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violoration - �f Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: El Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. (� lV ❑ 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 if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of )( ) 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 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspecto_r's��Signature n ��'' Print: 31.Dumpster screened from public view ' ►/��1 4(44 " �( „8 /` ` , v� Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N 1 #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signat e rint: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N .° '-„ �...r.] ^7 �: .._ a�i {. ''- ..4 f ��•- -'.-(vac 4,r^,-•.1`..-.- .. a i y _ a r • -� - ''.- L'' '.L Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventitins"- 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 Food or Color Additives. Law Cooled to 41°F/45°F Within 4 Hours* * 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge* 14 3-302.11(A)(1) Raw Animal Foods Separated from V- 02.12 Additives Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties - 3-302.14 I Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F *- EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the 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* 7-201.11 Separationg-Storage* Applicants* 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) 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 Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g ) 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* 4-501.111 Manual Warewashing-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* 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* - 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* 3-401.11 A(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 s„ _: Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ebecrr-uuzooi 4-602.11 _ Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Cough[Molluscan Contact Surf of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009 A incater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* - ( )-�) Ratites-165°F 15 sec* ing,mobile food,temporary and residential Sources* - 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* 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#29-Special 2-401.14 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition - - - g• g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* _ ' 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 PreventingContamination When Tasting* * (Blue Items 23-30) 3-102.11 Package Integrity g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated* a ( ) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1g 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[0 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/ 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* 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. I - 14/l/°FTC rq TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: ( Date: Page: of { 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 A ,6,19,a�0� HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEAS P T CLEARLY,,. 508-862-4644 'FDN1P` FOOD ESTABLISHMENT INS C ION REPORT Name PA Dat Type of Type of Inspection O e S Routine Address Risk -ood Servl Re-inspectio vel ketail_ Previous�l ecf Telephone Residential Kitchen Date: ( ' i Mobile Pre-opera io "�d Owner HACCP Y/N Temporary Sus e to Caterer General Complal Person in Charge(PIC) Time Bed&Breakfast AEG Other 42) InspectorLL� A - O �) Each violation checked requires an explanation on the narrativ page(s)and a citation of specific provision(s)violated. ' Violations Related to Foodborne Illness Interventions an Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ �q 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 FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands Ci ❑ 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 ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals M FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures - ❑ 5.Receiving/Condition ❑ 11.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 Lo ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Itemsl Total Number of Critical Violations ((11 Critical(C)violations marked must be corrected immediately. (blue&red items) I "I 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,th 'ems 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 non-critical violations if no critical violations observed,4 too 6 von-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 t' l violations. If 1 critical refrigeration. 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 violat erved,7 to 8 non- 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address ions tis ritica 29.Special Requirements (590.009) within 10 days of receipt of this order. violatio , to 8 non-critical vio tions C. 30.Other DATE OF RE-INSPECTION: Ins or's ignature int: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N Y #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI 's ig ature J Print- Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N 111 eve Dumpster Screen? Y IN 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 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* 5 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF.Hot and Cold Holding 2403.11 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 m 3-501.16(A) Hot PHFs Maintained At or Above 140°F* ge to - � - - - - 7-102.11 Comon Name-Working Containers* - -- Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) _Responsibility of A Food Employee or An 3-302.15 Washing Fruits Restriction-Presence and Use*its and Vegetables 3-501.19 Time as a Public Health Control* 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 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 7-203.11 Toxic Containers-Prohibitions* ( ) q - 3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* ti REQUIREMENTS FOR- 3-306.14(A)(B)Returned Food and AdulteReserrated or of Food 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and RestrictionsEE] g � ) Disposition ofAdulterated 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* 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 P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* - _ 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* _ _ _ _ Sanitization Temperatures* 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* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg crave 1/I12001 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-Ho[Water and 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* Proper,Adequate Handwashing 10 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* foodbome illness interventions and risk factors. h*W 2-301.14 When to as * Other 590.009 violations relating to good retail - $90.004(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#29-Special 2-401.11 - Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition - g, g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* I 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 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated* ( ) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing 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 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 ParasRecords, 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. 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. pp 114E rqr, ;- '-, TOWN OF BARNSTABLE HEALTH wsPEcroR's Establishment Name: Date:' Page: off ti OFFICE HOURS x.N e.o) PUBLIC 200 MAN STREEETSION s 30-4:30P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 079.a e� HYANNIS,MA 02601 MON.-FRI. No Reference R-.Red Item PLEASE PRINT CLEARLY rED MAC508-862-4644 ENTINSTF OD TABLISHM ON REPORT o I Name9.RA Dat Type of Type of Inspection d p Routine 1 Address Risk od rvice Re-inspection . y' W Level 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 In: Other Inspector Out: Each violation checked requires an Uplanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related tc 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 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) ❑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 8i red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items Embargo ❑ Emergency Closure ❑ Voluntary Disposal Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 6=One critical violation and less than 4non-critical violations 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 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. 4 to 3, n-cr tical violations=C. 30.Other DATE OF RE-INSPECTION: In - i t e Print,.- 31.Dumpster screened from public view -D Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI n ur a Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N �J�f �l Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions t r Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding, 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 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 * 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 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* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer - 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and 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 y Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed 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* 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* 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 145F 15 see* 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* Egcf'°e umo°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* 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* faces 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* P2401.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. * When to Wash* 3 401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )( ) 3-201.17 Game Animals* 11Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g. g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 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 foodbome 12Prevention of Contamination from Hands 3-403.11 Remainin Unsliced Portions of Beef Roasts*3-101.11 Food Safe and Unadulterated* (E) g illness interventions and riskfactors listed above,can befound in the 6 Tags/Records:Shellstock . ( ) 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 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* 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* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Fonnback6-2doc *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 To�, TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: r Page:_of 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 MASS. MON.-FRI. t639.pia HYANNIS,MA 02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY, 'EDN1P� FOOD ESTABLISHMENT INSP CTION REPORT Name Date wpe of e o inspection Ion Routine q�/� Risk I spection Address ,�l V O L Previous Inspection Level Retai P Telephone Residential Kitchen Date: Mobile Pre-operation q Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed 8 Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. 4 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( iLj FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ,q� Y� - ❑ 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 1 �� - ❑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 r t ( 0 ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS HSP 8.Separation/Segregation/Protection ( ) t l ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP r ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY �( t d ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories 1 ' Violations Related to Good Retail Practices Blue Items) Total Number of Critical Violations l Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: Qj ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined by the Board of Health. Overall Rating I A- I ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4non-critical violations 9 )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 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 violation,4 to 8non-critical violations=0- 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signa.ure Print: 31.Dumpst screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N Y ' #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Si nat/u�e Print: ^. Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N J 1� ^ �,� (. / /�i P] j t � Dumpster Screen? Y N V t 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* 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.* * 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* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to -- 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 P g Separation-Storage* Applicants* 3-302.11(A) Food Protection* * 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* uiremerits 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D)- Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated - Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y e P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* 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.]IA(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* Equipment* 8g Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg cave////zoo/ 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 Surf of Equipment*• Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 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* 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 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition g. g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) '' Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodbore 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°17,to 70°17 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 5-20411 Location and Placement* Temperature 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. 1Physical 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. Town of Barnstable Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MS Wayne Miller,M.D. June 11, 2003 Mr. Harold Mcllvane R.O. Box 782 ; West Barnstable, MA 02668 s Dear Mr. Mcllvane, You are granted a conditional variance from the Board of Health Regulation, PART II SECTION 1.00, which requires minimum 1,000 gallon capacity grease traps at all food establishments. This variance will allow you to operate a food establishment, utilizing a grease recovery device at Papa John's Pizza Establishment at 215 West Main Street Hyannis with the following conditions: (1) The menu is restricted to pizzas, breadsticks, cheesesticks, and chickenstrips as listed on the undated listing of foods submitted attached with your variance application form on May 15, 2003. (2) The grease recovery device shall be installed in accordance with the State Plumbing Code. (3) This variance is not transferable, and will be voided if the establishment has a change in use, change of ownership, or leased to a party other than an applicant. Your original request for a variance to install an under-the-sink grease interceptor was not granted. During the meeting, you revised your request to a request permission to install a mechanical grease recovery device (G.R.D.) which is known to be more effective in removing grease, fats, and oils. Since r yours, Wayne filler, M.D. Chairman Y > GRDVariance I o ce ,,, ---- — ! ---Y e_c-_e_.V t __Ov/Z-- f—P e Co p_.e .— - ---.-A�Reer,Q�.—P/��i,4P.� _�-o,•C _vSc.. ._._�,� .__cS__c�a_v_e ---4�-�- �� - -_. - -- --- -o e v --- --- ----- -- —k o, w.,-W-4----a 1 f. --__._fie o_ d►•.Gh -elty, -- - -----. _3nJ _b4el - z-fie ( ---�M M.S,4/L y—c✓ -'�" r_a __. - - I h e - s -741G _ 9,411ays vet k y e�----off - - - 9i Sc _.i•C-t�![Ce 2 _._F�_ 4---4�� i's 44:��xf jycf ye4 i . RE IV OF IHE Tp� DATE: ti0MAY 1 5 /UUJ v EE: /D =CBARN sTnat.E, TOWN OF KA MSTA81 P mnss. HEALTH DEPT, plfOMAfp Town of Barnstable CHED. DATE: Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. VARIANCE REQUEST FORM LOCATION t`,'Yry,r/, ��u Property Address: d/S U e1� 1)1GrnJ Self-ee s7t/, /vi C 602�Q ee Assessor's Map and Parcel Number: OD o713 Size of Lot: 0,41 /� Wetlands Within 300 Ft. Yes Business Name:k4y-jet)S"P-zu LL . d,6i4 &,7 4 J,k-,J PiZa No 7— Subdivision Name APPLICANT'S NAME: lyf 41A I- Ae-,a,.R- JQ Phone Ti _lt - 3Ka- t19117 Did the owner of the property authorize you to represent him or her? Yes H No PROPERTY OWNER'S NAME CONTACT PERSON Name: L..w,71�'kr►n AAIA AvI A V, No YeJ Name: �,¢k is lY1�lLya c� J4 Hys-y PQo A-+ AVB,vVe 9 Ai".),.) AdAess Aodo), 7f2 t e4 Address: QPad w+o;✓ # FL 3YP-a.3 Address: 3 y .T 6.t, <S, e weS� dq,e,�f) oa66� Phone: �Clw) -r O�;tee. Sd� 7 7.--109, Phone: Sadc- 3 0— y9�9 VARIANCE FROM R GULATI/ON(List Red.) REASON FOR VARIANCE(May attach if more space needed) 6t/041--k �-o&SA11 G gae43e it�etceD�r,2 vex kp ,�e2 Ex�•hrf 1 ale +hAP-t- <, *- r tkN i ¢. uji", NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System ❑ Checklist(to be completed by office staff-person receiving variance request application) _ Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) _ Signed letter stating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) _ Variance request application fee collected (no fee for lifeguard modification renewals. grease trap variance renewals [same owner/leasee only],Outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) _ Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S..Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Wayne A.Miller,M.D. Q:\HEALTH\Application Forms\VARIREQ.DOC [ | � �� Re nt w n ��U�N�� vw illo supply-^' SPECIALIZING(NE[0N'0>|IC\LLA!oLT.IDEj{G\ �NDEQi_,:>VE>TP+CKACE5 P.O. B'}��`w:' i``i {�VLLE. �'. May 11. 1S9O Mr. Nick EvolaJc. AIA Bayua Exo|aArohibaots 061 S. HursUoourna Parkway \ �/ Suite14O J Louisville, KY 40222 Re: Water Usage in Typical Papa John'sPizza Dear Nick: ' Based on actual water bills for the last six months in the following areas; Louisville, KY; ' {}dondo. FL; AUanba, GA; Nashville, TN; and Charlotte, NC. the average water usage for typical Papa John's was 7.41O gallons per month. This breaks down bzon average of247 gallons per day. Daily water usage ia broken down into five basic areas: 1. Washing Utensils (twice daily) 2. Cleaning and Mopping Floors (twice daily) 3 Food Preparation 4. RastroornUsage � 5. K8iocUsage 1 Washing Utensils: All containers holding food on the mahe|ine are rotated a minimum of twice daily. All containers are washed and sanitized before freshly prepared foods can be placed in them. These procedures would generally use less than 4Ogallons. 2. Cleaning: Normal daily maintenance uses approximately 1O '2O gallons ofwater. Mopping the floors (minimum of twice daily) uses approximately 25 gallons daily. 3 Food Preparation. Most o[the toppings used bv Papa John's are pre-cooked and delivered ho ' the store, so very little food preparation ia necessary. Water io used bo wash the vegetables and sanitize the containers. 4 Rastroom Usage� Most locations are carry-out and delivery only. Therefone, basing our figure on approximately 30 uses a day with an average toilet with a 5 gallon tank, this would yield approximately 150 gallons daily. 5. Misc. Usage: Drinking vvabar, washing of the hands, and various other uses. � The need for large tanks such as grease separators or holding tanks should not be a factor with the small amount of water used by an average Papa John's location. In many |ns'ances there are family dwellings that use more water than an average Papa John's � Ingredients.Better Better Pizza. � L r. r i' S7L ' LIGHT COMMERCIAL L V MAINTENANCEC', General Considerations To obtain optimum operating efficiency of a properly sized and installed PDI certified grease interceptor, a regular schedule of maintenance must be adhered to. Cleaning All grease interceptors must be cleaned regularly. The frequency of grease removal is dependent upon the capacity of the interceptor and the quantity of grease in waste water. Check interceptor daily until a grease level of 2"to 3"has been obtained (cleaning level). When the grease removal interval has been determined for a specific installation, regular cleaning at that interval is necessary to maintain the rated efficiency of the interceptor. After the accumulated grease and waste material has been removed, the interceptor should be thoroughly checked to make certain the inlet, outlet, and air relief ports are clear of obstructions. Please follow the steps below when cleaning. 1. Remove the 4 stainless steel flat head machine screws located in the corners. 2. Remove cover. 3. Grab onto diffusing baffle and lift handle and pull entire assembly out. Dispose of grease in proper waste container. 4. Clean out remaining grease. 5. Run water into interceptor to flush. Clean out 'outlet" chamber by removing cleanout plug and spraying water down inside. 6. Place cleaned baffle assembly back into unit. 7. Inspect cover gasket and replace as needed. 8. Replace cover and secure with (4) machine screws. ZURN PLUMBING PRODUCTS GROUP LIGHT COMMERCIAL OPERATION 2855 Girts Road Jamestown, New York 14701 Phone: 1-8001906-5060 Fax: 7161665-1135 Fes„#Jsz Pw2d2 Date:4112101 WEBSITE.www.zum.com r 0 LIG HT COMMERCIAL 1 SINK S —\ VENT ORIFICE VENT PLATE (AlF. !NTAKEj ; ill INLET _ I�. GUTL�i FLG`+V CONTROL VENT VCLEArIGUT !) CFTIGNALRAP i I ZUFPI LIGHT �\ F—T I \ / CGMME.;CIAL FLOW AERIE` 27G0 A FRGVE� NTERCEFTGR Zum Light Commercial Series Grease Interceptors#2700 consist of a interceptor rated at ( ) gpm and a properly sized flow control fitting. INSTALLATION 1. Zurn Light Commercial Grease Interceptors 5. The interceptor is to be installed using no- should be installed as close as possible to the hub couplings. fixture being served. Always install where there 6. Outlet piping should be connected to the is easy access for cover removal and cleaning. sanitary drain, and pipe size should be equal 2. A flow control must be installed as close as to or larger than the inlet piping. Outlet pipe possible to the underside of the fixture. The should also be vented so the interceptor is not flow control must be installed with the vent siphoned. or (air intake) on the downstream side of the 7. Solid waste should not go into an interceptor. orifice plate. The vent connection is positioned Food grinder waste and other solids should to the top of the flow control fitting and piped be captured in the sink or by a solids interceptor upward higher than source of water, or to before reaching the grease interceptor. building vent system 3. It is recommended that a cleanout tee be in- stalled before the flow control to access the flow control orifice and clear debris. 4. The cleanout plug should be installed over the outlet of the interceptor. Farm 0 JS2 PW+a x Date: 4/12/01 C.N.No.87859 Rev. C M. TT'' `Y� LIGHT GREASE INTERCEPTORS COMMERCIAL Ic GREASEINTERCEPTOR • Recommended for removing and retaining grease from wastewater in kitchen and restaurant areas where food is prepared. • Grease trap is corrosion-resistant coated fabricated steel with no-hub connections,slip- resistant cover,flow diffusing baffle, integral trap,and vented inlet flow control device. • Inlet and outlet sizes shown indicate standard operating sizes and flow control settings. The-20 and-25 can be reduced to 2'and the-35 and-50 can be reduced to 3".If changed, flow control must be adjusted accordingly. Flow Rate Grease Dimensions in Inches[mml Model G.P.M./ Capacity List Price Number [L/Ml Los./[kgj A B I C D E F G Each GT2700 04 4 8 2" 2" 10' 7-1/4" 7-1/4" 15-7/8' 9-7/8" [151 -41 [511 (511 [254] (1841 (1841 (4031 (2511 $240.00 GT2700-07 7 14 2' 2' 11-1/8' 8-1/8' 8-1/8" 17-1/4' 11-7/8' 316.00 [261 (61 [511 (51] (283] (2061 (2081 (4381 [3021 GT2700-10 10 20 2" 2" 11-3/4' 8-1/4' 8-1/4" 19-1/4' 14' 1381 (91 (511 (511 (2981 [2101 (2101 (4291 (3561 360.00 GT270015 15 30 2' 2" 13-3/8' 9-3/8' 9-3/8' 21-1/4' 16-3/4' (571 (14] (511 (511 (3401 [2381 [2381 (5401 (4251 428.00 GT2700-20 20 40 3" 3' 15' 11-3/4' 11-3/4' 24-1/8' 17-1/4' [761 (181 (761 p61 [3811 (2981 (2981 (613] [4381 480.00 GT2700-25 25 50 3" 3" 17' 12-1/2' 12.1/2" 26-1/8' 19-7/8' [951 [231 (761 P61 (4321 [3161 [3161 [6641 (5051 650.00 GT2700-35 35 70 4' 4' 18-3/4' 14-1/4' 14-1/4" 28' 22-1/2' p (1321 [321 (1021 (1021 [4761 [3621 (3621 Pill [5721 780.00 GT2700-50 50 100 4' 4' 21-1/2' 16' 16' 29-7/8' 24-1/2' 900.00 (1891 (45j [1021 [1021 [5461 [4061 [406] [7591 (622] C I` I LA 9 � I G CERtIFIEpC) D E i Sizes 20-50 INLET F GU U7 G=WIDTH OF eGDY LOW PROFILE GREASE INTERCEPTOR • Recommended for removing and retaining grease from wastewater in kitchen and restaurant areas where food is prepared. • Designed to be installed under the sink or in an area where space is limited. • Grease trap is corrosion-resistant coated fabricated steel with no-hub connections,flow diffusing baffle, integral trap,and vented inlet flow control device. Flow Rate Dimensions in Inches(mm] Model G.PM./ List Price Number (Urvll A 8 C D E F G Each ;- GT2701-ZO 20 3' 3' 10' 3-1/8' 3-1/8' 31' 21-1/8' $ 624.00[761 [761 [761 [254] [791 (791 [7871 [537) GT2701-35 35 4' 4' 10-3/4' 3-1/8' 3-1/8' 42-1/8' 29-3/8' 1,014.00 F [1321 [1021 [1021 [2731 P91 (791 [10701 [7461 Nlf( O-W107HOFSCOY ..1.'LE? GT2701-50 50 4' 4" 16' 10' 10' 49.1/2' 29-3/8' (189] [1021 [1021 [406) [2541 [254] [12571 (746j 1,170.00 Phone: 1-8001906-5060,Fax:7161665-1135 54 Websrte:www.zurn.com Octors: J J j r,Jf J William R. Teague, President Richard Friestad, Vice-President a�. J. C. Johnson, Secretary/Treasurer P. J. Gillespie, Director Merritt W. Wiseman, Director General Manager: William M. Northrup �Y r FEBRUARY 15, 2001 r WAYNE CARTER PAPA JOHN'S PIZZA 2002 PAPA JOHN'S BLVD. LOUISVILLE,KY 40299 Dear Mr.Carter: This,letter is written to confmn that on February 13,2001, the Director's of Valley Sanitary District conditionally waived the 750 gallon grease interceptor requirement for the proposed Papa John's Pizza at 81-002 Highway 111, Indio, Ca.. Enclosed is a copy of the draft minutes that reflects the Board's action by minute order 2001-567. The Board does want a condition on the permit that ensures that district employees may have access to the interceptor that is installed at subject facility. If district employee finds a serious problem then the Board wants to have the owner install a 750 gallon grease trap. Before such a finai order is issued the draft order would be presented to the Board for approval and the facility owners would have opportunity to appear at the public meeting of the Board. The action of the Board of Director's is final as of February 13,2001. However, the minutes will be approved February 27,2001. That is why the minutes are marked"draft". If there is dispute about the wording of the minute order or the interpretation by this letter please advise me by February 22, and I will bring your viewpoint back to the Board before they approve the minutes. Sincerely, William Northrup General Manager x/c Dan Cain O 4i-500 VAN SUREN, INDIO, CA 92201 i760? 3a7-2*1i6 =A ,7.J` ;1?.?) _ F•;n�ii' . >7{.br.yb .rJ6t.com 13. 0 0 12 VALLEY SANITARY DISTRJCT MINUTES OF REGULAR BOARD MEE-ffNG DRAFT February 13, 2001 A Regular Board Meeting of the Governing Board of Valley Sanitary District was held at the District offices, 45-500 Van Buren. Street, Indio, California,, on.Tuesday, January 9, 2001, CALL TO ORDER. ROLL CALL The meeting was called to order by President Teague at 12-30 P.M. Those in, attendance were: DIRECTORS PRESENT: Merritt Wiseman, Bill Teague, Richard Friestad. DIRECTORS A13SENT: J. C. Johnson, P.J. Gillespie STAFF PRESENT: Bill Northrup, General Manager; Darrel Gray, Collection Systems Supervisor.- Lu-pe Lara, OfEce Manager. GUESTS PRESENT: Greg Conrad., Area Manager, PAPA JOHN'S PIZZA Jim. Ducatte, Executive Director, Boys & Girls Club of Coachella Valley MINKU,5 There being no corrections or additions, DIRECTOR WISEMALN made a motion. to approve the minutes of the Regular Board Meeting held January 23, 2001. as submitted. DMECTOR FRIESTAD seconded. Motion carried by the following vote- 3 yes, 2 absent. PUBLIC COy.Wj,,:NT$ There were no public comments or correspondence items to present to the Board, EMPLOYUM PRESENTAT ON.-,T L Presentation of Employee Anniversary Pins_ Thefollowing employees were congratulated on.their many years of service as District employees. a Craig R. Harvey, 1.3 years of service on February 1., 2001.. a loupe Lara, 19 years of service on.February 1., 2001. 0 Dean Payne, 20 years of service on February 1.7, 2001. NON-HEARENSIG ITEMS 2. Re-consideration of Grease Trap variance requested by PAPA JOHN'S Pizza, PAPA JOHN'S Pizza. is proposing to open a pizza restaurant at 81.002 Highway 1.11, and they have requested a waiver of the 750-gallon grease interceptor. requirement. VALLEY SANITARY DISTRICT PAGE Min"fix 2/13107 Approved $�i�G P-012/C12 MR. NORTHRUP in.toced Greg� 4 g Conrad:, with Papa Jolur's9ita.the system and components used in thebaldn COlVJtAD explained no grease or oil products are used for their Process of their pizza, Jae informed. the Board that. meat toppings are pre-cooked and deliver.edpr Berated to t,s uses a fresh, dougl1 product. ,qll are a1I fresh. or canned. MR. red stated the pizzas axe bakedriy The vegetable toppings also demonstrated a. screen which had been used. for, 2 morrtar and had n conveyor style ovens, he no trace of,grease. MX CONRA.D informed the Board they would instal) which would. be installed by a 3-compa.ctment sink. a standard removable 4+0- gallon grease trap Pl_SIDENT T'-4-AGLM inquired if the 40- And if they would be willing to 'sign Sstatn interceptor would be 750- I a. waiver sta.ti.n. rFa accessible for sampling. gallon grease interceptor. �' violation were found they would install a MR. CONRAD stated he would have no problem, si $ring the document. ACTION TAKEN: IIvJU7TU)✓'; It was moved b . - y D mrcroR rRJ.ESTAD and WT.SrMAND to approve a van For the seconded by DIRECTOR PAPA JOHN'S Pizza to be located at 8l•402 ]�igse hlon wa requirement for. the `t stipulation that access for sampling Y , with the granted and if a violation is Found the Fa,cility0 rjlimmgr� interceptor rs ' gallon grease interceptor, Motion carried. by the fomediately install a, 750- absent following. Vote; 3 yes, 2 "-�UA'UTE ORDER NO. 2001-567 3. Consid,eration. of Request for. Approve) to attend Program. For GravitySewer S stem Seminar b Aat3emen.t of Operation Main.ten,an.ce Y Darrel,rel Gray. & - Dar.rel Grayf requested approvaJ for artendin the . . Program .for Gravity g Management of Operations and Maintenance , Sewer System Seminar to be held March 28-30, 2.001, at the Star t in Las Ve r gas. This seminar will address two new initiatives wluclt will have a t on wastewater collection. system, The Environmental Protection dustH.otel, Sant tremendous impact Sewer Overflow rule that incorporates a Capacity, Agency will be imp,ementi.ng the Maintenance requirement. The Governmental Accounting St Nana tBement of O discussed at this seminar also. g andards Board Standard 3 t'.on and will be DIRECTOR WISE MIrN comment, that this would be necessary information for the { asked for a. report to the Board. ,t GRAY said he will provide a,report for the Board upon his a Board., and P s return, VALr_F_Y Nl"rrARY r rSTp Min-f-for 2/13/07 PnGr_ 2 Ap r"Od i t s . a `� i 5 r 2 17 j 1-17 2 2 1 4 ?APA 1-1 0 4'10 13 0 2 1' 1'2 TOWN OF CLAYTON "SE,RV I C F, OPERATIONS CENTER "E.NVIRONMENT" ELEUMC SERVICE Ayr9 pijBi.rC WORK S (919)553-1530 (919)553-1530 VEHfCI FMAINTENNCC. X WATFR R-X-AMAT ION,0_uz (919)553-1535 July 16, 2002 Mr . Scott C. Evola Papa. John' s Pizza, 2002 Papa John' s Boulevard Louisville, KY 40299 RE: ALTZMMTZ EQUIPMZNT RZQtMST FOR PROPOSZD PAPA JOHN' S PIZZA FACILITY AT 914 RWr 42 WEST CrAYTON, NC Dear. Mr. Zvola: As we discussed recently by phone, your request to use alternate equipment (an under-the-sink unit in place of a. 1, 000-gallon. grease interceptor) to Meet the oil/grease control requirements of the Town' s Sewer Use Ordinance is approved.. This decision is based on, the operational information. you provided and, the fact that all ingredients are pre-cooked . You or your contractor must provide a submittal/catalog cut of the proposed alternate equipment . Also, please be aware that no other provisions of the ordinance are changed. if a grease-related problem occurs immediately downstream .- of the facility and/or analysis of the wastewater stream, leaving the operation reveals noncompliance, a 1, 000-gallon interceptor will be required . 1?1ease contact me if any additional information is needed . Sincerely, T Timothy S . Simpson, PE Public Works and Utilities Director CC : Building inspections, 0j.1/grease file 4. •: 7 1 29, 1997 ENT 1f ARY April " Wayne Carter General Manageer Equipment and Development Papa John's USA P.O. Box 99900 Louisville, KY 40299 Re: Papa Johns Pizza, Ocoee, Florida - Lab Results Dear Mr. Carter: Attached are the results of the laboratory analysis of the water quality sample collected from the Papa Johns Pizza, located in Ocoee, Florida, on July 261h, 1994. The results indicate that oil and grease in the composite waste sample was below the detection limit of the analytical method. Please call should you have questions or if we may be of further service in this matter. Respectfully, Grove cientific Cora ,Br n erraro, . P9esident BF:mp r.r,oi rnv�vrtoermeoeoo 6140 EOGEWATER DRIVE /SUITE F 9 ORLANDO. FLORIDA 3281C-4860 1(4071 2g8-2282 P r---x r4071 if?.i{ i 9.4 c 702 Zf.i y?F; ✓°. 'A. at�7iv:i #0136 P.004/ .)12 4ugust 1. 1994 20:38 - CERTIFICATE OF ANALYSIS Page t RE$Tj"LTS BY SAMPLE SENT GROVE SCIENTIFIC ANALYZI✓DP35W Eaviro=enmf, Laboratories TO: 6140 IsDGEWATER DRR T,, SUITE F BY: b63S F.= Culorr al Drive ORL ANDO, FL. 32810 Orlando. FL 32807 DART MORALES Phone: (407) 277-4443 407-298-2282 FAX 290-9038 Fax: (407) 392-8794 This Is to certify that the following samples were analyzed using goad taboraror)practices to show the following results. ar Ple iD. ps-4i cohoos=. Lab 11)— 9407316-01 Collected: 07/26194 23:30.00 "EST RESULT UNITS ANALYZED BY REASE &OIL. <s.►J U mg/I. 03/06/94 m�pm 1 �S4 OIAIIW313S 3AGN9 d90 'E0 EO OE Uwr --- ---------- HAY 1 3 4 9 502 2 1 4 8 5 0 PAPA JOHNS 0 13 6 P 10 12 Restaurant i 'own suprAy Coo :;QIA %l ENT PACKI GES P 0 BOX 99"Y!0.1.10 :5V1[, E. K% A0:6')-Y 90 May 11, 1996 Mr. Nick Evola Jr., AIA Bayus Evola Architects 661 S. HurstM. urne Parkway Suite 1140 Louisville, KY 40222 Re: Water Usage In Typical Papa John's Pizza Dear Nick: Based on actual water bills for the last six months in the following areas; Louisville, KY; Orlando, FL; Atlanta, GA; Nashville, TN; and Charlotte, NC, the average water usage for a typical Papa John's was 7,410 gallons per month. This breaks down to an average of 247 gallons per day. Daily water usage is broken down into five basic areas: 1. Washing Utensils(twice daily) 2, Cleaning and Mopping Floors(twice daily) 3. Food Preparation 4. Restroom Usage 5, Misc. Usage 1. 'Washing Utensils: All containers holding food on the makellne are rotated a minimum of twice daily, All containers are washed and sanitized before freshly prepared foods can be placed in them These procedures would generally use less than 40 gallons, 2. Cleaning: Normal daily maintenance uses approximately 10 - 20 gallons of water. Mopping the floors(minimum of twice daily) uses approximately 25 gallons daily, 3. Food Preparation: Most of the toppings used by Papa John's are pre-cooked and delivered to the store, so very little facd preparation is necessary. Water is used to wash the vegetables and sanitize the containers, 4. Pestroorn Usage: Most locations are carry-out and delivery only. Therefore, basing our figure on approximately 30d uses a day with an average toilet with a 5 gallon tank, this would yield approximately 150 gallons daily. 5. Misc. Usage: Drinking water, washing of the hands, and various other uses. The need for large tanks such as grease separators or holding tanks should not, be a factor with the small amount of water used by an average Papa John's location. In many instances, there are family dwellings that use more water than an average Papa John's. Nab -Better Ingredients. IMAM, 1 , 'i 03 09:; l h02 261 485-0 PAPA J^HNS # 13GTP.008 Mr, Nick Evola May 1 1, 1996 Page 2 If you should have any questions or need further information, please feet free to contact me. Sincerely, Z'�") i G2ie p Wayne Carter General Manager jc t Utilit rvices _ - APR Water & 'vVa tewaier -Nj �aWol (060ma City of Fort Collins March 25, 1996 Mike Lieb Williams Construction 659 Wadsworth Blvd. Lakewood, Colo. 80125 Re: Grease interceptor for Pappa John's Dear Mr. Lieb: After discussing the proposed operation of Pappa John's (1705 So. College Ave.) with you, I have decided the installation of a grease interceptor is unnecessary. The owners of the restaurant need to be aware that in the future, as a part of a program to eliminate grease in the sewer system, the Water Utilities Department will be monitoring sanitary sewer mains and services throughout the city. If grease is found in the sewer coming from Pappa John's, the owners will have to install a grease interceptor to keep grease out of the sewer system. In the event that they refuse to do so, we have the right to terminate water service to the premises until the restaurant complies with the City's grease regulations. If you have any questions or comments, please call me at 221-6681. Sincerely, T 4r Mark Taylor, P.E. Civil Engineer II cc: Sharon Getz; Building Permits & Inspections 110. Box q80 Fort C olhils. CO S05- 22 11=`?l) t1.�70l2-2I 66$1 r CITY OF FORT LAUDERDALE Eeniee cn:erica N ` FAXED 1/11/95 January 11, 1995 Mr. Wayne Carter General Manager Papa John's 11492 Bluegrass Parkway Louisville, KY 40299 RE: Grease. Trap Variance 800 S.E. 17 St. Dear Mr. Carter: A grease trap variance is granted based on the information in your letter dated 01/10/95. You therein stated that all food items will be delivered to the store precooked. Should conditions differ from what is stated in the above mentioned letter, the Public Services 'Department reserves the right to reconsider this variance. Sincerely, Karl V. Shallenberger Environmental Program Coordinator CC: Ted DeSmith, Chief Inspector, Plumbing rlc95.007 l PUBLIC SERVICES DEPARTMENT 9 49.N.W.:38 S r`+EET.FORT LAUDERDALE,FL 33309 (.305)77a•51 51.FAX(305)492.7881 �' C PRINTED ON RECYCLED PAPER i� PIZZA P So Papa John's International, Inc. 11492 Bluegrass Parkway January 10 1995 Louisville, KY 40299 (502) 266-5200 Fax: (502) 266-2925 City of Ft. Lauderdale Utillties Dept. Mr. Karl V. Shallenberger Environmental Services Supervisor 949 N.W. 3 8th St. Ft. Lauderdale, FL. 33309 RE: Papa John's Pizza 800 S.E. 17th Street Dear Mr. Shallenberger: I herewith request a waiver of the grease trap for the above referenced location. This facility will provide delivery and limited take-out services. All food items will be delivered to the store precooked, thus eliminating the need for grease traps. Cordially, Wayne Carter General Manager PNCHEST� CITY OF MANCHESTA � 9 ( WATER AND SEWER DEPARTMENT 736 W.HIGH STREET \ 7836 MANCHESTER,TENNESSEE 37355 TELEPHONE(931)728- 1273 FAX(931)728- 1563 3-28-01 Wayne Carter Papa John's Pizza P.O. Box 99900 Louisville, KY 40269-0900 Re: 1,500 Gallon Grease Interceptor Dear Mr. Carter, On Thursday, March 8, 2001, the Manchester Water& Sewer Commission met for a regular scheduled meeting. On that agenda was a grease trap variance for the proposed Papa John's. Enclosed is an excerpt from those minutes, which concludes with a decision based on our City Attorney's recommendation. Our Attorney recommends that because Papa John's has shown through sampling that the effluent will contain less than the set limit for oil and grease, no variance will be necessary. However, the Water& Sewer Commission stipulated that in the instance that Papa John's does discharge more than the prescribed limit, a fifteen hundred gallon grease interceptor will be required to be installed. We will need to coordinate with the storeowner in order to perform effluent monitoring. If you have any questions, please feel free to contact me anytime Monday through Friday, 7:OOAm till 4:00Pm. Sincerely, Bryan Pennington, Director Manchester Water& Sewer Cc: Water& Sewer Commission 11 CITY OF MANCHESTER WATER& SEWER COMMISSION MARCH 8, 2001 EXCERPT FROM DRAFT MINUTES 4) Papa Johns Grease Trap Variance: Papa Johns Pizza presented data from other locations, which displayed that their effluent would be below the grease limit of 50 mg/l or as prescribed by the State. Even with their discharge below the limit, Papa Johns is to install a 401b under the sink grease trap. The Water& Sewer Department is to work in conjunction with Papa Johns in order to monitor the wastewater effluent. If they exceed the oil and grease limit, they will be required to install a 1,500 gallon grease interceptor. The Water& Sewer Department Manager is to check with the City Attorney for clarification of the"prepare and serve" portion of the ordinance. See the attachment for the City Attorney's recommendation. The Water& Sewer Commission elected to follow the recommendation of the City Attorney. On March 13t`and 14t' the Water& Sewer Commissioners were contacted for a verbal query on the City Attorney's recommendation that Papa Johns should not have to install a 1,500 grease interceptor. Commissioners West, Smith, Bryan,Weaver, Crosslin, and Hunt voted unanimously to follow that recommendation. o � i Lc)v /�y rn e�N co p N (r�e o • 0 z x GREASE TRAP CALCULATION USING ASPE FORMAT. t„ GIVEN — GREASE FOR RESTAURANT IS LIMITED TO THE CLEANING OF w CONTAINERS THAT HOLD REFRIGERATED PEPPERONI, SAUSAGE PIECES, CHEESE & VEGETABLE OILS. ALL OF w THE ARTICLES ARE OF SMALL SIZE & TRACE QUANTITIES. THERE 1S ONE THREE COMPARTMENT SINK, EACH SINK BASIN IS 18" X 18" X 12". THIS IS A GROSS VOLUME w 50.5 GALLONS. CALCULATION Lo DRAINAGE LOAD = 50.5 GALLON @ 60% FULL t THIS INCLUDES UTENSIL DISPLACEMENT ) = 30.3 GAL 2. — FLOW RATE = 30.3 GAL. — 15. 15 GPM CD CD 2 MIN. DISCHARGE MAX FLOWN N CD GREASE TRAP = V — (30.3) (1 ) V = 4.05 FT 3 I VOLUME V _ MCP 7.48 7.48 ft GENERAL NOTES, P.O. EQUIPMENT SCHEDULE ME TA.KNOGKDOVW HOLLOW_ METAL FRAME 4'-0' SEE NOTE aq or I.DINE ON,ARE DRYWALL TO ptrINALL OR ElP6.FACE TO EAP9.PACE 1 PROJECT NUMBER 2X4 5TUDS ACROSS ISENERL NOTES 2.GENERAL CONtRALTOR SHALL INSTALL ALL REa<4REp BLOCKING FOR e KEMLITE IN• Au EOUPMRM.HAN6ER4,ETC. MK DESCRIPTION OF ITEM FURN. INST. REMARKS ROOF ROOF FRAMING CORNER GUARD 16'X 9H.C.K MIRROR S.ALL ruwc SHALL cowoRM ro All LxAL AND STATE covFs AND 57RLGNRE ®I6'O.C. AROUND PERIMETER I H .NAND SINK ALL,NTn,,_ - IA SEE NOTE X I ON WINDOW 4.ALL INTERIOR DRYWVLL PARTITIONS SHALL BE 2%4 W'JCG IB 18"X 56"SILL® OF WINDOW I 36•N.G.GRAB BAR sTwS BPALeD w•oC.rC R'M;•I21LE55 NOTED oTN�ewse. IC, IODLEBY MARSINALL MODEL P5399 PIZZA OVEN E.V. E.V. 42"A.F.F. 24' I7• 42'H.C.GRAB BAR D.INNERIOIa PARrmoNs BHALL,�PALED BOTH AIDED wTM V3'STANDARD DRYWALL. ID IDDLEBY MAR5HALL MODEL PS$TOYIB PIZZA OVE E.V. E.V. HG.WATER CLOSET 2 OVEN HOOD E.V. E.V. 6.6FWERAL CONTRACTOR TO INSTALL RYWOOD BACKINb BEHIND ALL ,� SHELVING AND SINKS AS NEEDED TO SUPPORT SVLX ITEMS. 3 MAKELINE-VICTORY PT-BB-S-PJ E.V. E.V. SEE NOTE•3Val PLY PLOD-Se ID TO Be INSTALLED BEHIND ITEMS U,2D,DT.9L N S5 .- \ I OFFICE LABIN'$T.f£E SHEET 12 FOR LIEN LOCATIONS.(VERIFY LOCATIONS w LWNEW 4A 4b'X46•GUTTIN6/BOX TABLE W(2)HEAT SHELVES E.V. E.V. SEE NOTE R 3 STS.CEILING 4 1.6ENGRAL LoH,,ACTOR TO RUN exreRIOR LUIPOD®PNONE LM THRU STEEL CONGVIT. 4B 46'%120'CUTTIN6/BO%TABLE W(2)SEAT SHELVES E.V. E.V. SEE NOTE M 3 6 10'-4"AF.F.MAX.' CAULK _ D.6 IC-coNNRACTOR SHALL ruRNul AND INSTALL THE POLLoraNs pp, 5 TELEPHONE COUNTER W ADJUSTABLE SHELVES E.V. E.V. SEE DETAIL THIS ENT. JOINT I? BATH ALLe550RIeT LT'BOBRILK OOo-DDD-4951•TAWW 5T012 G 6 FRONT LORIAN SERVING SHELF E.V. E.V, SEE DETAIL THIS 9NT. SYS.CEILING I,-6„ A.PAPER To•PEL DISFOLSER•BY O04 ,A FRONT STAINLESS STEEL SHELF TABLE E.V. E.V. .WILe SOAP F SPeNDENt•2I3WCKK 2s ®9'-0'A.F.F.AFF INSULATE PIPES I L. TOILET PAPER MOLDER•BRANED B-2 o 46/90 9TAINLE95 STEEL TABLE W S.S.SHELF E.V. E.V. 6' p.PCORI•STAINLESS STEEL FRAMED MIRROR•BOBRIGK B-MS o OF F I c' E WINDOW UNDER SINK- e. D L M,NTEP ROBE VAR e 60/30 STAINLESS STEEL TABLE W 5S.SHELF E.v. E.V. / SEE P-1 TYPICAL RESTROOM P YMLL H NRED GRAB LOAR•BOBRN2 L DWb 96' 6.NAN'DI(N F29TROOM REOD.67.VPI-f:NT PER LOCAL CODED v _LA 04/30 SS.TABLE W SAFE OJT OUT IN SS.SHELF E.V. e.V. MENU BOARD 28%'X95`iie° 50ALF: 11/2^=I'-o" MOUNTING HEIGHTS -`- qA 96lDO 59.TABLE W SAFE CUT OUT IN S.S.SHELF E.V. E.V. 1 q 46/30 STAINLESS STEEL TABLE W 5.4 SHELF E.V. E.V. I 2X4 STUD®Ib`OG. / 10 12/30 STAINLESS STEEL TABLE W S.S.SHELF e,v. EN. "FRP"PANEL "FRP"PANEL J A b'-10"MIN.AFF 14'DRYWALL `HOLD 5"A.F.F) IOA 12/30 S.S.TABLE W SAFE OUT OUT IN S.S.SHELF E.V. (HOLD 5"A.F.F.) �.�, 11 CLIP BOARD/DELI TICKET HOLDER E.V. E.V. °FRP°OVER O 12 WALK-IN COOLER(SEE PLAN FOR SIZE) E.V, E.V, SEE NOTE K b 1 0 T DRYWALL 6"LOVE .- 6"SANITARY Q BASE TILE BASE TILE ~ 13 KOLA PACK SPLITjBEIER TAM E.V. E.V. SEE NOTE•T/•T BULKHEAD DETAIL (LOU.TILE) 6 14 RED 44 bAL."RUBBERMAID'GARBAGE CAN W LID E.V. E.V. SEE DeraL THIS SHr. (TILE DISTJ ryQ 15 24•X 46-FLAT ALUMINUM DUNNA6e RACK E.V. E.V. 2B-E' Q 16 qb'(5)COMP.STAINLESS STEEL SINK W 10'12 B E V.1 ti PL HARDWARE SCHEDULE } mY 11 6REASE TRAP-ZURN MODEL 0 Z-INTO-K 46PH,OLD PC PC, SEE NOre D 4 IT.•A• BASE TILE DETAIL ..1nL.y` IB FLOOR SINK-PLAT MODEL MISS 2424 FIBERGLASS PL PL SEE NOTE•5 MARK REAR DOOR %10 F R4 x KM Ib• Z Y•l Iq IB'X 40'ALUMNNVM DUINAGE RACK E.V. E.V. CURRIe5 I PRAMS %10 TT SERIES •b 6A KNOCKDOWN _ Z FFF cuRRles I DOOR %TOTOTGm_ nuNl 20GAwrCPCAF ROOM FINISH SPECIFICATIONS O N W 20 10-%46--(4)SHELF PLASTIC.STORA6E UNIT E.V. E.V. HAGDL 9 HlHbes 691rR NaP+K'x4h' my MONARCH I EXIT SENILE 14-R-L-CONTROL X DAN,X 560 MAL/92O 21 mo ." 60'-(4)SHELF ZINK STORA6E UNIT e.V. E.V. $CHLAbe RTISE CriNDER 20-COI IW GG-P- 30D I.ALL DRYPIALL WALLS TO RECEIVE'FRP'PANELS FROM FLOOR TO CEILING EXCEPT BEHIND THE GOOIER 3I Z Y 22 35-X 41'H16H MOBILE S.S.GAKIZALK TABLE E.V. E.V. Noa AN II iLosEa cLPesDIBF 2.PAPA JCHNS SPECAL PANT COLORS •/�) 11a 23 'X2'YRP'CORNER 61JARD• E.V. 6G NA6ER 1 DOOa 5•.EEP 1565AV %- ALLP1 YdITE-'S1�aWIN WILLIAMS'-DM OIL NRE tTtI1TE MO TINT)ESSNIOI. •� �j W NN6ER 1 THRESHOLD 4125A %' ALUM RED-•SHERY4N WILLIAMS'-DTM ACRYLIC RED GLOSf-E66R38.GAL.FORMULA-WHITE 2Y32.BLACK,NO.NEW END 30/91. • V J 25A 2'X2'STAINLESS STEEL CORNER GUARDS E.V. 6G a I WPATMERSTWF T365 CMARCOA GREEN--S a-N NLLIAM5'-DM ALRYLG 6ReEH GLOSS.-T104-GALLON RORNOLA-YNIre 4U93.NEW GREEN 6 OUNCES. J HA6ER 1 NDRP BIOSA 40' LUM BLACK 13a2,YELLOW 2 OUNCES 1552. a' 24 TIC LAMINATE DESK TOP E.V. E.V. SEE DETAIL THIS ENT. PRECISION I LOCK GUARD I62lKL PwMe PA1M FLNR nue Tom 12WX CERH:IC TEE NW A WW CFRANL CODE BA2 6 ATO eE 4So T _'N"'ALL TILES TO W ADHESIVE 4 ry 25 OMER TABLE-50-%SO•RED PLASTIC LAM, E.V. E,V. METAL LEGS ON TABLE x 2 T.OILY TILE N l AGURIa FXALSKY IO PAPA YMHS DY TLORIDA TLf'Hm DSiRIBIIED BT 26 ME LEGS.RED UPHOLSTERY CUSTOMER CHAIR E.V. E.V. NVRK, RClTRQOM DOOR 50DD P FOOD X UST I%. LCMS U nLE CONPHO'(IN-41D-NO)MAY B-c NEED.UNFA a+ILR WOTIEN PEw055wx I5 oatA n LUR IE5 I F(tAVE 806E SOLO."'h-16 bA. KNOCKDOWN FROM PAPA GNPS GEVELOR4lIT O�ARIpYT.TIMERS GVI B2 NO E%CEPINNS. 21 CANBEVERAGE COOLER AND DISPENSER FRAM NDO I DOOR 306E SOLID PARTGL®OMO GOO=Ih'F�Ub I 4. INSTALL',RP'PANELS ON ALL WALLS FROM FLOOR TO CEILING.n S INCLUDES THE OFFICE AND THE RESTROOM. NA6ER 9 NGe9 091T y'X+y- D INSTALL COIiP1-Ere WITH ALL TRIM AND AGCE550RIE5 TO Be IN5TA,LED PER MANUFACTURER'S INSTTdKn 28 IS'X 40'ZINC WIRE SHELVES W EIRP4KET5 E.V. 6C HAUNT T2'A.F.F. SCHLA6E PwVACr 9Er AL4O5.SATURN"3 a�•xaM' 26D ® 1 NO TAN 1 CLOSER BSOI O ALUM PAN15 TO BS'FRP'..1 AS MANOAGn1RED BY'KEN4ITE LORORPORATWN•-I-BOO-455CODO (1 2q 40'X h-COAT HOOK STRIP W T HOOKS E.V. E.V. MOUNT 60'A.F.F._ --HA6 STOP NALL-356W R FLOOR-2NP 6D •FR-PANEL To BE(GLASSO -P,PPOO-T CODE•BE5305-PU FOR 2•CORNER GUARD 1T'RODUCT 11 OAD52-10 W11TFJ T OR MLARLIre BRIGHT Y611TE. O 30 3-RED PLASTIC,LAMINATE CHAIR RAIL E.V. E.V. MOUNT 50'A.F.F. CELINS SHALL M WASHABLE.NARD SURPALe VINTL FACED 24'X40'LAY-IN X:0U IC PANELS IN•SnFPLE•FINISH PHONE SYSTEM VENDO O INSTALL PER SPECS. OPPILe tTovn DODO P WOOD x M1 Itl' WITH WHITE ALMIKH•T-6RID SYSTEM IS PATTERN SHOPERIN2rER IN STORAGE ARENRESTROOM TO BE FAINTED DR»NALL CEILIX6. 5�2 DRAWER LETTER SIZE FILE CABINETS FRAN FRAN BEI6E COLI FRAM•@ 906E'C'SERIES 5h' MEGA KNOLKNhV b. ,STIC LAMINATE ORNERS DROP BOX HOLDER e.V. E.. HAbea 1 DOOR W.D SOLID PAan�LtH-LOREM FLUJI9 NIN6e5 B913tR N'X4y 26D ,-ISHAND INSTPLLDE WND FRAMEDO54 KING GASH DRAPER e.V. E.V. UNDER FRONT COUNTER BCNIlGE LOCKSET AL59PD•9ATURNX2 Y.•X4h- 26D ANP TRINE." I'FRP'CORNERS.(SEE DETAIL"I SHEET) 2I 2I NORTAN 1 LLO<RR 0901BP A'L� P.ALL EXPOSED PARnnON ENDS AND PgRNERS SNn1,L HAVE D'.STAINLE55 STEEL CORNERS TO FLOORINOT TOP OF LOVE) 35 19 CBS.MAY CHEMICAL PIKE EXTINGUISHER e.V. E.V. LeTE W BRACKET HALER II STOP WALL-296W OR PLOCR-NIP 26D - 36 FLOOR MOUNTED TIME DELAY SAFE EV, 6C .T-WEOUIPHIIENT REQUIRED FOR SAFE INSTALLATION I - 51 HAND SINK Y44LL MOUNTED e.V/RC. PC. MARK, FRONT DOUR PAR(OR DINGLE)GO-Po ALUM X ALUM NIL- I. 46p.G6'MOLLY PARA00.T 30 BUBBLE FORK HOLDER E.V. E.V. SLHLAbE I MORTISE CriIN 20-001 IL'•XCYL RING 5:K'DRILL MOTOR _ _ -.. ,. Pu05H TO MATCH AIMINNNI DOORS. D.h-CARBIDE BIT. I _ 3q MENUBOARD 60'X 211y'%316' E.V. 6C SEE DETAIL THIS SMT. - _ _ LANG<BY NOR SJF-H TO INCLUDE - 9 Tb'WRENCH OR BOGKET 4 DRIVER -. L, I 40 STAINLESS STEEL HOLDER E.V. .--^� I- N E NIVor9 2-CLOSERS D.UOVID POCK(I pt4) � 3 I - - _ �. II E.V. 6L MOUNT 72'AFF. LusH BOLte 3 eA.HFiWM1LL5 T.sAYeTY GOGGLES ._.__._ .II \� - �! 1 / I 41 9/4'%12•RED PLASTIC LAM.SHELF W BRACKETS I MORTISE r-ruRN I FA.rHRE51AOlD _ " II \ / U L__/ 42 COOLER LIGHT E.V. E.V. I.seT v,EATxEa STRm 1 43 ONE WAY WINDOW FROM OFFICE 6G 6G' Der 4• INSTALLATION INSTRUCTIONS N ''-,��ii `(' ` - 44 pRNERS TELEPHONE VENDOR NIAra MELK RM DOOR 3 DD 9/41q.R MTW DOOR I. MYInON SAFE IN PLACE WHERE R 15 COINS TO EE INSTALLED.. PET.-1 SET.>'2 I 1 CMRIES I FRAM 9060•C•SERIES 5Tb' 166A KNOCKDOWN 2.TRADE THE IDLES ON THE BOTTOM OP THE SAFE ONTO TIE'.FLOORSURPALE.:LOW 4, 1 1 _ 45 CI.OLIK E.V. E,V. I DNa GO68 SOLID PA¢tILLEDOARD GORE M'FU5N 9.FFlIOVE sAFE. 4 _ 1 4E FLOW SwELD E.V. E.V. WAbER 9 NNGES BBIT9 16-Xa1}• D 4.DRILL THE HOLES W THE h'CARBIDE BIT,HOLES�T Be AT LEAST 4y"pEFP. } S'-b° 9LNLA6E I LOGXYT ALD9 AtLRfM2%- Ib' 26D 9. L,-THE HALES OP DEBRIS,M%t POUR LIWIp ROCK TIRO EA:MOLE. .y` I .II' ID I 1 51 4l 29.6A9 LINE PG PG NORTAN I CLOSER 0901BF ALUM 2YN'SruRE4i ,,y,� 4i6' i - 13-0• NAGEa I STOP WILL-296W OR FLOOR-201P ffip b. UISEtT STAINLESS,STEEL RASED PLATTGRM 'T'D" 48 SPLASH GUARD E.V. 6L T.POSITION SAFE BACK INTO F E. SAFE D.TO WASHER a TI IGH T!HOLE IN W THE TOP OF THE BOLT(9E:.DET.•I) 49 COMMISSARY LOM4M(ICATION MOLDER E.V. E.V. +.DRIVE BOLT THROWN TNT HOLE IN TILE THREE 1 1 NOie, 10.TO SET TIff FASTL'NERs,TIGHTEN THE MY THREE(5)FLLL TURNS 50 1 EMPLOYMENT APPLICATION DEPOSIT E,V, E.V. /•LL IUViD WARE TO MEET LOCAL Aw AAA.CODES.ALL HARDWARE TO BE OR DOCKET ISM MT..y 2 11 d' j wc. 3I COMPUTER MONITOR SNLEF E.V. E.V. Tr.OF SHELF a 6O'AFF LEVER TYPE ON ALL DOORS.ALL a DOORS TO ce NTERIgt LATCH TYPE m M THAT OPEN Nlntll/T A KEY OR AM'SPECIAL KNOW-ED6E. 52 VEGGIE Sim e,V. PC 53 CHEESE RACK PROVU2E TPb CHANGE KEYS PER LLCK/LYL.AND 9 MASTER KEYS l . E.V. E.V. $4 UNDER COUNTER REFRIGERATOR E.V. E.V, 24�'D' N E 55 FF OICE CABINET(VERIFY LOCATION W OWNER) E.V. E.V. 22 " GIV�� SIPECE ' �.� 1 41 a m 5•_2. 1 QUIPMENT VENDOR L FURNISH 4 INSTALL NOTES : E WIL ❑ THE FOLLOWING PLASTIC,LAMINATE ITEMS. ®Q I 1 I i 1 3'-6'h' : 54 I. PIZZA OVEN TO BE MODEL P5-510 GA5 FIRED CONVEYOR OFFICE DESK TOP TO BE WILSONART"REGIMENTAL RED TYPE AS MANUFACTURED BY MIDDLEBY MARSHALL. OVENS 1 I 1 a❑❑� 4 „ 12-b"WH I SELF-EDGE AND 3"BALK AND END SPLASH. TOP ARE TO BE COMPLETE WIH ( EXHAUST CANOPY DUCTED TO W 51 I 4 L_ E� ROOF MOUNTED EXHAUST FAN. DUCT TO BE INSULATED 24 GA ❑❑aa WALK N, i 2'03�° -b' R' TO BE COMPLETE WITH WALL SUPPORT BRACKETS.30'A.F.F. GALV.STEEL. PLUMBING CONTRACTOR TO FLRN15H 25"GAS I 1 I SUPPLY LINE TO OVELu NS WITH 3/4"GA5 VALVES. ❑❑O❑ COOLER ry I O 23-CUSTOMER TABLE-30"X30"P41LSONART"RE6IMENTL RED E.V.TO FURNISH AND CONTRACTOR TO INSTALL OVEN I 1 I $ 1 -_ 12-6'TOP AND EDGES. TABLES TO HAVE BLACK METAL 2�0° -/�--- Q Q NQ �.- LE65.(OPTIONAL) EXHAUST HOOD ABOVE OVENS. _ _ _ _ ,I `--__-_- J (� GAS METER-1100 C.U.FT.-OVENS MIN.GAP.+ I I 1 ❑�� - 1 51 I 41 S/4"XI2"SHELF WIH WILSONART'RE&IMENTL RED 12-6' H.V.A.C.(WRNAGE)+HOT WATER HEATER. ❑❑a❑ / nl - 4 N Q ON ALL FACES. SHELF TO BE INSTALLED 12'ABOVE FINISH ELECTRIC-500 AMP-SINGLE PHASE SERVILE. I I 1 - ,�+1 I 10 O Q. Z L FLOOR WHERE SHOI"N4 ON PLANS. FURNISH ALL REQUIRED 2, MAKELINE TO Be-MODEL P7-50-COMPLETE WITH L MOUNTINb BRACKETS. 1 I 1 I L--J4 50'x5D' O V, BUN PANS,INSTRUCTIONAL/TICKET TAKER HOLDER AND ❑��. m i © 45 ® TABLE Q Z O29-3/4°X6'X40"GOAT HOOK STRIP WITH WILSONART CASTERS AS MANUFACTURED BY GLENGO STAR. "REGIMENTAL RED 12-6.ON FACE AND ALL EDGE5. S. PIZZA CVTTINC,AND BOXING TABLE TO BE PER PLAN. I I I �� °i ESQ, z ATTACH,ALUMINUM COAT HOOKS SPACED EVENLY AND STAINLESS STEEL COMPLETE WIH DEL.OVER SHELVES,TWO MOUNT 60'A.F.P. HEATED SHELVES,PAN HOLDER:AND CASTERS. TABLE TO BE 10-2' Q MANUFACTURED BY AIR SYSTEMS,INC. OFFICE SIDE WORKE25 SIDE SIDE VIEW in 4%" tu 1"""CHAIR FLAIL ON FACE AND BOTHI ED6ES. LENGTH OUT TO LETH AND INSTED ALL 4. GREASE INTERCEPTOR SEE SHEET P-1 `, Z N 30"ABOVE FINISH FLOOR WHERE SHOWN ON PLANS. S. FLOOR SINK TO BE 24°X24"FIBERGLASS MODEL 2424 AS DRIVER'S DROP SOX HOLDER 1 DATE: 9/I/03 II I°X6"X40'LONG CLIP BOARD STRIP WIH WILSONART MANUFACTURED BY FLAT,INC. SINK SHALL HAVE MODEL 830 °REbIMENTL RED 12-6°ON FAGS AND LL EDGES. INSTILL -AA FAUCET AND 88q-COMOP STRAINER DRAIN. OFFICE SIDE 15 MOP FACE AND ODORS ROUGH OPENING FOR 20 SLOT DROP paTE REVISED PAINTED REGIMENTAL RED. BOX 15 2242"WIDE X 342"HIGH. 60"ABOVE FINISH FLOOR ON OFFICE WALL. 6. PLUMBING CONTRACTOR 70 MAKE ALL CONDENSATE DRAIN WORKERS SIDE 15 PARTICLE BOARD 4O LINE CONNECTIONS FOR WALK-IN COOLER AND DROP-ININTERIOR- DRIVER'S •AFF. LAMINATED REGIMENTAL RED.ALL MITE MELAMINE 33-RED 6'ONOALL AGES EXCEPT BOTTOM AND BACK. INSTALL INSTALL COMPRESSOR AND EVAPORATORACTOR TO HEN DO FINAL BOX I5 22W WIDEX 541�H*DROP GONHECTION3 EQUIPMENT/FLOOR PLAN 34-Ib"X18'X4 I/2"GASH DRAWER FURNISH ALL HARDWARE AND INSTALL UNDER FRONT STEEL ,. ELECTRICAL CONTRACTOR TO MAKE ALL REQUIRED VERIFY WITH OPA'ER DROP BOX SIZE. 5GALE , %'=1'-O" ' SHEET TITLE WORK TABLE. ELECTRICAL CONNECTIONS FOR WALK-IN COOLER LIGHTING EN AND REFRIGERATION UNIT.ALSO HEAT UNITS ON GUT TABLE '� I - NEW PAPA JOHNS PIZZA STORE I 6OUIPMEM/FIAOR PLAN NOTE: RESP014SIBILITY: NOTE ° NOTE- NOS ' CONTRACTOR OR OWNER SCHEDULE GONTRAGTOR TO INSTALL PLYWOOD BALKING BEHIND THE FOLLOP41% E.V.-DENOTES EQUIPMENT VENDOR ,� ALL NEW WALLS ALL EXIST.WALLS ALL WALLS TO BE 215 W. MAIN STREET NOTES ITEMS 011,a24,R28,02q,DST,951 AND CABINET IN MGR.OFFICE.IF CONTRACTOR 6G_DENOTES bENERAL CONTRACTOR I SHOWN SHADED SHONN---p;TGHET DASNEDD SHOWN TO VERIFY.ALL DIMENSIONS HYANNIS, MA. DOES NOT INSTALL BACKING,THE CONTRACTOR BECOMES RESPONSIBLE EC-DENOTES&ENER L C CONTRACTOR AND GOND.I IONS,PRIOR TO FOR THOSE ITEMS SHOULD THEY FALL. ERECTING WALLS AND COPYRIGHT®PAPA JOHNS,U.S.A. SHEET NUMBER PG-DENOTES PLUMBING CONTRACTOR FRAM-DENOTES FRANCHISEE ;� STARTING GONSTRUGTION. 2002 -ALL RIGHTS RESERVED VENDOR-DENOTES LOLL SUPPLIER w ^_ 9 • P.O. # 6ENERA►L NOTES: NOTE: 16 o KNOCKDOWN HOLLOW IPMENT �� u L � � :- 4'-O° SEE NOTE #q OF I. DIMEN510N5 ARE DRYWALL - TO - DRYWALL OR E.LF.S. FACE TO E.LF.S. FACE 1 PROJECT NUMBER EQMETAL FRAME GENERAL NOTES 2• GENERAL CONTRACTORR SHALL INSTALL ALL REQUIRED BLOCKING FO 2X4 STUDS ACROSS KEMLITE MIN. ALL EQUIPMENT, HANGERS,ETC. MK M FURN. INST. REMARKS 16"X 30 H.G. MIRROR 5. ALL WORK SHALL CONFORM TO ALL LOCAL AND STATE CODES AND • DESCRIPTION OF ITEM ROOF: . ROOF FRAMING CORNER GUARD RE6ULATION5. IA SEE NOTE M I 5TRUGTURE ® 16" D.C. AROUND PERIMETER 1 H.C. HAND SINK 'ONE-WAY WINDOW 4. ALL INTERIOR DRYWALL PARTITIONS SHALL ESE 2X4 WOOD 1B OF WINDOW 56" H.G. GRAB BAR STUDS SPADED 16" O.G. TO al'-W UNLESS NOTED OTHERWISE. IS" X 36"SILL � IC, MICVLEBY MARSHALL MODEL PS-555 PIZZA OVEN E.V. E.V. 42" A.F.F. 24 12, 42" H.O. GRAB BAR 5. INTERIOR PARTITIONS SHALL BE FACED BOTH SIDES WITH 1/2"STANDARD DRYWALL. [I;) IDOLE13Y MARSHALL MODEL P5-o70WB PIZZA OVE E.V. E.V. H.G. WATER CLOSET . : b. GENERAL CONTRACTOR TO INSTALL PLYWOOD BACKING BEHIND ALL E.V. E.N. `• SHELVIN6 AND SINKS AS NEEDED TO SUPPORT SUCH ITEMS. O 2 OVEN Hoop 55 3 MAKELINE - VICTORY PT - W - rJ' - P.1 E.V. E.V. SEE NOTE M \�� I PLY WOOD BNET.SE 15 TO BE INSTALLED BEHIND ITEMS 16,(VERIFY 37,51, 4 O OFFICE CABINET.SEE SHEET A-2 FOR ITEM LOCATIONS.VERIFY LOCATIONS W/OWNER) 4A 48'Xgb" GUTTIN6/BOX TABLE W/(2) HEAT SHELVES E.V. E.V. SEE NOTE M g 5Y5. CEILING - dJ Q 7. GENERAL CONTRACTOR TO RUN EXTERIOR EXPOSED PHONE LINE THRU STEEL CONDUIT. 4B 48'Xi20- CUTTINWISOX TABLE W/(2) HEAT SHELVES E.V. E.N. SEE NOTE N 3 @ 10'-4" A.F.F. MAX. m '� b �_GAUL�G m F _� m 8. GENERAL CONTRACTOR SHALL FURNISH AND INSTALL THE FOLLOWING 5 TELEPHONE COUNTER W! ADJUSTABLE SHELVES E.V. E.V. SCE DETAIL THIS SHT. JOINT �_ } i BATH ACCESSORIES: BY SOBRICK 800-833-4331 ■ SHAWN STONE 6 FRONT GORIAN 5ERVING SHELF E.V. E.V. SEE DETAIL THIS SHT. I u ~ 4 — A. PAPER TOWEL DISPENSER - BY OWNER 5Y5. CEILING 5-4112 1A 24/50 STAINLESS STEEL SAUCE TABLE E.V. E.V. ® q'-O" A.F.F. B. LIQUID SOAP DISPENSER - BOBRIGK-2740 15° INSULATE PIPES 18" G. TOILET PAPER HOLDER - BOBRIGK B-2T40 � 'I 4b/30 STAINLESS STEEL TABLE W/5.5. SHELF E.V. E.V. 1z E. I DOOR STAINLESS STEEL FRAMED MIRROR - BOBRIGK Es-145 UNDER SINK- E. DOOR MOUNTEv ROBE HOOK 8 60/30 STAINLESS STEEL TABLE W/ S.S. SHELF E.V. E.V. NINVON 5EE P-I T5 " / " ®� � I �E TYPICAL RE5T�00� F. WALL MOUNTED bRAB BAR - BOBRIGK B-blob 96" a 48" + 6A 64/50 S.S.TABLE W/ SAFE CUT OUT IN S.S. SHELF E.V. E V. MENU BOARD 28/g X1_=A/* G. HANDICAP RESTROOM REQ'D. EQUIPMENT PER LOCAL CODES E.V. E.N. SCALE I/2::=I -o" (MOUNTING HE IGHTa - qA g6/30 S.S.TABLE W/ SAFE GUT OUT IN S.S. SHELF 2X4 5TUD @ 16" Of,. q 416/30 STAINLESS STEEL TABLE VV S.S. SHELF E.V. E.V. "FRP" PANEL "FRP" PANEL 10 '12/30 STAINLESS STEEL TABLE YV S.S. SHELF E.V. E.V. -� jk IOA 12/50 S.S.TABLE W/ SAFE OUT OUT IN SS. SHELF E.V. E.V. MIN. A.F.F. " DRYWALL (HOLD 5" "A.F.F.) (HOLD 5" A.F.F.) 11 CLIP BOARD/ DELI TICKET HOLDER E.V. E.V. 12 WALK-IN COOLER(SEE PLAN FOR SIZE) E.V. E.V. SCE NOTE N 6 4 '0 7 "FRP" OVER DRYWALL 6".COVE 6" SANITARY 13 KOLD PACK SPLIT SYSTEM E.V. E.V. SEE NOTE 16 rt M 7 BASE TILE `" BASE TILE {� 14 RED 44 GAL. "RUBBERMAID" 6ARSAISE CAN W/ LID E.V. E.N. SEE DETAIL TH1 SHT. BULKHEA12 DETAIL (TILE D)ST.) (LOU. TILE) (r 15 24' X 48" FLAT ALUMINUM DUNNAGE RACK E.V. E.V. 1(6 q6" (3) COMP. STAINLESS STEEL SINK W/ 16' D.B. E.V./m PG HARDWARE SCHEDULE ,: ui d '�. 11 BREASE TRAP - ZURN MODEL M Z-1170-K 46PM, 8LB PG PG SEE NOTE N 4 LL SET 'A' r y BASE TILE DETAIL _ 16 FLOOR SINK-FLAT MODEL MB5 2424 FIBER6LAS5 PG PG SEE NOTE M g MARK , REAR DOOR Os70 �+x HM 1#i• Z i - K E.N. E.N. CURRIES I:_FRAME 9670'M" SERIES 54s' 16 &A.KNOCKDOWN _ _ 7- 1q 18 X 48 ALUMINUM DUNNAGE RAG CURRIE5 I DOOR 5610 1015 SERIES FLUSH : 206A.W/TOP GAP p�� /� C //�� /� HASER 3 HINGES 88127q NRP Oki"X4kj" 26D 1WVVM FJNIrJ'H `SPEGIF NATIONS OAH cn �n U Z 20 19" X 48" - (4) SHELF PLASTIC 5TORABE UNIT. E.V. E.V. - MONARCH I EXIT DEVICE Iq-R-L-CONTROL X PANE X 5560 MALJ520 ■" `W' r r - E.V.. E.V.'". : SCHLASE :I MORTISE CYLINDER 20-001 IY".'G" 5EGTION 26P 1, ;ALL ORYWAL•L ,AALL5 TO RECEIVE_"FRP"PANELS FROM FLOOR TOLEILINb EXCEPT BEHIND.THE COOLER 31 �f. 21 Ib X 60 (4) SHELF ZINK 5TORAbE UNIT NORTAN I CLOSER GLP8501BF ALUM " » » E.V. E.V. 2. PAPA JOHN'S SPECIAL PAINT COLORS: ` 22 25 X 35 X 41 HIGH MOBILE S.S.55 GAN/IQAGK TABLE E. d Uj _j HA&ER I DOOR SWEEP 7565AV 96" ALUM WHITE - "SHERWIN WILLIAMS" - DTM OIL PURE WHITE (NO TINT) 555040I. . ■ r r " » E.V. GG ALUM RED "SHERWIN WILLIAMS" - DTM ACRYLIC,RED &LOSS- B66R38;SAL. FORMULA'-WHITE 22/52,BLACK 3/32,NEW RED 20/32. J 23 48 2 X2 FRP CORNER GUARDS _ HA&ER I THRESHOLD 4125A 96 HA6ER I< WEATHERSTRIP 7265 17" CHARCOAL GREEN "SHERKN WILLIAMS" - 12TM ACRYLIC, GREEN &LOSS - B"T104 -GALLON FORMULA -.WHITE 41/52, NEW GREEN b OUNCES, `� J 25A 48' 2'X2" STAINLESS STEEL CORNER 6UARD5 E.V. 60 HA&ER I RAINDRIP DIOSA 40' ALUM BLACK ISM2,YELLOW 2 OUNCES 102. PRECISION I` LOCK&UARD 162714E PRIME PAINT E.V. .V. AIL THIS SHT. " , 24 PLASTIC, LAMINATE DESK TOP SEE DETAIL I2" IY CERAMIC 41LE WITH?i b"X8'CERAMIC COVE BASE.6RdR TO BE G-543 PLATINUM ADMIX.ALL TILES TO BE ADHESIVE �_ OCT 'd■ FLOOR TILE TO EIE X � � � 25 CUSTOMER TABLE -'30'X30' RED PLASTIC LAM. E.V. E.V. METAL, LEGS ON TABLE SET.ONLY TILE MANUFACTURED EXGLSIVLY FOR PAPA JOHNS BY-TLORIDA TILE"AND DISTRISUMP BY T M R CHAIR E.V. E.V. MARK , MTROOM DOOR 5068 P MOOD X FM Iks LOUISVILLE TILE WMPAM'(800-676-6453)MAY BE ISED,UNLESS PRIOR MTTBI PERMISSION 19 OBTAINED QQ 26 CHROME LEGS, RED UPHOLSTERY GU5 O E CURRIES I FRAME 5066 'G' SERIES 5%" 16&A. KNOCKDONN I " DOOR 3ob8 SOUR PARTICLEBOARD GORE 144'- FLUSH FROM PAPA JOHNS DEVELOPMENT DEPARTMENT.THERE CAN BE NO EXGEPilONS. � 21 CAN BEVERAGE COOLER AND DISPENSER FRAN HA&ER 3 POORHINSE W66 4LyXPA 26H 4. INSTALL "FRP" PANELS ON ALL WALLS FROM FLOOR TO CEILING.THIS INCLUDE5 THE OFFICE AND THE RESTROOM, » T 72' A.F.F,. : HA&ER E I PRIVACY SET AL405x5ATURNx2 �i"X4T6° 26D INSTALL'GOMPILETE WITH ALL TRIM AND ACCESSORIES TO BE INSTALLED PER MANUFACTURER'S INSTRUCTIONS W/ BRACKETS E.V. 6G ►"10UN 28 (2) 18 X 48 ZING WIRE SHELVES NORTAN I CLOSER 8101DP AL.LM PANELS TO BE: "FRP" PANELS A5 MANUFACTURED BY "KEMLITE GORORPORATION" 1-500-455-0050 X 40" X " GOAT HOOK STRIP NV I HOOKS E.V. E.V. MOUNT 60" A.F.F. HALER I STOP WALL- 296w OR FLOOR- 241F 260 "FRP" PANEL TO BE(&LA550RID-P,PRODUCT CODE #5E5385-PQ*FOR 2" CORNER GUARD (PRODUCT 4 OA852-10 WHITE) 2 q 6i 1 I » PLASTIC LAMINATE CHAIR RAIL E.V. E.Y. MOUNT 50" A.F.F. DR MARLITE BRIGHT WHITE. 30 I X g RED SET "Co" S. CEILING`SHALL BE WA5HABLEi, (HARD SURFACE VINYL FACED 24'X46".LAY-IN ACOUSTIC PANELS IN "STIPPLE" FINISH — — � TELEPHONE SYSTEM VENDOR INSTALL PER SPECS. WITH WHITE ALUMINUM T GRID SYSTEM 15 PATTERN SHOWN STORAGE AREA (CAULK PERIMETER IN STORAGE AREA) 3I MARK , 011"l DOOR 9aae F NWO X HM , 1%* ;, RESTROOM TO BE PRINTED DRYWALL CEILING. 32 (2) - DRAWER LETTER SIZE FILE CABINETS FRAN FRAN BEIGE DOLOR "CURRIES _I FRAME Sobs "G"SERIES W 166A KNocKDowr 33 PLASTIC LAMINATE DRIVER'S DROP BOX HOLDER E.V. E.V. ' ` I ` DOOR So" 50UP PARTICLEBOARD CORE 1%*FLU5H 6• ALL DOORS, FRAMES AND HOOD TRIM SHALL BE PAINTED TWO GOATS OF "WHITE". HA6ER 3 HINGES BB121q 4Ni•X415" 260 7. FURNISH AND INSTALL AONE-WAY&LASS VIEW WINDOW IN OFFICE WALL -WINDOW TO BE WOOD FRAMED 34 LOG KIN& GASH DRAWER E.V. E.V. UNDER FRONT COUNTER 9CHL:A&E I LOGKSET AL53P0xSATURNx2 %"X4%* 260 AND TRIME12 WITH "FRP° GORNER5. (SEE DETAIL THIS SHEET) 0 NORTAN 1 0.05ER 85018E '�u•'I 8, ALL EXPOSED PARTITION ENDS,AND CORNERS SHALL HAVE 5', STAIPLLE5S STEEL CORNERS TO FLOOR.(NOT TOP OF COVE) 35 IS LBS. DRAY CHEMICAL FIRE EXTINGUISHER E.V. E.V. LETS YV BRACKET HA&ER I STOP HALL- 236w OR FLOOR- 241F 26D e 36 FLOOR MOUNTED TIME DELAY SAFE E.V. bG GET 'D' EG UI"NT ReQUIReG rOR we INSTALLATION s E V/FG PG , PROW DOM FAR OR SAD SOM P& AL,M X ALUM NI' 1. 4ea " MOLLY PARABOLT 31 HAND SINK WALL MOUNTED MARK ( �b 2` W DRILL MOTOR G, SCiHLAGE 1 MORTISZ GYLINDZR 20-001 U4'XGY4 RING `" :;.a • �r L ti•� R C.V. E.V. D IT 36 BUBBLE FORK HOLDER 9:i. "GARB( E B _7 __ FINISH T MATCH ALUMINUM DOORS. -. . 71 � THI �3NT a... A ENUBO ..?III RIVER .� _ H OR SOCKET a D - .- i �.. .. _a- �.; IVOTS _ _b: LIQUID fiC?C.LC_l1�kQ�._ - —=_, _:_._._.... - s ,,, �✓„.. a �.., .�, 1 40 STAINLESS STEEL HO LDER C.V. HlNbfs/P 2 EA. CLOSERS _—.T- -- :.,, .r 1 \ r Il » ,I PR FLUSH BOLTS . --"---2 E,q;PU5H/RJLL5 `_ 7.- SAFETY GOGGLE.` 1'i". .• 0 .., 0 - rM E.V. 6G MOUNT.72 A.F.F., '_m^• 41 9/4 X 12 RED PLASTIC LAM. SHEEP W/ BRACKETS ` t,f^oRrISE T TURN I EA.THRESHOLD - � •,�: - J I SET WEATHER STRIP R I T E.V. E.V. TI : 42 GOOLE L 6H xx INSTALLATION INSTRIJG ONS ;.:. 4 ONE WAY WINDOW FROM OFFICE GG SET "e' : :.:,..:..t ::�ti ' 3 ;; _.: . _ ,. PET. #I DET. #2 0 MAItIC , MEGH.RM.DOOR 30" 3,/4 HOUR RATIO DOOR 1 44 DRIVERS TELEPHONE VENDOR VENDOR 1. POSITION SAFE IN PLACE WHEWE IT 15 601N&TO BE INSTALLED. Iq C.URRIl:S I FRAAME 5065 "0"SERIES 5%" I66A. KNOCKDOWN 2. TRACE THE HOLES ON THE BOTTOM OF THE SAFE ONTO THE FLOORaURFACE BELOW = 4'1 I 1 E.V. E.V. DOOR 3066 SOLID PARTICLEBOARD CORE 1%"FLUSH 5. MOVE°SAFE. GLOGK „ - 45 HAbGR 5 HIN&E5 66127a1 41V'X4W 26P 4. DRILL THE HOLES THE 3b CARBIDE BIT,HOLES MUST BE AT LEAST 41g DEEP. E.V. .V. "X4 " 26D OF DEBRIS(MIX 4 POUR LIQUID ROCK INTO EA.HOLE. I- 46 FLOUR SHIELD SG++LA6e i LOGKSET AL53PDx5ATURNx2 9r. '►(> 5. GLEAN THE HOLES �g� I ID i I 5I AN I CLOSER 85015E �- STAINLESS RAISED PLATFORM. z"Xlq"SrAINL " r IN PG. : PG NORTAN WALL- 2.56H OR FLOOR- 241E L b.,.INSERT 5 A : STEEL PLA T� 45� 41 2 3 6A5 LINE MAbCR 1STOP 7. POSITION SAFE BACK INTO PLACE. SAFE a,r EQ•9UPFLIER 48 SPLASH GUARD E.V. 6G 8, ADD WASHER t THREAD NUT FLUSH W/THE TOP OF THE BOLT(SEE PET,�U 1 q.:°DRIVE BOLT THROU&H THE HOLE IN THE SAFE. - 4q COMMISSARY COMMUNICATION HOLDER 10, TO SET THE FASTEiNERS,TI&HTEIN THE NUT THREE(3) FULL TURNS HI'Iib WRENCH 4,.. •,a'<;:. o,;y'"': 50 EMP LOYMENT APPLICATION DEPOSIT : E.V. E.V. ALL HARD WARE TO MEET LOCAL AND A.DA.GORES. ALL HARDWARE TO BE OR 50GKET(SEE MT. #21 .iO I N " L.ZVER TYPE ON ALL°DOORS. ALL EXIT DOORS TO BE INTERIOR LATCH TYPE —�-�-�� F E.V. E.N. TT. OF SHELF • 60 A.F.F A KEY OR ANY SPECIAL,`KNOWLED&E. 51 COMPUTER MONITOR SHLE THAT oPeN wlTrlour < IQ E.V. PG 52 VE661E SINK PROVIDE TW0 C.HAN&E KEYS PER LOGK/GYL.AND 9 MASTER KEYS 53 CHEESE RACK E.V. E.V. 24 " 54 UNDER COUNTER REFRIbERATOR E.V. E.V. WORKER5 OFFICE c0 II O = 55 OFFICE CABINET (VERIFY LOCATION W/OWNER) E.V. E.V. 22�'e" SIDE 5�a" SIDE 42 j 41 4 �i in '"b 1 • : . : 7q" A.F.F. Ii J 5-2 EQUIPMENT VENDOR MILL FURNISH 4 INSTALL NOTES z - THE FOLLOWING PLASTIC LAM INATE ITEMS. NO rill - 1 : , " , 1 3-6/2 �. O � �� MODEL P5-510 6A5 FIRED CONVEYOR = 1. PIZZA'OVEN TO BE � �_ 4 - �o I 1 Y MI EBY MARSHALL. - OVEN S 5 r FAGTURED B DDL PE A5 MANU r . . .._ ,�TY I I © c RE61 MENTAL`RED n n ,� 51 I 4 TOP BE W I L50NART TO �1.�!`�� , 24 OFFICE DESK O TO COMPLETE WITH EXHAUST CANOPY DUCTED II, :.;:ARE . BE GO 10' X I6' d" O �. O• ND SPLASH. TOP mm 12- WITH SELF-EDGE AND 3 BACK AND E T T INSULATED 24 &A. 6 ROOF MOUNTED.EXHAUST FAN. DUG TO . , K-IN 2'-3 :: I�_6:� w W WAL _ SUPPORT BRACKETS. 30 A.F.F. �� _ ITH WALL SU _ OCLu ; TO BE COMPLETE W IN CONTRACTOR TO 2S 6A5 � 6ALV. STEEL. PLUMB b COOLER cv :' 4 VALVES. - M PLY LINE TO OVENS WITH 3/ 6A5SUP : :�(MENTAL RED : II _X O WILSONART RE6 1 1 CUSTOMER TABLE 30 3 CONTRACTOR TO INSTALL'OVEN E V, TO FURNISH-:AND __•� C� 0 � � �' - 2-10 O �� T HAVE BLACK METAL � ,: � '� 12-6 TOP AND EV&E5. TABLES O �p _ XHAUST-.MOOD :ABOVE OVENS. T ~ S. (OPTIONAL) I 1 . I _ N LE6 ( -'I I FT. OVENS MIN. GAP. + O 6A5 METER OO GU. ri N REbIMENTAL RED 12 6 H /.A.G:(FURNACE) + HOT WATER HEATER. ', 36 I 4 IO — SHELF WITH WIL50NART - XI 5 � 4 2 � � OI3/ IN TALLER 12" ABOVE.FINISH ELECTRIC - 300 AMP - SINGLE PHASE SERYIGE. [71 Q ON ALL FACES. SHELF TO BE 5 ; H ALL REQUIRED R WHERE SHOWN ON PLANS. FURN15 KELIN TO BE MODEL PT-88 COMPLETE WITH _ 15 I O I Si -- Z FLOG 2. MA E I `1 I - L--��;" MOUNTING BRACKETS. BUN°PANS, IN5TRUCTIONAL/TICKET`TAKER HOLDER AND rill MANUFACTURED BY GLENGO STAR: O 30 X30 MA FAG cry 45 10 TABLE � CASTERS A5 NU - " " „ AT HOOK 5TRI P WITH WI L50NART - - - - 2q 3/4 X6 X40 GO ri ri O " _ " I II I (MENTAL RED 12 6 ON FACE AND ALL EDGES. 3, PIZZA GUTTING AND BOXING TABLE TO BE PER PLAN, Q Z REG Q.. M ALUMINUM GOAT HOOKS SPACED EVENLY AND STAINLESS STEEL COMPLETE WITH DBE."OVER SHELVES, TWO = Q ATTACH 1 L HEATED SHELVES, PAN HOLDER AND CASTERS. TABLE TO BE a- N MOUNT 60 A.F.F. OFFICE,510E WORKERS SIDE SIDE VIEW MANUFACTURED BY AIR SYSTEMS, INC. 45/e v ry m w _ }- M I"X3" CHAIR RAIL WITH WILSONART "RE6IMENTAL RED 12-6 N = 4. GREASE INTERCEPTOR SEE SHEET P-1 15 , DROP BOX HOLDER- 50" CUT TO LENCGTH AND INSTALL ZON FACE AND BOTH ED6E5 DR E ABOVE FIN15H FLOOR WHERE SHOWN ON PLANS. FLOOR SINK TO BE 24"X24" FIBERGLA55 MODEL 2424 A5 1 DATE: 5 /. I / 03'S. r LO , BY. FLAT INC. SINK'SHALL HAVE MODEL 650' ,� MANUFACTURED - OFFICE 51DE 15 MOF FACE'AND DOORS ROUGH OPENING FOR 20 5LOT DROP ; ,, II I X6 X40 LONG CLIP BOARD STRIP WITH WILSONART AND 88q - COMOP STRAINER DRAIN. �� _ " E AND ALL ED6E5. INSTALL AA FAUCET A PAINTED RE&I'MENTAL RED. BOX IS 22 ' WIDE X 34/" HIGH. RE6IMENTAL RED 12 6 ON FAG 4 2 3q'-0" DATE REVISED : WORKERS 5117E 15 PARTICLE BOARD :: �, ICE WALL. T MAKE ALL CONDENSATE DRAIN �+0 A.F.F. 60 ABOVE FINISH FLOOR ON OFF 6, PLUMBING CONTRACTOR O LAMINATED REGIMENTAL RED. N FOR WALK-IN COOLER AND DROP-IN L: ITE MELAMINE INTERIOR. LINE GONNEGTIO 5 O ALL Y -i P W - " T R TO ROUGH OPENING FOR 32 SLOT,DROP ' H DER WITH WIL50NART REGIMENTAL KOLO PACK REFRIGERATION`UNIT. CONTRAC O 0-RED DRIVER 5 DROP BOX OL . " EVAPORATOR THEN D0 FINAL X PT BOTTOM ANDBACK. INSTALL GOMPRE550R AND E O BOXIS 223/4" WIDE X 54 " HIGH.-� 12-6 ON ALL FACES E GE CONNECTIONS PLAN .r, 3 4 16"X18"X4 1/2" GASH DRAWER, FURNISH ALL EGUIPMENT/FLOOR OELECTRICAL CONTRACTOR TO MAKE ALL REQUIRED VERIFY WITH OWNER DROP BOX SIZE. V " I _ HARDWARE AND INSTALL UNDER FRONT STEEL 1. ELEG., G ELECTRICAL CONNECTIONS FOR WALK-IN COOLER LI&HTIN6 SCALE 4 = ' O" ELE 1 SHEET TITLE Z WORK TABLE. AND REFRIGERATION UNIT. ALSO HEAT UNITS ON GUT TABLE Q EMIPMENT/FLOOR PLAN H U NOTE NOTE NOTE NEW PAPA JOHN'S PIZZA STORE 5G ED LE RE5pOWDLITY. CONTRACTOR OR OWNER _ NOTE . ALL NEW WALLS ALL EXIST. WALL5 ALL WALL5 TO BE 215` Y�l MAIN STREET NOTES TRACTOR TO INSTALL PLYWOOD BACKING BEHIND THE FOLLOWING CONTRACTOR E.V. DENOTES EQUIPMENT VENDOR 5HOWN SHADED SHOWN HATCHED REMOVED SHOWN TO VER1f:%(, ALL DIMENSIONS ITEMS #II, #24, #28, #2q, #37, #51 AND CABINET IN MDR:OFFICE. IF CONTRACTOR 6G DENOTES &ENERAL CONTRACTOR DASHED HYANN I S, MA. BECOMES RESPONSIBLE _------------ AND GONDLTION5, PRIOR TO ODES NOT INSTALL BACKING, THE CONTRACTOR EG -.DENOTES ELECTRICAL'CONTRACTOR , a ------------ G 1 SHEET NUMBER TH05E ITEM5 5HOULD THEY BALL. 5 PLUMBING CONTRACTOR ERECTING WALLS AND GOPYRIC�HT O PAPA JOHN 5, U.S.A. FOR PG -:DENOTE FRAN'- DENOTES FRANCHISEE , 5TARTING CONSTRUCTION. 2002 - ALL RIGHT5 RESERVED o VENDOR DENOTES LOCAL SUPPLIER .