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CAPE DAIRY PRODUCTS - RETAIL FOOD
CAPE DAIRY PRODUCTS 44 B 344 a . 09Q F `• pF� Tok Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. BAWNsTABLL = F.P.(Thomas)Lee,. "A �bzQ• .� 200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D. Alt. r�� atia 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: 136 Issue Date: 01/01/2022 DBA: CAPE DAIRY, LLC OWNER: CAPE DAIRY LLC Location of Establishment: 44 BODICK ROAD HYANNIS„ MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IncloorSeating: 0 OutcloorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2022 RETAIL FOOD: $100.00 COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: RETAIL/WHOLESALER I Initials: `' � ° ►.o Town of Barnstable II Date PaiQ� mt d$ „�,,�AB Inspectional Services i AjEp��a ``� Public Health Division Check# Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 c Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE i I'�I b( NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: Copt lbwI `I 1 1.C, ADDRESS OF FOOD ESTABLISHMENT: Ll`-f B U(1 I J, -Rol . H YC4 cn V 1 15, MAILING ADDRESS(IF DIFFERENT FROM ABOVE): '36( ry) C �C E-MAIL ADDRESS: d W k I f-e-a ca p e ck i f \�J, co py) °l' r w,C i a Q(,6 i f�, C b M TELEPHONE NUMBER OF FOOD ESTABLISHMENT: c5N) -LA 1 D 0 TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO__)o ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: /V 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. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:Wpplication FormsTOODAPP REV3-2019.doc OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: YES/NO OWNER PHONE# 60e ADDRESS_ SOU �' l S"� - N�Q,LG�Via.V X A CORPORATE OWNER: ,`&V- �i LLC CORPORATE ADDRESS: 1?7ack I GAL.- ZDM Ol l h.l S M Z (d o PERSON IN CHARGE OF DAILY OPERATIONS: S4:5v h-ey� V N)e\,V CA List(2) Certified Food Protection Managers AND at least(1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 2. 21 SI NATURE 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.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 0 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q\Application FormsTOODAPP REV3-2019.coc I T BOARD OF HEALTH Town of Barnstable John T.Norman Board of Health Donald A.Gaudagnoli,M.D. . UAWNSrAaLL Paul J.Canniff,D.M.D. o 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: 136 Issue Date: 01/01/2021 DBA: CAPE DAIRY, LLC OWNER: CAPE DAIRY LLC Location of Establishment: 44 BODICK ROAD HYANNIS„ MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2021 RETAIL FOOD: $100.00 COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q.n FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: RETAIL/WHOLESALER I For Office Use Only: Initials: Town of Barnstable Date Paid Amt1d$ /bD— Inspectional Services Maas. 3 9q''OTEp A. Public Health Division Check# Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE ( 1 NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: �'-��/ O�_I �✓� ICI. ADDRESS OF FOOD ESTABLISHMENT: �G4.01A MAILING ADDRESS(IF DIFFERENT FROM ABOVE)): E-MAIL ADDRESS: �w� I �- CG�I�-�- u) TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ��11_- TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V 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. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE ✓RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED& BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc i OWNER INFORMATION: (� y � FULL NAME OF APPLICANT_ _`�\ eol� \" '&Y-A SOLE OWNER:0YES/NO OWNER PHONE ADDRESS CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: �'�G`G'V l�,� clg��A List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 2. - o 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/henithdivision/applications.asi). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec. 3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC Ist. Q:\Application FonnsTOODAPP REV3-2019.dbc t tt BOARD OF HEALTH Town of Barnstable John T.Norman Board of Health Donald A.Gaudagnoli,M.D. nanxarrAui.e, •' Paul J.Canniff,D.M.D. �a39, 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate c +'' 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: 136 Issue Date: 12/10/2019 DBA: CAPE DAIRY, LLC OWNER: STEPHEN WARD Location of Establishment: 44 BODICK ROAD HYANNIS, MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 Outdoor5eating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2 O 2 O RETAIL FOOD: $100.00 COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: RETAIL/WHOLESALER f U oi� rq� • Initials: J � Town of Barnstable Date Paid\ - , Amt Pd$ ICO� BARNSTABLE. Inspectional Services f 59. Public Health Division Cash Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: Ctr - ^., LLC.. ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: ��A✓t z) ��X (� C"o k' CO-, TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (2-&�T\ - � TOTAL NUMBER OF BATHROOMS: WELL WATER: YES_NO (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: _ 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. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD'SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED& BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application Forms\FOODAPP 2020.doc r OWNER INFORMATION: FULL NAME OF APPLICANT 54QjLCt, � C% SOLE OWNER: O/NO \OWNER PHONE # ADDRESS I L44 Ee-� \C V� �(J\ � C�T����?:��-� 1"✓IY��.��5 CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. 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 ca7ers 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.as1). 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 COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPP REV3-2019.doc 1 Town of Barnstable BOARD OF HEALTH G Paul J Canniff,D.M.D. A.Ga Board of Health Donald A.Gaudagnoli,M.D. BARNgrAB L John T.Norman 43g 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: 136 Issue Date: 12/20/18 DBA: CAPE DAIRY, LLC OWNER: STEPHEN WARD Location of Establishment: 44 BODICK ROAD HYANNIS MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES -- FOOD SERVICE ESTABLISHMENT: YEAR: 2019 RETAIL FOOD: $100.00 COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: ------ ----- -------_- -- -� _ - MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: I FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: RETAIL/WHOLESALER FIKE roy� Initials: Town of Barnstable • Date Paid AmtPd b� 9WWSTA MAS& Fr Inspectional Services � 1 Check# ,0r prFDn+xiA Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE IZ l• I NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: C Gt,1pG D&i vu LE/C. ADDRESS OF FOOD ESTABLISHMENT: b0A 1 &V-- W0.0 1GCh vl l 5 M 0 Zlo� MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: l wei wrzk a C a, fX C cm TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( 06) - JOV TOTAL NUMBER OF BATHROOMS: Z WELL WATER: YES NO .. (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: N SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q:\Application FormsTOODAPPREV2018.doc i 1 PLEASE CALL 508-862-4644 OWNER INFORMATION: G FULL NAME OF APPLICANT SOLE OWNER: YESONO OWNER PHONE # • Ole ' 11 ADDRESS CORPORATE OWNER: �L� FEDERAL ID NO. CORPORATE ADDRESS: �-q f3n d i - l�o0, �A4a-4A xi S f�uo b PERSON IN CHARGE OF DAILY OPERATIONS: VIC'n 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. 2. 14 l� ✓� 2-/�/��_ .SIGNA 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.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1 st to Dec. 3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1 st. Q\Application Forms\F00DAPPREV2018.doc pp THE fok, TOWN OF BARNSTABLE - HEALTH INSPECTOR,s Establishment Name: S "'9 ram. Date-� / Page:. of 1 OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-6:30A.M. BARNSTABI.E. • 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION F VIOLATION/PLAN OF CORRECTION Date Verified MASS. MON.-FRI. cbp ,e3v p.0 HYANNIS,MA 02ti01 soa-as2-asaa No Reference R-Red Item PLEASE PRINT CLEARLY ,EOMP, FOOD ESTABLISHMENT INSPECTION REPORT Name T Dat Tvue of Typeof Ins ection Operation(s) Ro ne Address Risk Food Service e-inspectionCIA: Level a Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness Caterer General Complaint Person i arge(PIC) Time Bed&Breakfast HACCP In: Other `- Inspector Out: C' Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 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 Violation Critical(C)violations marked must be corrected immediately. (blue&red items) T*a I Corrective Action Required: No FED 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/Exclusio ❑ 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 B-One critical violation and less than non-critical violations 9 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 )( ) 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=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: TInspe Ig r Pnn. r� 31.Dumpster screened from public view �y 1��r Vl Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N Si's #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC g a P ri nt: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N .W 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 1q 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* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12- Additives 2-103.11 Person-in-Charge Duties - Cooked and RTE Foods.* 3-302.1d' 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-Or mall 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* 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- 3-304.11 Food Contact with Equipment and Utensils * ( ) q 590.003(G) Reporting by Person in-Charge* 7-203.11 Toxic Containers-Prohibitions Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS-FOR--- 3-306.14(A)(B)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* q Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( P - 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations * 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served Y P 7-206.13 Tracking Powders,Pest Control and • 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMElrEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY * Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eff"i"11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3 401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- * Ratites-165°F 15 sec* in mobile food,tem or and residential Sources 10 Proper,Adequate Handwashing g' P 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* 3-401.11 A 1 All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail practices 590.004(C) Wild Mushrooms* ( )( )(b) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requ emnos 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 Commercial] Processed RTE Food-140°F* (Blue Items non-critical 23-30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodbore 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-203.18 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 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 Proceduresdi 6-301.11 Handwashing Cleanser,Availability - 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 _ Reduced-Oxygen Packaging Criteria* _ 8-103.12 Conformance.with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. �p(ME TpN, TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: `'�-V `�`�'jyw Dater c Page: of �y OFFICE HOURS :x SARNSTARLE.O` PUBLIC 0 MAIN HEALTH RETSION - 8:00-9:30 A.M. • - - - 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. $ MON.-FRI. .639. HYANNIS,MA 02601 508-862-46" No Reference R-Red Item PLEASE PRINT CLEARLY �E0N1P`' FOOD ESTABLISHMENT INSPECTION REPORT Name Ur?i Date)�,,J� Type of section / Ooeration(s) Routi Address ! Risk Foo ervice Re-inspection Level Ret Previous Inspection J Telephone esidential Kitchen Date: Mobile Pre-operation t, ur 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 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) ❑ l�f 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 1 lag Critical(C)violations marked must be corrected immediately. (blue&red items) ONOW 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 to ,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 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 Physical C=2 critical violations and 18 on- non-critical. . no critical water,sewage back-up,infestation of rodents or insects,or lack of 27. 28.Poisonous Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to nous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 8 non-critical violations=C. 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspe ture Pn 31.Dumpster screened from public view- Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N + 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.* 3-302A4 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding _ Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F *- EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control*Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 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 Reared 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 Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of Eggs 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145`17 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg c i-11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 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* Ratites-165°F 15 sec* 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* Ell Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under 929-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 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23.30) 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3 403.11(E) Remaining Unsliced Portions of Beef Roasts* Critical and non-critical violations,which do not relate to the foodborne 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 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. 1 Special Requirements 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. � f., . TOWN OF BARNSTABLE, HEALTH INSPECTOR'S Establishment Name: �t O�(r� Date: J 16 �-Olq Page: of �{'4 OFFICE HOURS : BARNS7'ABLE.O` PU6200 MAN STREEETLIC HEALTH SION - 3::30-4:30 P.M.0-s:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MA- � HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY rF0 MP'� 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name 4 N I Date 7116/I1 Tvoe o Type of Insigreclion - u Alk coolt r- J u Ooeration(s) QQutire Address J3 G Risk Service Re-inspection fi _ ©p Level et ' Previous Inspection Telephone Residential Kitchen Date: - � 01 a Mobile Pre-operation q L. / Owner HACCP Y/N Temporary Suspect Illness I V� ✓ Caterer General Complaint Person in Charge(PIC) ,� v 0-.-A.f.L Time Bed&Breakfast Other CP - 1 f[Oo f I 1 In: Inspector R G n jj,(n S 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) ❑ 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 TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding 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 /{ t►���� I Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked mist be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-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 too 6 boon-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot C=2 critical violations and less than 9 non-critical. . f critical ' water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to anon-cri 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to Boon-critical violations=C. w 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert'Machines: Outside Dining Y N PIC's Signature ` ' Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen Y N C�_ �u, Violations related to Foodborne Illness Violations Related to Foodborne Illness Intervention_ s 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) Ass -ignment 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 3-20242 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* IF19 PHF Hot and Cold Holding Contamination from Raw Ingredients 9 5 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 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* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage*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* Requirements * 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* 590.004(I1) Variance Re q 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 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 ( ) P 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* t:/f cnvc uirzoot 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish.and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Chemical Stuffing Containing Fish,Meat,Poultry or 590.009 3-201.15 Molluscan Shellfish from NSSP Listed * (A)-(D) Violations of Section 5.90.009(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. 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 1 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) 3-102.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne 12 Prevention of Contamination from Hands 3-403.11E g 3-101.11 Food Safe and Unadulterated* ( ) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45`F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5=205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures I 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 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. q . pp tNF roy, TOWN OF BARNSTABLE _ EALTH INSPECTOR'S Establishment Name: FAff Date-' ate Page:, I of ti n OFFICE HOURS nnNsrne�e.o PUBLIC 2 0 MAIN STREET �` .', 8:00-s:30 A.RM. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified vl 30-4:30 P.M. MASS. : �• HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item. PLEASE PRINT CLEARLY �OlFD MA+° 508-862-4644 FOOD S BLISHME T INSP TI REPORT Name r Date a of T Inspection Ooeration(s) outin Address Risk Service pecti n Level t Pa vio Telephone ential Kitchen Date: Mobile Pre-o at' Owner HACCP Y/N Temporary Susect pIllness Caterer General Complaint Person in Charge(PIC ime Bed&Breakfast HACCP n: Other Inspector O ` Each violation checked requires an explanation on the narrative pa e(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ i� 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 9 O ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories L /i• Violations Related to Good Retail Practices.(Blue Items) Total Number of Critical Violations r Critical(C)violations marked must be corrected immediately. (blue&red items) 1 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 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 regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 6=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. 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 ritic I violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 4 to 8rton-critical vi ati =C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: I i ture -;,Print: 31.Dumpster screened from public view A 15 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N161 #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature,, Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness' - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 a 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 3-2827.1,2--_ Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* I - 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 r 590.003(C) Responsibility of the Person-in-Charge to - - 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130'F 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 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* Applicant3-304.11 Food Contact with Equipment and Utensils* 7.202.12 Conditions of Use* 590.004 Requirements ) - Variance 590.003(G) Reporting by Person in Charge* - - 7-203.11 Toxic Containers-Prohibitions* (I1 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 Reated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* µ 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 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law*_ 4=501:111 Manual Warewashing-Hot Water 17.206.12 1 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Tem eratures* 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. 1 g Proper Cooking Temperatures for PHFs CONSUMER ADVISORY * - - - Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water - _ 3-401.11A(1)(2) Eggs-155'F 15 sec Animal Foods That are Raw,Undercooked or 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145'F 15 sec* 5-101.11 Drinking Water from an Approved System* _ _ Equipment* gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* sg crave 11112001 4-602.11 __ Cleaning Frequency of Utensils and Food Animals-155'F 15 sec* 590.006(B) Water Meets Standards in 316 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From-an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130'F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4=702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155*F 15 sec* aces of Equipment* _ - Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed_ _ Chemical* g g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in ca[er- * Ratites-165'F 15 sec* in mobile food,temporary and residential Sources 10 Proper,Adequate Handwashing g' p � 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*17 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 he debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165'F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) ' Microwave,165`17 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140*F* (Blue Items 23-30) Critical and non-critical violations,which do not relate to the f oodborne 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 * Conveniently Located and Accessible Within 2 Hours and.From 70*F to 41*F/45'F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* � 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' I 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. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 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. Sore Ca`-1 Y ?(-j • Z :CAPE DAIRY,LLC STEPHEN WARD OUTSIDE SALES 1 800 698 4701 MILK/ICE CREAM P.O. BOX 716 1-800-352-7816 44 BODICK ROAD 1-508-771-4700 HYANNIS,MA 02601 FAX 508-771-9770 email:capedairy@aol.com Kai D Lo 1 1 i Crocker, Sharon To: Stanton, David Subject: CAPE DAIRY PRODUCTS Stephen Ward of Cape Dairy Products 508-771-4700 was in today. They are wholesalers who currently sell eggs and milk and want to expand to packaged meats (ie, bacon.) He would like to know if we require anything further from him. We currently charge for retail for their food permit. Any other requirements? V19-01 S b"1 r G � � e 1 certify under the penalties of perju&at I,-to my best knowledge and belief, have filed all state tax returns and paid all state taxes required under law. 'SignatureofIndividual - g or Corporate Name(Mandatory) (Mandatory,if Applicable) ** or Federal Identification Number * This license will not be issued unless this certification clause is signed by the applicant. ** Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation. This request is made under the authority of Mass.G.L.c. 62C s.49A. Received. 19 A M. Signature of Applicant Hour lrl p,M , Addre— Approved 19 Licence Granted 19_ FORM 460 Homs&WARREN.INC.PUBLISHERS BOSTON REVISED Cape Dairy Products, LLC: White Bros /All Star Fax.: 771-9770 Tel: 771-4700 1-800-352-781:6)1-800-698=4701 Code Quantity Description Code 3000 HOOD ICE GRE Quantity Descri tion AM BUId{.. p Code Quantity Description 3115 2 GII+FORD'S BULK 2 NO SUGAR ADDED Golden Vaiu11 25.15 NO, 4311: Chocolate 3332 Vanilla/Ras: Swirl 54038 2516 Chocolate Chi 3330 Coffee 2517 Coffee Black Ras berr 2518. 3109 Brench Vanilla NSA Vanilla 3020 HOOD BULK#2 2529 Black Ras be 59032 2530 Cookies&Cream French Vanilla 2531 Strawberry. 4310 Strawbe 2527 LANDMARK 54030. Black Ras be Ma.le Walnuf. 3092 Vanilla 59044 2519 Mint Chocolate Chi. Chocolate Chi 2534 3093 Chocolate 4285 Cookies N Cream Moose Tracks 3094 Coffee 54047 3326 Matne Black Bear 4440 Mint Choc Chi 2533 Cookies&Cream Choc Lovers.Choc 4.441 2521 Peanuf`ButterPie Mint Choc Chi 30,12 4442 Chocolate Chi 3021 C Fire..Smores 4443 Strawbe HOOD.BULK#3 2523 Pistachio 2524 3909 ZaB 60591 Cotton Can d Cake Batter 2524., 4269 3025 Cotton Cand 4439 Butter Crunch 3112 Strawbe. Cheese 54010 he Vanilla 3015 2152 54059 Choc.P:B Ri le . Fl Fish' Rid e 3875. le 4468 Carmel Caribou 312854078. Van:P.B.Ri le 3957 - Toasted Coconut 3991 Joyful Coconut Alm 3022. 3013 Butter Pecan 5123 HOOD BULK#4 3534 Pe erminf Stick Banana 4753 5936 Green Tea 53993 Cookie Do. h 5337 Frozen Puddin Butter Pecan. 3341 Maine Biuebe rry 3512 Cookie Dough 4466 311.6 Lobster Track NEVER FLAVORS Maple Walnut 4546 LL Bean.Mudd Boot 58104. 54077 Pistachio Almond 25:14 Black Rasbe Maine Deer Tracks. 581 t5 Ma le.Walnut 4897 IVlississi i Mud 58108 3994 Cotton Laud 3023 HOOD BULK#5 Apple Pie 3.996 I'utnpkn Pie OLD NEW ENGLAND 4455 Moose Track 3089 60590 Choc Peanut Butter 701$ Cake&:Ice Cream 31.13: Sea SaltCaramel Malt 3539 Pe ermint Stick 60556 Maine Bluebe 3507 StrawberryCheese 60597 1:Scream Cake. Java Chunk 3951 Pea:But.Carm:Coo.D 3418 Old Fashioned Vanilla $OOD SHERBET BULK 3011 Cherry Blossom , GIFFO.RD FROZE yO 70761 Oran a 3882 70762 Vanilla Bean 3319 BlackRas be' Ch Rainbow 4896 Moo-Slide 3323 Chocolate PB Cu 3091 Power Pla 4898 4768 Coffee Heath Bar South Peach 3321 Blueberry Oat Cruinb 4767 Super Hero HOOD,YOGURT.BULK 59056 3301 Mint Cookie Fudge Strawberry GIFFORD SHERBET 60595 Chocolate 3885 3242 Orange Sherbet Vanilla 3538. Rainbow Sherbet DEAN GIFFORRSORBET 2520 Bubble Gum ROYAL "BULK 3299 Raspberr 821 Cotton Can d 3320 Strawber Lemon 3466 Ras berry Sorbet Mocha Chi Lemon Sorbet 4367 Mango Sorbet 3815 Chocolate Walnut 3063 Coffee Carmel Chi Cape Dairy Products, LLC.•/ White Bros./All Star Fax: 771-9770 Tel: 771-4700 1-800-352-7816/1-800-698-4701 o e Quantity escnptton Co e Quantity ,. ecnpf ion 7 Code Quantity escnptton CREATIVE CREAMERY KEMP YQGURT. 472k HIE'S SLUSH 3057 Vanilla . , RIC:. i.0594 'USH Chocolate 47 3058 Chocolate 10593 00 Lemon NF Vanilla 4701 Watermelon 3059 Strawbe 10595: NSA Vanilla 3061 4702 Blue Raspberry Coffee ,. 3064 4713. Rainbow Cookies 8i:Cream �HON1+,Y HILL:YOGURT . . •4705> 3065 Cherry C C Cookie Dou h` 21005 Tahtttan Vanilla 4706 Cotton Candy 3067 Chocolate Cht 21009 Trt le Choc. 3076. 4707 Root Beer Coconut 21010 Strawberry Sensation 4708 f 3078 Sour le Ma le Walnut 21006 Espresso 4710 3081 Coffee Oreo Orange Cream Gin er 21003 Cheesecake 4719. Bubble Gum 4920 21007 Cookie&Cream. 4922 4711 Pina Colada Rum;Raisin 21034. Bluebe Tart 4703 30$5 Seaside S'More 21008 C Bab Peanut Butter 4714 Blue Vanilla 3083. Twisted Sea Turtle . 21011 Nsa Tahitian Vanilla 3135 3079 Straw Lemonade le Cove 21033: California Tart 4709 Man o 3080 Peanut Butter'9 21023 Island.Coconut 3082 NEW Pistachio 21020 Birthday Cake 4712 3077 Mango Banana. 21 071 C and .Bar Smash 4726 Strawberry 3111 Mocha Chi 21064. 3132 Sea.Salf Caramel Pretzel 4727 Ras'be 'He Bar 2.1080. Mint Choc.Chi 3134 Black Ras .Ch Ch Y. . 2107$ 4728 Sweetish Fish Che Limeade 4730 Tan Brine 3090. Butter Crunch. 21050 Whtte Choy Moose 4731 Grape, 4924 Green Tea :: 21015. Velencia Orange. 4732 p 3100 Mint Chi' Orange Cream 21045 Water melon.Sorbet .4733 3103 Pina , le Coconut 21037 Lemon/Lime Pink Lemonade ..4734 Coconut 3079: Red Bean 21027 Man o.Sorbet 3131 Black Ras Ch Ch 473$ Peach 21002 Dream Dark Choc. 4736 Pineapple 21048 . A le.Pie:.S 'ice 4737 21049 Egg-No - Black Cherry 9 4738 ICE CREAM PIES Keylime 21047. Ptimkiri:Pie 4729 � 3525 PumPecan Ice Coffee 21074 Toasted Coconut 7014- Mud Pie 12.cut 21061 3549 Card .Cane Peanut Butter Pie 21017 French Vanilla, 1023 Spumoni Pie. 2:1072 Yellow Cake Batter 7047 Minhchi 210b6 Strawbe Banann FOAM CUPS 24. 7073 Baked Alaska a 60290' VANILLA 210$8 Cultured Coconut 60284 COFFEE. 602.89 STRAWBERRY 7048 Cookie&.Cream Pie 60282 CHOCOLATE 7022 Miss Mud Pie. 70751 ORANGE',SHERBET ` 7069 Mud Pie 16 cut. 70752. RASP SHERBET 60886: LEMON SHERBET 3879 S umoni Wed e 32 3492 VANILLA LACTAII 7002 Cake Roll.36 .60894 RASP WATER I.CE 60285 ORANGE WATER I RICHIE'S CUPS 53. Soon Straws 54 7 oz Richie Cu s 55 12 oz Richie.Cups 56 16 oz Richie Cu s Cape Dairy Products, LLC./ White Bros./All Star Fax: 771-9770 Tel: 771-4700 1-800-352-7816%1-800-698-4701 de. Quantity Description Code Quantity Descri tion HALF"LLONS P Code Quant;ry Description 30321IAAGEN DApTS` 3162 HOOD 1/2(6) 3847 PINTS; 31889 Vatiilla 3040 BART' PINTS Golden Vanilla 3.850 31909 Patchwork Coffee. 3200 Vanilla 39729 3851 Vanilla Swiss Almond 3201 Fudge Twister 3848 Mass .Mocha 39739: Classic Trio Chocolate 3204 Dee .1'u ale 39749 3849 Strawbe 3205 Cream Coffee 3854 Choc.Chou.Chi Malted Vanilla 39759 Strawbe 3208 Local Ma le.Cream 39769.. 3855 Rum Raisin. 3114 Chocolate 3859 CCCookie Dou h Gin er . 44279 Cookie Dou Deli ht 3852 32"1S Chu Ch w/Ras 41389 . Chi. ed. Chocolate Dulce de Leche Carm 3216 3377 3 Geeks'and a Red 41409 . Cookies.n Cream But Pecan 3220. 3822 Rock Road Mud Pie, 41419. Ma 16 Walnut" 3222 3361 Sea S41t Caramel 44280 Peanut.Butter Cu Mint Chi 3223 Midtu lit Chocolate 44281 • 3600 Pines "le Coconut Butter Pecan 3928 3225. Coffee Heath.Cruncl 61598 Mint Choc Chi Whtte Ras Choc 3227 Black Ti er 70708 3860 Choc PeanutButter. Hoodwich 3927 3229 C.C. Cookie Dough 70709 Ma le French Toast Carmel Cone 3277 Almond EnJo 70700 3622 Vanilla Bean 3278 Peanut Butter Nation 3:124 Chocolate 70702 Comeback Caramel Vanilla Cho Chi 3219 3-127 Cookie N Cream: Coffee BcCream. 70703 BoSox Brownie 2262 3280 " Cookies&,Cream 70699 Fenwa` Fud a Man o Destination 3281 Local Ma le Walnut 41429 Vanilla Bean 3282 Mint Chocolate Chi HAAGEN'DAZ SORBET PT 8 70701; Green Monster Mint. :. 385.6. 3284 Peanut Butter:ParadiI HOOD.1%2 Ga.1 Sherbet Rasplierry 3285 3857 Lemon P.eppertnint Stick 70759 Rainbow 3858 . 3286 Strawberry. Peach 70758 Orange 3287 Ras be Sorbet 3052 Mango 3288. HOOD YOGURT 1/2.(6). Apple Crumb Pie 70923 Mocha"Fudge.. 3289 Bala Bing Chetry 70922 Vanilla..: 3290 Kahua Sombrero 70926 Peanut Btr Cu "Fud a 3291 Moose Trails 3292 Pum kin S ice GIFFORD QTS 3043 French Vanilla 3045 Coffee 3044 Chocolate 5974 3261 HAAGEN D..AZ QT 6 Toasted Coconut 3264 .3405 Old Fashion" Vanilla` Va villa 32 30 83 Coffee 75 Lob ster ster Track 3275 Chocolate 3062 Moose Track 33.63 3003 Camp Fire Senores Strawbe 3004 Fly Fish Fudge 3395 BRIGHAlyIS QT(6) 3074 LL Bean Mudd Boot '80034 3053 BlueberryVanilla 3960 80036 Chocolate Chi . Gra a-nuts Vanilla 80045 3071 Peanut Butter Pie Cookie&Cream 3072 80037. Coffee Carmel.Cookie Crunch 80035 3073 Choc Brownie Crunch 80042 Chocolate 3961 I Scream for"Cake MintChoc Chip 3142 80089 Rocky Ride Rower Play Fud a 80044 " Mocha Chi 80040 P ermmt Stick 80051 Big Dig 80043" Pistachio GIFFORD YOGURT 1'S HOOD QT SHERBET Q. 80038 Strawberry 3070 Moose Track . m' 70753 Orange : 3069 80039 Mocha Ahnond Black Ras "Choc Chi 80050. 70755 Rasbe` 3068 French Vanilla JustJimmies 70754 80094 Rainbow Oui of.the Park Coffee. 70756 Lemon/Lime. 80055 Li ht Vanilla 80047 Frozen Puddin Cape Dairy Products, LLC./White Biros/All Star Fax: 771-9770 Tel: 7714700 1-800-352-7816/1-800-698-4701 Code ty Description Code Cd Quart, Quantity Description Code. Quantity, Description HOOD SUMIVIE NOVELTLRS 3471 HoWsie:Van/Choc 36 3389 Cand Center24 34118 Sandwich,24 3176. Vanilla Crunch 24. 3615 Jolly.Rancher Snocor 3151 Orange Cream Bar 24 3509 Oreo.Sandwich 24 3611 Bubble Gum Sno Col 3700 Ice Cream Bar 24 3304 .Choco Taco 24. 3617 Watermelon Bomb 60298 . Nut Royale cone2. . .3918. Oreo Stick'.24 3609 Twqety Bird 12 3149 Eud e.Bar 24 3478 Lick A Color 24 3.665 Nina Turtle 12 . 3349 R/W/B Bomb Pop 12 81.8 D 3 Big KEMPS ipper.Choc 31.78 Klondike, '24 3618 Big Dipper Vanilla 64602 Asst Po s 24 3167 Reese's P.B.Cu 24,. . ..3619 65741' Choc:Eclair 24 3201 $i .Di er.C&Cr Kin :ICone 24 40012 Bi Di er Straw 65740 Strabe .Shortcake 24 3245. Snicker Bar:24. 001 Batman. 12 65190 Cookie`n Cream Sand 3390. Po shot L/Str.24 3602 Lil.Bratz .12 65191 Kem wick 24 . 3131. Sour Woi er 24 3603 Bugs Bunny 12 3123: Bi 1 12 3606 Pink Panther 12 3350: Che. . Scewball 24. 3031 Sonic:Hedge Ho 3613 . 131ueRas Screwball 3997 . 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Cherry .826 Malt.Cu 12 471`8 Blue/Vanilla 3998 Twix 24 4715 ' Lemon. 3056 FRUIT STICKS 24 3233 Mrs Fie1tl.Cookie Sand 4721 Cotton Candy " 3914 Strawbe 3515 Giant Neo.Sand.24 4722 -Orange Cream 3915, Coconut 349.9 Giant Vanilla Sand 4723 Mango 3917 Pinea le 3351 Rainbow Po 12 4724 3916 Man o Coconut 3604 Bomb Po Jr 24 4716 Watermelon 310.1 Po sicle Creanisicle. . 4725 Blue Ras berry 3102 GH Ice Cream-Bar NEW 3907 GH.Straw Shortcake 4739 Strawberry 3587 GH CCCookie Sand 4740 Banana 5042 GH Toasted.Almond -4741 Lemon/Lime HAAGEN DAZS:BARS 12 40206 Hawaiin Punch Bomb 4742 .3862 Vanilla Milk Choc 4130, Sour Apple Kin Browme.Cone. 4744 Rootbeer 3870 Choc Dark Cho, 40020': Bunn Track Cone 3865 Almond Milk Choc 4662 Tear Jerkr Cu 3867 Coffee Ab and 4839 Turtle;Sundae Bar. 3516 ' Big Miss Mud'Sand. DOVE BARS12 3541 Vanilla Dark BEN&JERKY CUPS` M TI ACK 3540 Vanilla Milk 7082 UL P $.. Americone .60321. Po Stiz 4/20 7080 Cherry Garcia 60318 Yce Cream Sandwich8/12 MAGNUIVL:BARS 12 7079` Ch.Ch Cookie Dough 60337 Sundae Cone 6/4 3365 Double Carmel 7081 Ch.Fudge Brownie 60314 Hoodsie Cu 6/10 3959 Almond 7078 Straw Cheesecake 60322: Fudge Stix 4/20 3138 Orange Cream 12/12 60311 Ice Cream Bar 6/12 :FROSTY PAWS: 3422 Sport Bar 12/6 1544 Peanut Butter. 3370 Klondike 12/6 1546 Vanilla 3098 Klondike Krunchl2/E