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HomeMy WebLinkAboutGEMINI CARIBBEAN MART, LLC - RETAIL FOOD GEMINI CARIBBEAN MART,LLC cc}} 18 Center Street,HYA Jo77—�55 p4� r Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. LARNSTADLE. F.P.(Thomas)Lee,. MM—a Daniel Luczkow,M.D. Alt. 200 Main Street, Hyannis, MA 02601 o ' 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: 871 Issue Date: 01/01/2022 DBA: GEMINI MARKET OWNER: GEMINI CARIBBEAN MART, LLC Location.of Establishment: 18B CENTER STREET HYANNIS„ MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 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: 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: VEr° • Initials:Town of Barnstable Gj Date Paid ,M,, Inspectional Services 639. 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 IQ-01—aO` k NEW OWNERSHIP RENEWAL V NAME OF FOOD ESTABLISHMENT: 6f_:,MtQt 669-199CA Q MAQ.T ADDRESS OF FOOD ESTABLISHMENT: 100E C_wr $"(, }}q(}(JiJ�S z O Q601 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: _ 6&kI,)LCf-tIz.4f?i9,VW °-VV1.VZG1J e k�&j TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 0$ - a5ao k/ TOTAL NUMBER OF BATHROOMS: 'P WELL WATER:YES NO_V/ ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: ✓ SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: O/A OUTSIDE: 0/A TOTAL: O 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? Uli� 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 508-8624644 Q:1Applicauon FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT NU&1C/ SOLE OWNER: YES/6 OWNER PHONE# ADDRESS_5 i'tgwooi ss w s-r yptaam ,AA 0Q-64-3 CORPORATE OWNER: CORPORATE ADDRESS: A W Ra`'f y' -NNIS, d A 09Go f PERSON IN CHARGE OF DAILY OPERATIONS: 5�'tll� fj� 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. 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 tab 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.townotbarnstable.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 1 st. Q:\Applicauon Form-,TOODAPP REV3-2019.doc Bellaire, Dianna From: McKenzie, Marybeth Sent: Friday, December 03, 2021 9:32 AM To: 'Aubrey Foster' Cc: Bellaire, Dianna Subject: phone message Hi Aubrey, I tried to call you back, but no answer and your mailbox is full.So the thing is when you have a food establishment permit you usually need two CFM and an allergen, but I have explained that you are just repackaging product with the same people that work at Caribbean cafe.We are contacting the Director to get permission for you to use the same CFM's, but with the restriction of only repacking food . If you start to make ANY product at the Gemini then you will have to have the required CFM's.Also, I have not given you a final for the back kitchen area at the Gemini. You still had some work to do so the permit can't be issued until then. Please contact me if you have any questions and I will let you know as soon as I have an answer for the Director. Marybeth McKenzie R.S. Town of Barnstable Health Inspector 508-862-4644 1 Bellaire, Dianna From: McKean, Thomas Sent: Friday, December 03, 2021 12:18 PM To: Bellaire, Dianna Cc: McKenzie, Marybeth Subject: RE: Gemini Market changing category There are no such exemptions. From: Bellaire, Dianna Sent: Friday, December 03, 2021 9:28 AM To: McKean, Thomas Cc: McKenzie, Marybeth; Bellaire, Dianna Subject: Gemini Market changing category Tom, Gemini market wants to go from retail food to food service. They opened the Cape Cod Caribbean Cafe for food service, which is next door. Aubrey Foster, the owner,wants to re-package frozen meat and spices. They state they are using the same food protection managers/allergen employees for both places. They have provided two food protection managers and 1 allergen for Cape Cod Caribbean Cafe. They want to know if they can have an exception to obtaining two more food protection managers/1 allergen for Gemini Market, since it is next door and same people. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us The information contained in this electronic transmission("e-nail"),including any attachment(the"Information"),may he confidential or otherwise exempt from disclosure..It is for the addressee only.Thus Information may be privileged and confidential work-product or a privileged and confidential communication.The.Information may also be deliberative and pre-decisional in nature. As such,it is for internal use only.'ihe:Information may.riot be disclosed.without the prior written consent of the Director of Public I lealth and/or the Town:Attorneys Office of the Town of Barnstable. If you have received this e-mail by mistake,please notifi7 the sender and delete it from your system.Please do not copy or forward it.'I hank you for your cooperation. 1 4 N Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. ?isfts Paul J.Canniff,D.M.D. a 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: 871 Issue Date: 01/01/2021 DBA: GEMINI MARKET OWNER: GEMINI CARIBBEAN MART, LLC Location of Establishment: 18B CENTER STREET HYANNIS„ MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: Indoor5eating: 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: 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: i Town of Barnstable For Office Lice Only: Initials: . P I _— 1 Date aid �11��/� MASS � Inspectional Services T �l� ►`� Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,NIA 02601, Office: 508-862-4644 Fax: 509-79€1-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT:6k-9 ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: 6 TELEPHONE NUMBER OF FOOD ESTABLISHMENT: V 1/0, QSDv TOTAL NUMBER OF BATHROOMS.- WELL WATER:YES NOANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:Q� O 12-1:51?6?,f NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DIMING REMME.R.* 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._0-F ESTABLISHMENT; (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE NAIL.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 QAA"ication FtumslF{)t)DAPP.2Li2t1.doc OWNER INFORMATION: FULL NAME"OF APPLICANT' SOLE OWNER: YES/NO OWNER PHONE# ADDRESS_. CORPORATE OWNER: CORPORATE ADDRESS. PERSON IN CHARGE OF DAILY OPERATIONS: r 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. Pmnoc4Zg( nL�23i ZoT�! GNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVtL`E:All seasonal food establishments,includiing mobile trucks must be inspected:by the Health Div. prior to oueninQtt 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 tab 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 ma. 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 httv://www.townofbarnstable.us/healthdivision/annlications asn. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January i st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY-DEC 1st. I QAApPlication FamTOOD"P REV3-2419.dm a SF BOARD OF HEALTH Town of Barnstable John T.Norman Board of Health Donald A.Gaudagnoli,M.D. �tRrrsr�n�e. Paul J.Canniff,D.M.D. 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: 871 Issue Date: 12/10/2019 DBA: GEMINI CARIBBEAN MART, LLC OWNER: AUBREY FOSTER Location of Establishment: 18B CENTER STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: CQA FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: IMME' .� Town of Barnstable Initials: Date Paid[ 31 Iq Amt Pd$ ate" • Inspectional Services 1639. �`� Public Health Division I Check# fD►rlA 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 �2A ICl NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT:�Zin L—G— ADDRESS OF FOOD ESTABLISHMENT: 1 e-e--,ft`74-,?— Hv "d 15 /Vn 67�7— MAILING ADDRESS(IF DIFFERENT FROM ABOVE): i0/1p Cl E-MAIL ADDRESS: et-6 \✓1 S 0� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO ✓ .. (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: r 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) -OOD 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:VApplication FormsTOODAPP 2020.doc f OWNER INFORMATION: FULL NAME OF APPLICANT MWN�3 ��� �L�So►� SOLE OWNER: YES/NO OWNER PHONE# y04 (0 (2-1 SC)q`I ADDRESS ✓ �j��lkl�nk7 G10�� f'd'1g l�v l"4l� C7�p :1 CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: �I t.�Cte.✓� Sl'KIlL 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. : / l�/�?—( �k 1. -3,/ / a 2. _ ,Gl �llll 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/heaIthdivision/ai)plicationS.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.31s`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:Wpplication FormsTOODAPP REV3-2019.doc MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include copies of your employees' food protection manager training certificates (at least two) and food allergen awareness training certificate (at least one.) In addition, please include the required fee amount (see fees at bottom of this page). Make check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax copies of your employees' food protection manager training certificates (at least two) and food allergen awareness training certificate (at least one.) In addition, you must mail the required fee amount(see box below). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. FEES: Bed &Breakfast Permit=$55; Food Service Permit 0-49 seats=$250; 50 or more seats$300; Continental Breakfast=$30; Retail Food (only TCS Foods)= $20; Retail Food Store—Less than 8,000 S.F. _ $100, more than 8,000 S.F. = $285; less than 1,000 S.F.; Retail Food Combo/Limited Prep. - $200.00; Cottage Food Industry=$75; Mobile Truck= $50; Mobile Ice Cream Truck= $35; Frozen Dessert License= $30; Additional non-refundable Fee for New Establishment or New Ownership= $100-$500(see staff), Late Fee= $10 Q:\Application FormsTOODAPP REV3-2019.doc Town of Barnstable BOARD OF HEALTH Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. - ,; John T.Norman 'SASS. F.P. Thomas Lee Alternate v � 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, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 871 Issue Date: 12/18/2018 DBA: GEMINI CARIBBEAN MART, LLC OWNER: AUBREY FOSTER Location of Establishment: 18B CENTER STREET HYANNIS MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES , (� FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2019 r RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: CQ� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: FIMME ram, Initials: r "o Town of Barnstable Date Paid dwklAmt Pd$ " BARNSTABLF ` Inspectional Services MASS.8. ��� s63q. ♦� J(y(J�ay ��/ �rF16 9. Public Health Division Check#` Thomas McKean Director b-200 Main Street, Hyannis,MA 02601 6& I �'� Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: � a n 1(11 ca(-t bb e o n ADDRESS OF FOOD ESTABLISHMENT: �� C. -0-n-war N qa n n i S MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: q2m 1^01 GA Ue-r i ?�O�► �C� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: U V - D TOTAL NUMBER OF BATHROOMS: 0 WELL WATER: YES NO ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:oi/j2//-dTO /V,3/9 NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: PAP 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)? Mt 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 r -- - �r PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT U SOLE OWNER: &S! NO OWNER PHONE ADDRESS ���7 V a rf-n" 60 Pr CO ORATE OWNER: A�lr rV5K-�EDERAL ID NO. CORPORATE ADD ! 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 CERTIFJEATES at your food establishment. Certified Food Managers Expiration Date - er en Awareness Expiration Date 0 7 lr� Sn SIGNATURE OF APPLICANT DATE i ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to 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.townofbarnsiable.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 APPLICATION(S)AND REQUIRED FEES BY DEC 1 st. QAApp(ication FormsTOODAPPREV2018.doc TOWN OF BARNSTABLE HEALTH INSPECTORs Establishment Name: Date: Page: of 1 - OFFICE HOURS P ° PUBLIC HEALTH DIVISION 8:00-9:30A.M. - BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified e39. �0� HYANNIS, MA 02601 MON.-FRI. No Reference R Red Item PLEASE PRINT CLEARLY ,e n . . 508-862-4644 - .. . 'EON1A` FOOD ESTABLISHMENT INSPECTION REPORT Name [ �' Dat�j/ Tyne of Type of Inspection or [( Operation(s) outineon Address Risk Fo eryice spection Level etail s ion s Telephone 4 ntial Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary f Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: t J � ^-' 4 Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)v e . Violations Related to Foodliorne Illness Interventions and Risk Factors(Red ItemsI Anti-Choking 590.009(E) ❑ 01 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 67 ❑ 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 L ❑ 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 / C� ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) / ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP (xJ� ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories + Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No El Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Emergency Closure Other: Voluntary Disposal ❑ 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 4npn-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 aggrieved b this order, o C=2 critical violations and less than 9 non=critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of � 27.Physical Facility (FC-6)(590.007) agg y you have a right to a hearing. Your request must violations observed,7 to 8npn-critical violations. If 1 critical refrigeration. " 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address = 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N 4 I u" #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's SignatUm Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y IN Dumpster Screen? Y N l Violations related to Foodborne illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* . 19 PHF Hot and Cold Holding 2-103.11 - Person-in-Charge Duties � 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 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 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) 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 ated or of Food Contaminated 7-204.12 i Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 590.003(E) Removal of Exclusions and Restrictions Disposition ofAdulter3-306.14(A)(B)Returned Food and Reted or 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 4-501.1-11 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16' Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 _ Drinking Water from an Approved System Not Otherwise Processed to Eliminate Equipment* ( )( ) Pathogens 590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meats&Game * e ecrme tnnom 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 3-0Ol.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, 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. * 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 5-201.1(C) Wild Mushrooms practices should be debited under#29-Special 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11 A&D PHFs 165°F 15 sec* $ Receiving/Condition - ( ) ( ) 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 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* LL8 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 590A00 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 A Supplcessied 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 6-301.11 Handwashing Cleanser,Availability 2 . Physical Facility FC-6 .00 7 Conformance with Approved Procedures/ 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 1 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. TA °F.i�*Oa TOWN OF BARNSTABLE ..; HEALTH INSPECTOR's Establishment Name: Date: Page: Of ' p�' 1 OFFICE HOURS ` PUBLIC HEALTH DIVISION 800=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 A 639. �•� - HYANNIS,MA 02601 508-862-464a No Reference R.-•Red Item .. PLEASE PRINT CLEARLY 'FDA""`' FOOD ESTABLISHMENT INSPFECTION REPORT Name Da �e of Tyne of Insuection ` 66�6 O eration s Routin Address Ris F ervice -inspection Level etail Pre ion Telephone esldential Kitchen Date: Id,' Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time f / Bed&Breakfast HACCP ` In: , 1 !I-/ 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) ❑ nA 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 44 ❑ 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 i ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.CoolingZJ ❑ 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) 99 ❑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 4 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 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 6=One critical violation and less than 4non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 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 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION,• Inspector's Signature Print: 31.Dumpster screened from public view 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 Signatu Print6mi ' Self Service Wait Service Provided Grease Trap Size Variance Letter Posted.. Y N Dumpster Screen? Y N oltAS Q/FiWWW Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* - 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 7-102.11 Common Name-Working Containers*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-Ori mal Containers* 590.004(F) 590.003(C) Responsibility.of the Person-in-.Charge[0 Other* g g 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 Se azation-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 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 - * 3-801.11 Use of Pasteurized Eggs* g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria �) gg 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(1--)) Raw or Partially Cooken-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 1 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* 3-401.11 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 E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System Eggs Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg cd-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 155ved Source 3-401.11(B)(1)(2) Pork and Beef Roast-1 121 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 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Ratites-165°F 15 sec*3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* 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 929-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C * (Blue Items 23.30) 3-202.15 Package Integrity ( ) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* �) g 12 Prevention of Contamination from Hands 3-403.11 Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 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* Convenien0y Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products P16-301.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* Location and Placement * 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 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/ 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* 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. `�p1ME Tory TOWN OF BARNSTABLE _ ,. HEALTH w$PECTOR's Establishment Name: - Date: Page: . of o OFFICE HOURS PUBLIC HEALTH DIVISION - 6:0029:30A.M. BARNSTABLE. ' 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified Wj9- �0� HYANNIS, MA 02601 More.-FRI. No Reference _R-Red Item PLEASE PRINT CLEARLY 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name Dat �05 e Type of Inspection eration s Routine Address / Ris a Re-inspection ( ' Level Re 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 ir 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) ❑ r 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 . Lb ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories v Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations ]� Critical(C)violations marked must be corrected immediately. (blue&red items) v Corrective Action Required: ❑ No Yes Non-critical(N)violations must be corrected immediately or Overall Rating f 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. El go 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) 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 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's 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 C's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N C� 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.) w 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 Cioss-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 l Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties � " 3-302.14 Protection from Unapproved Additives i 1 Contamination from Raw Ingredients 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 15 7-101.11 Identifying Information-Original Containers* 590.004(F) 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 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* ) q 590.003(G) Reporting by Person in Charge _-^ t Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR a, 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions i g � ) j Disposition of Adulterated or Contaminated °s : 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 g '1� 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 Hermetically Sealed Container* i 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*; , - * j Sanitization Temperatures* , TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 �, Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-]Ol.l1 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate Equipment 590A06(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective utrz°°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 Fastcurized 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 1 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 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved By �; _ 3-0Ol.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 ( ) practices should be debited under#29-Special 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. P 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11 ) 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 Corrunerciall Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 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°17 Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures 1 6-301.11 Handwashing Cleanser,Availability 28. 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. Op IHE rok, TOWN OF BARNSTABLE.-. � ..HEALTH INSPECTORS Establishment Name: Date:. Page: of - - OFFICE HOURS PUBLIC HEALTH DIVISION 9:00-9:30XM. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/P AN 4 CORRECTION Date Verified HYANNIS,MA 02601 MON.-FRI.sos-s62-4644 No Reference R-Red Item., PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT Name Da a of Type of Inspection O era ' Routine 44 Address Ris Re-inspection Level e- Previous Inspection Telephone ential 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: 09 Each violation checked req s 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) ❑ bill A 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 j - 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 Asa 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 ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices. ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating y y ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑'Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items F] Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. � 6=One critical violation and less than 4 non-critical violations 9 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC,6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC=7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other /� DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from+pu Iblic view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed �Ffozen Dessert Machines: Outside Dining Y N 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) I and Risk Factors(Red Items 1-22) (Cont.) W. 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 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=Suti`stances 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 * 590.004(F) '� 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 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 Requirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) 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 Reservice of Food * ' 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003E 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 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* 4-561.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* ' Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* _ Eggs Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* _. _ 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef°ti° 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell ,Shellfish and Fish From an Approved Source 3-401.11(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 I 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 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* in mobile food,temporary and residential Sources 10 Proper,Adequate Handwashing g' PY Game and Wild Mushrooms Approved By - - 3-401.11(C)(3) Whole-muscle,In[ac[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* I 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 3-003.11(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 foodbome 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 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 * 5204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3�02.11 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 1.009 3-502.11 Specialized Processing Methods* 30. 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. ��ptNE Toh, TOWN OF BARNSTABLE.. ... - - ., - HEALTH INSPECTOR'S Establishment Name: Date: - Page: . -.of 4 OFFICE HOURS PUBLIC HEALTH DIVISION 6:00-6:30A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified HYANNIS,MA 02601 sos-sz FRRI. No Reference _ R-Red Item, PLEASE PRINT CLEARLY . p'EDN1P�� FOOD ESTABLISHMENT INSPECT) N REPORT. � Und < Name Dat a of Type of Inspection Gx er Routine Address Risk 7Sery Re-inspection Level Previous Inspection _ Telephone Residential Kitchen Date: Mobile pera' 1 Owner HACCP Y/N Temporary us ss Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP v ' 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) ❑ 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 /J FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foops) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures T4! ❑ 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 Asa Public Health Control e ❑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 fa,,�;2 � 04 r Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: I ❑ NJ Non-critical(N)violations must be corrected immediately or Overall Rating ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled Emergency Suspension within 90 days as determined by the Board of Health. � C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo 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 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 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 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: 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 I ignatu Prin.4 Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N .. _ -�..:.---..--.�-._.,�.....tee..:�_... .. -...- _�.....� ��- .,_.. �v..�. � ..r. - T--r.. .r ....���,. _.....- '•-- . . r � -�. n �-..r - ..�..-��•.�- v � t s--- r ..-� Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination L14 Food or Color Additives _ Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding - 2-]03.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous of 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-WorkingContainers* • Require Reporting by Food Employees and Contamination from the Environment * 3-50 L16(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 7-203.11 Toxic Containers-Prohibitions* ( ) 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* q Food and Water From Regulated Sources` g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Contact E Utensils and Food Contt Surfaces of s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 1 g Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 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 * 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 3�01.11(A)(2) Ratites,Injected Meats-155°F 15 sec Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* A 1 All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail _ 3-401.11( )( )@) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3 403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 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 3-501.1 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 FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 1 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S: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. `gyp THE Tow TOWN OF BARNSTABLE. . . - ...HEALTH INSPECTOR's Establishment Name: Date: Page: of v tip OFFICE HOURS sWRAR E. PUBLIC 2 0 MAIN STREET DIVISION 8:30-4:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:30-4:30 P.M. c3v a a� HYANNIS,MA 02601 MON.-FRI. No Reference R-Red,Item P ASE PRINT CLEARLY 508-862-d644 FOOD ESTABLISHMENT INSPECTION REPORT , Name ( , Dat [ Type of !Xp&gflnsRectionL / eration s outine Address ' Risk F Service �ection Level et ' Previous Inspection Telephone esidential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Pt .� Caterer General Complaint Person in Charge(PIC) a D Bed 8 Breakfast HACCP 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) ❑ 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 42 ❑ 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 '0 ❑ 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 ❑ 9 9 ❑ ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY { f ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories �u u Violations Related to Good Retail Related to Good Retail Practices(Blue ltemslltems) Total Number of Critical Violations C ❑ No ❑ Yes ritical(C)violations marked must be corrected immediately. (blue&red items) t Corrective Action Re uired: Non-critical(N)violations must be corrected immediately or 4 within 90 days as determined b the Board of Health. Overall Rating Y y O ❑ 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. ❑ 9 Y ❑ rY P ❑ 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 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility FC-6 590.007 aggrieved b 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 y ( )( ) 99 Y Y 9 g q l refrigeration. iti If 1 i crca l i l i violations. i 8 7 to non-critical 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, � ) � 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's 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 o 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* * 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 19 Cooked and RTE Foods.* * PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients r15 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* 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-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance Requirements * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) 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 Rated or 7-204.12 Chemicals for Washing of Food* Produce,Criteria* HSP HIGHLY SUSCEPTIBLE POPULATIONS 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashin 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 Pe 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202:13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 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 Equipment 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 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* effe criw uvzoor 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* 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°F 15 sec* Other 590.009 violations relating to good retail practices 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirem nos]d be debited under#29-Special 5 Receiving/Condition 2 401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* 590.004(E) Preventing Contamination from Em to ees* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock g P Y 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A Cooling Cooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) g 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 1590.000 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. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1 .009 3-502.11 Specialized Processing Methods* 30. 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. pp1MF rp TOWN OF BARNSTABLE _ HEALTH INSPECTOR'S Establishment Name: Dat;5VIN 1. Rage: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified a3q: �0� HYANNIS, MA 02601 M -FRI. No Reference R-Red Item PLEASE PRINT CLEARLY M , sos-8-8s2-asaa rFD Py FOOD ESTABLISHMENT INSPECTION REPORT. Name Dat j Tvoe of rk T Ins ec ion L ,r ' l oeration(s) outine Address ///,�,� Risk Fo ervice ll� e-Inspection Level etail Previous Inspection Telephone I ential Kitchen Date: N9 �eco�v Mobile Pre-operation Owner HACCP WIN Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other V f 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) ❑ 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 TIMErTEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑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) ek- ❑ 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 Vej Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations lea Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: No Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating Y y ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo 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 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 C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. violation,4 to 8non-critical violations C. 29.Special Requirements (590.009) within 10 days of receipt of this order. = 30.Other DATE OF RE-INSPECTION: Inspector's 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 Signatur P int: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N f ._-.-..-...-�.;t-� ..-�..�. ,�_� ...-..-•..�-. •-�•-----...-_.-.... ��._.-t .-� n....��.-,..-.«-�---._ ..�-.-.�.--�- _-`-.-�.__.ra..r--.�..--4.+---..+�-..-�+-terrr.r .. .� �tti^ .. *yw..r w,- �..�. .... ..__ .,. .- --. _ _, _ .... -Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding. 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 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 2 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*r P 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 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) 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 Reservice of Food* 7-204.12 Chemicals for Washin Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashin 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* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 'Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Es-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or m 5-101.11 Drinking Water from an Approved Syste gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eff crave 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 temporary and - ide in cater- Sources* atites-165°F 15 sec* ing,mobile food,temporary and residential CO 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. 2-301.14 When to Wash* * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* 4' 3-0Ol.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 17 Reheating for Hot Holding Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165`F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C 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 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3 403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 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 Tagsiltecords:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 1.003 * 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. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand�Yin 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. P`oFtff row TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: Date:J ob Page: of OFFICE HOURS BARE. PUBLIC 2 0 MAIN STREET 3:30-4:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:30-4:30 P.M. 639. �0� - HYANNIS,MA 02601 M-8 -46 No Reference R-Red Item - - PLEASE PRINT CLEARLY �PrFO MPS� 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT IT 6 Name t Type of T Ins ction - e s outine Address Risk rvi = pe ion Level Previous Inspection Telephone ential 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 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 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 L ❑ 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 �- r-- ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No TO Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating +HfTY y El Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ m 90 Ebar checked indicate violations of 105 CMR 590.000/Federal Food Code. Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 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 � 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. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: I 31.Dumpster screened from public view . , Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N .2 0= #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's S1aDR=tLLM 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 n 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* * 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 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-�Ori mal 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 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(13) Exclusions and Restrictions* 7-204.11 Sanifizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual 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 Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Surfaces Eggs Utensils and Food Contact Sfa 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* Ery cri�e 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 Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' S90.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * 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* 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 Requirements. radicsshould be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 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 590.004(E) Preventing Contamination from Employees* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock g18 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. Special Requirements 1.009 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. pp1HE T TOWN OF BARNSTABLE _ HEALTH.INSPECTOR's Establishment Name: - Date:' ) r 9 g of ti OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. •� HYANNIS, MA 02601 5M068- -FRI.62-4644 No Reference R-Red Item PLEASE PRINT CLEARLY a)9• . prFDMP�p FOOD ESTABLISHMENT INSPECTION REPORT Name `A a ((`. ZZ)TvRe o !Xna2lMpspection peration(s) ti Address Risk Fo ervice �fn ection Level etail Previous Inspectionen A- Telephone esidential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In:1.7;7 10 Other �r Inspector Out: - ` 66 +r1Se 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) ❑ ` L Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ �1 FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 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 L �� ❑ 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 _M ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY fJ ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations ® l Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: o Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Re riction/Exclusion ❑ Re-inspection Sched led mergency Susp siPon C N Official Order for Correction:Based on an inspection today,the items Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ ❑ Emergency Closure ❑ Voluntary Disposal Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 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 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 9non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's 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 o 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.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 7-1 02.11 Common Name-Working 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-Storage* Applicants* 3-302.11(A) Food Protection* P20 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 7-203.11 Toxic Containers-Prohibitions* ( ) 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 Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE 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* 3-401.11 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* Equipment* gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Watcr* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective inrzooz 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 see* 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* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145`F 15 sec* Other 590.009 violations relating to good retail practices 3-201.17 Game Animals* 11 . Good Hygienic Practices 17 Reheating for Hot Holding Requirements.ushould be debited under#29-Special $ Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165'17 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 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 * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y 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 13 Handwashing Facilities 3-202.18 Shellstock Identification* 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 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 .out 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF� roH TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: Date: Page: of c` ~a OFFICE HOURS M� PUBLIC HEALTH DIVISION 8:00-9:30 A.M. enaNsrnsLe. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ocbp "p.. HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY 508 862 4644 FOOD ESTABLISHMENT INSPJECTION REPORT Name ` ( ate e1 Type of lypq oflinspection Operation(s) ine Address Ris Food Service lion Level. aa� Previous Inspection Telephone ITesidential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint f „ Person in Charge(PIC) Time Bed&Breakfast HACCP UI/ yl- C� In: Other Inspector 1" 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 Led Items) Anti-Choking 590.009(E) ❑ f Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS U ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ILZA if ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) 1714.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 ` S ❑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 all l iI 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. B=One critical violation and less than 4non-critical violations 9 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t F is scored automatically lack of 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 9non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or la 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 equirements (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 Signature Print: 31.Du m ter screened from public view n „L ,� I 5 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 x ,�-r}:�ir.. ... .....� _ +S,�c. � .,.r--.�• "x h..o'�r.i...�r.�r.r!'^�_.�_,-�.--A�+.�.,..�"' r"+.L�- ..�.-.�, q.� .:�-r=+ � r,T.,.�. ..-.. s 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* 6 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.I 1(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 2-103.1 I Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.1 I(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 Other*590.003(C) Responsibility of the Person-in-Charge to 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 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* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 1 I 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 terateReser for of Food 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions 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 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y 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* 1 13-801.11(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 Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* rf Nve 11112001 4602.11 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* 4-703.1 1 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 temporary and - ide in cater- Ratites-165°F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and�Id Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. * 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 590.004(C) Wild Mushrooms ( )( )( ) 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 S 3-403.11(A)&(D) PHFs 165°F l5 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 16 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 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 5-2041 I 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 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. oFIK rok TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of �P OFFICE HOURS M PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE, : 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date Verified v "'"SS 0 HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �iOrFD MA'S 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name AADate Tvoe of T9!N!PQnsi3ection O er i s outin Address Ris F ervice -nspection Level etai Previous Inspection Telephone i ential Kitchen Date: Mobile Pre-operation Owner HACCP YIN 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) ❑ 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 POPULATIO (HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ArIl ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations. Critical(C)violations marked must be corrected immediately. (blue&red items) �_ Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. / ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. B=One critical violation and less than 4non-critical violations 9 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t F is scored automatically o la hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's 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 Sig Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y IN Dumpster Screen Y N -••�-�-�'a--w--''.•�sr.+ -l"..".'-....�v".i�'`��"..``-.1,.^.'r"'..' �,rli"� - „�,".,,�-...+r�`f_.�.� � .�.!-� ---- � v . '�••-•'�..r'`�,.r Ja ~J'`- ..��` �i, Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions r Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) 1 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* 6 Cross-contamination L14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated Cooling from 3-202.12 Additives* g Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.1 l A 2 Raw Animal Foods Separated from Each * 590.004(F) ( )O P 7-101.l l 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 * g 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 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils * ( ) q 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria.-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and AdulteReserrated for of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition ofAduIterated 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 4501.111 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 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 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* gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A 2)O Comminuted Fish,Meats&Game Pathogens** Effective iiirzvni 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g y 590.009(A)-(D) Violations of Section temporary and a ide in cater- * Ratites-165°F 15 sec* in mobile food,tem orar and residential Sources 10 Proper,Adequate Handwashing g' P Y 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 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 CommerciallyProcessed 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 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 16 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 13 Handwashing Facilities * 3-501.14 A 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 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* 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. oF.1KE roy TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of PUBLIC OFFICE HOURS % RARNSTARI.€.O' c + 2 0 MAINLSH DIVISION 3:30-4:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date Verified 3:30-4:30 P.M. 9cbp ��63q• �0� HYANNIS,MA 02601 M-8 -FRI.62-4644 No Reference R-Red Item PLEASE PRINT CLEARLY 'ED1AP`p FOOD ESTABLISHMENT INSPECTION REPORT 508-8 _ e Name - Date G 9 Tyne of Tyoe of Inspection C o` Operation(s) Routine e Address Risk Foo ervice spection I IF Level etail ection Telephone sidential 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: W 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 - ca ❑ 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) 1719.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action ReauirE o es Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion Re-ins ection Sched d m ency s en on C N Official Order for Correction:Based on an inspection today,the items Embargo Emergency Closure checked indicate violations of 105 CMR 590.000/Federal Food Code. ® g ❑ g Y ❑ Voluntary Disposal F] 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. 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 o la hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. If f critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008 9 violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view L 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' re Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N �,,,. ,-,., ---- -- - ,.._, -'»'- ,. .__ r-'.�----•--1"''.+---�,-•-�- �"`-"_. _•---_• •� � ter: - �..r..---�- t„ Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives law Cooled to 41°F/45°F Within 4 Hours* 590.003(B)' Demonstration of Knowledge* r 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 * 590.004(F) 7-101.1 1 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* Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers* 3-501.16(A) Roasts Held At or Above 130°F* Applicants* ` 7-201.11 Separation-Storage* . PP i 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* * 3-302.15 Washing Fruits and Vegetables 3-SOl.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* 3-306.14(A)(B)Returned Food and Reservice of Food* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 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.I I 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* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* E/1 i-11112001 4-602.11 CleaningFrequency of Utensils and Food g 590.006(B) Water Meets Standards in 310 CMR 22.0* q y Animals-155°F IS sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source Contact Surfaces of Equipment* 3-40L11(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-155'17 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* t 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Stuffing Containing Fish,Meat,Poultry or Chemical* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* Ratites-165°F 15 sec* in mobile food,temporary and residential 10 Proper,Adequate Handwashing g, P Y 3-40L.11 C 3 Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and wild Mushrooms Approved By ( )O p Regulatory Authority 2-301:11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification'Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices Reheating for Hot Holding practices should be debited under#29-Special 17 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 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C)` Commercially Processed RTE Food-140°F* (Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.1 l(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 4.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.1 i Parasite Destruction* 5-20 * 5-20 .11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Water,Plumbing and Waste FC-5 .00 2 7 2 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 8. Physical Facility FC-6 .00 HACCP Plans 6-30I.12 Hand Drying Provision 29. Poisonous Special Req Toxic Mater als-u FC-7 .008 uirements 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:590Formback62doc `Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF. ► TOWN OF BARNSTABLE HEALTH INSPECTOR's Establishment Name: Date: Page: of l OFFICE-HOURS 00 i BAa'NSr�Eo: PUBLIC 2 0 MAIN STREET 3:30-4:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:30-4:30 P.M. MASS. g MON.-FRI. 1679. �0 HYANNIS,MA 02601 sos-8 -4644 No Reference R-Red Item• PLEASE PRINT CLEARLY ,FDM�,p FOOD ESTABLISHMENT INSPECTION REPORT l 1 �L Name Date e o I s ec ion JA e o s outine Address Risk Foo ervice Ion . Level etail Previous Inspection Telephone esI ential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness (� Caterer General Complaint \" Person in Charge(PIC) Bed&Breakfast HACCP . Other � Inspector ��i1� Out: t� � /1 Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s) - to Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ '� r� z, 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 ��L` ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMErTEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures. 1 K--- ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ZI ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding ( PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control �e��\`� ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP / N ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP v ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY L ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) i Corrective A ion eq 'red: s Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating Y y ❑ Voluntary Compliance ❑ Em yee 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. 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 )( ) aggrieved b 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.Physical Facility (FC-6 590.007 99 Y Y 9 g q violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials. (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address = 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view ` � n Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N �/ �/l� / #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 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* 8 Cross-contamination 44. 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 Require Reporting by Food Employees and Contamination from the Environment 7-202.11 01.11 Separation-Storage*Common Name-Working Containers* 7- 3-501.16(A) Roasts Held At or Above 130°F* 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* 3-304.11 Food Contact with Equipment and Utensils Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 590.003(G) Reporting by Person in Charge* _ _ _ 7-203.11 Toxic Containers-Prohibitions* ( ) q - Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.J1 _ Sanitizers,Criteria-Chemicals* REQW REMENTS 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 � 590.003(E) Removal of Exclusions and Restrictions g ( ) Disposition ofAdulterated or Contaminated Food I _ 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* 590.004A-B Com Hance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P h_ - - - - 4-501.111- - Manual Wazewashin 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 r 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-Tem H. I CONSUMER ADVISORY 3-202.14 Eggs and Milk Products,Pasteurized P•.P 16 Proper Cooking Temperatures for PHFs 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* Ef came 11112001 4-602.11_ Cleaning Frequency of Utensils and Food _ Animals-155°F 15 sec* 596.006(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* I - Shellfish*- - - - 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot 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-16 °F 15 sec* ing,mobile food,temporary and residential Sources* y R 5 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under -- Game and Mid Mushrooms Approved By - - - - --- ---Regulatory Authority 2-301.11 Clean Conditio-- * - n-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* I * 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 Piacfiees- 17 Reheating for Hot Holding R radices shots.Id be debited under 929-Special - Receiving/Condition - - - 2-401-.1-1-_ Eating,Drinking or Using Tobacco*-- 3-403.11 A&D PHFs 165°F 15 sec* en 5 Recelving/Co ( ) ( ) 3-202.11 PHF's Re`'cbived at Proper Temperatures* r, I 2�01.12 Discharges From the Fry"es,N6se and Mouth* 3 403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventin Contamination When Tastin * * (Blue Items 23-30) 3-202.15 Package Integrity* g g 3 403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the 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* 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 FC-4 .005 3 402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29, Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-.Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. ypF tNE 1p� TOWN OF BARNSTABLE.. - ., HEALTH.INSPECTOR,s Establishment Name: - Date: 7 Page:,. of OFFICE HOURS 7 BARNSTABLE.O` PU62 0 MAIN LIC LSTREEETSION - a 00-'4:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/ N F CORRECTION Date Verified 330- :30P.M. 639. �•� HYANNIS,MA 02601 M-8 -FRI. No Reference. R.-:Red Item PLEASE PRINT CLEARLY, PIED MPS° 62-4644 508 FOOD ESTABLISHMENT INSPE TI N REPORT Name Date-- ate . e of Type of Inspection r do s Routine Addres Risk F ervice Re-inspection ` Level etail Previous Inspection on Telephone esidential Kitchen D ��j/\ Mobile re-operatio Owner HACCP Y/N Temporary ness ` Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: TT Each violation checked rebLe quires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ -Pl`0- I FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 4 VjA �• ❑ 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) d� ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations ,�-� �'� Critical(C)violations marked must be corrected immediately. (blue&red items) (� a l Corrective 'cti u ed: ❑ No Yes Non-critical(N)violations must be corrected immediately or Overall Rating o within 90 days as determined by the Board of Health. ❑ Volunta o i ❑ E I e i / i Re-ins a dul e y S 5pension C N Official Order for Correction: Based on an inspection today,the items Ern o checked indicate violations of 105 CMR 590.000/Federal Food Code. bar❑ g ❑ Emergency Closure Voluntary Disposal ❑ Other: 23.Management and Per (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 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of )( ) 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 g 4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation, 30.Other DATE OF RE-INSPECTION: Inspector's Sig ature Print: 31.Dumpster screened from public view A. Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC' -Signature "" Print: Self Service_- Wait Service Provided Grease Trap Size Variance.Letter Posted Y N Dumpster Screen?�Y N III 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 Hat and Cold Holding -- --- --- -- - - --- Contamination from Raw Ingredients 15 Poisonous or Toxic•S566stances 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-15Aginal 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 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* 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G)_1 Reporting by Person in-Charge* - -- Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* �. _ REQUIREMENTS FOR 3_-306.14(A)(B)DispositiReturhedon Food and Rrated or C 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 ipontact 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-SOLIl1 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 Pe i 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mecha,nijaf Warewashing-HotlWater 7 Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* -_ _ _ _ _ _ _ _ Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* - 22 3-603.11 Consumer Advisory Posted for Consumption of - 3-202.16 Ice Made From Potable Drinking Water � 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 4-601.11(A) Clean Utensils and Food Coritact Surfaces of Eggs-Immediate Service 145°F IS sec* 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* Effe°"°e m@OOr __ _ 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-1 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and F60(1- 3-40 1.11(A)(2) Ratites,Injected Meats-155 155°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 3-201.15 Molluscan Shellfish from N_SSP Listed_ _ _ _ _ _ _Chemical* g 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* 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'Rygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eatin Drinkin or.,sin Tobacc * Requirements. 5 - Receiving/Condition- _.- _- _ _ _ _ g� g g 4�`� r 3-003.11(A)&(D) PHFs 165°F 15 sec 3-202.11 _ PHF's Received at Proper Temperatures* y 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 Whdn fasting* 3 403.11 C Commercial] Processed RTE Food-140°F* Blue Items 23-30) 3-202.15 Package-Integrity ( ) y Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated*J 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* + illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F 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(1) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures 1 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .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 1 Conformance with-Approved Procedures* S:59017orm6ck6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.0 0. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. f r °F. roj TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of q OFFICE HOURS TH AR�E°) PUBLIC 2 0 MAIN LSTREET SION 3:30:30--4:30 P.M.:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified S p 67q.a HYANNIS,MA 02601 - 508-862-4644 ,No Reference R-Red Item PLEASE PRINT CLEARLY . 'FDN1P� FOOD ESTABLISHMENT INSPECTION REPORT ^\ U Name Date ype of Tyne of Inspection G O e s- Rout' Address �"�- Risk a ice e-inspection Level etai re ctOn-- Telephone si ential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness �- Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP JZ Z 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) ❑ ✓ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands J ❑ 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 tN ❑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) if ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP `,S ❑ 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 T_� Critical(C)violations marked must be corrected immediately. (blue&red items) r Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ VoluntarY Compliance Employee Restriction/Exclusion Re-inspection Scheduled Emergency Suspension ension 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 4npn-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 C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. violation,4 to 8npn-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: In pector'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 Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 1q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* - 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients. 55_ Poisonous or Toxic Subitances 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.l1 Identifying Information-Original Containers* * g3-501.16 A Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to Other _ 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 7-202.11 Restriction-Presence and Use* 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* 590.003(G) Reporting by Person in Charge* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 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* 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* eff Hive inizooi 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 Cough[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 Stuffing ContainingFish,Meat,Poultry 3-201.15 Molluscan Shellfish from NSSP Listed _ Chemical* g or 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. * 2-301.14 When to Wash* 3-401.11 A All Other - F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )(1)(b) r PHFs145° practices should be debited under#29-Special 3-201.17 Game Animals* 11 Good Hygienic Practices 1 T Reheating for Hot Holding 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(13) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 * (Blue Items 23-30) 3-202.15 Package Integrity (C) ' Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbore * 12 Prevention of Contamination from Hands 3-403.11E Remaining 3-101.11 Food Safe and Unadulterated ( ) g 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* 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 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 1590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 3-501.14 B Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement ( ) g 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 129. 1 Special Requirements 1009 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. �F IME Tor, TOWN OF BARNSTABLE _ HEALTH INSPECTOR•s Establishment Name: Date: Page: of .. 'b -OFFICE HOURS ° PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNS'rABLE. ' 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified Mesq: �0d; HYANNIS,MA 02601 MON.-FRI. No Reference ,R-Red Item PLEASE PRINT CLEARLY OrFD Mn�°' 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name Date J NLIN a of Type of Inspection yv ra Ap Routine Address Risk ervice Re-inspection Level a 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 HA CC er Inspector / Out: / ! i L Each violation checked requires an explanatio 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 590.00 r) ❑ a � i %lit - Action as determined by the Board of Health. Allergen Awareness 590.0 ( ) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands t ❑ 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 �1►l` 7 FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Po ��i ly Hazardous Foods ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures �'- ❑5.Receiving/Condition ❑ 17.Reheating C104011-�1 J ❑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 PO ATION( 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 Lb 1a;3r Le Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations n�7 Critical(C)violations marked must be corrected immediately. (blue&red items) '�tb(0 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 Complian E 1oyee 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 t F is scored automatically o la hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. . f critical refrigwateeration. 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: Inspector's Signature Print: 6 31.Dumpster screened from public view ) 1 ,,� e '��Z� P'✓ Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N u �l #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signatur 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-Chazge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 590.004(F)Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45°F EMPLOYEE HEALTH,_, 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F * 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 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* Food Contact with Equipment and Utensils* 7.202.12 Conditions of Use* 590.00411) 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 RestrictionsRe, 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 strictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a 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. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* "Concentration and Hardness* 3-401.I lA(l)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods'That.are Raw,Undercooked.or 5-101.11 Drinking Water from an Approved System* of Equipment* Not Otherwise-Processed to Eliminate 590.006(A) Bottled Drinking-Water* - - 3 401:11(A)(2) Commimved Fish,.Mrats*game Pathogens* Ery ai-1/1nom 4-602.11 Cleaning Frequency-of Utensils and Food Animals-155°F 15-sec* 590-006(B) Water Meets Standards in 310-CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for:Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130'F 121 min Eggs* 4-702.11 Frequency of.Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan .Contact-Surfaces-of-Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or. 590.009(A)-(D) Yaolations.of-Section-590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* Proper,Adequate Handwashing ing' Por mobile food,temporary and residential 10 � Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under RegulatoryAuthorily 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 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* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eatin Drinldn or Usin Tobacco* * Requirements. 5 Receiving/Condition g g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial) Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne 12 Prevention of Contamination from Hands 3-403.11 Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated* �) g 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. 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* 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 IKE,, TOWN OF BARNSTABLE. HEALTH INSPECTOR'S Establishment Name: Date: Page: of p.. ti. OFFICE HOURS ' ^ PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. jr MONHYANNIS, MA 02601 -FRI. 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY �„ +as4• .0 8-8 'FDM FOOD ESTABLISHMENT INSPECTION REPORT Name Dat e o -Typeof Inspection O era ions utine ^� s Address Risk Service on Level a ai Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation fw 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) ❑ 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 c, ❑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 zxkVV ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) VA ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑.10.Proper Adequate Handwashing CONSUMER ADVISORY `�/) ( I. pQ �[ J01 - . - , ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories (((jjJJJIJ{v1 f J o J t Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue 8+red items k 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 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 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: 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 C s Signatur Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N �! r 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) +Des.-, signment of Responsibility* 8 Cross-contominatlon 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) nstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods! 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41*F/45°F 590.004(F) EMPLOYEE HEALTH., 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 7- Common Name-Working Containers 7-202.11 01.11 Separation-Storage* 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions*590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or g 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 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 Wazewashing-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 Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 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 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System * g8 Not Otherwise Processed to Eliminate Equipment 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eb­"°°1ui2001 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.l l(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 or590.009(A)-(D) 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources 10 Proper,Adequate Handwashing g' P � Game and Wild Mushrooms Approved B 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority y 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 HOIdIng 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 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) * 12 Prevention of Contamination from Hands 3-403.11 Remaining Unsliced Portions of Beef Roasts* Critical and non-critical violations,kfac or which do not relate to the foodbome 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* 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 I 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 1 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 1 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 1 130. 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. oFt roi TOWN OF BARNSTABLE HEATH INSPECTOR,s Establishment Name: Date: � A 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 v MASS. HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY 508-862-4644 M FOOD ESTABLISHMENT INSPECTION REPORT c Name Dat f �e of T ns ec io Uy IN O e outine Address Risk o ery ion Level i revious Inspection dgZ Ile 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 La Cd-1646 In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. T Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ v 'Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.0C(F Action as determined by the Board of Health. Allergen Awareness 590.0 + 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 71 ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Food❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures bj ❑ 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(H ❑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 i•' 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 tod ,the items ® go ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. B=One critical violation and less than 4non-critical violations re g 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. 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 ti 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: Inspec tor's Signature Print: 31.Dumpster screened from public view /J �I� L.. / `�✓1 d/�1` Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered #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 IN Dumpster Screen? Y N Zi0 , , 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.) F60D 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) jDerronstrationof 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 Require Reporting b 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* q � g Y7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* p g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* 590.003(G) Reporting by Person in Charge* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( � Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 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 Pe 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* 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 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils an Eggs d Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* of aic 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 rf ces Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155'F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 8 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources 10 Proper,Adequate Handwashing g' p raTY 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 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 * 12 Prevention of Contamination from Hands 3-403.11(E) 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 * 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 TagsiRecords: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. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 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. L oF. r TOWN OF BARNSTABLE . HEALTH INSPECTOR•s Establishment Name: Date: Page: of v�4 -OFFICE HOURS c, PUBLIC HEALTH DIVISION 8:00-9:30 A.M. - BARNSTARLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified "'"­ HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY. �A .639. m� 508-862-4644 - . FOOD ESTABLISHMENT INSPECTION REPORT Name Dat Tvne of Type of Inspection Ro Address Ri a-ins "n �, �L Level S nspectton Telephone ,� ntial Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint ? Person in Charge(PIC) Time Bed&Breakfast HACCP J' In: Other y 7- Inspector Out: V Waj Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. IL Old 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 l ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities V EMPLOYEE HEALTH PROTECTION FROM CHEMICALS C AA '^ ❑ 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 '1 ❑ PP ❑ 9 P ❑ 5.Receiving/Condition ❑ 17.Reheating F­] 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 Ato ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) A A. ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for SP s ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of ConsumerAdvisories ," Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Co ctive c ' n Re uired: 4 s Y Non-critical(N)violations must be corrected Immediately or Overall Rating N too within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Sus nsion C N Official Order for Correction:Based on an inspection today,the items Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ ❑.Emergency Closure Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a,Board of Health member or its agent A=Zero critical violations and no more than'3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 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 Orion-critical violations g )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,.4 to 6,non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations.and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to.al Violations G. non-critical violations. If 1 critical refrigeration. violation,4 to 8rion-critic 29.Special Requirements (590.009) within 10 days of receipt of this order. = 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' 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 Into entions z Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) •- FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) . Assignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives*. - Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45°F 590.004(F) • EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 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* 590.003(G) Reporting by Person in Charge* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 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 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* 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. 18 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from.an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 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- Ratites-165°F 15 sec* Sources* - ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145'F*' kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other es should 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 Tb * 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 ( ) 1 illness interventions and risk factors listed above,can be found in the 8 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 3402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004 Labeling of Ingredients* Supplied with Soap and hand Drying Devices (J) 9 9 _ __ 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* 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. OpIHE rpm TOWN OF BARNSTABLE HEATH INSPECTOR'S Establishment Name: Date: Page: of q OFFICE HOURS PUBLIC HEALTH AR ABLE. 200 MAIN STREET : 0 SION 33 - :30A.M. 4 Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified HYANNIS, MA 02601 Sag asz asaa No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPFECTION REPORT Name " Dat l e o Tvoe of Inspection ` Ro Address Risk Re e _ Re insIf 0 pectio Level l nspection Telephone dential Kitchen Date? Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness C Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Z Each violation checked requires an explanation on the narrative page(s)and a citation of specific provisions)violated. Violations Related to Foodb"orne 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 Asa Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance. ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a.Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4ron-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 C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8ron-critical violations. If 1 critical refrigeration. 29.Special Requirements , (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view (. Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N J #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signa Print: r / 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 InteirvVtions 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 1' 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 of 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* 7-102.11 Common Name-Working 590.003(C) Responsibility of the Person-in-Charge to Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 Require Reporting by Food Employees and Contamination from the Environment g Containers* 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P20 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 llo Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 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 Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition ofAduIterated 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 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-202.13 Shell Eggs* 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 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and 8g Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef crrve 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 3-40 1.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS e 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* in mobile food,temporary and residential Sources g, P aTY 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 3-401.11 2-301.14 When to Wash* 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 Critical and non-critical violations,which do not relate to the.foodbome 12 Prevention of Contamination from Hands 3-403.11 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* 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) 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 5-20411 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 1.009 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. i Op IKE Tom TOWN OF BARNSTABLE. _ HEALTH INSPECTOR'S Establishment Name: Dater h Page:�_of qo OFFICE HOURS PUBLIC HEALTH DIVISION 8:00,9:30A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. g. HYANNIS,MA 02601 _ MON.-FRI. No Reference R-Red Item PLEASE PRINT.CLEARLY �p .639•ewe 508-862-4644 'FOM FOOD ESTABLISHMENT INSP CTION REPORT Name Datep4 Tyne of Tyne of Inspection p Routine L Address Risk inspection Leve etail revious ction 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 r ` Inspector Out: Ld- 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) ❑ ArD Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ r L FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands 1.PIC Assigned/Knowledgeable/Duties ❑ g g ❑ 13.Handwash Facilities LA EMPLOYEE HEALTH PROTECTION FROM CHEMICALS AA', ❑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) JN ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ' i ❑ 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 �6 PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control l ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) n hi .� ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP � f7 11 ❑ 1� � 10.Proper Adequate Handwashing CONSUMER ADVISORY _ / ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) ❑ Corrective Action Required: ❑ No Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. .23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (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 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation,4 to 8npn-critical violations C. 29.Special Requirements (590.009) within 10 days of receipt of this order. = 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 Si ture Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y. N Dumpster Screen o 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* S 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* 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* 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* P20 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* 3-50 1.19 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 P on in Charge* Contamination from the Consumer 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q ers 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* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( P 4-501.111- Manual Wazewashin Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* t 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. 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° Not Otherwise Processed to Eliminate F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved.System* * gg Equipment 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* effe cfive tnnoor 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 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stu Ratites-165°F Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- � Sources* 1 p Proper,Adequate Handwashing 15 sec* ing,mobile food,temporary and residential Game and Mid 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 Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 23-30) 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items non-critical 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* Lu 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* 3 * 5-204.11 Location and Placement* -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. 1 Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.00g 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. F„,r r TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: Date: Page: ::�L Of ' cPUBLIC - - OFFICE HOURS - LTH BARNSTABLE., PUB2 0 MAN STREEETSION 3:30-4:30 P.M. 3:MON.-0 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 16l HYANNIS,MA 02601 08-8 -FPo. No Reference R-Red Item PLEASE PRINT CLEARLY �A .a39•p�0 508-862-4644 'EON1�` FOOD ESTABLISHMENT INSPECTION REPORT Dat-0 T e of Type of Inspection + Name y �� Routine Z Address Risk Ital - spectonLevel r n Telephone ential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP %1 , In: Other _ r� Inspector Out: J( �. Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. IL 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 r ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS G✓ `✓ cj ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives y ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) 17^❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures W ❑ 5.Receiving/Condition ❑ 17.Reheating, ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling _ L ❑ 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 I ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories LOrS .t+. �, •Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations ( 1 Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee R triction/ xclusion ❑ Re-inspection Scheduled ❑ ergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo C] 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 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 anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8npn-critical violations=C. 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 ItSeats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: j 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* 6 Cross-contamination L14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Chazge 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 * g 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 7-203.11 Toxic Containers-Prohibitions* ( ) 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* 4-501-1 l l Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* 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 5-101.11 Drinking Water from an Approved System* -4601.11(A) Clean Eggs 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* Eg°rive 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.00603) 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 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* Proper,Adequate Handwashing 10 Ratites-165°F 15 sec* ing' Po mobile food,tern and residential �S' 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 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition � g, 8 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* * (Blue Items 23-30) 3-202.15 Package Integrity* g g 3 403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbome * 12 Prevention of Contamination from Hands 3-403.11(E) 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* 16 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 13 Handwashin Facilities 3-501.14 g 3-202.18 Shellstock Identification* g (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.I I 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 590.004(J) Labeling of Ingredlen Supplied with Soap and hand Drying Devices Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 ts* 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 .008 HACCP Plans 6-301.12 Hand�'in Provision 29. Special Requirements 1 .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. FtHE Tp TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: Date: 4 Page:.� of p OFFICE HOURS _ BARNSTABLE. ' PUBLIC 2 0 MAN STREET 3 SION : 0- :3A.M. :30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date verified MASS. g, MON.-FRI. HYANNIS, MA 02601 e08-862-4644 No Reference R-Red Itern PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSP CTION REPORT Name y Da t fl _TYpe of Toutinef l s ectio L er V �•L--�V Address % Risk Ice e-inspection Level al Previous Inspection s Telephone idential Kitchen Date: i^ ` Mobile Pre-operation !✓ Owner HACCP YIN Temporary Suspect Illness n l Caterer General Complaint Person in Charge(PIC) Time. Bed 8 Breakfast Other HACCP In Inspector Out: +J t 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) ❑ i L FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS Z c ❑ 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 ❑ 11.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling r ; ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding v 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 _ 5 Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes 1 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 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 suspensi reon or revocation of the food B=One critical violation and less than 4non-critical violations g if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste. (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous orToxic Materials (FC-7)(590.008) be in writing and submitted to the'Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspectors Signature Print: 31.Dumpster screened from public view CA 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 Law Cooled to 41°F/45°F Within 4 Hours* 14 Food or Color Additives 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge* Cross-contamination 3-302.11(A)(1) Raw Animal Foods Separated from 3-202:12 Additives* Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11 A 2 Raw Animal Foods Separated from Each * 590.004(F) ( )O P 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 b Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* q P g Y7-201.11 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* 3-304.11 Food Contact with Equipment and Utensils Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* ( ) ance 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)Resumed 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 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* 4-501.1- Manual Wazewashing-Hot Water 7-206.11 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization wa ing-es* Raw Seed Sprouts Not Served Y p 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY * 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* Eg°&° 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* 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 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* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Ratites-165°F 15 sec* Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. * 2-301.14 When to Wash* 3-0Ol.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* 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 * (Blue Items 23-30) 3-201.11 Package Integrity ( ) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11 E 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* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-20118 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 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 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. HEALTH INSPECTOR'S Establishment Name: yGm t n' C4rf mq& Date: r7I �d�'� Page:_- oF��r TOWN OF BARNSTABLE ��+•' 9 of OFFICE-HOURS PUBLIC HEALTH DIVISION : 0- :30 . . 3:3o-4:3o P.M.SARNsrE 20 MAN STET Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified A 5 t63:n�0� HYANNIS,MA 02601 MON.-FRI. No Reference08-8624644 _R-Red Item PLEASE PRINT CLEARLY 'E°""�` FOOD ESTABLISHMENT INSPECTION REPORT Name G�rn Cgr(i e ��4- Dateb/1S�I Type of of Ins ec ion ac Operation(s) outin �4 �1 r l0 Address 'g � r �� Risk Food Service pection �.,1 ��} �� Level a ail Previous Inspection �lA V Telephone Residential Kitchen Date: O �►I _^� Mobile Pre-operation r���+� r 0t1, I Owner HACCP Y/N Temporary Suspect Illness * S Caterer General Complaint ` Person in Charge(PIC) Time Bed&Breakfast HACCP w oymow1d In: Ir30 Other 4��D Inspector R5411 �0(�IS Out: A* s ; l walk ; ffIrig 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) ❑ rwi 1 1✓ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ -�3 a rO�lY13 C�ltap� I 1YkK Action as determined by the Board of Health. / Allergen Awareness 590.009(G) ❑ _Ya sfo� -- a 7D PROTECTION MANAGEMENT [VJ 2.Prevention of Contamination from Hands v I o PIC Assigned/Knowledgeable/Duties 13.Handwash Facilities n // C FE PLOYEE HEALTH PPrTECTION FROM CHEMICALS .�+b FYI IIC - 2.Reporting of Diseases by Food Employees and PIC .�14.Approved Food or Color Additives G .Personnel with Infectious Restricted/Excluded LL��II((15. Toxic Chemicals r O _T L ��ri F OD FROM APPROVED SOURCE TI E/TEMPERATURE CONTROLS(Potentially Hazardous Foods) y► �/I,4.Food and Water from Approved Source 716.Cooking Temperatures 'v 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 120.Time As a Public Health Control r T 8.Separation/Segregation/Protection UIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 9.Food Contact Surfaces Cleaning and Sanitizing 721 Food and Food Preparation for H P �[UrvewtA ,L i ` n /� sh W10.Proper Adequate Handwashing NSUMER ADVISORY I 1r► VI L' 11.Good Hygienic Practices 22.Posting of Consumer Advisories V �G 11 •✓1I&JA0 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations I n Critical(C)violations marked must be corrected immediately. (blue&red items) /n ( �-1( Corrective Action Required: FED No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating v( within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal 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 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 n-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 C=2 critical violations ,17 to 8 than non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed, I to8non-critical itical violations=C.violations. If 1 critical refrigeration. violation,4 to 8.non-cr 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector s Signature Print: Gn �f✓r�S 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 Si gnat Prinn Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N V1oblS �1 Violations related to Foodborne Illness I 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 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45'F 15 Poisonous or Toxic Substances 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* 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 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 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) 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 I 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* 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* 3-401.11 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 Equipment 5-1.01.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meals&Game Pathogens* eff-"°e 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* 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* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009 A D Violations of Section 590.009 A Chemical ( )-( ) O-(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 11 Good Hygienic Practices practices should be debited under#29-Special 3-201.17 Game Animals* 17 Reheating for Hot Holding 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 * 3-301.12 PreventingContamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity g 3-403.11(C) Commercially Processed RTE Food-140°F 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41'F/45'F Item Good Retail Practices FC 590.000 TagsiRecords: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. 1 Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* _ 8-103.12 Conformance with Approved Procedures* I 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 1ME Tp� TOWN OF BARNSTABLE HEALTH.INSPECTOR`3 Establishment Name: C9-eintA n. ( 0 , ��e�� M41 ate: o l Page:�_Of _ OFFICE HOURS f " C HEALTH ' A0. Eon PUBS 0 MAN STREEETSION 3:30-:304:30 P.M.:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MON.-FRI. NO Reference R-Red Item PLEASE PRINT CLEARLY :639-p0� HYANNIS, MA02601 sos-asz-asaa 'E0A . FOOD ESTABLISHMENT INSPECTION REPORT '0 v v�, o u u Name I Date Tyne of Tyoe of Inspection _ / I 2✓VI,n G : 4 A�/ J O s Routine a (emu U Address Risk t o Servic Re-inspection Level I Reta' Previou Ins ection Residential Kitchen Date: L�. Telephone d Mobile Pre-op rati n _ rY HACCP Y/N Temporary Suspect Illness Owner Caterer General Complaint J Person in Charge(PIC) Time Bed&Breakfast HACCPrJ In: Other Inspector vI Out: AcrAn� 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) ❑ ` n d Q Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ I gr tan 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 o d In / ❑ 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 l ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY �/X\ ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations �� I Critical(C)violations marked must be corrected immediately. (blue 8,red items) ` g Corrective Action Required: D40 Yes V" I ❑ 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. ❑ 9 ❑ 9 Y ❑ rY P ❑ 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 n-critical violations 9 if no critical violations observed,4 too 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 rion-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28:Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 -cr i al violations= 30.Other DATE OF RE-INSPECTION: Inspector's ignature Pr' 31.Dumpster screened from public view 01 J I t (' Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N (((/// W #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's SI ature PrintA 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* 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* Cooked and RTE Foods.* 37302.1419 PHF Hot and Cold Holding 2-103.11 Person-in Charge Duties 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* 590.003(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* 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 * ( ) 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*590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Re or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP ted 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 Warewashin 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 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products 4-501.112 Mechanical Warewashing-Hot Water Monitoring 3-202.13 Shell Eggs* 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 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils an Eggs d Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef dive 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 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* (A Stuffing Containing Fish,Meat,Poultry or 590.009 D Violations Sion 590.009 cater- Sources* )-( ) ations oect (A)�(D). m ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Ratites-165°F 15 sec*3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3AD3.1 I(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF s Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3 403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 * (Blue Items 23-30) 3-202.15 Package Integrity (C) Commercially Processed RTE Food-140°F 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140'17 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 PBFs 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 Labeling of Ingredients* Supplied with Soap.and hand Drying Devices (n g 9 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 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. °F IKE r TOWN OF BARNSTABLE _ HEALTH INSPECTORS Establishment Name: lo em,'n, CA rr �J�M- 00i r�Date: 2 7 4 Page: ( of OFFICE HOURS AR E PUBLIC 0 MA N STREET DETSION 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 �p ,63.e�0� HYANNIS,MA 02601 M-8 -FRI.62-4644 No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT RFD MPS 508-8 Name * Date , Tvoe offA section `'C O S Routine Address Risk i pection Level Re Previous ns ection D Telephone sidential Kitchen Date:'3�at/9(b l Mobile Pre-operati6n 'p, Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP a, In: Other Inspector ✓.: 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 Eye) 4- 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 � LD) ' [311.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories n 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 lash`� Corrective Action Required: o El Yes Non-critical(N)violations must be corrected immediately or Overall Rating 1 within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal 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. ) cited in this 25.Equipment and Utensils (FC-4)(590.005 6=One critical violation and less than 4non-critical violations 9 report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to anon-cri 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address non-critical violations. If 1 critical refrigeration. ~� violation,4 ION non-critical violations C. 29.Special Requirements (590.009) within 10 days of receipt of this order. = 30.Other DATE OF RE-INSPECTION: Insp ctor's ' ure t: 31.Dumpster screened from public view pne Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N ` #Seats Observed Frozen Dessert Machines: Outside Dining Y N P C' Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N q V A- 1 y`. Dumpster Screen? Y N Violations related to Foodborne-lllness - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 1q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below.41°F/45°F 590.004(F) *- - EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* * _ - Applicants 3-302.11(A)- 7-201.11 Separation-Storage*Food Protection* 20 Time as a Public Health Control Employee 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control 590.003(F) Responsibilityof A Food Em to ee or An Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 1590.004(11) Variance Requirements * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* 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 Rrated or 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 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 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* 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* eff°"°e 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 3-40L11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* aces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* 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. * 2-301.14 When to Wash* 3 401.11 A 1 b All Other PHFs-145°F IS sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 * (Blue Items 23-30) 3-202.15 Package Integrity (C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbome 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* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 13 Handwashing Facilities A 3-202.18 Shellstock Identification* 3-501.14(.) Cooling Cooked PHFs from 140°F to 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/4545°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 Supplied with Soap and hand Drying Devices Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(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 FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision ' 29. Special Requirements .009 3-502.11 1 Specialized Processing Methods* 130. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590F9rmback6-2doc '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.' °FISE,°,r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name:�f'{�^�.�� �G�r.aet-101 Date: 3 (Za Page: Of'Z_ q OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified mass. $ MON.-FRI. No Reference R Red Item PLEASE PRINT CLEARLY HYANNIS,MA 02601 508-862-4644 rFO MPS FOOD ESTABLISHMENT INSPECTION REPORT N� r , �� eon Name Date Z Impe of sec 'on pRV_ Routine r V C,i-e N Address Risk ood'Service nspection � it r A'h" Level Retail Previous Inspection Telephone I ential Kitchen Date: _ Mobile Pre-operation A Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Uon✓ �- 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 Heatth Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 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 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 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 vio 4 to on-Critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Insp ctor's Sig toe Pri t: 31.Dumpster screened from public view I/V, Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N P ' 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 I 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.* *--- 19 FHF Hot.and Cold Holding 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information.Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person-in-Charge to Other* 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 7-201.11 Se 3-501.16(A) Roasts Held At or Above 130°F* 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-SOL19 Time as a Public Health Control* - .3-302.15 Washing Fruits and Vegetables * Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003 D Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* _, ( ) 3-306.14(A)(B)Returned Food and Reservice of Food* REQUIREMENTS FOR 590.003(E) I Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-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 Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* I Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 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 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils an Eggs d Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* EN cli-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 3-0Ol.l1(A)(3) Poultry,Wild Game,Stuffed at,P SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009 A Chemical O-(D)in cater- Ratites-165°F 15 sec* Sources* 70 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 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 * (Blue Items 23.30) 3-202.15 Package Integrity (C) Commercially Processed RTE Food-140°F 2 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the.foodborne 1 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item I 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 3-002.11 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 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. 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. 06/04/2098 :34�13: 71858531141 x 5 <` "� v,SiK irn: rF+uic c i ui Siegmund Strauss, Inc. 110 East 149P Street Bronx, SPY 10451 (718)292-4520 May 30, 2008 Mr. Aubrey Foster Gemini Caribbean Mart 10 Center Street Hyannis,MA 02601 Dear Aubrey: Thank you for your recent inquiry regarding Siegmund Strauss,Inc.'s HACCP Plan As one of our customers, you can feel safe when you.purchase Herring and mackerel'products from us. Siegmund Strauss,Inc. is operating under and in compliance with the U.S.Food and Drug Administration's HACCP rules ind tegulations for herring and mackerel. Siegmund Strauss,Inc.has a current HACCP Plan in place to$sure the safety and quality of all the herring and mackerel products we handle. Also,all of our herring and mackerel vendor have HACCP Plans in place and are on the-List of Canadian Establishments Approved for.Export". Please noe;it's your responsibility to make sure that these products are maintained at or below 38 degrees once you have taken possession of them. Siegmund Strauss, InCis not responsible for these products once they have left our facility. If you bdve any questions, please call me at(718)292-4520. Sin Manuel. D.Rodriguez HACCP Mairager 9 D /O /S - - ---------------- THE LOG J Caribbean Mart` Tynan said. reopens after fight Police arrested Harakh and 1 cleanup charged her with assault and ' battery with a dangerous HYANNIS—Gemini Carib- weapon,he said.Harakh was bean Mart reopened Sunday taken to the hospital after she following•a bloody fight was struck by the bottle she ,A between an employee and had thrown. a customer the day earlier, The store was closed Satur- according to Barnstable police day because there was blood s Sgt Kevin Tynan. "all over the floor,"Tynan said, which the Board of Health had Barnstable police responded i to a report about a fight at ordered cleaned up. the Center Street store at 5:24 Tynan said the 30-year-old C P.m.Saturday,Tynan said.The employee,whom he did not customer,identified as 30-year- name,will be summonsed to old Jahsha Harakh,allegedly court on charges of assault 'e s e threw a glass bottle at one of and battery with a dangerous � the store's.employees,who weapon. try in turn threw the bottle back,, —Tanner Stening 'I AV. _. a, 4 00 O U Wadlington, Ellen From: Miorandi, Donna Sent: Wednesday, April 04, 2007 9:51 AM To: Heath DeptMailbox Subject: Gemini Caribbean Mart Just an inportant FYI that whoever does any further pre-op and final inspections for the new.Gemini Caribbean Mart located at 18 Center Street, 'Hyannis needs to cap all the basement plumbing per Ed Jenkins, plumbing inspector. There are many open drains in basement that were connected to sinks for the previous hair salon and they are not capped. The odors are currently emanating into the building due to this problem. Any further questions please see me or Ed Jenkins. Thanks!! Donna At I TOWN OF BARNSTABLE LOCATION 6_ _ 17eP 57 SEWAGE# VILLAGE ASSESSOR'S MAP& LOT` eY"�+5 INSTALLER'S NAME&PHONE NO.'"AI t I/ /AE'Am b eI'' SEPTIC TANK CAPACITY f LEACHING FACILITY: (type)1WN —6dW '(size) � tL 75;Q�y�� NO.OF BEDROOMS BUILDER OR OWNER -, 2�„/u,oa�l �+L��.L I PERMITDATE: II`��S COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility. (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet lleaphing facil;40JAf- ) c--- AM7 Feet Furnished by a i Products MEATS: Oxtail, Goat, Fresh Fish, Cod Fish, Corned Pork Beef, Mackerel, Pig Tail, Goat Head, Cow Cod, Cow Skin, Tripe, Chicken Feet, FRUITS: Mango, Giunepp, Pineapple, Papaya, Coconut, June Plum, Sugar Cane PROVISIONS: Breadfruit, Yam, Cocoa, Green Banana, Plantain, Dashene, Sweet Potato, Cassava VEGETABLES: Okra, Chocho, Turnip, Carrot, Calaloo, Bok Choy, Pumpkin, Egg Plant HERBAL ITEMS: S&S Tonic, Assorted Teas, Tiger Bone Tonic, Ginseng, Rose Water, ' Almond Essence, Vanilla HEALTH ITEMS: Buckley's Cough Syrup, Liqui-Fruta vitamin, Scott's Emulsion, Cod Liver Castor Oil BEVERAGES: Fruit Syrup, Drinks Mixes, Supplegen, Nutrament, Sorrel, Noni, Irish Moss, Carrot, Coconut Water, Ting, Cane Juice, Miscellaneous CANNED GOODS: Corned Beef, Sardine, Mackerel, Ackee, Calaloo, Milo, Condensed Milk, Breadfruit, Cheese, Coconut Milk, BAKED GOODS: Hard Dough Bread(wheat& white), Spice Bun, Bulls Cake, Fruit Cake, Sweet Potato Pudding, Totoe, Meat& Vegetable Patties SEASONINGS: Caramel Browning, Curry, Jerk, Scotch Bonnet Pepper, Thyme, Escallion, Cock Soup, Ginger, Nut Meg, Pimento DRY GOODS: Beans, Peas, Porridge Mix, Water Crackers, Shirley Biscuit, Tamarind, Bammie, Peppered Shrimp, Blue Mountain Coffee, Horlicks, Chocolate(Tea) Gemini Carribean Mart Prime Fire & Ventilation, Inc 18 Center Street 79 Brook Street Hyannis, MA 02.601 New Bedford, MA 02746 508-999-2277 Exhaust Fan . I I MUA Fan I All duct wrapped wfth l zero clearance fire - I I Wrap I I I ! Exhaust Duct I I Mu Duet I I I I I I I 2W a ----_------- --1N=a Ansul R-102 1F 1F 9 230 245 _ o • • • • Pull p � Station � gas valve 6 Burner Ranae Frver 4 Burner R-WT Urw Exhaust Fan -- 10, ---� M.0 A.Fan Sriingie Roof I I Zero Clearance Fire Wrap Over [ Duct Work l I [ T—Drop Calling-- Grease wall Is 1 Sk"layer of sheet `!;,. F` Filters roc,: 1 layer of metal studding: r I than another layer of 518" Preferated sheet rock Supply Plenum (P s.p) Stainless Steel wed panel { STAINLESS STEEL SQUARE CORNER SCULLERY BUDGET SINKS ADVANCE TABCO• "400"Series "600"Series SMART FABRICATION" .t -o ® Item #: Qty #: ` Model #: a Project #: 1 , a 0 ❑ ONE COMPARTMENT S'j/UK 0O -� THREE COMPARTMENT ❑ ❑ O TWO COMPARTMENT MATERIAL: FOUR COMPARTMENT "400"Series is 16 gauge type 430 Series. "600"Series is 16 gauge type 304 Series. Galvanized tubular legs. 1"adjustable plastic bullet feet. DETACHABLE DRAINBOARDS CONSTRUCTION: • •All heli-arc welded. N-5-818 Welded areas blended to match adjacent surfaces , N-5-18 and to a satin finish. N-5-24 MECHANICAL: N-5-30 Supply is 112"hot&cold. ) N-5-36 Faucet holes on 8"O.C. N-5-48 Waste drains are 1 112"IPS basket type and are r N-54 24 included. N-54-36 Faucets are not included(see accessories). N-54-48 Four compartment units require two faucets. Drainboards 36"and 48"are supplied with legs for support. Three compartment units with 24"sink bowls require two faucets. Customer Service Available To Assist You 1-800-645-3166 8:30 am-8:00 pm E.S.T. ®® Email Orders To:customer@advancetabco.com.For Smart Fabrication-Quotes,Email To:smartfab@advancetabco.com or Fax To:631-586-2933 ADVANCE TABM NEW YORK GEORGIA TEXAS NEVADA SM FASPoC 0— www.advancetabco.com Fax:(631)242-6900 Fax: (770)775-5625 Fax: (972)932-4795 Fax:(775)972-1578 E-2 x � � Y' DIMENSIONS and SPECIFICATIONS TOL Overall: ± .500" Interior: ± .250" ALL DIMENSIONS ARE TYPICAL ONE COMPARTMENT �, 0 600 "Series Ship lB `. T 18" 18" 21 1/2" "1-18 6-81-18 451bs:, '+ 21" 18" 24112" 4-1-18 6-1-18 47lbs. A 21" 24" 24 1/2" 4-1-24 6-1-24 53 lbs. � /r 21" 36" 24 1/2" 4-1-36 6-1-36 66lbs. . 24" 24" 27 1/2" 4-41-24 6-41-24 53lbs. 24" 36" 27 1/2"1 4-41-36 6-41-36 691bs. B TWO COMPARTMENTS • 00 .0 0 'Series Ship �+ Ga.S/S"300" Weight 21" 36" 24 1/2" 18" 4-2-36 •6-2-36 73 lbs. IC A 21" 48" 24 1/2" 24" 4-2-48 6-2-48 86 1 bs. 1 1 00 lbs. 24" 48" 27 1/2" 24" 4-42-48 642-48 88lbs. 24" 60" 27 1/2" 30" 4-42-60 6-42-60 108lbs. THREE COMPARTMENTS B 00 .00Series D - -I ' 21" 36" 24 1/2" 12" 4-3-36 6-3-36 78lbs. 21" 48" 24 1/2" 16" 4-3-48 6-3-48 91lbs. C A 21" 54" 24 1/2" 18" 4-3-54 6-3-54 98lbs. 24" 60" 27 1/2" 20" 4-43-60 6-43-60 105lbs. 24" 72" 27 1/2"1 24" 4-43-72 6-43-72 120 lbs. D B FOUR COMPARTMENTS C 21" 48" 24 1/2" 12" 4-4-48 6-4-48 961bs. IA 21" 60" 24 1/2" 15" 4-"0 6-4-60 115lbs. ! I 21" 72" 24 1/2" 18" 4-4-72 6-4-72 11201bs. DETACHABLE DRAINBOARDS ,FRONTVIEW PLUMBING ROUGH-IN Ship Size 18 Ga.S/S " Weight { , 1 1/2" �I r 2" 18 x 18 N-5-818 10 lbs. 8„� 21 x 18 N-5-18 11 lbs. 411$ 21 x 24 N-5-24 12 lbs. T a a � 14 37 1/2„ 21 x 30 N-5-30 22 lbs. 12" 14" 21 x 36 N-5-36 25 lbs. 41" i 21 x 48 N-5-48 28 lbs. 24 x 24 N-54-24 18 lbs. 7 1/2" 24 x 36 N-54-36 32 lbs. 24 x 48 N-54-48 36 lbs. ADVANCE TABCO is constantly engaged in a program of ADVANCE TABCO. improving our products.Therefore,we reserve the right to P 9 —P4BR1CATbO w change specifications without prior notice. E-2a 200 Heartland Boulevard,Edgewood,NY 1 1 71 7-8380 ©ADVANCE TABCO,JANUARY 2005 r 4 Item# C.S.I.Section 11420 ti. R- ESTAURANT RANG ES ENDURANCE GAS RESTAURANT RANGE %mLun 6 OPEN BURNERS 36 WIDE GAS RANGE ❑ 36-S-6113-N 1 Standard Oven/Natural Gas ❑ 36-S-6113-113 1 Standard Oven/Propane 9'-36-6-6113-N 1 Convection Oven/Natural Gas ❑ 36-C-613-P 1 Convection Oven/Propane STANDARD FEATURES ■ Fully MIG welded frame --�" ■ Stainless steel front,sides,backriser,lift-off high shelf 6` ■ 6"stainless steel adjustable legs w ■ Six open top burners,each burner is 30,000 BTU/hr. 77with lift-off burner heads ■ Shrouded flash tube pilot system(one pilot per two burners) ■ Heavy duty cast grates,easy lift-off 12"x 12 1/2"in O front and 12"x 141/2"in the rear ■ Extra deep pull out crumb tray with welded corners ■ 35,000 BTU/hr.baker's depth standard oven cavity. Full size sheet pans fit side-to-side or front-to-back. ■ Oven thermostat adjusts from 250OF to 500OF Model 36-S-61113-N ■ Heavy duty cool touch oven door handle (shown with optional casters) ■ Two oven racks and four rack positions j oEsler ■ 35,000 BTU/hr.convection oven in place of standard oven NSF24"d x 26 3/8"w x 13 7/8"h(115v-1 phase blower motor 6'4 amp, cord and plug),includes three oven racks. Full CFgi1F��O® CERTIFIED ® size sheet pans only fit side-to-side in convection oven. ■ One year limited parts and labor warranty SPECIFICATIONS ACCESSORIES(Packaged&Sold Separately) ,( 36"wide gas restaurant range,Vulcan Model No. 36-S-6B-N. Fully MIG welded aluminized steel frame for added durability. ❑ Extra oven rack with rack guides Stainless steel front,sides,backriser,highshelf and6"adjustable ❑ Casters(set of four) legs. Extra deep crumb tray with welded comers. Six 30,000 BTU/hr. open top burners with lift-off burner heads. Energy ❑ Flanged feet(set of four) saving flashtube open burner ignition system(one pilot for every ❑ 10"stainless steel stub back two burners)shrouded for reliability.Heavy duty cast grates,easy ❑ Reinforced high shelf for mounting salamander broiler lift-off 12"x 12 1/2"in the front and 12"x 141/2"in the back to better accommodate stock pots or large pans. Grates have a built in aeration bowl for greater efficiency. Burner knobs are cool to the touch,high temperature material.One oven:35,000 BTU/hr. standard bakers depth ovens with porcelain oven bottom and door panel, measures 27"d x 26 3/8"w x 14"h. Oven thermostat adjusts from 250OF to 500OF with a low setting. Oven is supplied with two racks, two rack guide sets, and four rack positions. Oven door is heavy duty with an integrated door hinge/spring mechanism requiring no adjustment. 3/4" rear gas connection and pressure regulator. Total input 215,000 BTU/hr. Exterior Dimensions: 34 3/4"d x 36"w x 58"h on 6"adjustable legs vu n a division ofITWFood Equipment Group LLC P.O.Box 696 ■ Louisville,KY 40201 ■ Toll-free: 1-800-814-2028 ■ Local:502-778-2791 ■ Quote&Order Fax: 1-800-444-0602 F-38260(3/10) RESTAURANT RANGES ENDURANCE GAS RESTAURANT RANGE vmLun 6 OPEN BURNERS 36 WIDE GAS RANGE INSTALLATION INSTRUCTIONS 1. A pressure regulator sized for this unit is included. 5. Clearances Rear Sides Natural gas 5.0"W.C., propane gas 10.0"W.C. Combustible 6" 10" 2. Gas line connecting to range must be 3/4"or larger. Standard Oven Non-combustible 0" 0° If flexible connectors are used,the inside diameter Convection Oven Non-combustible Min.4° 0" must be 3/4"or larger. 6. For proper combustion, install equipment on adjustable 3. An adequate ventilation system is required for commercial legs or casters provided with unit. cooking equipment. Information may be obtained by 7. For proper combustion, install equipment on adjustable writing to the National Fire Protection Association, legs or casters provided with unit. 1 Batterymarch Park,Quincy, MA02269,www.NFPA.org. When writing, refer to NFPA No.96. NOTE:In line with its policy to continually improve its 4. These units are manufactured for installation in product,Vulcan reserves the right to change materials accordance with ANSZ223.1A(latest edition), National and specifications without notice. Fuel Gas Code. Copies may be obtained from The American Gas Association,400 N Capitol St. NW, Specify type of gas when ordering. Washington, DC 20001,www.AGA.org. Specify altitude when above 2,000 feet. 53 V2" of 1LY m CMVM11M HMS 36" 4612" I 35" 2 13n6" v v2" 1 21n6" 27 V4" CHD@1G AREA 58" 14" ® O 24" SM CAVITY WIG(T 3TioN 7" CAVITY��PTH 24 1/2" ' O N V4" 26 3ff SID CAVITY VT[TH 6"to 7 1/4" 27" UR4-1840 STD CAVITY am AdjustWe 31 1/4" I1/16" TOP MODEL TOTAL INPUT SHIPPING WEIGHT CONFIGURATION NUMBER DESCRIPTION BTU/HR LBS/KG 36-S-6B-N 1 Standard Oven/6 Burners/Natural Gas 215,000 520/236 36-S-6B-P 1 Standard Oven/6 Burners/Propane 215,000 520/236 r`36-C-6B-N 1 Convection Oven/6 Burners/Natural Gas. 215,000 . _ 580/.263^] t 36-C-613-13 1 Convection Oven/6 Burners/Propane 215,000 580/263 This appliance is manufactured for commercial use only and is not intended for home use. � n a division of n W Food Equipment Group LLC P.O.Box 696 ■ Louisville,KY 40201 ■ Toll-tree:1-800-814-2028 ■ Local:502-778-2791 ■ Quote&Order Fax:1-800-444-0602 NOTE.In line with its policy to continually improve its products,Vulcan reserves the right to change materials and specifications without notice. ` F-38260(3/10) �Pd„a on a�yaka Pp. STAINLESS STEEL WORK TABLES ADVANCE TABCOB SUPER SAVER Series - Flat Top - UNDERSHELF Style SMART FASRICATION- ~t Item #: Qty #: Model #: Project #: r - Featuring as Standard: FEATURES: NEW "TIM PROVEN" To is furnished with 1-5/8"sanitary rolled rim edges on front& Rolled Rim Edges on ORIGINAL ADVANCE TABCO P rY 9 Front&Back and back and square side edges. Square Side Edges Adjustable Undershelf To reinforce and maintain a level working surface,24"wide w tL Die Cast Leg Clamp tables are supplied with TWO hat channels and 30"and 36" MATERIAL: wide tables are supplied with THREE hat channels. Pre-engineered welded angle adapters insure ease of future SAG-SERIES: Stainless Steel Legs&UndersheH drawer installation. TOP: 16 gauge stainless steel type"430"series. Aluminum die cast"leg-to-shelf"clamp secures shelf to leg SHELF: 18 gauge stainless steel. eliminating unsightly nuts&bolts. Undershelf is adjustable. LEGS: 1 5/8"diameter tubular stainless steel. CONSTRUCTION: 1"adjustable stainless steel bullet feet. All TIG welded. Exposed weld areas polished to match Stainless steel gussets. adjacent surfaces. AG-SERIES: Galvanized Legs&Undershelf Entire top mechanically polished to a satin finish. TOP: 16 gauge stainless steel type"430"series. Top is sound deadened. SHELF: 18 gauge galvanized steel. Roll formed embossed galvanized hat channels are secured to LEGS: 1 5/8"diameter tubular galvanized steel. top by means of structural adhesive and weld studs.. 1"adjustable plastic bullet feet. Gussets welded to support hat sections. Galvanized steel gussets. SAG-Series: AG-Series: Stainless Steel Legs & Undershelf Galvanized Steel Legs & Undershelf Wide Wide Wide Wide Wide Wide 30" SAG-240 SAG-300 30" AG-240 AG-300 24" SAG-242 SAG-302 24" AG-242 AG-302 36" SAG-243 SAG-303 SAG-363 36" AG-243 AG-303 AG-363 4e,, ?7SAG244) c.SAG-304 SAG364 48" AG244 AG-304 AG-364 60" SAG245" SAG305 SAG-365 60" AG-245 AG-305 AG-365 72" SAG-246 SAG-306 SAG-366 72 AG-246 AG-306 AG-366 84" SAG-247 SAG-307 SAG-367 84" AG-247 AG-307 AG-367 96" SAG-248 SAG308 SAG-368 96" AG-248 AG308 AG-368 108" SAG-249 SAG-309 SAG-369 108" AG-249 AG-309 AG-369 120" SAG2410 SAG-3010 SAG-3610 120" AG-2410 AG-3010 AG-3610 132" SAG-2411 SAG-3011 SAG-3611 132" AG-2411 AG-3011 AG-3611 144" SAG-2412 SAG-3012 SAG-3612 144" AG-2412 AG-3012 AG-3612 Create.Your Own Efficient Workstation with the Available Standard Accessories (Visit Section K) Customer Service Available To Assist You 1-800-645-3166 8:30 am-8:00 pm E.S.T. ®� Email Orders To:customer@advancetabco.com.For Smart fabrication-Quotes,Email To:smartfab@advancetabco.com or Fax To:631-586-2933 ADVANCE TABM NEW YORK GEORGIA _ TEXAS NEVADA SMAFTT FABRICATON- www.advancetabco.com Fax:(631)242-6900 Fax: (770)775-5625 Fax: (972)932-4795 Fax:(775)972-1578 H-4 DIMENSIONS and SPECIFICATIONS ALL DIMENSIONS ARE TYPICAL TOL±.500" All Units Shipped Unassembled(KD)for Reduced Shipping Costs. SAG &AG Series UNDERSHELF Style FLAT TOP Finished size of undershelf=Length minus 5 3/4" Width minus 5 3/4" \Units 8 ft.and larger are furnished with six(6)legs Square Side Edges W Rolled Rim Edge Front&Rear 4" r 1 5/8' 4" Clearance= L-91/2" 35 1/2' TTr1 1//2' 1 T 110" SAG-Series: Stainless Steel Legs & Undershelf AG-Series: Galvanized Steel Legs& Undershelf Wide Wide Wide Wide Wide Wide 30" SAG-240 49lbs. SAG-300 65lbs. 30" AG-240 49lbs. AG-300 65lbs. 24" SAG-242 31 lbs. SAG-302 55lbs. 24" AG-242 31 lbs. AG-302 55lbs. 36" SAG-243 64lbs. SAG-303 72 lbs. SAG-363 88lbs. 36" AG-243 64lbs. AG-303 72 lbs. AG-363 88lbs. 48" SAG-244 79lbs. SAG-304 891bs. SAG-364 981bs. 48" AG-244 791bs. AG-304 891bs. AG-364 981bs. 60" SAG-245 92lbs. SAG-305 107lbs. SAG-365 118lbs. 60" AG-245 92lbs. AG-305 107lbs. AG-365 118lbs. 72" SAG-246 109lbs. SAG-306 125lbs. SAG-366 138lbs. 72" AG-246 109lbs. AG-306 125lbs. AG-366 138lbs. 84" SAG-247 130lbs. SAG-307 148lbs. SAG-367 164lbs. 84" AG-247 130lbs. AG-307 148lbs. AG-367 164lbs. 96" SAG-248 145lbs. SAG-308 166lbs. SAG-368 184lbs. 96" AG-248 145lbs. AG-308 166lbs. AG-368 184lbs. 108" SAG-249 161 lbs. SAG-309 176 lbs. SAG-369 190 lbs. 1 o8" AG-249 161 lbs. AG-309 176 lbs. AG-369 190 lbs. 12o" SAG-2410 261 lbs. SAG-3010 287 lbs. SAG-3610 308 lbs. 120" AG-2410 261 lbs. .AG-3010 287 lbs. AG-3610 308 lbs. 132" SAG-2411 293 lbs. SAG-3011 324 lbs. SAG-3611 358 lbs. 132" AG-2411 293 lbs. AG-3011 324 lbs. .AG-3611 358 lbs. 144" SAG-2412 308 lbs. SAG-3012 339lbs. SAG-3612 373lbs. 144" AG-2412 308 lbs. AG-3012 339lbs. AG-3612 373lbs. ADVANCE TABCO is constantly engaged in a program of ADVANCE TABCO® improving our products.Therefore,we reserve the right to SMART FABRICATION- change Specifications without prior notice. H-4a 200 Heartland Boulevard,Edgewood,NY 1 1 71 7-8380 0 ADVANCE TABCO,SEPTEMBER 2005 KitchenAid®: Built-in Ovens Page 1 of 3 PRODUCTS • • • Enter Keyword or Model# Home> Products>Built-in Ove-is 4A Cu:F_t: 1 True Conve U cti5h ppei &Lower ovens 1 Double Oven 1 30 in:Width >PRODUCT FEATURES >WARRANITY ),SUPPORT The ideal addid6h to any kikhen;this sleekly designed 4 Flrali A D LE. . double oven features our E-19yConVeet"4 conversion system:You simply enter your conventional e66king PRINT THIS PAGE time and temperature;and the oven makes the precise FOR IN-P ORE Vurr i conversion,offering you profesSl6nal;even results every time: OEIMIL TH IS MGE TO A FRIEND Available ihs Black I KE862D8kBL- ®_m..e- ■MSRP*i$2749:U0 PRODUCT FEATURES PERFORMANCE 6 The sel6cleaning system with soil level/time selec-tibn automatically cleans Your oven;and eliminates kFubbing and fumes: Plus;ah automatic door Oven UPPER C ]LOWER 4A Cubic lock"secures the door during the selkleah cycle: Capacity foot : The CleanBak#iM Hidden Element provides more evenly balanced heat Broil Element 1667 Waits distribution by warming both the bottom&the sides of the oven eivity; Rating resulting in better baking p@rformance: Because if is'hidden'from view by Corivetti6h the porcelain oven cavity;the bake element IS protected from spills& Element i;660 Watts drips that fall to the bottom of the oven: Rating 6 The True Convection cooking system with a Third Hidden Element Oven Bake (T.H.um)utilizes both a rear element and a rear fan t6 circulate Element 2006 Watts preheated air around the oven cavity for faster and more even E66king Rating results than e6hv@nt16nal cooking: UPPER OVEN FEATURES 6 Our Ei§Konvect Conversion System offers-you professiohal;even results every time.You simply enter your conventional e66king time and Forced temperature, p-"- "-;and the oven makes the pr@cis-e conversion: Convection 6 Maxi and econo thermal broiler settings feature two broiling elements so Convect Full that you can choose the right setting for your needs:The inner(econo) Meal element Gan be used for smaller--rtionS while the inner and outer Automatic � �.- ___�.._._ (maxi) feature iS used when broiling ah entire pan of food: 96th are adjustable Cooking temperatures: Temperature i The Sabbath mode feature makes it p6sSible to use the ran'e on the Probe � P --- - :- .- g-on and other religious holidays Without having to turn it on:Tones; LOWER OVEN FEATURES lights and error messages are over=rldden;and a set temperature can be maintained for extended periods of time: Hidden Cidderi eT;; 6 The temperature probe Ih our Thermal=COfiveeti6h"'oven makes it easy � Element to get perfect roasts every time:Simply set the internal oven or food Cleaning temperature;based oh your recipe or pr@ferehee;and insert the electronic System Variable Time S-66 ieariing temperature probe in the roast:The probe will signal the oven to turn off Convection automatically once the desired temperature IS reached: Bake&Roast ✓ 5@lecfiohs Maxi&Ec6n6 Thermal Broiler Settings CONSOLE FEATURES Auto/Manual Oven Light Switch http%/www:kitchena- d.corn%catalog%product:]sp?src=Built=in+Ovens&cat=124&prod=110 !l/1%2007 KitchenAid®: Built-in Ovens Page 2 of 3 Sabbath Mode ✓ Functions DESIGN Oven window V Oven Window Large Pofceiain Finish Oven& ✓ D66F Interior DIMENSIONS" Cutout Depth 23 1/4 in: Cutout Height 49 3/4 in: Cutout Width 28 /2 in: Depth 23 i/4 in: ELECTRICAL 40 Ampere,268/246 Volts;66 Hertz(i/second):AC=ONLY: USE COPPER WIRE ONLY:A FOUR=WIRE-OR THREE=WIRE; SINGLE PHASE ELECTRICAL SUPPLY REQUIRED:A TIME= DELAY FUSE OR CIRCUIT BREAKER AND SEPARATE CIRCUIT IS-RECOMMENDED: WARRANTY Return to top All kittheh.AidO major appliances come with outstanding warranties that back up the prm eium quality of our products: reg 79 Warranty For more information of complete warranty details on kitchenAido Major appliances;please call Customer Service at i=800=422=1230: SUPPORT Return to top Product Literature Service Plans Additional Resources Use&Care Guide Enjoy continued coverage after-your fnanufaeturers warranty ends: i Email Customer Service Call Customer Service at em Dimension Guide >Learn More i=800=422=1230 >Get a quote Installation Guide To view and print these documents,you will need Adobe®Acrobat®Reader& *Manufacturer's Suggested Retail Pric@: Dealer alone determines actual price: "Dimensions shown afe for pianning purposes only: For complete information;see Installation Instruction's packed with product, =j%P! Select Another Country Site I About KitchenAid I Contact Us I Press Room I Careers I Site Map I Privacy Policy I Terms of Use ®Registered trademark/TM Trademark/the shape of the mixer is a trademark of KitchenAid,U.S.A.©2007.All Rights Reserved, htt e;// ww:kitehenaid.com/catalo W -roduct.js ?src=Built=iri+Ovens&cat=124&pr-od=110 11%t%2007 r �r .� r r 1 V V azi S O Vp L, V 5/' ✓L � � ®Consuming raw or uncooked meat,poultry,seafood, shellfish or egg may increase the risk offoodbourne illness F•Consuming raw or uncooked meatpoultry,seafood, especially if you have certain medical condition. ITEM DESCRIPTION Item SMALL MEDIUM LARGE RED PEAS SOUP" Item JERK PORK MANISH WATER Item JERK CHICKEN COW COD SOUP Item CURRY GOAT SEAFOOD MIX CURRYCHICKEN B WEA X(FA S r FRYCHICKF.N BROWNSTEW CHICKEN Item OXTAIL ACKEE&CODFISH Item ESCOVISCH FISH CALLALOO &CODFISH Item STEW PEAS BOILED FOOD shelNsh or egg may increase the risk offoodbourne illness Item especially if you have certain medical condition. FRIED DUMPLINGS All meals are served with rice& peas/white rice, vegetable and fried plantain. �L GE91415V I I -d 4.! }� i;tV a arc fi' � V R Hours Monday- Saturdays 7 A.M. — io P.M. Sundays 8 A.M. — 9 P.M. — Specializing in Caribbean Foods. We accept Visa and Master cards. Checks are also accepted 14195 rt Gemini Cari66ean Stye De fi 18 B Center Street Hyannis MA 026ol �W e n u Phone (5o8) 790-0500 Fax(5o8) 79o-8400 E-Mail: geminicaribbean@verizon.net ilk E -W. - T(B (B DELI Hours Monday- Saturdays 7 A.M. — ii P.M. Sundays 8 A.M. — io P.M. " Specializing in Caribbean Foods. We accept Visa and Master cards. Checks are also accepted I } % +' e At Or, Gemini Cari66ean Styfe (Defi 18 B Center Street 394 Main Street Hyannis West Dennis MA 026o1 MA 02670 JVl e n u Phone (5o8) 790-0500 (508)394-1552 Fax(5o8)79o-8400 (508)394-1553 ..,�._ . .. .....�_... _�. - E-Mail: geminicaribbean@verizon.net L V5VCYf L;j ITEM DESCRIPTION Item SMALL MEDIUM LARGE GRACE TROPICAL RHYTHM $1.79 Item JERKPORK $6.20 $7.35 $8.10 D&G SODA $1.50 Item JERK CHICKEN. -,$6.20­ $7.35 $8.10 MISTIC DRINK $1.95 Item 3st r CURRYGOAT $7.35 $8.40 $9.45 BOTTLED WATER (5oo ml)' $0•95 CURRYCHICKEN . $6.20 $7.35 $8.io FRYCHICKEN $6.20 $7.35 $8.10 Bs PA 2II ES W $6:20 $735 $8.10 CHICKEN OXTAIL $8.40 $9.45 $10.30 Item BEEF $2.00 ESCOVISCH n/Q. $9.45 $si.6o FISH Item CHICKEN $2.00 Item VEGETABLE '` $2.00 Item 4. X.B. A!C meats afire served with rice-and peas COCOA BREAD $1.00 t , and/or white rice, and steamed v g ta6te. �.- I'LlwAl ® INTERCEPTORS . DRAINAGE TYPICAL OREASE INTERCEPTOR INSTALLATIONS 3 �c9ntQi��jv1Q�,� S� I ' AIR INTAKE 1 I VENT — I � I I ROW CONTROL TEE I Ii I I WD Series - WASTE AIR INTAKE OUTSIDE WAIL FLOW CONTROL t i TEE BOLT-ON EXTENSION VENT rev - � WD-E Series WASTEr AIR INTAKE I I VENT 1 1 I 1 v I 1 I I I i 1 1 i 1 i FLOW CONTROL TEE 1 I i 1 1 1 1 1 i I i I DRAW-OFF HOSE ACCESS COVER 1 I SHUTOFF VALUE WD-AH Series WASTE SWD-INTER-6 0310 w WD Series PDI Certified Grease DRAINAGE Tag: Interceptor -- SPECIFICATION: Watts Drainage Products WD Series PDI Certified recessed or floor mounted epoxy coated steel grease interceptor with gasketted solid steel cover, hex head center bolt(s), removable baffle assembly,deep seal trap with cleanout, no hub connections, and external cast iron flow control fitting. r EFow Rate.(5efect'-One) �, avid': pAa+ • 9002 Suffix BescnphoiE 4 4 GPM ❑' 7 7 GPM ❑ 10 10 GPM ❑ is 15 GPM 11 UPC 20 20 GPM ❑ MrMo 25 25 GPM ❑ 35 35 GPM ❑ 50 50 GPM ❑ a Oti437ffi'(. 0R,"OJ1e..Qt''tN1Q1'e)�, Secured — D x Ear SuAnc . flescEtFtfwrt_.� ��7 Non-slip B Cover Sediment Bucket ❑ Clean-out -E Extension ❑ Locking Plug -F Flange ❑ Device -FC Flange&Clamp Device ❑ Neoprene -O Inlet&Outlet other than ❑ Gasket C Standard Size Air Relief ❑ One-piece= _;• I By-per 55 Stainless Steel Removable T" - -- — -THD Threaded ❑ Baffle -�I ______.______�_____....__-_.__-- - No-hub EE q ( .s U t fe�tetfQ+�EeiStzes r Static 1 Inlet 8 F � Water Et � � 7R4 Outlet Level 8 j Integral -2 2'(51)Inlet/Outlet ❑` it Deep Seal -3 3'(76)Inlet/Outlet ❑ Baked Epoxy Trap -4 4'(102)Inlet/Outlet ❑ Coated Body Trap -6 6'(152)Inlet/Outletrix ❑ amen 3/8'(10) Note: 'Optional Threaded Inlet And Outlet Baffle Air Space -(includes Threaded Flow Control) ggg CrA Ir °F s y�Fs Catalog Rate '�x tntetxw,xicr WD-4 4 8 2-(51) 7-3/4-(197) 3-1/4"(83) 16-(406) 10-(254) 11-(279) WD-7 7 14 2-(51) 8-1/2-(216) 3-1/2-(89) 18'(457) 13-(330) 12-(305) WD-10 10 20 2-(51) 8-1/2-(216) 3-1/2"(89) 21-3/4-(552) 14-(356) 12'(305) WD-15 15 30 2-(51) 10-1/2-(267) 3-1/2-(89) 22-(559) 15-(381) 14-(356) WD-20 20 40 3-(76) 11-1/2-(292) 3-1/2-(89) 24-(610) 15-3/4-(400) 15-(381) WD-25 25 50 3-(76) 12"(305) 4-1/2-(114) 26-(660) 16-1/2-(419) 16-1/2-(419) WD-35 35 70 3-(76) 14-(356) 5"(127) 30"(762) 18-(457) 19"(483) WD-50 50 100 4-(102) 16"(406) 5-1/2-(140) 32-(813) 22-(559) 21-1/2-(546) Job Name Contractor Job Location Controctors P.O.No. Engineer Representative WATTS Drainage reserves the right to modify or change product design or construction without prior notice and without incurring any obligation to make similar changes and modifications to products previously or subsequently sold. See your WATTS Drainage representative for any clarification. Dimensions are subject to manufacturing tolerances. USA:100 Watts Road 5 indale NC 28160 TEL 828-288-2179 TOLL-FREE:1-800-338-2581 Website:w .wattsdrain DRAINAGE P a9a-corn Watts Drainage 2003 ES-WD-WD SERIES USA 0349 WD SERIES IOAI Fa LtCgWg&.D 64CIV ry VC4 IF/CA r let lvry4& CpEZ/ J 9&Z&6" 00&on/, 02> WUHam Frands Galvin sectary of the Commonwealth November 26,2007 TO WHOM IT MAY CONCERN: I hereby certify that according to the records of this office, GEAIINI CARIBBEAN STYLE DELI&LIQUOR,INC. is a domestic corporation organized on September 18,2007,under the General Laws of the Commonwealth of Massachusetts. I further certify that there are no proceedings presently pending under the Massachusetts General Laws Chapter 156D section 14.21 for said corporation's dissolution;that articles of dissolution have not been filed by said corporation;that, said corporation has filed all annual reports,and paid all fees with respect to such reports,and so far as appears of record said corporation has legal existence and is in good standing with this office. ` In testimony of which, I have hereunto affixed the Great Seal of the Commonwealth ' on the date first above written. o� w Secretary of the Commonwealth Processed By:TAA ca t: NUMBER oyW0�oF,y COMMONWEALTH OF MASSACHUSETTS BHP-2007-1044 Town of Dennis FEE Board Of Health $100.00 DATE ISSUED •`�GpAPDR4tf0* 1793. GEMINI CARIBBEAN STYLE DELI &LIQUOR, INC. January 15,2008 --------------- -------------------------- --------------- tJAME 394 MAIN STREET WEST DENNIS,MA 02670 ------------------------------------------------------------------------- ADDRESS IS HEREBY GRANTED A RETAIL FOOD SERVICE(OVER 1000 SQ. FT.)LICENSE RETAIL FOOD SERVICE(OVER 1000 SQ.FT.) This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires-------------December 31,2008----------------------------------------unless sooner suspended or revoked. ------ ---------------- Board Of ---- ------ Health ____ -- __ ------- ------------- ---------------------- --- --- - ___-------_ Health it or NUMBER o��oyWOF a, COMMONWEALTH OF MASSACHUSETTS BHP-2007-1045 a a Town of Dennis FEE Board Of Health $0.00 •`N�pavoagrFp* DATE ISSUED 1793. GEMINI CARIBBEAN STYLE DELI&LIQUOR,INC. January 15,2008 --- --------------------— NAME 394 MAIN STREET WEST DENNIS,MA 02670 -------------------------------------------------------------------------------------------------------------------------------------------------------- -------- ADDRESS IS HEREBY GRANTED A FOOD SERVICE(UNDER 50 SEATS)LICENSE Sery Safe Certified In accordance with Regulations promulgated under authority of Chapter 94,Section 305A and Chapter 111,Section 5 of the General Laws a Permit is hereby granted. This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires December 31,2008 unless sooner sus a ded or evoked. ------ � -------------------------- Board Of --------a------a- --4--------------- Health e -------------- Health Director NUMBER COMMONWEALTH OF MASSACHUSETTS BHP-2007-1046 a s Town of Dennis FEE ` Board Of Health $2.00 IiPORg DATE ISSUED • tFOt 1783. GEMINI CARIBBEAN STYLE DELI&LIQUOR,INC. January 15,2008 ---------------------------------- --------- — ---------------------- ---------------------------- NAME 394 MAIN STREET WEST DENNIS,MA 02670 ADDRESS IS HEREBY GRANTED A MILK& CREAM LICENSE MILK&CREAM This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires.............December 31,2008-------------unless sooner suspended or revoked. ------ ----- ----------------------------------------- ------------------------ Board Of Health = e -- ----- --------------- Health ire or 09390 sa T ,1 yaGHUgF Form CT 3A 2006-2008 C 5=4 Cigarette Excise Unit 'rToc�� Retailer's License for Sale of Cigarettes This license must be posted and visible at all times.Sales to persons under 18 years of age are prohibited by law. Federal Identification License number: Date of issue: r , Mailing address for license: Cigarette sale location(if different than mailing address): 3TiL DBE! ` E : et : ti ji) T y t"f=; y ? A } Tr r v required license fee and is licensed to retail cigarettes This certifies that the taxpayer named above has paid the at the ad- dress shown above until June 30,2008.This license is not transferable,and is subject to suspension for failure to comply with the law. fed on recycled paper 12M 2106 2006JBPRINTOFF150041 �prin Massachusetts Department of Revenue MT-1 4 ; Data Integration Bureau 100 Cambridge Street 6214196 Boston, MA 02204 CERTIFICATE NUMBER The vendor herein named is registered to sell meals and all beverages pursuant to the General Laws, 62C and 64H. This registration is effective only for the registrant at the location specified herein.Any change of mte or address renders this registration null and void. CARIt8-A`N STYLE JELI AN-D ?61-142 LIQUOR I N C ���J IDENTIFICATION NUMBER GEMINI CArISS .Aa3 STILE DELI Af4D WEST?` DEN:tjIS 02670 70 12121 /0 7 ISSUE DATE HENRY DORMITZER This registration must be displayed for customers to see and is not assignable or transferable. COMMISSIONER OF REVENUE Massachusetts Department of Revenue — Customer Service Bureau ST 1 PO Box 7010 'nV oF� Boston, MA 02204 n 0 The vendor herein named is registered to sell tangible personal property at retail or for resale,pursuant to the General Laws, Chapters 62C,64H and 641.This registration is effective only for the registrant at the location specified herein. Any change of name or address must be reported to the Department of Revenue so that a correct ST-1 can be issued. IDENTIFICATION L aa� g A �A� g�y NUMBER !GEP.I61 9.�i�t3a :LEAit ad L 394 ARAIN S Rjjj 13� C E N N I S AA C 2 s7 s ISSUE DATE This registration must be displayed for customers to see and is not assignable or transferable. COMMISSIONER OF REVENUE i Training for Intervention ProcedureS Cerfiflied! www. gettips. com 1 -800-GET-TIPS ice �+l��ta4 QICE 4 0�95 �s 6OCi'Oa 4f.0 sWfi Al, Sd € Knob Lid €: Inner Bowl Marking I e. .ao � ; Inner Bowl Handle . i Silicone Sheet Body Heating Plate € Indicator Light. Power Supply Cord f Thermostat Cooking Switch Inner bowl marking ---------------------- Use for short grain rice Use for other kinds of rice Kg Lb Cups water 5 12 40 10 E 4 20 ' 6 10 F I 2 L— ————————————————————— —J r # G O V Rated voltage 120V, 60Hz,AC only Power Consumption 1700 W Outside dimensions . 19 77/16"(W)X 1711/16"(D)X 13 3/4" Weight Approx.20 lb. f Plug 3-Prong Plug(5-15P) Receptacle 3-Prong Receptacle(5-15R) t 4 .1 ,at E Please check the following before calling for service. ;. Check point Problem Uneven cooking Improper amount of rice or water • Foreign matter was on outside of.inner bowl Boiling over occurs during cooking and heating plate Lid was not used properly NSF® This symbol on the nameplate means the product is certified by NSF International(NSF-4). u� This symbol on the:nameplate means the product is listed by Underwriters Laboratories, Inc 0 i SHARP SHARP ELECTRONICS CORPORATION 99Y1K5071U//l/ Printed in Thailand 2003.10 Sharp Plaza, Mahwah,New Jersey 07430-2135 ALL A eAO7' NOW6 r4dl...64 7fb� TALL 6PaFs Fmg cl�, E�ea+ cri9�e ALL. mco*? CAN de &eor or r/VC-0/lot rQES9�C91U� Y�i�s��P9eCs�S . �gCeY�p GJ/Yft � y� 7� � I r� t S _ r � a r ;a+x� dM rf �n A .L err � Mock its r MODEL.'L f4 SEF41AL 1,40: 100742E ` tam 303E iA �'xY OPERATING THE AEROHOT OR THURMADUKE PREHEAT- To preheat individual sections, turn the switch dial to high for 10 - 20 minutes before the foods are placed in the compartments.Insure that pan openings are covered to prevent loss of heat. ECONOMY OF OPERATION WATER IS NOT NECESSARY IN THE AEROHOT FOODWARMER. IF WATER IS USED,SPILLAGE PANS ARE REQUIRED. Air. being easier and quicker to heat than water, makes the waterless foodwarmer faster and more economical to operate than a table using water. Foods can be kept moist by keeping them at the correct temperature. Foods dry out only when excessive temperatures are reached,so when foods tend to dry out,REDUCE HEAT. If only part of the foodwarmer is needed compartment, the p artment not in use need not be heated. Insulation between the compartments divide the unit into a series of smaller independent foodwarmers. CARE AND CLEANING Care should be used to prevent spilling when placing full food containers into the pan openings. Spilled foods that are not removed will dry out and eventually burn, causing odors. The inside of the heating compartments should be wiped out daily and thoroughly cleaned at least once each week. SWITCH SETTINGS The most satisfactory switch settings must be determined by experience based on the nature of the foodservice and the type of operation as well as individual preference of the restaurant operator. The proper switch setting necessary to keep foods at the desired temperature will vary dependent upon the frequency of turnover, size of food containers, amount of food in each container, room temperature, location of foodwarmer with respect to range or other heated equipment, air outlets,fans, doors and passageways. SWITCH DIAL SETTINGS RECOMMENDED Covers Covers TEMPERATURES FOODS OR TYPES OF FOODS (in degrees) ON OFF Lo 2 Rolls-Thick Soups 140°- 150°F Creamed Foods-Mashed Potatoes Roasts*-Short Ribs Sliced Meats Baked Ham*-Fish-Vegetables-Cutlets 2-3 4-5 150°- 170°F Stews-Baked Beans-Croquettes Fried Liver—Fried Potatoes Fried Chicken Medium Gravies 3-4 4-6 1700-200°F Baked Potatoes-Barbecued Ribs Dressing-Thin Gravies and Soups *A low perforated rack is recommended to keep roasts and hams off the bottom of the pan.When a rack is used,keep 1"-2"of thin gravy in the bottom of the pan. 219736 Page 10 of 29 5/14/04 PARTS # Part# Part Name 1 154047 Food well,with drain I � � 2 215550 Pilot, 120V I --^�. 3 215555 Pilot,240V 1 4 212081 Thermostat 5 212190 T-Stat Knob I 12 9 13 INFINITE SWITCHES 14 S ' I t 6A 155580* 120v j i t6 6B 155578 208V ' 6C 155579 240V 7 212I64 Infinite Switch , -� ch knob 8 153471 Hi-Limit thermostat �' 9 154458 Nut w/star washer 10 230162 Element pan t 6 1 ELEMENTS A 8 0 _ 12 154352 120, 750 WATT 13 154046 120V, 1200 WATT 2 3 14 154353 208V,750 WATT 4 15 154355 240V, 750 WATT 16 154354 240V, 1200 WATT 5 17 154048 Strainer ALTERNATE PART WS 212074 -5580-2 212076 —5578-2 212075 —5579-2 212081 —2081-2 219736 Page 14 of 29 5/05/04 i N AND ELELELMTE ECUPBkDR OL RUMANT DOME atallo ° y ELEMENT 1i 7d CORD CONNI�ICTED UNITS — E WIRE — I PHASE — CROUNDED O To se AND Mons O t u OROUND a.Om I Q�TANT O mat �.I Lt WIN 9 89= ttAts M tt3-M Taft ,� �r. I;— Nlli !1/i S91UA') Rcm l 1 `b 1til SAt IXN1�'L DA S�d?�HES � D COMN=jrD UNITS — 3 w?JW — 3 PHASE — GROUNDED � Aumm i tQ a LOOPELEMENT u eta Um OLV M a Rm tst PaRMANENTLY CONNrcrrD UNITS — i & s PHASr — cROUNDED t°v�atA eA RResc M n�a,A=aR Rm iron IIII + VIM ou"TIM l tu,rwr wo o WAT aiomrt ants itf101 a EQAT eBAtear► �[1Rf0t M 1 tttAex am s •• I ( T flt16 �� • ttAM tDIQCw�t 6llslllS a�lICN ttMtM 010r011R K w NK im Uh NOONCORD CammEM tmM cm is ATTACM CROSS SECTION — SHOWING 17IRING & ELEMENTS mmmms, To CApjET AT OPGtATOn MT IX UNITS WITH INFINITE SWIMHES SACTIONAL DETAIL ON POWANOMY CONNElC7Ea MOO &"CrAM 1FOR INFINITE SWITCHES � MST���N�a PANEL AT WIRING DIAGRAM FOR SEALED WELL AEROHOT FOOD SERVICE HOT FOOD UNIT LT ----- NOTE: NO{ )NEAIED MIS SIIOWL WM e Is CAN It�M W 110 SOC(`� L2 - --- P LT L2 P Li L2 ( SMtTCH MODEL) Nft Si E J� 12q E M PMASE E VOLT i H2 ; H2 TWO,(2)HEAlW IIEL S SHONN. — --------------- OUAIMTY OF HEATED ME "t CAN K FROM TWO(2)TO S1X(4 L2 CD— FQlr- CDMOSTAT SNITCH MODEL) _ 12q 2O4 240 VOLT Swett PMiLSE u ------ -- -------- NOTE ------- THREE(3)HEATEA VQLS SHOWL La C3— L3 n ------ CAN IRON r*0(2)TO SIX(4 P Ll Lg ►',Ll t= P L1 Ll (N MMTE SUTCN MODEL) 120. 204 240 VOLT 3 PHASEEZ u ---- -------------------- NOTE: tit ------------- 71r1EE )HEATED WILS S awL OUAMIITY W!!EA=IVRLLS ------ CAN BE FROM TWO(2)TO SIX(4 (mmoSTAT Swim MODEL) T20.2W UO VOLT 219736 Page 13 of 29 5/14/04 � JIIo P�o�aecc� �s K�r iw �� Dis��s / 01sY �Kc�ce cgY 6f1�.���1� � ��uiP��a�v if eB•L C�lgr�� . " RuPaa��F�iC T�s�,d��� rGr2� cav�ae � ' t�a.Li wl�gtra/ �' ��1�l�ra1�A1Y a k �r - .71 ? 4+G �iO Irk AC"-ST F.RE AN-D EL--CMC '" CffN'F N a !�1lt��.pg.��� //.� w�+y,� yyy}}} yam, WiV V-R REP LA 1l..m�iJ ID [DEPAWMEWOFI::i/+I� AIJ.PME F%.rz ANY COVER MEA 210-".e P �f•Y" � � ,� gx Me POWER MEN I-Owl, r. re _ - U•LLrT IS ° Henny Penny Model HMR 103,104,105,106,107 2-3. ELECTRICAL The Heated Merchandiser is available from the factory wired CONNECTION for.120/208-240 volts,single or three phase,(includes neutral),220-240 volts,or 380-415 volts. Refer to the table at SEMANUMBERS: left,.and bottom,for proper power connection. Alod 3ph NOTE 107 14-50P Hardwire Hardwire International units are not supplied with cord and plug,and must 106 14-501? L21-30P Hardwire be provided upon installation. If 2 CE units are placed side- 105 14-50P L21-30P Hardwire by-side,a grounding wire needs to be placed between the 104 L14-30P L21-20P Hardwire equipotental bonding lugs,located under the cutting board 103 L14-30P L21-20P Hardwire brackets,of both units. ----------- - - - CAUTION The unit must be adequately and safely grounded. Refer to local electrical codes for correct grounding procedures. A separate disconnect switch with proper capacity fuses or breakers must be installed at a convenient location between the unit and the power source. 24. :ELECTRICAL DATA TABLE Amps- 1 Phase Voltages Amps-3 Phase Voltages Model Combinations KW 120/208 120/240 220-240 120/208 120/240 380415 HMR-107 7S 7.4 35.7 30.9 30.9 25.8 22.4 11.0 7F 8.5. 40.8 35.4 35.4 25.8 22.7 12.7 5S/2F* 7.9 38.1 33.0 33.0 25.8 22.4 12.7 5F/2S* 8.0 38.5 33.3 33.3 25.8 22.4 12.7 4S/3F* 8.0 38.5 33.3 33.3 25.8 22.4 12.7 4F/3S* 8.0 38.5 33.3 33.3 25.8 22.4 12.7 3S/2F/2S 7.9 38.1 33.0 33.0 25.8 22.4 12.7 3F/2S/2F 8.5 40.8 35.4 35.4 25.8 22.7 .12.7 2S/3F/2S 8.0 38.5 .33.3 33.3 25.8 22.4 12.7 2F/3S/2F 8.4 40.4 35.0 35.0 25.8 22.4 12.7 2S/2F/3S 7.9 38.1 33.0 33.0 25.8 22.4 12.7 2F/2S/3F 8.5 40.0 35.4 35.4 25.8 22.7 12.7 HIVIR-106 6S 6.1 29.4 25.5 25.5 21.0 18.2 10.4 6F 7.2 34.5 29.9 29.9 21.8 19.4 12.0 4S/2F* 6.6 31.8 27.5 27.5 21.0 18.2 12.0 2S/4F* 6.7 32.2 27.9 27.9 21.0 18.2 12.0 2S/2F/2S 6.6 31.8 27.5 27.5 21.0 18.2 12.0 2F/2S/2F 7.1 34.1 29.6 29.6 21.5 19.1 12.0 .3S/3F* 7.3 35.3 30.6 30.6 23.4 20.5 12.0 HMR-105 5S 5.5 26.2 22.7 22.7 18.8 16.3 8.3 5F 6.0 29.0 25.1 25.1 18.8 16.3 9.9 3S/2F* 5.9 28.6 24.8 24.8 18.8 16.3 9.9 2S/3F* 6.0 29.0 25.1 25.1 18.8 16.3 9.9 HMR-104 4S 4.1 19.9 17.2 17.2 14.0 12.2 7.6 4F 4.7 22.6 19.6 19.6 14.1 12.5 9.3 2S/2F* 4.6 22.2 19.3 19.3 14.0 12.3 9.3 HMR-103 3S 3.5 16.7 14.5 14.5 11.8 10.2 5.5 3F 4.0 19.5 16.9 16.9 11.8 10.5 7.2 *Well modules can be arranged in opposite order 2.2 200 V Henny Penny Model HMR-103,104,105,106,107 2-5. CABINET DMENSIONS Curved Profile Flat Profile 313/8 in. 313/s in. (796 mm) Zf (796 mm) 37 in. 393/4 in. (938 mm) (1011 mm) Vision Profile Advantage Profile l 3 31 / � s in. 313/e in. (796 mm) (796 mm) 373/4 in. 371/2 in. (959 mm) (952 mm) 3-well 4-well 5-well 6-well 7-well Width 43/4 in. J56,hin. 69/4 in. 8295 /,in.> > > > 1099 mm 1429 mmJ(l 759 mm 2089 mm 2419 mm t 2-3 399 u� gZ it 1 r r r r r�• pp p � r 8 nn ia•u r_ J •nnv u.ro a nv _ r � 4 ' rvnry �b r r r _._._...• C • 'b n V N b f• n V 3 fmi�SM1 1 0 0 0 0 0 gp�� i i �; i �. j, . � � r ' n v v♦ n n v v r i c v.+v NOZCLT T - - J�JM ==d•� ' ' ' g ' � � P b Nbl�b V Nb r_ e =^N^ a =a sAg TSB ��s J r r r r r o r 1.M b o n..TY1 l A MUCTION rwlrN Wiif OTrtbri MIiOr 0 X_• ' ecrm N.D•.o.oco 0 rYY•t U.o' MOIL..1• w Y1rYrtn�.i�11,1rr•ru a M � A• �:.s.�. ryr :... + .... . .:::::.. .. . . ... ... .. ... ... ... .... . ........._. ...:: .:: }�[P� we yyyyj l .r. ... ... .. .....:vn.•.:,.:•...,_.............:.......V.S:,:: .c:.r: :�. !:4'iw:i::�i::',J::g:!;:r _ av;J.'iM ,a..!�.....vn-.Y....✓. .. .....I,..+... ...- .:._..... r:..a::_... ..... ....:. TC ...:,R. ,-..,... .J�.rN.c .7..:....>: :.5'�.i•. _ .'.......::.......:...... t I v 6Vf\- Page 1 of 1 f o - I 4 k 17� _ a arc http://pictures.sprintpcs.com/mmps/001_265d84101464aa73_1/2 jpg?partExt--jpg&&&ou... 11/7/2007 b t I I 3 I I 1 t t t. f w v Y; I M Q' I� #Y� Ki ctienAid �® Electric Built-in Single and Mouble Ovens PRODUCT MODEL SERIES OVERALL DIMENSIONS KE80107K KVI07P 2�a afi EB 132:1 cam)oiaif: KE80208K Kf BV208M _ recessedwidth - — — (92:i ant)max, _ recessed width—_ A three=wire or four=wire,single phase,240=v®It, *Hz,AO=only electrical supply Is required: Models rated from 71 to 9:0 kW at 240 volts 2e" 2�=ilia MAN; oil (5:6 to 7:2 kW at 200 volts)require a separate 1es a overall 112e:11 am) 40=ampere circuit,fused on both sides of the line: recessed height 4e4 2" may, Models rated at 7:2 kW and below at 240 volts heigh4 ies®si;®d ea®iaii �GA kW and below at 208 volts)require a separate // height _ height 0=ampere circuit,fused on both aides of the line:Use minimum 8 gauge copper wire only.A time= delay fuse or circuit breaker is recommended:A 1.11:=1sted conduit connector must be provided at � 2e-3/4"i�o:eem) the junction boil: �� ($,a )��c'rerail vAdth bit reeaseed depth single oven � 21i�3/4�(ie:e efn) 2a" / overall width 11 :4 oin)yj inauf: �I reeessed CABINET OPENING DIMENSIONS depth Double even eb"J7e:2 ei�!min,Cabinet wilt e®"19$:2 6fiifBin, j�a®"(iq:2 eiiilm-in, Eafiifi it WI Me am) I� 6er�i6et wn h i"(g:e am) 29=e/4" loin:top of tea of cutout 13a:e or) cutout to i"(2:e am) to bottom of thin: underside top of Cutout up OF autaut of to better of satirist deep countertop ep oP cabinet deer 2e=1/2 (72:4 col) b=i/4"liars am) (i 4am) Cutout bottom of Cutout 274N' 2e=1/2" rid: 2e=i/2" width to floor 17e:s am i eutout i72:4 Ci�)— fithi MOW IOU am) height 6w6ut �i I oven lief§lit VAat p NO unde'eounter (without ceoktop Installed above) 2e=i/4" (€e:i am)fain: " WOW epth i=i/2" e2" 9=i/2" (3e em) 2e"(9e:4 am) Me am) tei:e 6rj (ere er) bottom recessed min:bottom !, 6'"6 min:bettor of cutout oven depth of cutout ut to fl u tto of outout to to floor topCabinet door eabinot deer Double oven ®veal cabinet reeessed /@Von even front Cabinet aide view Wouaa wfildpml 06fp6fation p6lioy ineludos a mfitinwu§cofriniitrnafit to irpfove OifiieftioH afe fof planning 00f06s'es only: p6f 6or0106 MAN,9#6 Insiallatim flaf:9300691 6uf pfodu6fs;Wa fwfiio IN fight to 6hanga fnotodala and 80661fications without n6tim Wifuctiona packed with pfado6t. 8p66if165ti6na s610 t6 6fiafige without fiotim: 0e=22=0e f ELECTRONIC OVEN CONTROL This manual covers different models.The oven you have purchased may.have some or all of the items listed.The locations and appearances of the items shown here may not match those of your model. A B C D E F G 7 0o e STMT - � • 4 5 6 OOO DO 001 O O O Oorev Lam OVER L !-JLM J � O�uSxr M� auraiac itiisda� Svpe�a I 1 H 1 J K L M N A.Oven display G.Start L Oven light B.rimed cooldri f H.Upper or lower oven selectors M.Timer C.Number pads (double oven models only N.Upper and lower oven CanceUOff(double oven D.Control lock 1.Oven option selectors models)Cancel OA(sing/e oven models) E Clock- J.Easy Convectim conversion F.rime of day,timer display K.Convect f dl meal When power is first supplied to the appliance,everything on the The START pad begins all oven functions except the Timer, displays will light up for 5 seconds.Then,"PF"will appear on the Control Lock and Sabbath Mode.if not pressed within 5 seconds oven display and a time of day will appear on the Time of Day after pressing a pad,"START?"will appear on the oven display as display.Press LOWER OVEN CANCEL/OFF,UPPER OVEN a reminder.Depending on your model,if not pressed within CANCEL/OFF or CANCEL OFF to clear the oven display. 4 or 5 minutes after pressing a pad,the oven display will return to If"PF"appears at any other time,a power failure has occurred. inactive mode(blank)and the programmed function will be Press LOWER OVEN CANCEL/OFF,UPPER OVEN CANCEL/OFF canceled. or CANCEL OFF and reset the clock if needed. Ogren Day When the oven(s)are in use,this display shows the oven temperature,heat source(s)and start time.On double oven The LOWER OVEN CANCEL/OFF,UPPER OVEN CANCEL/OFF models,this dray will also show which oven is being set The and CANCEL OFF pads stop their respective oven functions left cavity symbol represents the upper oven,and the right cavity except for the Clods,Timer,Control Lock and Sabbath Mode. symbol represents the lower oven. The cooling fan may continue to operate even after an oven In addition,during Timed Cooling,this display shows a vertical function has been canceled,depending on the ovary temperatura bar and time countdown and the stop time(d entered). If"Err"appears on the oven display,an invalid pad was pressed. Press LOWER OVEN CANCEL/OFF,UPPER OVEN CANCEL/OFF This is a 12-hour dock and does not crow am or p.m. or CANCEL OFF and retry your entry. When the ovens are not in use,this display is blank. To Set Before setting,make sure the oven(s),Timer and Timed Cooking Time of Day,Tuner Display are off.On some models,the dock can be set when the oven(s) This display shows the time of day or Timer countdown. are on,however the start time will disappear. 1. Press CLOCK SETISTART 2. Press the number pads to set the time of day. 3. Press CLOCK SET/START or START. To Remove/Retum Tpne of pay from DisphW..Press and hold CLOCK SET/START:for 5 seconds.Repeat to redisplay.The time should not have to be reset. 6 PARTS AND FEATURES This manual covers differ rd models.The oven you have purchased may have some or all of the its fisted.The locations and appearances of the features shown Fie may not match those of your model. E F A— — II ,_�...._._ I G AMk III K C e e D A Oven vent H.T.H.ETu(Third Hidden Bement) Parts and Feaf nes not shown B.Brot7 elements(not shown) convectk-element and fan(m back oven right G�floorpp�Gake element(hidden ! TemeQ Third oven ma perature probe (upper and Broiler pan and Vid D.Lower oven(on double oven models) single ovens only) Roasting rack _contid I Gasket peraf i F.Automatic oven switch k Model and serial numberplate Tem re probe raffl G.Oven lock latch (on right mounting 5 IMPORTANT SAFETY( INSTRUCTIONS For self-cleaning ovens: a Clean Only Parts lasted in Manual. m Do Not Clean Door Gasket—The door gasket is ■ Before Self-Cleaning the Oven.—Remove broiler pan essential for a good seal.Care should be taken not and other utensils. to rub,damage,or move the gasket. ■ Do Not Use Oven Cleaners—No commercial oven cleaner or oven liner protective coating of any kind should be used in or around any part of the oven. SAVE THESE INSTRUCTIONS The California Safe Drinking Water and Toxic Enforcement Act requires the Governor of California to publish a list of substances known to the State of California to cause cancer,birth defects,or other reproductive harm, and requires businesses to wam of potential exposure to such substances. WARNING:This product contains a chemical known to the State of California to cause cancer, birth defects, or other reproductive harm. This appliance can cause low-level exposure to some of the substances listed,including benzene,formaldehyde, carbon monoxide,and toluene. 4 O V E SAF 1 1 Your safety and the safety of others are very important We have provided many important safety messages in this manual and on your appliance.Always read and obey all safety messages. This is the safety alert symbol. This symbol alerts you to potential hazards that can kill or hurt you and others. All safety messages will follow the safety alert symbol and either the word"DANGER"or "WARNING"These words mean: ! ` You can be killed or seriously injured if you don't Fr Immediately follow instructions. You can be killed or seriously injured if you don't AWARNING follow instructions. All safety messages will tell you what the potential hazard is,tell you how to reduce the chance of injury,and tell you what can happen if the instructions are not followed. IMPORTANT SAFETY INSTRUCTIONS WARNING: To reduce the risk of fire,electrical ■ Use Care When Opening Door—Let hot air or steam shock,injury to persons,or damage when using Pe escape before removing or replacing food. oven, follow basic precautions,including the foll wing: ■ Do Not Heat Unopened Food Containers—Build-up ■ Proper Installation—Be sure the oven is property of pressure may cause container to burst and result installed and grounded by a qualified technician. in injury. ■ Never Use the Oven for Warming or Heating the ■ Keep Oven Vent Ducts Unobstructed. Room. ■ Placement of Oven Rados Always place oven racks ■ Do Not Leave Children Alone—Children should not in desired location while oven is cool,. If rack must be be left alone or unattended in area where oven is in moved while oven is hot,do not let potholder contact use.They should never be allowed to sit or stand hot heating element in oven. on any part of the oven. ■ DO NOT TOUCH HEATING ELEMENTS OR ■ Wear Proper Apparel—Loose-fitting or hanging INTERIOR SURFACES OF OVEN—Heating garments should never be worn while using the oven. elements may be hot even though they are dark in ■ User Servicing—Do not repair or replace any part of color. Interior surfaces of an oven become hot the oven unless specifically recommended in the enough to cause bums. During and after use,do manual.All other servicing should be referred to a not touch,or let clothing or other flammable materials qualified technician. contact heating elements or interior surfaces of oven ■ Storage in Oven—Flammable materials should not until they have had sufficient time to cool.Other be stored in an oven. surfaces of the oven may become hot enough to ■ Do Not Use Water on Grease Fires—Smother fire or cause bums—among these surfaces are oven vent flame or use dry chemical or foam-type extinguisher openings and surfaces near these openings,oven ■ Use Only Dry Potholders—Moist or damp potholders doors,and windows of oven doors. on hot surfaces may result in bums from steam. Do not let potholder touch hot heating elements. Do not use a towel or other bulky cloth. SAVE THESE INSTRUMONS 3 11MOOLMHOOTINIP Try the solutions suggested here*st in order to avoid the cost of an unnecessary Wrylm can. Nothing will operate 1111 Has the function peen enbwed? See"Self-Cleaning cycle"section. • 'kias a household fuse 4lown,or has a circuit breaker a On some models,has a delay start SO-Clean cycle been tripped? set? Replace the fuse or reset the circuit. See"Self-Cleaning Cycle"section. • Is the appliance wh*4 properly?. 0 Has a delay stwt been qet9 See Installation Instructions. See—rimed Cooking-section. N On double MCI"models,is one oven self-cleaning? Oven will not operate When One OVenk self-cleaning,the other oven cannot be set to self-dean. ■ Is the electronic oven control set com"W. See"Electronic Oven Control"section. Oven cooking VWAps not wh*expected tias a delay#art been See"Timed Cooking"section. a Is the appliance level?Level the appliance.See the Installation instructions. On some models,is the Control Lock S-"? See"Control Lock"section. 0 Is the PrQIW VnIPerature set?Double-check the recipe in a relWp cookbook. On some models,is the Sabpqth Made sop See'Sabbath Mode section. 9 Is the PTOW WPn temperature 081ftWfion set?See-Oven Temperature Control"section. On double oven models,is one oven seff-cleaning? When one oven is self-cleaning the other oven cannot be set Wqs the oven preheated?See"Baking and Roasting" or turned on. section. On double oven models,has the conxK*oven been Is the Proper tleware being used?See"Bakeware" selected? section. Choose UPPER OVEN or LOWER OVEN first. iili Are the racks positioned. Proper. See"Positioning Racks ".:­_ .n­­.,­­­..­.' _,; -1-1-I-­­_ and BakewareP section. Oven tempeiraturp too high or too low Is there Proper air circulation around bakeware?See Positioning Racks and Bakeware section. ip Does the oven temperature calibration need adjushinient? See"Oven Temperature Control"section.: Is the IandWbuted in the Check to make sure batter is level in the pan. Display shows messages ip Is the proper I"of time being used?Adjust cooking time. Is the display showing"PP,uff k4r or"PF kt=30'9 Has the oven dew beanopeirie4 while cooking?Oven There has been a power failure.Clear the cftsplay.See Peeking releases oven heat and can result in longer cooking "Display(s)"section.On some modelsreset the dope,if times. needed.See"Clock"section. lyre the disgilpy 0 baked#OMP too brown on bq#or�?Move rack to s wwing a a nualflor9 higher position its the ovep. leer the� . i 014 See"Display(sr s000r� i treapppqrscall r service. Are 4TP"ln fo ce..See"Assistance or Service election. Use 2opMinum f9il to cpv et 1) 09 or reo, to MPP T119 �MV ..................—9- AWSTANCE OR SER)ICE Woluic%'c11111 g lul awslecanc*o-rAse-rviCe,pioase check Accessories "Troubleshooting."It may save you the cost of a service call.It To order accessodM call the KitchenAid Customer eXperience you still need help,follow the instructions below Center toll free at 1-000-442-9991 and follow the menu prompts. When calling,please know the purchase date and the complete Or visit OUT Websitelat www.Mtchenaid.com and click on"Shop- model and serial number of your appliance.This information will Online,"then"Accessories.'Portable appliances,bakeware, help us to better respond to your request. cookware,gadgets and textiles are also available. Stainless Steel C[eqw PolishIt you need replacement parts (stainless steel models) It you need to order replacement parts,we recommend that you Order Pan#4396095 use only factory specified parts.These factory specified parts will fit right and work right because they are made with the same precision used to build every new KITCHENAIIPP appliance To locate factory specified parts in your area,call us or your For product related 44estions,please call the KdchenAid Canada nearest KitchenAid designated service center. Customer Irderactibn Center toll free.-1-800-461-Ml Monday to Friday 8.0.0 a.m.-6:00 p.m.(EST). Saturday 8,30&m.-4.30 p.m.(EST). -4- Our WRvioe assistance wrath:Call the KitchenAid Customer eXperienoe Center toll free- a Features and I-O00-422-1230. specifications on our full line of appliances. , qur consultants providesIssistance wift Referrals;to local dealers Features and specifications on our full line of appliances. For parts,qppps"rps anti service in qqnada Installation information. Call 11-IM-407-4M.40trhenAid designated service technicians are trained to fulfill the product warranty and provide after- Accessory and repair parts sales. warranty service..qiowherp in Canada. Specializedcustomer assistance(Spanish speaking,hearing impaired,limited vision,etc.). Fore aM"g9pe If you need"r--issistance,you can write to KitchenAidReferrals to local dealers,repair parts distributors,and Canada with arty q40stions or concerns at: service companies.lKitchenAid designated service technicians are trained to fulfill the prodilot warranty and Customer Inter4ption Center provide after-warranty service,anywhere lira"United States. 10tchenAid Gqn'd a 1901 Minnes9j4-Qourt To locate the KitchenAid designated service comparry in your Missiissauga,i**o L5N 3A7 area,you can atsq b*in yaw tetephone directory Yellow Pages. f Rease include me one numbpr in your correspondence. For L L you!1n=ed'j=rther*j"pe,you can write tp t"anAtdl with 4ny questigns or concqrpa pt KitchPrlAid BrandYpfrter Appliances us p[ppreXperie 553 boson144 Ejpq Harbor, "0 22-2692 ?lease i90de a clay"q.j� prp qne number in Yo Rq ppondence. TECH SHEET-DO NOT DISCARD PAGE 1 ® ® IMPORTANT Electrical Shock Hazard Electrostatic Discharge (ESD) Disconnect power before servicing. Sensitive Electronics Replace all panels before operating. ESD problems are present everywhere. ESD may p pdamage or weaken the electronic control assembly. Failure to do so can result in death or The new control assembly may appear to work well electrical shock. after repair is finished, but failure may occur at a later date due to ESD stress. ■ Use an anti-static wrist strap. Connect wrist DIAGNOSTICS strap to green ground connection point or unpainted metal in the appliance Before servicing, perform the following checks: -OR- Touch your finger repeatedly to a green ■ The most common cause for control failure is corro- ground connection point or unpainted met- sion on connectors. Therefore, disconnecting and al in the appliance. reconnecting wires will be necessary throughout test procedures. ■ Before removing the part from its package, touch the anti-static bag to a green ground ■ All tests/checks should be made with a VOM or DVM connection point or unpainted metal in the having a sensitivity of 20,000 ohms per volt DC or appliance greater. ■ Avoid touching electronic parts or terminal ■ Check all connections before replacing compo- contacts; handle electronic control assembly nents,looking for broken or loose wires,failed termi- by edges only. nals, or wires not pressed into connectors far enough. ■ When repackaging failed electronic control a checks must be made with all connectors assembly in anti-static bag, observe above in- ■ Voltage structions. attached to the boards. ■ Resistance checks must be made with power cord unplugged from outlet, and with wiring harness or connectors disconnected. Fahrenheit (°F) to Celsius (°C) ■ Is oven in "Sabbath Mode"? If so "SAB" will appear Conversion in the digital display. Press and hold W key for 5 seconds to end Sabbath Mode. The default is Fahrenheit(°F). 1. Press the BROIL pad for 5 seconds.The temperature PROBLEM: Bake Temperature Needs will be displayed in degrees Celsius indicated by the Adjustment "CA in the temperature display. 1. Press BAKE pad for 5 seconds.The default temp.0° 2. To return the display to degrees Fahrenheit press the or a previously entered offset temp. will show in the BROIL pad again for 5 seconds. "F" will show in the Temp. Display. temperature display. ■ Press the TEMP pad "up" arrow (v)to increase programming the Cavity Size the temperature in 5°F or 3°C increments. ■ Press the TEMP pad"down"arrow(1w)to decrease When replacing the electronic control, be sure to pro- the temperature in 5°F or 3°C increments. gram the cavity size within 60 seconds of power up by Maximum offset temperature adjustment is±36'F or Pressing the following keys: ±21°C. BAKE (upper half of BAKE key), 2. Press the START pad to save the temp.adjustment. CONVECTION BROIL(lower half of BROIL key), STOP TIME, CONV FULL MEAL, digit#7, digit#9, TIMER SET/START, START. 1. Size is shown in display-"ID 24". 2. Press CLOCK SET/START until correct size is displayed. 3. Press CANCEL key(do not press the OVEN START key). 4. Press and hold "1"key for 5 seconds to verify programming. FOR SERVICE TECHNICIAN'S USE ONLY PART NO.4451879 REV.C PAGE 2 TECH SHEET.DO NOT DISCARD NOTES: ■ Always disconnect power before touching ■ For double ovens,the failure code is displayed internal parts of the oven! on the side of the display that corresponds to ■ Upon replacement,immediately return old the oven with the faulty part(upper oven = left electronic oven control using the mailing label side of display). supplied with each new control. FAILURE/ERROR DISPLAY CODES 11 ' ' 1 1 FPO Default F code - no failure Will only be displayed if user presses and holds V key for 5 seconds and there are no pre-existing faults. Press CANCEL to dear display. F� All E Codes Electronic control malfunction Replace control. EO Key held down too long, or key is shorted 1.Check keypad connector for firm connection. F2 2.Press CANCEL If error code returns after 60 sec., replace keypad. E1 Keypad keytail not connected 3.Replace control. E5 Cancel key drive fine open EO Temperature sensor opened 1,.Check sensor connection. El Temperature sensor shorted 2.Measure sensor resistance (10809 at 210 C VO° F].Add 2Q per degree F.) F3 Oven temp too high (over 3.If resistance is not valid, replace sensor. E2 301°C[575°F]in Cook mode 4.If sensor resistance and connections are good, then the oven cavity temperature must have exceeded a safe level. Check for welded-closed relays Oven temp too high (over on the control. E3 510°C[950°F],in Bean mode) 1.Disconnect meat probe and measure probe resistance(78kQ at 15.T C JW F]; 37kQ at 322°C[W Q. F4 E1 Meat probe malfunction - 2.It resistance is not valid,replace prone. shorted 3.Insert probe and check for a firm connection between probe and jack (in oven cavity). 4.Check connection between jack and harness (in rear of oven). Door is open, but latch is 1.Check the Latch,AssembV. locked (condition exists -Check latch arm pivot joint, arm/solenoid connection, solenoid spring, EO when door switch is dosed and spring washer. indicating an open door 2.Check the Latch Solenoid: and latch switch is closed - Check for firm electrical connections. indicating a locked door) - Disconnect the two wires from the solenoid and measure the resistance of the solenoid. A small resistance (approx. 175Q) is normal. If the solenoid F5 E1 Self dean latch will not rock is open(-°°Q) or shorted(00), it should be replaced. 3.Check the Latch Switch.Disconnect fi and use a continuity tester: -Door latched =switch dosed, continuity should read OQ. Self clean temperature -Door unlatched=switch open, continuity should read oo52. E5 (2880 C 15500 F])not reached 4.Check Door Open/Closed Switch.Disconnect it and use a continuity tester: within 45 minutes - Door open =switch dosed, continuity should read 09. -Door dosed=switch open, continuity should read ooQ. E7 Sell dean latch will not unlock 5.Check power and element connections. F6 EO Return line not connected If switch pulse return line not connected, electronic control will display F6 within 60 seconds after power up.Replace control. / �A PART NO.4451879 REV.C FOR SERVICE TECHNICIAN'S USE ONLY TECH SHEET•DO NOT DISCARD PAGE 3 7. WIRE HARNESS SCHEMATIC GROUND(CHASSIS} — AC DRIVE o-�M -o NOTES: MOTOR SOLENOID ■ When replacing the electronic control,be PLUG CONNECTOR RELAY COIL ENCLOSED sure to program the Cavity size.See THERMISTOR "Programming the Cavity Size"on page 1. RECEPTACLE VWTH RELAY o OPERATED r-r-m MALE CONNECTOR CONTACTS BY DOOR I ■ Dots indicate connections or splices. LIGHT HEATING THERMAL f (p ■ Circuit shown in STANDBY/OFF mode o� ELEMENT FUSErr.O.D. o U o with oven door closed. Ll SUPPRESSOR-WP#445,985 N GND L2 JR BU 0ONTROL POWER BU: TRANSFORMER 7 THERMAL BK P19-1 P763 P162' P163 FUSE W V Pi&3 W TEMPSENSOR (�W P15-0 ELMTROMC THERMAL 1080 C2 AT 21°C(70°F) CONVECTION -- ------1 ----�------- 1654 C2 AT 177°C(350°F) N - -------------- ------------------ ONLY -----------r----------- W --Y- ------- 19-7 M W MEAT PROBE '�� i 78k in AT 15.6°C(60°F)\ y ) Pt9-4 Y CONV.-1600W AT 32.2*C 3-- -----(---\?L-W�j�GjN P78- R -----++�=�+� R. dv`� � +SV SWITCH PULSE TA1v r DOOR ON LATCHASSY P151 -------_-_-_-_ V SWITCH 1T1 R R TAN TAN TAN BR P152 P18-1 BU OUTBROIL-10WW� --- LATCH OPERATED BY SELF CLEAN /� ( MODELS ONLY SWITCH -0 SOLENOID) =BRDIL-1667WBU OR TAN TAN BU B-10 U P/5 3 P18 2 BK P17-1 BLOWER BK P17-2 �� GY W M Y P201 LIGHTPOWERSUPPLY +UPPER Pt&9' BK 18 V DC LATCH SOLENOID DRIVE W GY P20.2 CIRCUrr DOO�Lq�XW BK BK HALOGEN UPPER SOLENOID W W 5W/BULB LOWER YPN P203 - - -------- -- ---- - +LOWER 18 V DC LATCH BK BK B DRIVE SOLENOID C RCUR W W GYM P20-4 BLOWER DOOR LOCK, W P19.5 GYM M W SOLENOID BK P22-1 THERMAL BK P22-2 CONVECTION ONLY DOOR ON LATCH ASSY --------- ------------ --------- SWITCH E: CONV.FAN P19-8 ORMI M W TAN TAN TAN BRAN P213 P23 f Y CONV-1600W Y LATCH /� (OPERATED BY -- i SWITCH Tp SOLENOID) !--- ------�® r------------ TAN TAN BU BUM ----'----P23.4 R20M R P21-4 =___-===R- P23-2 BU, OUT BROIL-1000W TEMP SENSOR W d P21-2 R 1080 C2 AT 21°C(70°F) t° P233 OR IN BROIL-1667W BU OR 1654 n AT 177°C(350°F) W SELF CLEAN P16.1 P15.6 P12D6 MODELS ONLY GN GN GN FOR SERVICE TECHNICIAN'S USE ONLY PART NO.4451879 REV. C PAGE 4 TECH SHEET-DO NOT DISCARD UPPER OVEN COMPONENTS CONTROL POWER TRANSFORMER Low Voltage Transformer cg Oven Temperature Sensor Suppressor(mounted on (on Rear Panel) Blower Terminal Block L1 and Neutral) Motor Thermal Fuse Oven Shutdown (Connector P19) Thermal Fuse Lamp Transformer (on Inner Control Power Primary Rear Panel) Transformer o Halogen Lamp Convection Electronic Control Fan Motor (Behind Front Convection w Panei) Secondary Bake Broil Element Element R(Pt6-5) (P16-2)BU Door Late 120 VAC Halogen .: gssembly 6p Hz PRIMARY ESEC. 20.3 VAC Lamp - R(PIS-7) (P163)Bu Oven Door Glass Hidden Bake Tech Sheet Element Door Gasket LOWER OVEN COMPONENTS ELECTRICAL COMPONENTS KEY OVEN COMPONENT FRONT/REAR Lower Blower Oven SERVICEABLE Motor Temperature ELECTRONIC.CONTROL FRONT Sensor (Rear) MEMBRANE SWITCH FRONT DOOR SWITCHES FRONT LATCH SWITCHES FRONT ., LATCH SOLENOIDS FRONT MEAT PROBE SENSOR PROBE FRONT JACK- REAR Oven Shutdown OVEN TEMPERATURE SENSOR FRONT � �: ' Thermal Fuse CONSOLE BLOWERS REAR (Rear Panel) HALOGEN LIGHTS LIGHT BULB-FRONT Halogen Door Latch Assembly LIGHT ASSY.- REAR Lamp (Solenoid&Latch CAVITY LIGHT TRANSFORMER FRONT (Sides) Ste) CONVECTION FAN MOTORS REAR T.O.D. REAR BAKE ELEMENTS REAR OUTER BROIL ELEMENTS FRONT INNER BROIL ELEMENTS FRONT CONVECTION RING ELEMENTS FRONT THERMAL FUSE FRONT CONTROL POWER TRANSFORMER FRONT SUPPRESSOR FRONT PART NO.4451879 REV.C FOR SERVICE TECHNICIAN'S USE ONLY TECH SHEET.DO NOT DISCARD PAGE 5 ELECTRONIC CONTROL PINOUTS RELAY LOGIC UPPER AND LOWER OVEN I PIN FUNCTION COLOR v P18-1 OUTER BROIL UPPER BU P18-2 INNER BROIL UPPER OR MODES P18-3 BAKE UPPER R OFF O' 010100 0 0 P184 CONVECTION RING UPPER Y E PREHEAT-BAKE + + + O O 0 X P23-1 CONVECTION RING LOWER Y BAKE 24n,3r N + + + Q O 0 X P23 2 OUTER BROIL LOWER BEJ BAKE 27" N + + + O O 0 X P23-3 WNER BROIL LOWER OR ECONO BROIL O X 0010 0 X P23-4 -. ..._.BAKE-LOWER...- R MAXI BROIL O X X O O 0 X P15-1 +5 SWITCH PULSE TAN CONV BROIL O X X O X 00 X P15-2 DOOR SWITCH UPPER BR PREHEAT-CONY + + + O X 0 X P15-3 LATCH SWITCH UPPER BU CONV ROAST 2410 X O X O X 0 X P15-4 OVEN SENSOR UPPER V CONK ROAST 2r,30n* X + X O X 0 X P15-6 EARTH GROUND GN CONV BAKE 2C9 Q -Q Q + X N X P15-8 MEAT PROBE Y CONV SAKE 27V O O O X X N X P16-1 EARTH GROUND GN CONV BAKE 3r* + O O X X 0$ X P16 2 CONTROL POWER BU PREHEAT-CLEAN + -f- + 010 O X TRANSFORMER CLEAN A X + + 010 O X P16-3 CONTROL POWER BO PREHEAT DEKYORATE O O O + X 0 X TRANSFORMER CONTROL POWER DEHYDRATE O O O X X X P16 5 R TRANSFORMER PREHEAT BREAD O O O + X 0 X CONTROL POWER RAISING BREAD O O O + X 00 X P16 7 TRANSFORMER R P21-2 OVEN SENSOR LOWER V1W RELAY LOGIC KEY P2i-3 DOOR SWITCH LOWER BRIW OFF P21-4 LATCH SWITCH LOWER BUM P19-1 L1 BK X - ON P19-3 NEUTRAL W + - CYCLING P19-5 COOLING FAN LOWER GYM - ON OR OFF P19-6 COOLING FAN UPPER GY P19-7 CONVECTION FAN UPPER OR P19-8 CONVECTION FAN LOWER ORMI P19-9 LIGHTS BK P20-1 + SOLENOID UPPER Y P20-2 — SOLENOID UPPER GY P20-3 + SOLENOID LOWER Y!W P20-4 - SOLENOID LOWER GYM P20-6 EARTH GROUND GN P17-1 L1 BK P17-2 L1 BK P22-1 L1 BK P22-2 L1 BK FOR SERVICE TECHNICIAN'S USE ONLY PART NO.4451879 REV.C TECH SHEET-DO NOT DISCARD PAGE 6 AdMIL OVEN SHUTDOWN THERMAL FUSE The oven shutdown thermal fuse is located at the back of the oven. It will shut down the elements if the temperature at the back of the oven exceeds component limits. Verify that the Oven Shutdown Thermal Fuse is okay. THE FOLLOWING COMPONENTS CAN BE TESTED AT THE CONTROL PANEL: FRONTIREAR CHECK RESULTS COMPONENTS f iONTIREAR CHECK RESULTS COMPONENTS SERVICEABLE, POINTS SERVICEABLE POINTS Door Open= Door Open= P21-3(BR"to Closed Chd Door Swftch Front P15-2(BR)to Closed Circuit Door Switch Front P15-1(IAN) Door Closed= F15-1(TAN) Door Closed= Open.Circuit Open Circuit Door Lock OP 4(G:YNN�tow tc P20-2(GY)to Solenoid(with Front 50 9 Solenoid{with Front P20-1 M 509 20-3 N) Door Cl� Door Closed) Oven Senor Oven Sensor P15-0{V)io Temperature Front P2i S ns;or to 108012 @ 70'F Temperature front Ground(GN) 1080 9 @ 70T Sensor Ground(GN) Sensor Pig-5(GY m to PNeut(GY)to 14 Qto 18 QBlower Rear Neutral� 14 g to 1:$S2 Blower Dear Neutral(IN) Oven U t Primary Wmcng 40 Q to 45 0 Oven Li lst Front Primary W Windiftgng 40 s to n 152 Transformer Front Secondary Wmdmg Less than 10 Transformer Secondary Winding Less than 1 52 Oven Shutdown. P23 3 Red Closed t>irarit Oven Shutdown Rear P18 2(OR)to Red Closed Circuit .:. . Rear V�ie at Terminal Block Thermal Fuse Wire at Terrmnal Block Thermal Fuse P23-4(R)to Red Wire Bale Element Rear 25 Q to m t2 P18-3(R)to Red Wire 25 Q to 30 Q Bake Element Rear at Tem*W Block atTemvnal Block Inner Broil P23-3(OR)to Red Ihrrer Brat' P18-2(OR)to Red 45 Q to 55 Q Element Front Wire at 45 52 ttr 55 S2 Element Front Wire at Terminal Block Temunat Block Oar Broil NRea P18-1(BU)to Red 45 Q to 55 Q P23-2 PA to Red ElementWire at Terminal Block Outer Broil Front ye at 45 9 to 55 9 78 4 to Red Wire Terminal'Bl�c ConvectionM 28 52 to 35 52 Element Element atTerrrdnalBlock P23-1(Y)to Convection FanP19 7(OR)to 8 S2 to 12 52 Convection Ring Front Red Wire at 28 Q to 35 0 Neutral(Wj Element Motor Temmrnat Block Probe into Jacc- rLatch ction Fan EP214 Neutral Pik f0 Check for 78 kSL Rear8Q t2 Meat Probe JackGmun (GM Room Temp. Door Unlocked= Control Panel P11-3 to Neutral(Vt) Closed Circuit Swatch Frond Open Cirrit Thermal Fuse Front Across Fuse Door liked= Door Unlocked= Closed Cirmdtd P15-3(BU)to Open Circuit Latch,Switch Front P15-1(AN) Door Locked= Closed Circuit PART NO."51879 REV.C FOR SERVICE TECHNICIAN'S USE ONLY TECH SHEET•DO NOT DISCS PAGE 7 Now OVEN STRIP CIRCUITS NOTES; The following individual circuits are for use in diagnosis. ■ Pin numbers and wire colors shown in parentheses Before starting diagnosis,check the line voltage and ()denote lower oven connections. for blown fuses. ■ Pins denoted as # see wire harness schematic on page 3 for routing configuration from relays to Li. PREHEAPBAKE/ BAKE L1 P18-3 R BAKE-2aaoW R N L2 M-4) BK # P18-1 Bul OUT BROIL 1000W (#) (P23-2) R P18 2 OR 1N BROIL-1667W BU OR T23-3) BLOWER Pi 6 GY M W ECONO BROIL L1 N L2 P18-2 OR 1N:BRQIL-16S7W OR R BK # (�-3) BLOWER (#) P19 S GY M W (Pt9-5) (GYM+) MAXI BROIL L1 p181 BU OUT BROIL-1000W N L2 BK # P 8-2) OR IN BROIL--1667w BU OR R (#) (P23 3) P19-6 GY M W (F19 5) (GY/w) BLOWER CONVECTION BROIL N L2 (Thermal Convection P19-7 OR coNVM.FAN W Models Only) Tis B) (ORMW Lt BU OUT BROIL--1000W BK # (3-2) �:]N BROIL 1667W R (#) P18 2 OR (P23-3) BLOWER P13 6 GY M n W (M9-5) (GYAM CONVECTION ROAST N L2 AND PREHEAT-CONV P19-7 coNv FAN BAKE (m") (O� W L1 P1B-3 R BAKE-2000w R Y (Thermal Convection (P23-�) Models Only) BK # P18-1 BU OUT BRQIL-10aaW R (#) (P23 2) P18-2 OR IN BROIL-1667W BU OR TM) BLOWER P19 6 GY M W (P19-5) (GYMI) FOR SERVICE TECHNICIANS USE ONLY PART NO.4451879 REV. C PAGE 8 TECH SHEET-DO NOT DISCARD OVEN STRIP CIRCUITS ■ Pin numbers and wire colors shown in parentheses () denote lower oven connections. The following individual circuits are for use in diagnosis. � pins denoted as # see wire harness schematic on Before starting diagnosis,check the line voltage and page 3 for routing configuration from relays to L1. for blown fuses. NOTES: CONVECTION BAKE N L2 COW_FAN (BAKE ELEMENT USED ONLY P19a OR W ON W) f ISA @Rplo (Thermal Convection a P184 Y COW-1600W y Models Only) 8K # (P23-1) U R (#) P1:8-3 R BAKE-20MW A (P23-4} P19.6 M W (P19 5) (CY/W), BLOWER CLEAN AND PREHEAT +5V SWITCH'PULSE TAN P15-1 DOOR ON LATCH ASSY SWITCH TAN TAN TAN !BA P15.2 + P201 Y BWW (P213)` LATCH DRIVE (P20 3) {YM� f4-0 N L2 OPERATED BY.... 18 V DC - LATCH (� SWITCH SOLENOID) P20 2 GY SQLENQIQ W ::. TAN: ';:TAN: BU BU Ptfi 3 (PMA (GY1tM QDOR LDCK Lt BUM (P21-4) SOLENOtO P1&3 R BAKE-2000W R BK # (P23-T1)' #) P181 BU OUT BROIL-1000W R (i 23-2) P1&2 OR IN BROIL--1667W BU OR (P23 3} P19-6 GY M W (P19-5) (GY/W) BLOWER PART NO. 4451879 REV. C NOTE: This sheet contains important MANUFACTURED UNDER ONE OR MORE OF THE FOLLOWING Technical Service Data UNITED STATES PATENTS: 4,102,322 4,364,589 4,467,184 FOR SERVICE TECHNICIAN ONLY OTHER PATENTS PENDING DO NOT REMOVE OR DESTROY PART NO.4451879 REV.C FOR SERVICE TECHNICIAN'S USE ONLY Town of Barnstable °FSHE' ti Regulatory Services Richard V. Sca li Director r t BAMSTABLE r * 3ARNSfASLE, • euuaru�•�rtavwe•mnm•x;u+xa 4''°Y „A g Public Heat Division � 16 1m9-2014 ��ED Thomas McKeary Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE: J� NAME OF FOOD ESTABLISHMENT: GEm1 1 C f Bf�€�#of �►7 � ADDRESS OF FOOD ESTABLISHMENT: /� ��E� S' R 7�, #V4nOPT e c E-MAIL ADDRESS: 9 l //a,rl x M, ad TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( 5� ) �- F �� NUMBER OF SEATS*: INSIDE: OUTSIDE: TOTAL: * Note: If indoor seating provided, see.Licensing regarding Common Victuallers License TOTAL NUMBER OF BATHROOMS: ANNUAL OR SEASONAL OPERATION: A-,rJNUA-[_ TYPICAL HOURS OF OPERATION MON-FRI: a •MTO : 00 a-M DAYS CLOSED EXCLUDING HOLIDAYS (I.E. MONDAYS.) IF SEASONAL: APPROXIMATE DATES OF OPERATION: _/ /_ TO ***REMINDER*** SEASONAL ESTABLISHMENTS MUST CALL FOR INSPECTION PRIOR TO OPENING i TYPE OF ESTABLISHMENT: PLEASE CHECK ALL THAT APPLY �/FOOD SERVICE RETAIL FOOD BED & BREAKFAST CONTE" EETAL BREAKFAST RESIDENTIAL KITCHEN MOBILE FOOD TOBACCO SALES FROZEN DAIRY DESSERT MACHINES CATERING OUTSIDE DINING (OVER) !F OUTSIDE DINING, YOU MUST BE APPROVED BY THE HEALTH DIVISION AND LICENSING AND MEET ALL OF THE OUTSIDE DUPING CRITERIA IS FAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? CONTACT INFORMATION: FULL NAME OF APPLICANT i � R�_��i�Od SOLE OWNER: YES /NO ADDRESS s f Z-j (A S f y /77,. g7,b9� PHONE # 5'00 IF APPLICANT IS A PARTNERSHIP,FULL NAME.AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. Z602f/S STATE OF INCORPORATION AAs's,0- G#ms&T l!S FOOD SERVICE ESTABLISHMENTS CONDUCTING FOOD PREPARATION (EXCLUDES RETAIL FOOD ESTABLISHMENTS THAT DO NOT PREPARE FOOD AND CONTINENTAL BREAKFAST): EFFECTIVE JANUARY 1, 2004, EACH FOOD SERVICE ESTABLISHMENT IS REQUIRED TO HAVE AT LEAST TWO CERTIFIED FOOD PROTECTION MANAGERS. AT LEAST ONE CERTIFIED FOOD PROTECTION MANAGER IS REQUIRED TO BE ONSITE DURING ALL HOURS OF OPERATION."-**PLEASE PUT THE NAME OF THE ESTABLISHMENT ON EACH 'OF THE CERTIFICATES*** �� LIST THE NAMES OF YOUR CERTIFIED FOOD PROTECTION MANAGERS (I.E. SERVSAFE.) 1. EXPIRATION DATE:4/�2/ i j 2. 9 6EiV EXPIRATION DATE:�I�:Z/ EFFECTIVE FEBRUARY 1, 2011 EACH FOOD ESTABLISHMENT THAT COOKS, PREPARES, OR SERVES FOOD INTENDED FOR EYRdEDIATE CONSUMPTION EITHER ON OR OFF THE PREMISES SHALL HAVE AT LEAST ONE CERTIFIED FOOD ALLERGEN AWARENESS TRAINED STAFF MEMBER. *** PLEASE PUT THE NAME OF THE ESTABLISHMENT ON THE CERTIFICATE*** LIST THE NAME OF YOUR CERTIFED FOOD ALLERGEN AWARENESS TRAINED STAFF. i 1. IRATION DATE:/ 30 16 i f Zi a-i /171(l SIGNATURE OF APPLICANT AND DATE I i 0-\Ann[ication Forms\Foodann2.doc { _ ♦ �~ SAS r.� 4`� _�;.' 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