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HomeMy WebLinkAboutCENTERVILLE FOOD SHOP - FOOD Centerville Food Shop 1638 Falmouth Road, Centerville oF.Ne rok TOWN OF BARNSTABLE HEALTH INSPECTOR-s Establishment Name: U ILL Ab& Date: Page: t of ' � 4•P ° PUBLIC HEALTH DIVISION OFFICE HOURS8,00-9:30A.M. i BARNSTABLE. 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified � HYANNIS, MA 02601 - M-8 62�64-46FRI44 508 No Reference R-.:Red Item PLEASE PRINT CLEARLY .i0rF0 MA'S° FOOD ESTABLISHMENT INSPECTION REPORT 3 L I Name 'LC _ DatAtj Tyne of Type of Inspection � 2 Ooeration(s) Routine �1 � r(JI0j,vtlC� Address 3 isk Food Service Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: / Mobile Pre-operation C� Owner HACCP YIN Temporary Suspect Illness �QQ.���,�, QQ Caterer General Complaint Person in Charge(PIC) ;�N�r^"^ � Time Bed&Breakfast HACCP (�-`(j '� l In: Other Inspector ] Out: CA V, u Each violation checked re uires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ _ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) L41n V Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ r� J � . 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 ( S v` ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals �1 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 rD 12 C ❑ 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 HSPI- , s1 / O ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ) 'V/ `� n/� [ CJ 14 Iraq ✓4c Y�`c ❑ 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: ❑ No Y s 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 o 6 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 to 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 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. e\ 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 Sig ure 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' Ig'nat re Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) 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* F 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.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Chazge Duties � 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 7 5 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- to * Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 - Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 1307-102.11 °F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 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* Variance Requirements 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* 590.004(11) q 590.003(G) 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)Returned Food and AdulteReserrated or 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* 590.004A-B Compliance with Food Law* * 3-80L11(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 i 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*_ gg Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ery i-11112001 _ 4 602.11 _ Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* - Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g Y 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- - * - - Ratites-165°F 15 sec* in mobile food,temporaryand residential Sources 70 Proper,Adequate Handwashing i g' _--. - . _ 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 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 * 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 * Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities _ 24. Food and Food Protection FC-3 .004 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 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 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. iNF r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: _ - _ � Page: of _ OFFICE HOURS PAR E PUB2LIC OHEALTH DIEVTsION 8:00-9:30 A.M. MAIN3:30-a:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date Verified MASS. O MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY - 94, ,,39,pia HYANNIS,MA 02601 spa 8s2 asaa tFD MPS FOOD ESTABLISHMENT INSPECqgIQN REPORT Name 1/2VDate �,� of Type of Inspection _ p Routine 1 AddressFAIA Risk �' pod Service Re-inspec io y 1 y U Level btai Previous ecfi Telephone Residential Kitchen Date: Mobile Pre-operatL,bn 41 Owner HACCP YIN Temporary Suspect Illness r' Caterer General Complaint , Person in Charge(PIC) Time Bed&Breakfast HACCP dn: Other r /,! Inspector O Q 9 Each violation checked requires an explanation on the narrat`ve age(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and sk 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 IV " ❑ 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 41 r � ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ti ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding crl PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) I ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP U1 ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Lo Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) )I0 Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating J within 90 days as determined by the Board of Health. ® Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items 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. B=One critical violation and less than 4npn-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 9 non-critical. . f critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address viol observed,7 to 8npn-critical viola.ions. If 1 critical refrigeration. 29.Special Requirements (590.009) Y p vi ation,4 0 8npn-critical violation -G. within 10 days of receipt t of this order. 30.Other DATE OF RE-INSPECTION: Inspect o ig a re a Prijit: 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) (Cant.) 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) emonstration 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) 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-Stara e* 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(1)) 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 Hermetically Sealed Container* Sanitization Temperatures* - 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean 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 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg cn�c uuzoa 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 Stuffing Containing Fish,Meat,Poultry or 590.009 A D Violations of Section 590.009 A D m cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )-( ) ( )-( ) Ratites-165°F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 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 foodborne * 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 3-101.11 Food Safe and Unadulterated O g 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 V5-205.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 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* 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 1.008 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* I, S.,590Formback6-2doc 'Denotes-critical item in the federal 1999 Food Code or 105 CMR 59O,tgQb. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF. roy TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name:(2RJM Uf) �"Date: ' Page: Of OFFICE HOURS y ~° 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 HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �p ,639•a 0 508-862-4644 'F0M FOOD ESTABLISHMENT INS EC 10 REPORT Name Da t Tvne of f 1 s ection r - _K_ - I '�11, 1 r I _(� Address Risk o d Service-' n Level Retail Telephone Residential Kitchen Mobile Owner HACCP Y/N Temporary uspecness Caterer General Complaint Person in Char a(PIC) Time Bed&Breakfast HACCP In: Other Inspecto ut: P Each violation checked requires an explanation on the narrati a page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions an Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ vy 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 1 FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) IF r ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating AI ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures I HACCP Plans ❑ 19.Hot and Cold Holding 4 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 -y2, g �� 1 t ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories 9 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 it s ❑ 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. 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 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation,4 to 8 non-critical vi do C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: ect atu rint- 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 Sign tur t 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* I 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* * y 19 . PHF.Hot and Cold Holding g 3-302.14 Protection-from Unapproved Additives Contamination from Raw Ingredients Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each * 590.004(F) 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* Storage* - Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation 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* 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* 3-304.11 Food Contact with Equipment and Utensils*- 590.004(11) Variance Requirements Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* .. REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) - Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 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 7-206.13 Tracking Powders,Pest Control and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 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 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* EX cnvc inrzoor 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155'F 15 sec* aces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed . Chemical* g g �' 590.009(A)-(D) Violations of Section 590.009(A)-(D)in ca[et- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. $ 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) 12P203.11 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 Preventing Contamination from Employees* 1 8 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13Handwashing 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 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 Destruction* . Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Creation aTemperature 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 l 6-301.11 Handwashing Cleanser,Availability PP I 28. 1 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. �p IME ram, TOWN OF BARNSTABLE HEALTH INSPECTOR's Establishment Name: Date: Page: of �{ ti OFFICE HOURS t BARNSTABLE.O PUBLIC 2 0 MAN STREET EEVTSION - - - 3:30-s:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified -3:30-4:30 P.M. -SS y MON.-FRI. 9$p ,b39•pie HYANNIS, MA 02601 508-862-4644 No Reference ft-Red-Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT Name f� Q� Date Type of We o Inspection A era ions Routine Address Ris -ce e-inspection Le el Retail Previous Inspection Telephone es, ential Kitchen Date: L f Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP Lam✓ In: Other Inspector YA 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 P 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- oods) ` ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures61,Ali ❑ 5.Receiving/Condition ❑ 17.Reheating �U ,rYzi - 1 ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control - �-'- ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) I ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP - ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer 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) �1q A Corrective Action Required: ❑ No ❑ Yes - Non-critical(N)violations must be corrected immediately or Overall Rating 11 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 F] Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9-or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical, results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of 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 8 non critical violations=C. 29.Special Requirements (590.009) - , 30.Other D T Print: RE-INSPECTION:C �Inspector's Signature 31.Dumpster sc e e o pub v� Permit Posted? Y Cade Trap P wous um ng Date Grease Rendered Y N wY ���/'V PIC's Si natu,e Pri #Seats Observed Frozen Desse Machines: Outside Dining Y N 9 a Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N IX No Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assi nment of Responsibility* 8 Cross-contamination Law Cooled to 41°F/45°F Within 4 Hours* g14 Food or Color Additives 590.003(B) ::[Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 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 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* 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 7-201.11 Separation-Storage* 3-501.16(A) Roasts Held At or Above 130°F* _ _ _ Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use** 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* - 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and AdulteReserrated or 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 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. 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-I55°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* E.d 6-uu2001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* aces of Equipment* Shellfish* 3-401.1](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*3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Cbndition 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 foodborne * 12 Prevention of Contamination from Hands 3-403.11 E 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* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from.140°F to 70°F * Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. 1 Special Requirements 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. '_�6 `pF INE Jp� TOWN OF BARNSTABLE.. HEALTH INSPECTOR-s Establishment Name: .,QN '�•��(-FJ EC,�C-) Date: .Page: of , q OFFICE HOURS BAR E.O` PUBLIC 0 MAIN STREETDIVISION 8:00=9:30 A.M. 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. g, MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY. ,639, HYANNIS, MA 02601 508-862-4644 """�' FOOD ESTABLISHMENT INSPECTION REPORT ) Namer-R I/ Date Type of Type of Inspection ✓r rs O r Routin Address Risk oo Se e-inspectio / n" �' Level -i us Inspection Telephone Residential Kitchen Date:(yYj�y („ ccf/ _ u Qd. ( Mobile Pre-operation (< Owner HACCP Y/N Temporary Suspect Illness Im"I , / Caterer General Complaint (� �W Person in Charge(PIC) Time Bed&Breakfast HACCP 26 4 u, Sj 4,P , In: Other elf Inspector ` 5' • ,V � Out: (nva vr/v� 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 1 ❑ 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 Q ❑ 11.Good Hygienic Practices ❑22.Posting of ConsumerAdvisories ' [_1 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) 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 (FC73)(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 C=2 critical violations and less 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 erved to 8 non-cr.itical violations. If 1 critical refrigeration. violation 4 to 8 •o 29.Special Requirements (590.009) within 10 days of receipt of this order. ritical violati ns=C. 30.Other DATE OF RE-INSPECTION: Inspecto Signat Pr' 31.Dumpster screened from public view Vk/1 jA V,d �/V, -Gty1• V, Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N _- -) #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's gna re t: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted .Y N ` Dumpster Screen? Y N l Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 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 PHF 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* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F* * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003 F Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* * O P y3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) I Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* 7-206.13 Tracking Powders,Pest Control and 3-201.13 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 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* eU cri,e innooi 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* aces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 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 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 Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * Blue Items 23-30) 3-202.15 Package Integrity* 8 g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbore 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 S 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 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. 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* r8-103.12 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 THE r°jr, TOWN OF BARNSTABLE. HEALTH INSPECTOR'S Establishment Name: Date: Page: of 4 OFFICE HOURS PUBLIC HEALTH DIVISION 6:00-9:30 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 MA.- �eS HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item - PLEASE PRINT CLEARLY sob-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name Date Tvoe of Type of InspectionIT 7j� 11�7O Routine l Address Risk/ god Service J Re-inspection Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pr ratio Owner HACCP Y/N Temporary Caterer enera omplaint 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) ❑ i, Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health.. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted%Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags!Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories r Violations Related to Good RetaiCPractices Glue Items) Total Number of Critical Violations V� Critical(C)violations marked must be corrected immediately. (blue&red items) ` + �' l� 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 no 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 anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to 8pon-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 PICn t/pr�to e� Print: Self Service Wait Service Provided Grease Trap Size Variance Letter.Posted Y . N �/�1/1� � G'�(�-�► 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 o_f 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 -EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) * - - 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140'F 7-102.11 Common Name-WorkingContainers 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 and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer � 3 590.003(D) I 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* * 3-801.11(D) Raw or Partially Cooked Animal Food and * 4-501.I11 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 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* Eff°nee inrzooi 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency rf 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* g g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11 A 1 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 Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* 3-403.11 C * (Blue Items 23-30)' - 3-202.15 Package Integrity ( ) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate,to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated O g illness interventions and risk factors listed above,can be found_in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F * Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained 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 I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 11.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 1 Reduced-.Oxygen Packaging..Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.0 0. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. ' °F IRE►° TOWN OF BARNSTABLE ... _ HEALTH.INS PECTOR-s Establishment Name: Date: Page: of q OFFICE HOURS PUBLIC HEALTH I]IVISION 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. $• HYANNIS,MA 02601 MON.-FRI.508-862-464a No Reference R-Red Item, PLEASE PRINT CLEARLY 'FDN1�' FOOD ES 7ABLISHMENT INSPECTION REPORT Name t e of _1XIBEREhipection O e Routine Address Risk I. Sesi rvice rrl action Level Previous Inspection - Telephone ential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) t "" Time Bed&Breakfast HACCP In: Other Inspector Out: L , 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 s , EMPLOYEE HEALTH PROTECTION FROM CHEMICALS / a ❑ 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 Hazar us 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 C PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control 1 ❑ 8.,Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTI E POPULATION S� ❑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) `� 1 Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating I l 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. 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 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 t anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (F6-7)(590.008) be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. violation,4 to 8 non 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 r #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance.Letter Posted, Y, N Dumpster Screen Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 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 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* 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* Applicants* - 3-302.11(A) Food Protection* 7-201.11 Separation-Storage*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)DispositionRetumed-F of and Reared 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 g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* _ * 3-801.11(D) Raw or Partially Cooked Animal Food and - 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations * � 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served P 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* - Concentration and Hardness* 3 401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* . gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef cri"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 E ui ment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source q P 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Stuffing Containing Fish,Meat,Poultry or 590.009(A)-( ) ons o Section ( )-( )in Violations Si 590.009 A D cater- Chemical* Ratites-165°F 15 see* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By- 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding 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 * 3-301.12 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 13 Handwashing Facilities 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* 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 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 w th Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc `Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 food Code or 105 CMR 590.000. i ly °F* r TOWN OF BARNSTABLE . HEALTH INSPECTOR�s Establishment Name: Date: Page: of °k$ 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 MONMASS. g 508-62-4r44 .639. o ren+"�0 HYANNIS,MA 02601 No Reference R-Red Item - PLEASE PRINT CLEARLY FO ESTAB ISHMENT INS ECTIO REPORT 70, Name Dat Tvue of Tyne of Inspection LZD Ions Routine Address RiskIl If Aoe5til e ce Re-inspection - Level Previous Inspection Telephone -Kesliintial Kitchen Da Cl A Mobile re-operation Owner � ���OQ� / /� HACCP Y/N Temporary. ess O` ' �✓� Caterer General Complaint �� Person in Charge(PIC) Time Bed&Breakfast HACCP ' 6 � 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) ❑ S 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 t ❑ 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 fs� ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot aid Cold Holding r PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control - Ok 14 nt - ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATI NS(HSP) * �- Ce�r ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP , ❑ 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 a a_J 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 f within 90 days as determined b the Board of Health. M 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 ❑ 90 Embar checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Emergency Closure ❑ Voluntary Disposal Other: ❑ 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no'more than 3 non-critical violations. F=3 or more critical violations.9'or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 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 B-One critical violation and less than o 6observed,4 to 6rion-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 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* $ 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* 7-102.11• Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-201.11 Separation-Storage* 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* 7-202.11 Restriction-Presence and Use* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public.Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 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 Reated 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 Watei 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* 3-401.11 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 * Animal Foods That are Raw,Undercooked or -" -5-101.11 Drinking Water from an Approved System* _ ( )_ 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* 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* 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* - 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 Violations of Section 590.009 A D in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )-�) ( )'( ) Ratites-165°F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential - Game and Wiid 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 - 1=• 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* * (Blue Items 23-30) 3-202.15 Package Integrity* g g 3 403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E Remainin Unsficed Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the $ Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1$ Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities ` 3-202.18 Shellstock Identification 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' ISupplied 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 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. `a.THE r TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: Date: Page:_ of • _ ry OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. ` 200 MAIN STREET 3:MON.-o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MAcs, q MON.-FRI. �A ,679,6 m HYANNIS,MA 02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY - 'E0 MPS FOOD ESTABLISHMENT INSPECTION REPORT - - Name I( Dat Tvoe of Type of Inspection `\ O Routine Address Risk:/ Re-inspection r Level Retail Previous Inspection Telephone V�� T e51 ential Kitchen rre-op;erat'0�_ ti Mobile Owner HACCP Y/N Temporary spelness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP 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) ❑ ­7J;aVAOAction as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ r 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 - m� ❑ 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) 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 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 6=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 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 violation,4 to 8 non-critical violations C. _, (590.009) within 10 days of receipt of this order. - 30.Other D F C 1 Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y Grease Trap Previous Pu ing Grease Rendered Y N a #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Sign u Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N _-._ ._ _ _. .:_ _ _. _---_ _ � _. _ ` _ ti,. _ .. _- r _ .- a^Y-T a s'v. ♦ • _ _ Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 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 EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F 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* _ Separation-Storage*Applicants* '3-302.11(A) Food Protection* _ 7-201.11 Se 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 3-304.11 Food.Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and 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* .4-501.111 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 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* 4-501.111 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. 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 5-101.1-1 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* 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* 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* fodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms_* 2-301.14 When to Wash* 3-401.l l A)( )( )1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail ( 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 'Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* g g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the Foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* ( ) 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 Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* ocation an acement 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 O 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 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 I 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 690.000. 7/7/2021 (6)Centerville Food Mart I Facebook entC erville Food`Mart July 3 at 2:35 PM [FRE' H SUSHI AVAILABLE IN CENTERVILLE FOOD MART! COME try it out u� a F � i ®® 84 22 Comments 8 Shares Like "` Comment Share Most Relevant Write a comment... El 11 0 Press Enter to post. Tammy Lyn Deese Got some yesterday it was delicious Like•Reply 3d � View 7 more comments Centerville Food Mart El June 28 at 6:36 AM [3 Y� Come try the best sushi in TOWN.. https://www.facebook.com/Centerville-Food-Mart-104474171402168/ 3/7 7/7/2021 (6)Centerville Food Mart I Facebook Most neievant is seieciea,so some repues may nave peen Tuterea out. Donna Turco-Hill ' No reviews yet. I'm waiting for them Like-Reply•9h Justin Freeman Do you guys make breakfast sandwiches at 11:01 am? Like•Reply-2d Nicole Lynch Excellent! ®-J; Like•Reply-10h Rebecca Duart Sweeney Can anyone give me a review. I love Sushi but I am leery buying from anywhere with the name "food mart" it reminds me of a convenience store. 01, Like Reply 14h O,Author Centerville Food Mart co, e_in the_morning any t Ie.yH.e_ma:kes fres�b-7 front o"'f yo_u.Chef�w.en.t to_ja.pan_to.lear_n_it-l-ts-a mast t �" Like•Reply•14h 0 1) AP Author Centerville Food Mart Donna Turco-Hill try a sample and im pretty sure you will Be surprised.This is authentic sushi made fresh everyday ski• '?Ip'ht���`�`A�i 411 ` �: sn Like Reply.9h; �' 1 Author Centerville Food Mart Rebecca Duart Sweeney�149 Falmouth road, Centerville right behind lamberts market. Like•Reply•2h Rebecca Duart Sweeney Centerville Food Mart Thank you!! I will be there!! Like•Reply 14h Donna Turco-Hill Rebecca Duart Sweeney supermarket sushi! Not a fan Like•Reply-9h https://www.facebook.com/Centerville-Food-Mart-104474171402168/ 5/9 I � r Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. t RMAIL rhucE F.P.(Thomas)Lee,. 200 Main Street, Hyannis, MA 02601 Daniel Luczkow.M.D. Alt. 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: 65 Issue Date: 01/01/2022 DBA: CENTERVILLE FOOD SHOP OWNER: AMNA INC. Location of Establishment: 1638 FALMOUTH ROAD CENTERVILLE„ MA 02632 Type of Business Permit: RETAIL WITH FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE- FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: � Initials: Town of Barnstable For Office Us Date Paid 10 I A m t Pd$ W BA STABLE, : Inspectional Services MA SS. Check# Arfo��A Public Health Division (ArP Thomas McKean, Director 200 Main Street,Hyannis,M.A 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL X / ry NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: �� MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: 9/n n a n OO( A rn �C TELEPHONE NUMBER OF FOOD ESTABLISHMENT: t TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NOJ ... (ANNUAL WATER ANALYSIS.REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/ / TO NUMBER OF SEATS: INSIDE: O OUTSIDE: O TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE _RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST . CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 r^ Q:�P.pplication Forms�FOODAPP 2020.doc !n OWNER INFORMATION: FULL NAME OF APPLICANT ��V114J� � L SOLE OWNER: YES/(��9 OWNER PHONE # `In ADDRESS 319 R RPoie ed M:R�b�/ 6�� 526 CORPORATE OWNER: �/�-I�1 12 (� 6 1�-� CORPORATE ADDRESS: fc U PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least (1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 2. :ra(Ji t 1::n$k AIILIS7 JO 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.townotbarnstable.uslliealthdivision/at)plieations.asi). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January l st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q\Application FormsTOODAPP REV3-2019.doc Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. 'BARN BM 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: 65 Issue Date: 01/01/2021 DBA: CENTERVILLE FOOD SHOP OWNER: AMNA INC. Location of Establishment: 1638 FALMOUTH ROAD CENTERVILLE„ MA, 02632 Type of Business Permit: RETAIL-COMBO Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q.h FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: �SNE rp� For_ • Initials: Town of Barnstable I ��' Amt Pd$�Q,�Date Paid : .,�,,,�AB�, : Inspectional Services 9� Public Health Division Check# '°ran Mor" 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 //- 2, IP NEW OWNERSHIP RENEWAL I// NAME OF FOOD ESTABLISHMENT: ( ,p�1'f-e✓V le- Foodl�kq ADDRESS OF FOOD ESTABLISHMENT: �lo� pG VWBiJ �^- -JG2'J3w •�If^Q /'/ MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: h a d r7 r D L'•L�/�a J TELEPHONE NUMBER OF FOOD ESTABLISHMENT: � 3 L TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO t, ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL:✓ SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: _TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) ZYOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 QAApplication FormsTOODAPP 2020.doc i OWNER INFORMATION: FULL NAME OF APPLICANT I �N `le SOLE OWNER: AS/NO OWNER PHONE# 5'0$ 0'3 ADDRESS_ �S1n�R�2r_/►�1} CORPORATE OWNER: '�I,t�,-IT9 :;Z7—tA,a 4=1r\�,, CORPORATE ADDRESS: � �}'(j PERSON IN CHARGE OF DAILY OPERATIONS: / A H►^ -5:s�g A-L— List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. fflda&RjMQ Ili 3 TZa2 2. �'N l.l� ?oA- 0 I l `3 a l 204W I I2 SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/apylications.asi3. 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. 3I't each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC Ist. Q:\Apphcation FormsTOODAPP REV3-2019.doc L I Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Guadagnoli,M.D. BARNSTABLE F.P.(Thomas)Lee MAW Daniel Luczkow,Alternate 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Sell Tobacco In accordance with regulations promulgated under authority granted by Sections 5,31 and 127A of the General Laws of the Commonwealth of Massachusetts and Chapter 371 of the Town of Barnstable Code, a permit is hereby granted to: Permit No: 65 Issue Date: 1/1/2021 DBA: CENTERVILLE FOOD SHOP OWNER: AMNA INC. Location of Establishment: 1638 FALMOUTH ROAD CENTERVILLE, MA 02632 Type of Business Permit: Non-Flavored Annual Seasonal FEES YEAR: 202 1 TOBACCO SALES: $85.00 Permit Expires: 12/31/2021 a" Thomas A. McKean, RS, CHO, Health Agent Restrictions: PLEASE POST CONSPICUOUSLY For Office U • Initials: Town of Barnstable �"► Date Paid (� AmLPd S � CfWsAB I Inspectional Services , �6 Public Health Division Check# P Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 TOBACCO ESTABLISHMENT PERMIT APPLICATION (Non Flavored,. DATE �, I/-2tO NEW BUSINESS OWNERSHIP RENEWAL NAME OF TOBACCO ESTABLISHMENT: (�,tm6�y iltt FoerA ice/ w-0 C ADDRESS OF TOBACCO ESTABLISHMENT: . ���� �✓1W1pUly� ( T�11✓1 Q MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: li► na nO01� L •(�f/�I' TELEPHONE NUMBER OF TOBACCO ESTABLISHMENT: LLO6 � OWNER'S NAME: ��� -r--,V aAL OWNER'S PH#Qja -� - ? OWNER'S ADDRESS: e . Q-e 6L� r J CORPORATE NAME: _ CORPORATE ADDRESS: 1-6 b `P per" le— R _ CORPORATE FID# z S'947 d ANNUAL: SEASONAL: DATES OF OPERATION:_/ / TO DAYS CLOSED EXCLUDING HOLIDAYS(EX.MONDAYS) a: TOWN OF BARNSTABLE.COMMA GENERAL.LAW INTERNET LINKS: TOWN OF BARNSTABLE TOBACCO CODE LINK FOR CHAPTER 371-9: https://www.ecode360.com/33996392 e MA GENERAL LAW CHAPTER 270/SECTION 6: https:Hmaleg.islature..gov/Laws/GeneralLaws/PartI V/TitleI/Chaer270/Section6 ***NEW BUSINESSES AND NEW OWNERS ONLY*** REQUIRED TO CALL HEALTH DIVISION AGENT FOR AN INSPECTION PRIOR TO PERMIT BEING ISSUED. PLEASE CALL 508-375-6621 ALL APPLICANTS ARE REQUIRED TO SUBMIT THE FOLLOWING REQUIRED DOCUMENTS: 1) MA State License to Sell Ci arettes 3) IRS Federal Tax ID#Document 2) MA State License to S 11 Ci ars and Smoking Tobacco 4) Payment of Fee(s) -see page 4 SIGNATURE: . ' A'�/PRINTED NAME: � � 'C� DATE:. Q:1Application Fonns\TOBACCO APP-NonFavor 12-18-19.docx u j Y/ g V ESTABLISHMENT'S NAME ` TOBACCO SALES a Employee Signature Form This form is for official use to indicate that the employee(s)of this establishment received and understood Chapter 371 of the Town of Barnstable Code and Chapter 270 Section 6 of the Massachusetts General Laws which describes the penalties for selling and/or giving tobacco products to any person under the age of twenty-one (21). Below is Section 371-9.of the Town of Barnstable Board of Health Regulation: Sales to Minors— 371-9. Sale and Distribution of Tobacco Products, 1. No person shall sell or provide a tobacco product,as defined herein,to a person under The minimum legal sales age. The minimum legal sales age in the Town of Barnstable is 21 years of age. 2. Identification: Each person selling or distributing tobacco products,as defined herein, shall verify the age of the purchaser by means of a valid government-issued photographic identification containing the bearer's date of birth that the purchaser is 21 years old or older. Verification is required for any person under the age of 27. The employee(s)below received and understood Section 371-9 of the Town of Barnstable Board of Health Proh' ition c f Smoking Regulation and Chapter 270 Section 6 of the Massachusetts General Laws: Signature Printed Name Date fr Signature Printed Name Date Signature Printed Name Date ` Signature Printed Name Date Signature Printed Name Date x Signature Printed Name Date Signature Printed Name Date r Q:\Application Forms\TOBACCO APP-NonFavor 12-18-19.docx ` Ell � t�r Commonwealth of Massachusetts Letter ID:L0947904832 �r Department of Revenue Notice Date:November 16,2020 � ° Geoffrey F.Snyder,Commissioner Account TD:CGT:10266416-009 Iftw ' mass.gov/dor 0 RETAILER LICENSE FOR SALE OF CIGARETTES �lrll�l�h111111ii111hl�dll�l�u1��1111���1�ll�ullll���ul111 TAHIR 1QBAL AMNA INC CENTERVILLE FOOD SHOP 319 HOOPPOLE RD MASHPEE MA 02649-4361 Attached below is your Retailer License for Sale of Cigarettes(Form CT-3). Cut along the dotted line and display at your business location. At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license,call us at(617)887-6367 or toll-free in Massachusetts at (800)392-6089, Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE •----------------------------------------------------------------------------------------------------------------------------------------------- �cu�s MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3 ' Retailer License for Sale of Cigarettes / gr'hrc� This license must be posted and visible at all times.The sale of tobacco products to anyone under 21 years of age is prohibited. AMNA INC - Account ID: CGL 10266416 008 CENTERVILLE FOOD SHOP Location ID: 1 02664 1 6-0002 1638 FALMOUTH RD License Number: 1710462976 CENTERVILLE MA 02632-2948 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date: November 16,2020 Expiration Date: September 30,2022 ' � Commonwealth of Massachusetts Letter ID:L0376217920 °2 Department of Revenue Notice Date:November 16,2020 Geoffrey F.Snyder,Commissioner Account ID:CRL-10266416-011 ztv'peg mass.govldor RETAILER LICENSE FOR SALE OF CIGARS AND SMOKING TOBACCO �1I�11111�1IIllhr�l���lllultl���l�li�llulllhll�lllllillrlr TAH1R IQBAL AMNA INC CENTERVILLE FOOD SHOP 319 HOOPPOLE RD MASHPEE MA 02649-4361 Attached below is your Retailer License for Sale of Cigars and Smoking Tobacco(Form CT-3T). Cut along the dotted line and display at your business location. At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license,call us at(617)887-6367 or toll-free in Massachusetts at (800) 392-6089,Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE c"� Fy MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3T s, Retailer License for Sale of Cigars and Smoking Tobacco This license must be posted and visible at all times.The sale of tobacco products to anyone under 21 years of age is prohibited. AMNA INC Account ID: CRL-10266416-011 CENTERVILLE FOOD SHOP Location ID: 10266416-0004 1638 FALMOUTH RD License Number: 738691072 CENTERVI:LLE MA 02632-2948 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date:November 16, 2020 Expiration Date:September 30, 2022 p•'91 tus Commonwealth of Massachusetts Letter ID:L0536529472 �_ ds �s Department of Revenue Notice Date:May 26,2020 q �M Geoffrey E..Snyder,Commissioner Account ID:EDL-10266416-016 � t . ��vroF�' mass.gov/dor LICENSE FOR SALE OF ELECTRONIC NICOTINE DELIVERY SYSTEMS III""II111111�'I�I1��'1'III1�'�11111�1111'll'�I1��1'1'I"1�1�� AMNA INC o= CENTERVILLE FOOD SHOP o- 319 HOOPPOLE RD MASHPEE MA 02649-4361 Attached below is your Retailer License for Sale of Electronic Nicotine Delivery Systems. Cut along the dotted line and display at your business location. At any time, you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license,call us at(617) 887-6367 or toll-free in Massachusetts at (800)392-6089, Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE ------------------------------------------------------------------------------------------------------------------------------------------------ °SsJsF�� MASSACHUSETTS DEPARTMENT OF REVENUE 9 , i Retailer License for Sale of Electronic Nicotine Delivery Systems This license must be posted and visible at all times. The sale of �'F'•N'r aF� tobacco products to anyone under 21 years of age is prohibited. AMNA INC Account ID: EDL-10266416-016 CENTERVILLE FOOD SHOP License Number: 1153095680 1638 FALMOUTH RD CENTERVILLE MA 02632-2948 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell electronic nicotine delivery systems at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date:May 26, 2020 Expiration Date: September 30, 2022 Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. �,►n.r�re�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, 30513, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 65 Issue Date: 12/10/2019 DBA: CENTERVILLE FOOD SHOP OWNER: TAHIR IQBAL Location of Establishment: 1638 FALMOUTH ROAD CENTERVILLE, MA 02632 Type of Business Permit: RETAIL-COMBO Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean,FRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: f For Office jalv: Initials: j"�'°"' Town of Barnstable _ a i; Date Paid �� �� AmLPd$_3 - Inspectional Services a mass. Public Health Division Check# ,r _ ,. Thomas McKean, Director r, 200 Main Street,Hyannis,MA 02601 , rr: Office: 508-862-4644 Fax: 508-790-6304 "- APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE k7— < NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: � h� e ADDRESS OF FOOD ESTABLISHMENT: I vU1 -64 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: am/aG oc/ C (P A.a L L-eo/YJ TELEPHONE NUMBER OF FOOD ESTABLISHMENT: q )L�_-5s7 ) 3cts o TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NOA ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/ i_ 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) X FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING .,, (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:Wpplication FormsTOODAPP 2020.doc 1i OWNER INFORMATION: FULL NAME OF APPLICANT J k � `-- SOLE OWNER YE /NO Q OWNER PHONE ADDRESS_ � -1 � 1 6te Ma— �e D A 02-G 1. / CORPORATE OWNER: Mft:.jijC CORPORATE ADDRESS: 3 I PERSON IN CHARGE OF DAILY OPERATIONS: 0a I List (2) Certified Food Protection Managers AND at least (1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. L�n Q, I l 7/.2D l 1. rAl4 R �'1� lCK /17 / 1 SIGNATURE OF APPLI ANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/apl)lications.asi). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q\Application FormsTOODAPP REV3-2019.doc 9 Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Guadagnoli,M.D. RNWAgM : PaulJ,Canniff,D.M.D. 4- 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Sell Tobacco in accordance with regulations promulgated under authority granted by Sections 5,31 and 127A of the General Laws of the Commonwealth of Massachusetts and Chapter 371 of the Town of Barnstable Code, a permit is hereby granted to: Permit No: 65 Issue Date: 1/1/2020 DBA: CENTERVILLE FOOD SHOP OWNER: TAHIR IQBAL Location of Establishment: 1638 FALMOUTH ROAD CENTERVILLE, MA 02632 Type of Business Permit: Non-Flavored Annual X Seasonal FEES YEAR: 2020 TOBACCO SALES: $85.00 Permit Expires: 12/31/2020 Thomas A. McKean, RS, CHO, Health Agent Restrictions: PLEASE POST CONSPICUOUSLY �FIME For Office Us OnIv.• Initials: Town of Barnstable �Q _ Date Paid Amt P �.2d$ � BM ,�AB�, : Inspectional Services v� , . ,0$ Check# .` i°rFOMA'la Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 s u Office: 508-862-4644 Fax: 508-790-6304 TOBACCO ESTABLISHMENT PERMIT APPLICATION (Non-Flavored) DATE , / 7 NEW BUSINESS OWNERSHIP RENEWAL NAME OF TOBACCO ESTABLISHMENT: (2-e4j1j Cry ADDRESS OF TOBACCO ESTABLISHMENT: 3 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: aM h,<n o®r TELEPHONE NUMBER OF TOBACCO ESTABLISHMENT: ( ) -3 1403`o OWNER'S NAME: h1 l�/i'l, OWNER'S PH#CO%�-- . /— OWNER'S ADDRESS: �� f a k� CORPORATE ADDRESS: CORPORATE FID# -7SLL ANNUAL: SEASONAL: DATES OF OPERATION:_/ / TO DAYS CLOSED EXCLUDING HOLIDAYS(EX.MONDAYS) TOWN OF BARNSTABLE CODE/MA GENERAL LAW INTERNET LINKS: TOWN OF BARNSTABLE TOBACCO'CODE LINK FOR CHAPTER 371-9: https://www.ecode360.com/33996392 MA GENERAL LAW CHAPTER 270/SECTION 6: https://malegislature.gov/Laws/GeneralLaws/PartIV/TitleI/Chai)ter270/Section6 ***NEW BUSINESSES AND NEW OWNERS ONLY*** REQUIRED TO CALL HEALTH DIVISION AGENT FOR AN INSPECTION PRIOR TO PERMIT BEING ISSUED. PLEASE CALL 508-375-6621 ALL APPLICANTS ARE REQUIRED TO SUBMIT THE FOLLOWING REQUIRED DOCUMENTS: 1) MA State License to Sell Cigarettes 3) IRS Federal Tax ID#Document 2) MA State License to Sell Cigars d Smoking Tobacco 4) Payment of Fee(s) -see page 4 SIGNATURE: PRINTED NAME: DATE: l /420- Q:\Application Forms\TOBACCO APP-NonFavor 11-21-19.doc Tw t3 lie n ESTABLISHMENT'S NAME TOBACCO SALES Employee Signature Form This form is for official use to indicate that the employee(s)of this establishment received and understood Chapter 371 of the Town of Barnstable Code and Chapter 270 Section 6 of the Massachusetts General Laws which describes the penalties for selling and/or giving tobacco products to any person under the age of twenty-one (21). Below is Section 371-9. of the Town of Barnstable Board of Health Regulation: Sales to Minors—�371-9. Sale and Distribution of Tobacco Products. 1. No person shall sell or provide a tobacco product, as defined herein,to a person under The minimum legal sales age. The minimum legal sales age in the Town of Barnstable is 21 years of age. 2. Identification: Each person selling or distributing tobacco products, as defined herein, shall verify the age of the purchaser by means of a valid government-issued photographic identification containing the bearer's date of birth that the purchaser is 21 years old or older. Verification is required for any person under the age of 27. The employee(s)below received and understood Section 371-9 of the Town of Barnstable Board of Health Prohibition of S oking Regulation and Chapter 270 Section 6 of the Massachusetts General Laws: Signature Printed Name Date Id-lql Signature Printed Name Date Signature Printed Namd Date Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Q:\Application Forms\TOBACCO APP-NonFavor 11-21-19.doc IRSDepartment the Treasury Internal Revenue Service In reply refer to: 0457809026 OGDEN UT 84201-0038 Dec . 10 , 2018 LTR 147C 0 26-2594754 000000 00 00002917 BODC: SB AMNA INC , 439 E FALMOUTH HWY 7-ELEVEN 37478A FALMOUTH MA 02540 041607 Employer identification number : 26-2594754 Dear Taxpayer . Thank you for your inquiry of Nov . 29, 2018. Your employer identification number (EIN) is 26-2594754. Please keep this letter in your permanent records . Enter your name and EIN on all federal business tax returns and on related correspondence . You can get any of the forms or publications mentioned in this letter by visiting our website at www. irs . gov/forms-pubs or by calling 800-TAX-FORM (800-829-3676) . If you have questions, you can call us at 800-829-0115. If you prefer , you can write: to us at the address at the top of the first page of this letter . When you write, include a copy of this letter , and provide your telephone number and the hours we can reach you in the spaces below. Telephone number ( ) Hours Keep a copy of this letter for your records. Thank you for your cooperation. I Commonwealth of Massachusetts Letter ID:L1475262080 Department of Revenue Notice Date:December 28,2018 Christopher C.Harding,Commissioner Account ID:CRL-10266416-011 `f CS mass.gov/dor RETAILER LICENSE FOR SALE OF CIGARS AND SMOKING TOBACCO AMNA INC 7-ELEVE14 37478A o- 319 HOOPPOLE RD MASHPEE MA 02649-4361 Attached below is your Retailer License for Sale of Cigars and Smoking'I'obacco(Form CT-3T). Cut along the dotted line and display at your business location. At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions.about your license, call us at(617) 887-6367 or toll-free in Massachusetts at (800)392-6089,Monday through Friday, 8:30 a.m.to 4:30 p.m. DETACH HERE •-------------------------------------------------------------------------------------------------------------------------------------- MASSACHUSETTS DEPARTMENT OF REVENUE Form CT- Retailer License for Sale of Cigars and Smoking Tobacco / z This license must be posted and visible at all times.The sale of tobacco products to anyone under 18 years of age is prohibited. AMNA INC Account ED: CRL-10266416-011 CENTERVILLE FOOD SHOP Location ID: 10266416-0003 1638 FALMOUTH RD License Number: 1212114944 CENTERVILLE MA 02632-2948 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date:December 28, 2018 Expiration Date:September 30,2020 Commonwealth of_Massachusetts Letter ID:L1 151022720 log r Department of Revenue Notice Date:December 31,2018 m Christopher C.Harding,Commissioner Account ID:CGL-10266416-008 f? p mass.gov/dor RETAILER LICENSE FOR SALE OF CIGARETTES �II�I"1�1lIill�� �i� llllli��l��ll�lllllll� l11�'ill) AMNA INC N 7-ELEVEN 37478A o 319 HOOPPOLE RD MASHPEE MA 02649-4361 Attached below is your Retailer License for Sale of Cigarettes(Form CT-3T). Cut along the dotted line and display at your business location. At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license,call us at(617) 887-6367 or toll-free in Massachusetts at (800)392-6089,Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE •------------------------------------------------------------------------------------------------------------------------------------------- �ysN�say MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3T Retailer License for Sale of Cigarettes 'Y tyc rti This license must be posted and visible at all times.The sale of tobacco products to anyone under 18 years of age is prohibited. AMNA INC Account ID: CGL-10266416-008 CENTERVILLE FOOD SHOP Location ID: 10266416-0002 1638 FALMOUTH RD License Number: 1409226752 CENTERVILLE MA 02632-2948 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date: December 31,2018 Expiration Date: September 30, 2020 0' I `R F Commonwealth of Massachusetts Letter ID:1,0401520256 r ' Department of Revenue Notice Date:December 28,2018 �+ Christopher C.Harding;Commissioner Account ID:SLS-10266416-014 fpF mass.gov/dor SALES AND USE TAX REGISTRATION CERTIFICATE AMNA INC o= CENTERVU LE FOOD SHOP _ 319 HOOPPOLE RD MASHPEE MA 02649-4361 Attached below is your Sales and Use Tax Registration Certificate(Form ST-1). Cut along the dotted line and display at your place of business.You must report any change of name or address to us so that a revised ST-1 can be`issued. At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this certificate. DETACH HERE •------------------------------------------------------------------------------------------------------------------------------------------- cacl�trE MASSACHUSETTS DEPARTMENT OF REVENUE - Form ST-1 Sales and Use Tax Registration Certificate 3 ' � This registration must be posted and visible at all times. AMNA INC Account ID: SLS-10266416-014 . CENTERVILLE FOOD SHOP Certificate Number: 809461760 1638 FALMOUTH RD C:ENTERVILLE MA 02632-2948 This certifies that the taxpayer named above is registered under Chapters 62C, 64H.and 64I of the Massachusetts General Laws to sell tangible personal property at retail or for resale at the address shown above. This registration is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date:January 1, 2019 Town of Barnstable BOARD OF HEALTH G Paul 1 Canniff,D.M.D. Board OI Health Donald A.Gaudagnoli,M.D. [RARNSThBLL = John T.Norman Ma5,5 F.P. Thomas Lee Alternate 'o r�3� , 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstablems Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections f. 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 65 Issue Date: 12/26/2018 DBA: CENTERVILLE FOOD SHOP OWNER: TAHIR IQBAL Location of Establishment: 1638 FALMOUTH ROAD CENTERVILLE MA 02632 Type of Business Permit: RETAIL-COMBO Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 _ FEES - ---- FOODSERVICEESTABLISHMENT: $250.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD_OPERATION: Permit Expires: 12/31/2019 B&B- FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE- FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: $85.00 FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: FIKE r • Initials: C "o� Town of Barnstable q Date Paid Anit pd$ f � BARNSTABLE,MASS. Inspectional Services l/() �__ , A i6Jy' ♦0 Check# 'E�►�r° Public Health Division Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE J2-01% NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: apiEW Nam-- ezd ADDRESS OF FOOD ESTABLISHMENT: I&3s ljP.v+p'VV,# A MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: 0m r\< n or Q4A1,.&" TELEPHONE NUMBER OF FOOD ESTABLISHMENT: `60 - �3 TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NOI� ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL:✓ SEASONAL: DATES OF OPERATION:W04 TO / /,70 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)? l� 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) 4LTOBACCO 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 PLEASE CALL 508-862-4644 OWNER INFORMATION: /� /' FULL NAME OF APPLICANT ,A A, :MN SOLE OWNER: 0/NO OWNER PHONE 5-A—40-3�,a ADDRESS_ 312 l �P��� PL2� YVI�i S('1 ke-e/ Z 6Z6 e& CORPORATE OWNER: 110,_L Tek, FEDERAL ID NO. : CORPORATE ADDRESS: 30 l *�h-e, YI A ozc-7' / PERSON IN CHARGE OF DAILY OPERATIONS: 1t )` 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. N xC�4J Val Con 9 11 / 21 / 2:019 , JA16uj Pq)CoNE A X kW 24z9 f l� 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 openinc!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/apt)[ications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1 st to Dec. 3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1 st. Q:\Application FormsT00DAPPREV2018.doc FWThe Commonwealth of Massachusetts (P4--ml.�, Department of Education Educator's License r Y r Tm s To am THAT THE PERSON NAMED HEREON IS QUVW INCER of PIDRSION OF CORAL WNS cls.5.G.CA 138G.C.71A,71B AND/OR C.74 AS AAABCID AND tj 6M IM REGAAlM PRESM 1Ff BCkARD OF EOUCWK AND 5 8Ka'BtE FOR AROHMM N RE HA C SCHOOLS OF MASSACFRl US lO SERVE N THE CAPA M UCAIE)_I-E OUNSE S UW AS ISSUE)UNLESS REVOM FOR CAUSE_ Congratulations on completing the requirements for licensore. lrafe worked diligently toward 7777777=Michael Falcone: :_,..:. , l and should be proud of 35 B. Leyden ccomplishment. Brockton, BA 02302 i — ` - M` 3s; people like you who help to eB1ia4�ce the quality of education he Commonwealth. I wish you best in your future endeavors. Dr.David P.Drisca COMMMSK)NE9t OF E DUCATM -- The Commonwealth of Massachusetts Department of Education Educator's License THS Is TO COY THAT THE PERSON NAME)HEREON IS QUMM INDffi THE PROVOON OF GENEPAL LAWS,C.15.S.1G.C71,S_38G,C71A,718 AND/OR C74 AS AMENDED AND UNDER TtE RECIAMM PRM THE BOARD CF 8)UC MR AND IS HKME FOR APPONnv1 M N TFf PUBIC SCHOOIS OF TO SERVE N THE CAPAC HY MCAT81 Rf nC3NS£IS VALID AS WJED L MESS WiOKED FOR CAUSE- Educator: Michael Falcone Certificate f: $-ft396067 SSR: 026-54-1073 �lriginal Certification Date: 02/0112005 FIELD(LEBEL) - OR1' TYPE ISSUED EIPIRES ------------ ..--- ----- -- Culinary Arts (9-14) `` �9ClI.� Preliminary 1111602 op BO ERTRIES BELOM THIS LIME :a 9�hd fSF f 1- 0-4- 6s- employment. Dr.David P.Drisc A - COMMMSKWM OF EDUCATION — �114 E , Town of Barnstable Initials: �.� Date Paida $ Inspectional Services Check# — • BL BARNSTAE, 9� M 9. � Public Health Division �F011"p'r 200 Main Street, Hyannis MA 02601 Office: 508-790-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health Fee: $85.00 MAIL TO: TOWN OF BARNSTABLE PUBLIC HEALTH DIVISION 200 Main Street HYANNIS,MA 02601 FAX 508 790-6304 PLEASE INCLUDE THE REQUIRED FEE OF$85.00 APPLICATION FOR A TOBACCO SALES PERMIT Aln IVA N C 0-04ty bf/ r—oocL " n ESTABLISHMENT NAME (D/B/A) 4iA 11,01 V► � 0� ADDRESS OF BUSINESS MAILING ADDRESS (IF DIFFERENT FROM ABOVE) -74Hr� 1341— EMAIL PHONE# FEDERAL ID# Do you currently possess a state license to sell tobacco products? Yes ® No Each employee who sells tobacco products must receive and understand Chapter 371 of the Town of Barnstable Code (copy provided herein) and the Massachusetts General Law Chapter 270, Section 6. 0 (a copy is provided on the next page). Each employee who sells tobacco duct must sign the Employee Signature Form (provided herein). Signature Date (A 1.2 Q:\Application Forms\TOBACCO APP2019 dob.docx ESTABLISHMENT'S NAME TOBACCO SALES Employee Signature Form This form is for official use to indicate that the employee(s) of this establishment received and understood Chapter 371 of the Town of Barnstable Code and Chapter 270 Section 6 of the Massachusetts General Laws which describes the penalties for selling and/or giving tobacco products to any person under the age of twenty-one (21). Below is Section 371-9. of the Town of Barnstable Board of Health Regulation: Sales to Minors—&371-9. Sale and Distribution of Tobacco Products. 1. No person shall sell or provide a tobacco product, as defined herein, to a person under The minimum legal sales age. The minimum legal sales age in the Town of Barnstable is 21 years of age. 2. Identification: Each person selling or distributing tobacco products, as defined herein, shall verify the age of the purchaser by means of a valid government-issued photographic identification containing the bearer's date of birth that the purchaser is 21 years old or older. Verification is required for any person under the age of 27. The following employee(s) received and understood Section 371-9 of the Town of Barnstable Board of Health rohibition of Smoking Regulation and Chapter 270 Section 6 of the Massa us /s Ge ra ZLas: r AN L �yJ V Signature Printed Name Date Signature Printed Name Date 7- I MAW 13-���� ) Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Q:\Application Forms\TOBACCO APP2019 dob.docx Item 037 , ,*,,SELEC 1T PRODUCTION LINE STAINLESS PRODUCTS SMALL HAND SINK FEATURES&CONSTRUCTION. Our sink bowls are fabricated using type 304 stainless steel. Our top is constructed with an inverted"V"edge to prevent water run-off. Our backsplash is 6"tall from the deck, with a 2"return at 45'and a standard 314"rear turn down. It includes a splash-mounted gooseneck faucet. 0 The sink bowl is 6-314"deep and includes a 1-112"NPS small basket strainer. 0 STANDARD SIZES (in.) MODEL BOWL LENGTH WIDTH HEIGHT PL-SHS-1 14 X 10 18-718" 14-314" 12-314" REV.07-23-13 Item 037 SELECT STAINLESS DATE: MODEL NO: PRODUCTS PROJECT: SPECIFICATIONS PRODUCTION LINE SMALL HAND SINK N S F® 18 718" 2 7/16" 14" 2 7116" A 14 3/4" PLAN VIEW 2"@45° 10" 11/2" 01 118"HOLES M 4„ o ELEVATION SECTION "A" DIMENSIONS (in.) MODEL APPROX. WT lbs. ** PL-SHS-1 10 REV.07-23-13 Select Stainless Products 11145 Monroe Road Matthews,NC 28105 Phone:704-841-1090 Toll Free: 1-888-843-2345 Fax:704-841-1590 23.875 CHECK FOR AND DEBUR ANY SHARP EDGES. 0.250 HEM 23.875 23.875 SECTION B-B GRIND RADIUS SECTION C-C (2)CORNERS A I 62- C I 16.084 C 138° �' \ I D 4 0.550 A 1.000 HEM 1.00 B B SECTION A-A DETAIL D 17.783 NEXT STEP: WEIGHT: S AC AREA: ROYSTON LLC These designs are 0 ONE PICKROYROAD proprietary SHIP 10.3 Ib 13.428 ft'2 M ROYSTON JASPER,GA 30143 tnop3s34ss information,property I oerance Unless PARTOESCRIP ION of ROYSTON LLC. omen ise Nocea GRD,SPL,16.08X23.88X23.74,ANG-SDE,HEM,S They shall not be .x1oc=:.o10 copied or duplicated .Xx=-02o DATE REr.a � r w� _� Angles=:1• 6/2/2008 25541 � 71.501 in any manner without C ECN 9933 JCD 04-28-09 Hole Dia.=t.003 prior written consent, 13 ECN 9606 WAS 29.739 LONG REP 08-22-08 MATERIAL THICKNESS DRAWN SY PART k A INITIAL PRODUCTION RELEASE REP 06-13-08 SS,430-3 PP2S .037 jeremy.dobson 22058312 11 REVISION eY OATE \\jasdc.roystonllc.com\se$\part\GRD,SPL\GRD,SPL,16.08X23.88X23.74,ANG-SDE,HEM,SS.dit PRINTED 6/6/2009 P 00 � OM I` O ON M '7 OM h M f� m 't I-- 00 0) O N N 17.783 17.516 6.084 5.474 219X.438 2.256 — OBR(6) 1.521 0.905 o 0.000 co co O m co co o c`no, � � CD CO O V W O N N N LOA Lo w P� WEIGHT: ROYSTON LLC 10.3 Ibm E ICKROYROAD ME R®YST®N� JASPER,GA3Dl43 SURFACE AREA: (770)735-3456 PART p 13.428 ftl2 SHEET 2 OF 2 22058312 1ljasdc.roystonilc.comise$lpartlGRD,SPLIGRD,SPL,16.08X23.88X23.74,ANG-SDE,HEM,SS.dft PRINTED 6/6/2009 T&S BRASS AND BRONZE WORKS, INC. Model No. 2 Saddleback Cove/P.O. Box 1088 U� EC-3103 Travelers Rest, SC 29690 1W REG.#A2601 Item No. ISO#9001 478 Travelers Rest SC: 800-476-4103 Simi Valley, CA: 800-423-0150 Fax: 864-834-3518 www.tsbrass.com This Space for Architect/Engineer Approval (2X)0 5/16" to 0 1" Job Name Date I [8mm-25mm] 0 1„ Model Specified Quantity ADA Compliant [25mm] Mounting Hole Customer/Wholesaler Detail Contractor ®ChekPoint- I 2" Architect/Engineer I [51 mm] 4" 3 5/8" x 4 3/16" x 2" Deep [102mm] — Solid Cast Brass Spout [g2mm x 106mm x 51 mm] � w/ Polish Chrome Plated Finish Water Resistant Control Module Box (Blue) and 2.2 GPM [8.3L/min] w/ Internal Flow Control Setting Switches, Vandal Resistant Aerator AC or DC operated w/ (4) AA Batteries 4 7/8" [123mm] 24" [610mm] 4" Sensor Cable 5 1/16" [102mm] .V Removable 4 1/16" _ [129mm] Strainer [103mm] DECK i 1/2" NPSM x 1/4" NPSM a cr 18" [457mm] Long Flexible St. Steel Hose (1) 100-135 VAC Adapter w/ 144" [3658mm] Long Power Cord. (Remove Rubber Plugs on Module and Cable to Connect) Temperature Mixing Valve Furnished w/ (2)3/8" Compression x 1/2" NPSM w/ Integral Check Valves 18" [457mm] Flex. St. Steel Supply Hose NOTE: Supply Stops by Others Product specifications: Chrome Plated Brass Electronic Faucet: 4" Drawn Checked Approved c/c Deck Mount Spout w/ VR Aerator, AC/DC Control Module GEF DMH JHB w/ Internal Flow Control Setting Switches, Temperature Scale: Date: Control Mixing Valve w/ Integral Check Valves, 18 Long NTS 08/23/10 Hot & Cold Supply Stop Flexible Connector Hoses Sheet: 1 of 2 T&S BRASS AND BRONZE WORKS, INC. Model No. IV 2 Saddleback Cove/ P.O. Box 1088 U� - EC-3103 Travelers Rest, SC 29690 REG.#A2601 Item No. ISO#9001 478 Travelers Rest, SC: 800-476-4103 Simi Valley, CA: 800-423-0150 Fax: 864-834-3518 www.tsbrass.com ITEM SALES NO. DESCRIPTION O. 1 016355-45 Aerator w/ Key, Vandal Resistant, 2.2 GPM, 13/16-27 Male 2 017195-45 Angled Sensor w/ Cable 016297-45 Inlet Hose, Faucet, 1 2" N P M-F x 1 4" N P M-F 4 016647-45 ChekPoint Module Blue 5 5EF-0002 A/C Transformer 6 5EF-0006 Mechanical Mixing Valve 7 5EF-0005 Supply Hose, 9/16-24 Female x 1/2" NPSM 8 015425-45 lVandal Resistant Key tl 3 I n 4 I a Label for Flow Control Switch Settings is located on Inside of Back Cover. 2 ® Flow Control Switches are located r� 5 inside Module Housing in Black Box ® next to Battery Compartment. *Switches are set to DEFAULT position: Auto Time Out = 10 seconds Shut Off Delay = 1 second 6 7 Auto Flush = OFF Remove (4) screws and back cover to access switches. *Available Water Flow Control Selections: (6) Auto Time Out Selections - 10 sec, 25 sec, 45 sec, 60 sec, 3 min, 20 min (4) Shut Off Delay Selections - 1 sec, 2 sec, 4 sec, 10 sec Auto Flush for 30 Seconds After Every 12 Inactive Hours - ON or OFF Product Specifications: Chrome Plated Brass Electronic Faucet: 4" Drawn Checked Approved c/c Deck Mount Spout w/ VR Aerator, AC/DC Control Module GEF DMH JHB w/ Internal Flow Control Setting Switches, Temperature scale: Date: Control Mixing Valve w/ Integral Check Valves, 18" Long NTS 08/23/10 Hot & Cold Supply Stop Flexible Connector Hoses Sheet: 2 of 2 r Ceiling I Solutions USG CLEAN R®®MTMAC®USTICAL PANELS CLIMAPLUS'" PERFORMANCE 'D` i4 i..tt 3 ;6y ��`P , r' - - ` z' r_. Nik iL a i u C'? E USG Clean ROomTM Class ' g - ✓ ,' �, a -y,t Y a ! i-M 100M A Panels { with ClimaPWsl Performance/ Performance/ • ,._tE - -� _ .r� ,. - USG Donn'Brand DXLA' ( a * '�- a• ,Ls; m �s .�� ,,,� : � _ •. �� � � Acoustical Suspension System O TO USG.COM OR CGCINC.COM -� RSAMPL ES G 3 h Flat White 050 .010 UH • • • ! FEATURES AND BENEFITS - • ' • USG Clean Room'"Class 100 and Class IOM-100M panels have an • embossed,vinyl-laminated face with sealed back and edges for use in . Class 100(ISO 5)or 10M-100M(ISO 7)Clean Rooms. " • USDA Certified Biobased Product 8Q * • • Firecode®product designed to meet life-safety codes. #� - • • ClimaPlus"30-year limited system warranty against visible sag. ! •• APPLICATIONS SUBSTRATE • Clean Rooms Wet-formed mineral fiber a • Laboratories _ qt7r7m c rooms . • • Kitchens/food prep areas " • (Class 100 only) a USG CGC F'S YOUR WORLD.BUILD F.' 1 I USG CLEAN ROOM"ACOUSTICAL PANELS ORDER SAMPLES/LITERATURE FOR CALI UP-TO-DATE USG:samplit@usg.com TECHNICAL INFORMATION CLIMAPLUS'"PERFORMANCE fax:888 874-23 48I usg.com AND LEED REPORT TOOL CGC:contact Sales Representative usgdesignstudio.com TECHNICAL SERVICES cgcdesignstudio.com 0 800 USG.4YOU(874-4968) YEAR LIMITEn SYSTEM NIGN RECYCLED 115DA WARRANTY CONTENT CDtT6gD •No visible Sag - aim •-id/Mild—Vratectlon LvLJ ULClassified Edge' Panel Size Fire Item No. NRC4 CACMin. LR7 Color Grid Options Recycled Panel Cost Rating' Content' 0 ® ® 0 ® " USG CLEAN ROOM'" SQ 2'x2'x5/8" ® 56099 — 35 0.79 White A,B,C,D,E 55% $SE CLASS 100 Unperforated (ISO 5)PANELS ..................................................... .............. .............. ........................... ................. .............. ............... 2'x4'x5/8" ® 56091 — 35 0.79 White A,B,C,D,E 55% $SE Unperforated USG CLEAN ROOM'" SQ 21x21x5/8" ® 56060 0.55 35 0.79 White A,B,C,D,E 55% $$$ CLASS10M-10OM r Perforated (ISO 7)PANELS7 ............................................. l... .............. .......................................... ................. .............. ............... t 2'xWx5/8" ® 56090 0.55 35 0.79 White A,B,C,D,E 55% $EE Perforated ® High Recycled Content Firecode' Classified as containing greater than 50%total recycled content.Total recycled content is based on product composition of postconsumer and preconsumer(postindustrial)recycled content per FTC guidelines. GRID PROFILE OPTIONS A e C D Es USGDX•/DXU' USGDXLAT" USGZXLATM USGAX' USGCE'" `- EL E±1 E±�] PHYSICAL DATA/r Product literature Online tools Notes FOOTNOTES Data sheet:SC1811 usgdesignstudio.com or cgcdesignstudio.com 1.For details,see LEED report tool at usgdesignstudio.com or cgcdesignstudio.com. ASTM E1264 classification Thermal resistance 2.Fire-rated items:see UL design details. Class 100:Type X,Pattern GI R-1.6 Class 10M-700M:Type X,Pattern CGI Maximum backloading 3.LR values are shown as averages. ASTM E84 and CAN/ULC S102 See USG 30-Year Limited System Warranty 4.NRC rating for USG Clean Room'"ClimaPlus'"Class 100 panels is 0.10.USG does not surface-burning characteristics Commer WApplicatfons(SC2102). consider a ceiling panel to be acoustically rated if NRC is less than 0.50. Class A 5.Field-cut ecges of USG Clean Room'panels may be sealed with white latex paint. Flame spread:25 or less Maintenance Smoke developed:50 or less Can be cleaned easily with a damp sponge, 6.Clean Room-rated applications require a suspension system with gasketed tee flanges such mild detergent and water.Do not use acetate, as USG Dom•Brand CE1" ULType ammonia,or highly concentrated chlorine, M bromide or other harsh chemicals. 7.Not intended for kitchen/food prep applications.Use unperforated product(Class 100)— item numbers 56099 and 56091. Weight Metric sizes available 1.1 lb./sq.ft.(Class 100 panels) Contact sales for minimum quantities and 8.This product has achieved both BioPreferred initiatives:Federal Procurement Preference 1.2 lb./sq.ft,(Class 10M-100M panels) lead times. and Certified Product Labeling.See the complete listing of all USG ceiling panels on biopreferrea.gov website. Notice The information in this document is subject to change without notice. CGC Inc.or USG Corp.assumes no responsibility for any errors that may inadvertently appear in this 1 document. I SC7811/rev.11-16 Manufactured by The trademarks USG,CGC,AX.CE,CLEAN ROOM,CLIMAPLUS, Safety First!Follow good safety/industrial hygiene �)2016 USG Corporation and/or USG Interiors,LLC DONN.DX,DXL,DXLA,FIRECODE,ZXLA,IT'S YOUR WORLD. practices during installation Wear appropriate personal /�40 /.� its affiliates.All rights reserved. 550 West Adams Street BUILD IT.,the USG/CGC logo,the design elements and colors,and protective equipment.Read SDS and literature before USG CG7 Printed in U.S.A. Chicago,IL 60661 related marks are trademarks of USG Corporation or its affiliates. specification and installatior. t&�ardm Cl e spl OR iafttniC��;�' Turning On .- Preheating takes 20-30 minutes.Start with a clean,sanitized display case. Aar 3 w 1. Press the power button in the upper right-hand 2. When the unit is ready,the display case corner once to turn the warmer on.The indicator temperature reads approximately 15o°F. lights up. e During holding,make sure product temperatures stay above 140'F. • When the timer ends and the products expire,an alarm will sound . ^ - and the timer light turns red. lk. ` • Discard products they are below 14o°F and check the function of the display case. f Funn v - IMI IF It may be necessary to open the front of the display case while products are on display. r� The grooves on the door go on the outside. - 4, Be sure to keep it open for a minimum amount of time to make sure the product maintains proper _ temperature. - To open and close the display case's front door: 3 1. Locate the levers under the front door. 2. Squeeze the levers to unlock the door. 3. Pull the door to slide it out.The light inside the display case will turn off. -.r To close the display case's front door: OF 1. Push gently until it locks in place and the inside light turns on. F ©2013 7-Eleven, Inc. Page 1 10/4/2013 i Removing Trays - I • Do NOT remove product display trays with bare hands. • Always use oven mitts provided. 'I. Shelves • Do NOT touch interior shelves when the display case is hot. v Moving the Display Case �° • Do NOT move the display case while it is hot. No, r ■ r M' r° Cleaning the Display Case < • Do NOT clean the display case when it is hot.Turn the unit off and allow it to cool(about 30 minutes). a 1h ©2013 7-Eleven, Inc. Page 12 10/4/2013 J, Using the Sanden Display Case Quick Reference Preheating the Display Case =-, , Step 1 It takes approximately 20-30 minute to preheat the display case.Start with a Y clean,sanitized display case. - Ste z Press the power button in the upper right-hand corner once to turn the warmer ' p m on.The indicator lights up. Step 3 When the unit is ready,the display case temperature reads approximately 15o°F. " Turning off the Display Case Step 1 To turn off the warmer, press the power button in the upper right-hand corner once. Display and Keypad Upper Right Upper Left Shelf Timers Power Button Shelf Timers LED Display TIMER TIMER O O O O O O C O O C ® O O Lower Left Shelf Timers SD card slot Middle Right Shelf Timers Middle Left Shelf Timers Time Remaining Button Lower Right Shelf Timers ©2013 7-Eleven, Inc. Page 13 10/4/2013 Setting the Sanden Display Timers Quick Reference Press the Timer Button Expected Result Using the Timers Set timers to keep track of hot food products'shelf life.You can set the timers for any time between 1 to 4 hours.The Quick Reference Guide shows the expiration time for each product. Top Left Shelf • There is one button/light for one area of the hold-hot display For example;the upper nYen nuen n■��� • left button/light is for the top shelf on the left side. ®®�� When you press the button next to the light,the timer shows the remaining display ® time in hours. ® I • To set the timer to the last used setting,press the timer button once. Press time. Press again,within 3 seconds. nYen men nYeY men To change the setting: ■B®® I ■®®® • Press the timer button again within seconds to set the timer to 1 hour. g 3 __ x� • Press the timer button again within 3 seconds of the previous time to set the timer to 2 hours. Press again,within 3 seconds. m�^ ; • Keep pressing the timer button to cycle through 3 hours,4 hours,and then 1 hour �.TYEn TYen ■�®® � again. n en men e��■ • To reset a timer, press the center button beneath the timer display.Then press the ® button of the shelf location you want to reset. ■®®® � � R • When you press the button next to the green light,the timer shows the remaining Gri ® ,� display time in hours. r �1 n rn rnEA • When the display shows a solid yellow light,it is time to make fresh product.The ■■■® . Yellow Light yellow.light means there is less than 15 minutes left on the code life timer.When you 15 minute warning press the button next to the yellow light,the timer shows the remaining display time ® Time to make fresh products in hours. • When the display shows a flashing red light and a beeping sound,it means the ■�®� product is past its code life and you cannot sell it. Remove the product and discard it following your store's write-off and disposal procedures. ©2013 7-Eleven, Inc. Page 14 10/4/2013 E�E�rEn � - Microwave Oven: Heating Chart Microwave Buttons to Use for Heating Products Product Arnount = 1 2 3 1 � Use button number. Twister Type Egg, Ham & Cheese 2 3 4 Sausage, EggA Cheese, _ 3 4 _4 or�5 On a Croissant Egg, Ham&_Cheese= 2 3 4 Egg, Sausage & Cheese 3 4 4 or 5 English Muffin. Egg, Ham or Bacon & Cheese 2 3 4 or 5 Sausage,_Eg9_' Cheese- - - - 3 4 „ 5. On a Biscuit Sausage (with &,without cheese) 2 3 3 Sausage, Egg, & Cheese 3 4 4 or 5 French Toast/Pancake Ham & Cheese 2 3 4 or 5 Burritos (Under 5 oz.) 2 3 4 or 5 (Over 5,oz.) ` - 3 4; 4':or 5- © 2012 7-Eleven, Inc. Updated 10/10/2012 r I A EE�fEt1 Quality Advisement: Pizza Handling and Baking Pizza Handling: The Quality Assurance Department does not recommend or support refreezing previously frozen food items for quality and food safety reasons. Ice crystals will form when a previously frozen product is thawed and slowly re-frozen.These ice crystals will change the texture and appearance of the product. 7-Eleven and our vendors have worked hard to develop the appearance,taste and texture of our proprietary pizza. Refreezing pizza can damage our highly successful pizza program. Inferior products disappoint our guests and misrepresent our brand. From the day of receipt,the pizza may be cooked over a 3 day period as the first day is the thaw day either in store or the thaw/transport date from the CDC. For example, a thawed pizza has a 4 day shelf life which includes 24 hours of thawing.The shelf life starts when the product is removed from the freezer at the commissary or at the store. McLane delivers to the store or the commissary delivers to the Central Distribution Center(CDC)who then delivers to the store. For the products delivered by the CDC, 24 hours of the shelf life are gone. For pizzas delivered frozen to the store,the clock starts ticking the moment it is put into refrigeration so again 24 hours at minimum lost during thawing. So either way we are looking at 3 days for baking(72 hours). If the pizzas are thawed and then placed back into the freezer,you are looking at another 24 hours for a complete refreeze and another 24 hours for a complete thaw so you have the potential of 2 days lost just for this practice. At best if you decide to refreeze at beginning of day 2,you will only have 24 hours of shelf life left for baking the product. It is doubtful that the decision would be made at beginning of day 2. Making that decision on day 3 or day 4 means you would have no shelf life left. An important distinction particularly with the pizza is that you are looking at a multicomponent product with ingredients that are extremely sensitive to temperature abuse. Refreezing the pizza dough and cheese is simulating a freeze-thaw situation which means dramatic effect on quality: drying out the crust and cheese.Sauce may break down due to the'refreeze, and meats will dry out and lose their fat. The abuse of the component ingredients will affect cooked appearance,taste and texture and shelf life. The oven settings are designed for product handled properly so this will be another variable that will impact the finished quality as a pizza that has been refrozen will not bake the same way as one handled properly. Lastly,freezing food does not stop or kill all bacteria; for some it merely slows the growth. Refrigerated temperature has already allowed some bacteria which thrive in cold temperatures time to multiply. Pizza Baking: With our current equipment, processes, and products, only whole pizzas can be baked in the oven. Do not cut the unbaked pizza into smaller sections to bake. These pizzas require reheating to 165F and special handling to avoid cross-contamination with our current foods. Cross-contamination potential is increased when the pizzas are handled and sectioned prior to cooking.All utensils, pans, and work surfaces would need to be cleaned and sanitized prior to and after working with this food as well as hands washed prior to and after handling such foods.The proper smallwares and utensils to enable preparation of partial pizzas have not been sourced or tested. The SOPS and SSOPs for such an undertaking have not been developed or vetted. Rewrapping the cut pizzas could also cause cross- contamination of work and storage surfaces if extreme care is not taken during this process. In addition, if the product is not adequately sealed,the pizza will begin to lose moisture affecting holding quality. Baking smaller sections of pizza does not yield a quality product for our guest. It is difficult to cut pizzas in exact sections for cooking.Again,the proper smallwares have not been sourced or tested to allow food safe and quality sectioning of pizza. In addition the ingredients will not be contained within the pizza section due to the cut edges and will cause ingredients to melt and flow over the sides. The pizza will look unappealing, and the customer will not get the full ingredient quantity on the slice of pizza.The oven will also get dirtier and be harder to clean due to the ingredients flowing onto the surface. Per our standard operating procedure on 7hub: Only whole pizzas can be baked. Never heat less than a whole pizza. Heating partial unbaked pizza is prohibited. © 2015 7-Eleven, Inc. 7/8/15 Small Ware: Carry Hot'm Use the Carry Hots'to store GUEST pizza orders prior to arrival/pickup. Product Description The Carry HotTm has the ability to hold up to 3 pizzas hot for up to 15 minutes. Product Use ; Pizza Storage Do not store more than 3 pizzas in bag or hold for more than 15 minutes If store is using multiple Carry HotTm bags,do not stack them on top of each other with product inside. i Use the clean in place method daily to clean and sanitize the interior and exterior of the bag;more often as required i Do not store the bags on the floor,oven,or heated display case Do not use the bag for anything other than whole pizzas When using the bag to hold product,they must be on a stainless steel surface 1. Heat pizza according to procedures(see NMI-- Preparing and Serving Pizza for more _ - �—-- �/ information).` 2. While pizza is heating,assemble pizza box. won 3. Wearing oven mitts,remove the pizza from ■ oven and place in the pizza box. 4. Cut pizza using the pizza cutter Trt; a 5. Close pizza box and place directly into Carry Hot . bag �.-•-- - 6. Seal the bag using the attached Velcro(or use the Velcro and straps if less than three pizzas) V fi 7. Place up to 3 pizzas in bag for a maximum of 15 minutes. 3 . 8. When GUEST arrives,remove pizza(s)from bag g and complete transaction. - a 74 ,. *� 6 K�- ©2013 7-Eleven,Inc. Page 1 �o 10 zo13 f�+TZ64 twl 10 PV I& Hot Foods Under Display Setup This supports procedures outlined in the Operations Manual. f——————————————————I r————————i i---------I I I 1 Chicken Dipper I I I I Pizza Slice Box Single Serve Box I I Sauce I I HF Snack Bag I (Open side down with (Dippers,5 Wings,3 I I (High Usage) Tenders) white top facing out) Bottom facing up __________ ._________ 1 -------- ————————— L——————————————————� I Chicken Dipper I Chicken Dipper Sauce I Sauce 1 I (Low Usage) ----------------- (Medium Usage) II ---------- '--------� 1 I r--------i I--------- I I I I I I I I I Condiments I I Condiments I I I I I I I I I I I I I Print this form and write the food product name in location space provi e a ove with the most frequently used on the top. Reprint and re-label this form when new products are introduced or top sellers change. Food Item Hold Time Packaging Type Food Item Hold Time Packaging Type Chicken Wing(<to) 2 Hours FTG SgISrvBox Egg Roll 1 Hour HF Snack Bag Chicken Tender(1) 2 Hours HF Snack Bag Jamaican Beef Patty 2 Hours HF Snack Bag Chicken Tender(>_3) 2 Hours FTG S ISrvBox Pizza Slice(1) 1 Hour FTG Pizza Box Flute Chicken Dipper 2 Hours FTG S ISrvBox Pizza Whole 1 Hour FTG Pizza Box Doritos Loaded 1 Hour Doritos Box Potato Wedges 1 Hour HF Snack Bag Mini Tacos 2 Hours HF Snack Bag Hash Brown Bites 1 Hour HF Snack Bag Breakfast Empanada 12 Hours I HF Snack Bag IStuffed Hash Brown 1 Hour HF Snack Bag Standardize-Under Counter Freezer Display Hot Food Products Display a maximum of eight(8)unique SKUs and two(2)pizzas Top Shelf Chicken Products Middle Shelf Snack Items Bottom Shelf Pizza and/or Breakfast Sandwiches Storing Product Packaging Store pizza slice boxes with bottom side facing up and pointed at you. Store the most frequently used packaging in top drawer. Store the least frequently used packaging in the lower drawer. Do not store retail sauces here;place them in front of the hot food display case. Displaying Hot Food Products Follow the directions in the Hot Food Display Case Job aid to set the case timers. Follow the hold times listed above. Cleaning Following the manufacturer's daily and weekly cleaning and sanitizing guidelines. Clean the display case and cabinet daily using the 3-bottle cleaning method. Clean the smallwares and utensils daily using the 3-compartment sink method. Fill the x 4" metal pan with sanitizer and place utensils in pan. Replace sanitizer every two (2) hours or after heavy use. Merchandising>Fresh Food>Wall Charts and Quick Reference>Hot Food Wall Charts Updated: o6/19/15 ELOEn Heating and Holding Chart SETTINGS (Heat/Hold) Grill Size Taquito Grill* Hot Dogs Grill* Star - 45 - Standard Sneeze Guard 7/5 7/4 Star - 75 - Standard Sneeze Guard 8/5 7/4 Star - 75 - Recessed, High Profile 9/5 9/6 Sneeze Guard AP Wyott - Recessed High Profile Heat/Hold Heat/Hold Sneeze Guard AIT/ADCO - 75 Standard Sneeze 7/2 7/2 Guard AIT/ADCO - 75 Recessed, High Profile 8/3 8/3 Sneeze Guard © 2012 7-Eleven, Inc. Updated 11/01/2012 t Using the Turbo Chef Encore Oven Using the TurboChef Encore Oven 7-Eleven use the(TurboChef) Encore Oven to reheat or toast fresh food ' products. The oven: _ • uses convection(forced hot air,up to 6o MPH),microwave,and radiant energy to heat foods - : • can heat foods 12 times faster than conventional heating _, .- • bottom radiant heater transfers heat to the bottom of the food • The cook chamber is the cavity in which you place the food for heating. Mill z r r Cooking Cavity ENS r Oven Heating Stone r Raised Rack .3 { _ 1110 Under Counter Refrigerator '�llill��� :9 •`:.,. el Y4,1C L;111. M ...� Y^� Under Counter Freezer It E Oven Counter ©2013 7-Eleven,Inc. Page 11 1014/2013 Using the Turbo Chef Encore Oven off Heating Basket Mesh Pad Heating Basket Liner Oven Paddle — ___ Li Pizza Cutter Tongs _ G VON lLU VON W/ Pizza Pan Display Tray and Display Tray LinerAL _ %Y Oven Mitt - -- 't - Thermometer s� x 3 ©2013 7-Eleven, Inc. Page z 1014/2013 �I i Using the Turbo Chef Encore Oven • After the oven is plugged in,it a powers on and eventually enters sleep mode. _ • The screen displays OVEN 3; OFF.The oven also goes idle if -- j it is not used for more than an s hour. WARMNG UP • When the oven is ready to use,the display shows READY y TO COOK. • The display will then show the pre-programmed menus. =� 1. Press any key or open the 2. Press the ON/OFF key.The door to light up the screen. screen shows WARMING UP. Using the Encore Oven's Programmable Menu EN - ®/ 10 7 7 » $ a� / ) w/ �� C o 06 n On/Off key turn the oven on(warm-up)or off(cool-down) . i key used to enter"Info"mode,for menu editing, updating,viewing oven logs, settings,etc. Arrow keys used to move between screens Display shows information relevant to the current oven operation and/or user options. Back/Stop key stop a cook cycle,move to previous screen or edit Enter key saved selection or entered data ' Soft keys menu keys used to select product types and other functions Numeric keypad used to enter data in edit mode or cook times manually Brown More key use if outside of food item requires more browning or crisping Cook More key use if inside of food item requires more cooking Cook&Brown More key use if both inside and outside of food item require more cooking ©2013 7-Eleven,Inc. Page 13 10/4/2013 Using the Turbo Chef Encore Oven Bone In Wings Boneless When the oven is ready to use,the a display shows READY TO COOK. The display will then show the pre- M programmed menus on the screen. 1. Prepare the product for 2. Press the soft key next to the heating.Open the door and desired menu group. Press place the product in the oven. the up or down arrow keys,if ' needed. LA e r CDOKING DONE rr. e o PLEASE REIVE FOOD FROM OVEUEON L 1 m °lip 3. Press the soft key next to the 4. When the cook time is 6. Check the temperature of the item in the menu group. complete,an alarm sounds item. If it needs additional The display shows COOKING, and the screen shows DONE heating,follow the Cook e� and the oven re-heats the PLEASE CHECK FOOD. More, Brown More steps. product according to the 5. Open the oven door,remove preset amount of time. the product,and shut the door. To stop a cook cycle,press the BACK/STOP soft key. ©2013 7-Eleven, Inc. Page 14 10/4/2013 Using the Turbo Chef Encore Oven If a heated product is below the proper serving temperature or looks undercooked,the product needs to be heated more. Refer to the products'Quality Assurance Job Aids for more information. The Encore oven has the following keys: COOK MORE inside of food requires more cooking more microwave BROWN MORE Outside of food requires more browning or crisping more convection COOK+BROWN inside and outside of the food require more cooking more microwave&convection Press one of the keys oven starts a 15-second cook cycle Press the key again oven adds 15 seconds to the cook cycle,up to 5 minutes Cook food items longer Use these keys to - Cook food items"on the fly" e&4 1. Place the product in the oven and close the door. , � 2. Select the appropriate option. 3. When the heating time ends,the screen shows DONE. ' PLEASE CHECK FOOD. . a 4. Take the product out of the oven and check the _ temperature again. If the product is still not to the proper temperature or quality,repeat the steps. -- r s� -Y - ©2013 7-Eleven,Inc. Page 5 101412013 f Using the Turbo Chef Encore Oven Oven Door . y.Op en and close the oven door gently. V • • Do not pull the door down with excessive force. • Do not jerk the door or slam it shut. 1A } Airflow • Keep the airflow open. • Do not block airflow in the back or sides of the unit. b Every 16o hours of operation,the oven will display a message to clean i r' the oven filter.When this happens: t. Remove the oven filter(pictured)and rinse it with water. z. If the mesh is deteriorated,replace the filter with a new one. 3. Re-install the filter before cooking. „ a e 4. Press"o"to clear the message and return the oven to its normal 10 operation. / Utensils • Do not touch the heating basket(black tray)with bare hands ` immediately after removing product from the oven. o/ • Use only serving utensils to transfer product. Cleaning • Do not perform daily cleaning procedures when the oven is in operation or cooling down.Wait until OVEN OFF READY TO CLEAN displays on the screen. a • Do not remove the rack or oven(baking)stone when the oven is hot. ,y ©2013 7-Eleven,Inc. Page 6 101412013 Using the Turbo Chef Encore Oven Hands .= • Do not touch the inside surface of the door when it is open. R` {` • Do not put bare hands in the oven. - s 4 � r • Always use the oven paddle and oven mitts to place product in the --'" oven or remove product from the oven. o PON f 4 ©2013 7-Eleven,Inc. Page 7 10/4/2013 Using the Turbo Chef Encore Oven 1. The Encore Oven has a drip tray to capture the grease and an air filter system.You must clean both of these items daily. 2. There should 32 oz.of water(equivalent of a Big Gulp cup)in they . pan at all times while it is operating. Drain excess water throughout the day;most stores drain the pan at the beginning of second shift. 3. If your store sells approximately$800-goo in hot foods per day,you _- will clean the drip pan twice a day. , - - 1. Press the ONIOFF key until the screen shows COOLING DOWN. _ COOLING DOWN PLEASE OPEN OVEN MOR Li CC 165F VON ME O EON MM IMP 77 ©2013 7-Eleven,Inc. Page 8 10/4/2013 r antrZi its E E>uEn Held Hot: Holding Cabinet Preparation, Display and Cleaning/Sanitizing Note:Always run trial batches on any new item before holding in warmer. Materials Needed: • Clean,sanitized Held Hot unit • In-code products • Clean, sanitized microwave • Clean, sanitized probe and surface thermometers Preheat Warmer • Set thermostat to setting 4-5,to maintain a thermometer temperature of 150°F-160°F/65°C- 71°C • Check internal thermometer. • Pre-heat for 25 minutes • Microwave sandwiches prior to displaying in the Wisco. Verify temperature is 155°F-165°F/66°C - 74°C. • Time stamp all sandwiches(2 hour shelf life). Stock Warmer with Preheated Products • Place preheated product into Held Hot unit. Use trays or mitts to handle product. Do not stack products. Use single layers. Lay flat. Restock Warmer with Preheated Products as Needed • Place preheated product into Held Hot unit. • Use trays or mitts to handle product. • Do not stack- Use single layers and lay flat. • Check expiration dates regularly. • Remove unsalable or expired product. • Rotate product so oldest product is closest to guest. Remove Unsalable Product • Remove at end of expiration time or if product temperature falls below 140°F/609C. • Follow local procedures for discard. • If you pull an out of code product and its temperature is below 140°F/609C, pull all units of that product from the Held Hot case. © 2013 7-Eleven, Inc. Updated 03/04/2013 ELEVE n - - Held Hot: Holding Cabinet Preparation, Display and Cleaning/Sanitizing • Check their temperatures. Before you again display this product in the Held Hot case, see Product Preparation section to make sure you are preparing product correctly. NOTE: This will help you decide if the problem is improper preheating or if your Held Hot unit is unable to keep the product at a safe temperature Verify Current Procedure • Temperature probe product before discard. • If the product temperature is below 140°F/60°C,the product was not preheated correctly in the microwave or your Held Hot unit will not hold this product at the correct temperature for 2 hours. NOTE:The setting may need to be higher or your Held Hot unit is not operating properly. Daily Cleaning • Turn off unit. • Allow unit to cool. • Wash, rinse,and sanitize using 3-Bottle Clean-in-Place Method. © 2013 7-Eleven, Inc. Updated 03/04/2013 t ' f Item 023 EVERPURE'HF CSR.,PLUS-XC(2)2SR X,,W/O1PA,.MODEL EV934710 HIM cOverall_Dimensions:_29&9"H x.31.58"W_x�6.75"D (excludes-tank cService_FIow=Rate: Maximum_6 7°00 (25A Epm) Connectio is:_Inlet.connection: 3/4 Outlet connection:_3/4 Rated_capacity_: 48;000_gallons_(181,699.87L), �Pressure_Requirerr 1O. 125_psi(0:7 8:6_bar), non-shock LMaximumaTemperature:_351-100°F=(2- 38°C) E_Electrical_Power_Supply:_None_required A Operating Weight:,50_Ibs._system; 60 Ibstank (22.78 kg system;_27.22_kg_tank) CShipping Weight: System is packed_in two'boxes_and cari.be_shipped via UPS. Box System: 44; Ibs.;- Box 2,_Surge Tank:_28rlbs. - See_more_at htto-//-est-aurqpttory.com/­�pver.r)ure-hf-csr-, plusxc22srxgvv-o-Ip!_model ev9347-10:asp#accessoriesjump t. � IIGI 11 VLF.! PROJECT: 11145 Monroe Road NSF CUSTOMER: S S Matthews,NC.28105 Phone: (704)841-1090 LOCATION: ORACLE 3145472 Fax. (704)841-1590 DRAWN BY.' CHECKED BY.- SELECT STAINLESS UL ITEM#: DATE: ® QUANTITY: REVISION DATE.' 10YR Manufacturer of Quality Food Service Equipment MODEL: 3B1219-2D18-SS-SK-HFSL-CRSL-CUSTOM I SHEET: 1 OF 2 APPROVED FOR FABRICATION ❑ APPROVED ❑ APPROVED AS NOTED ❑ RESUBMIT APPROVED BY.- TITLE DATE. 72" 1811 12" 1211 1211 18'1 I` ---- ------ --—� � � � r i I C} PLAN VIEW A SCALE:3/4"=F-0" 1-1/8"0 16 GA S/S TOP&SINKS (` 8" 0 S/S SKIRT 1. 15/8"DIA, S/S LEGS, S/S GUSSETS & ADJ S/S BULLET FEET ELEVATION SCALE:314"=V-0" N-Wisr. fr11P.r:R SP.vpn P.P.VP.rI . . - - - - wn r PROJECT. 11145 Monroe Road NSF CUSTOMER: S S Matthews,NC.28105 Phone: (704)841-1090 LOCATION: ORACLE 3145472 Fax: (704)841-1590 DRAWNBY: CHECKED BY: SELECT STAINLESS UL ITEM#: DATE: ® 10YR Manufacturer of Quality Food Service Equipment QUANTITY REVISION DATE. 381219-2D18-SS-SK-HFSL-CRSL-CUSTOM I SHEET: 2 OF 2 "SINKS" GENERAL NOTES: APPROVED FOR FABRICATION ❑ APPROVED 1. TOP: 16 GA. S/S ❑ APPROVED AS NOTED A. REINFORCEMENT.• S/S ❑ RESUBMIT 2. SINK BOWL: 16 GA. S/S; 12"X 19"X 12"(D) APPROVED BY.- TITLE DATE: A. FULL SKIRT: 18 GA. S/S B. BASKET DRAIN: BK RESOURCES "BKDR-4" FAUCETS 3. LEGS & CROSSBRACING: 15/8"DIA. S/S TUBING BY OTHERS A. S/S GUSSETS: COMPONENT HARDWARE "A18-0206" B. ADJ S/S BULLET FEET COMPONENT HARDWARE "A10-0851" 25" 2"@ 45° 11/4" 11/2" N 19" N M O SECTION "A" SCALE:1 112"=1'V isr. rniPctc cPvPn P PvPn . . - -, , -, - -(- -(-I wn t Item 037 SELECT STAINLESS PRODUCTION LINE PRODUCTS SMALL HAND SINK FEATURES&CONSTRUCTION: Our sink bowls are fabricated using type 304 stainless steel. Our top is constructed with an inverted"V"edge to prevent water run-off. Our backsplash is 6"tall from the deck, with a 2"return at 45'and a standard 314"rear turn down. It includes a splash-mounted gooseneck faucet. 0 The sink bowl is 6-314"deep and includes a 1-112"NPS small basket strainer. 0 STANDARD SIZES (in.) MODEL BOWL LENGTH WIDTH L HEIGHT PL-SHS-1 14 X 10 18-718" 14-314" 12-314" REV.07-23-13 Item 037 SELECT STAINLESS DATE. MODEL NO: PRODUCTS PROJECT: SPECIFICATIONS PRODUCTION LINE SMALL HAND SINK DSFo 18 718" 2 7/16" 14" 2 7116" A 14 314" If PLAN VIEW 2"@45° 10" 1 112" f�1 1/8"HOLES 4" ELEVATION SECTION 'A" DIMENSIONS (in.) MODEL APPROX. WT. Ibs. ** PL-SHS-1 10 REV.07-23-13 Select Stainless Products 11145 Monroe Road Matthews,NC 28105 Phone:704-841-1090 Toll Free: 1-888-843-2345 Fax:704-841-1590 Item 037 23.875 CHECK FOR AND DEBUR ANY SHARP EDGES. 0.250 HEM 23.875 23.875 SECTION B-B GRIND RADIUS SECTION C-C (2)CORNERS A I 62- C 16.084 C 138' I D 4 0.550 A �i 1.000 HEM C B B SECTION A-A DETAIL D 17.783 NEXT STEP:IWEIGHT: RAC AREA: ROYSTON LLC These desiONE PICKROY ROAD popneary9nsare SHIP 10.31b 13.428ftA2 NEROYST®N' JASPER,GA0143 information,property O eYdneO n eSS PART DESCRIPTION (770)735-3456 of ROYSTON LLC. Otherwise Noted GRD,SPL,16.08X23.88X23.74,ANG-SDE,HEM,S They shall not be .xxx=x.010 copied or duplicated .xx=x 020 REF.a 7r i01 I —I in an manner without C ECN 9933 JCD 04-28-09 Angles=m 1' 6/2/2008 25541 Y Hole De.=x.003 prior written consent, B ECN 9606 WAS 29.739 LONG REP 08-22-08 MATERIAL Ic ss oRAwN ev PART a A INITIAL PRODUCTION RELEASE REP 06-13-08 SS,430-3 PP2S .037 jeremy.dobson 22058312 a REVISION BY DATE \\jasdc.roystonllc.com\se$\part\GRD,SPL\GRD,SPL,16.08X23.88X23.74,ANG-SDE,HEM,SS.dit PRINTED 6/6/2009 Item 037 r c a Mo N O N OM 0) co I� O N M co N N V co O 17.783 17.516 6.084 5.474 219X.438 2.256 — f OBR(6) 1.521 0.905 d o 1-/ 00.000 — O 00 00 � IT I O Cn M M Nil � (D O O O cp M V 00 (O O - 00 f` O 00 O N - - 7 N N V Ln � CO WEIGHT: `'^ ^w, ONE P KROY ROAD ROYSTON LLC III 10.3 Ibm EM®RO ` T N ASPER,GA30143 SURFACE AREA: VVV a ��JJ VVV (770)735.3456 PMTq 13.428 ftA2 SHEET 2 OF 2 22058312 \\jasdc.roystonlic.com\se$\part\GRD,SPL\GRD,SPL,16.08X23.88X23.74,ANG-SDE,HEM,SS.dit PRINTED 6/6/2009 Item 065----- i - • - `ter � _ - -4 - 57 ., Commercial. ' � r Microwave, Oven _ i W4 RfY on ds a w � 1 : 'X MIThl Trio a o' Ipl?'��• yl 9 e fl 1 1 1 . 1 . . 1 i I. t •ra - TM � q t e • y 1 ti Bly�t + U+w UKAS -� .... -IM-1110A ISO 14001 m,wrra,ua 091 A 3 hftp://,www.p'aknasonic.com/cmo f Item 065 PO r° _ N ,Eml 757 } 1700 Watt* NE-1021 Commercial Microwave NE-1051 � Oven + • 1700 Watts* of power i i' • 2 magnetrons Technical Specifications I (heating elements) p Top and bottom energy feed Power source:208/230-240V, 60Hz, Single phase - - • NE-1056 Receptacle required: N E M A 6-15 R or O • "Grab & Go" door handle NEMA 6-20R Frequency:2,450 M H z • Large oven capacity: gr°I 0.6 cubic feet only 16 5/8" wide Required power:208V (14.3A), 230-240V (13.1A) • Chef technical support Output*: 1700 watts �� • Fits one 6 tall, half size steam Outer dimensions: 16'A"w x 20"d x 13'&4 h table pan with cover Cavity dimensions: 13"w x 12"d x 6'A"h • 60 programmable memory Net weight:61 Its. 3 power levels Shipping weight: NE-1257/NE-1258 • 3-stage cooking Shipping box size: 19 15/6"w x 24'W'd x 16 T'h, 4.7 f' Timer: Maximum times for each stage of cooking • Enhanced diagnostics — Hi and Med. power=15 minutes - • Cycle counter - Defrost=30 minutes • One touch" start feature To specify a Panasonic • Programmable lock Commercial Microwave Oven: • Easy to clean air filter with reminder The NE-1757 Commercial Microwave Oven meets or NE-1757 exceeds all safety performance and sanitation standards • Stainless steel cabinet& cavity set for commercial food service microwave ovens by: UL,HHS,FCC and NSF. • Patented safety door seal system Plus,oven shall have output power 1700 watts,top and • See-through oven door bottom energy feed,Grab&Go door handle,patented safety door seal system,60 programmable memory, • Removable ceiling splatter shield 3-stage cooking, 3 power levels(HI, MED., DER), -` digital display w/countdown, programmable lock, self- Digital display diagnostics,oven cycle counter,stackable,video training and Chef/Test Kitchen technical support. NE•2157 • stackable *i.E.C.705-88 Test Procedure.Specifications subject to change • Only 61 lbs. without notice. • Will ship via UPS 20" I- 16 V I 1 '/,e' 18'%2" 1 'Az" 35 2A2" NE-2180 I--15 2 11 �- 18'/a p Panasonic Home and Commercial Products Company Commercial Foodservice Division One Panasonic Way,Panazip 4A-4,Secaucus,NJ 07094 TEL:(201)348-5377 FAX:(800)553-0384 NE-3280 http://Www.panasonic.com/Cmo Item 074 R® Star Manu�facturi,.ng, _.:Intorn'ational , Inc PERISTALTIC HEATED CONDIMENT DISPENSERS Models HPDE1, HPDE1 P, HPDE1 H, HPDE1 HP Models HPDE2, HPDE2P, HPDE2H, HPDE2HP Features/Benefits: • Adjustable electronic temperature and quality control for perfectly warmed pre-measured product every time. - * Attractive design in a smaller footprint to fit in locations where =: ° space is a premium. High impact plastic keeps the front and sides I of the unit cool to the touch. • Patented heating and pumping system designed for safe, efficient and consistent dispensing of Nacho Cheese, Chili and other =_ • pouched hot condiments. • Patented forced air heating system for precise uniform c temperature. -_ • No more pumps to clean and sanitize. Patented peristaltic pump design evacuates product directly from plastic pouch to plate andwhen the ouch is empty, simply discard and easily load a new P ..PtY P Y Y - pouch in seconds! • 95% plus evacuation of pouch reduces waste and saves money. ° • No mess, no fuss, no more messy cans. Unit dispenses one or two 6 pound pouches while holding additional pouch(es)for pre-heating. • Unit operates 24/7- No need to heat and reheat product requiring Model HPDE1 (cheese not included) less handling of product. • Available in single or double units, with or without portion control � for your specific serving needs. /A • High speed motor dispenses one ounce every second or choose our standard motor to dispense one ounce every three seconds for lower volume or self serve operations. ' • Double wall construction for quiet and cool operation. -M^ ' .I  A' • Removable stainless steel drip tray for easy cleaning. • Lighted on/off switch for quick, easy visual confirmation of power., 42 • Eye-catching colorful merchandising graphics to build impulse sales. , , Applications: Star's Peristaltic Dispensers dispense delicious hot foods such as A. k chili, cheese, spaghetti sauce, gravies and many other pouched hot , condiment products with the touch of a button. Located in conven- ience stores, concessions, recreational facilities, restaurants, institu- tions or wherever you might need to safely dispense a pre-measured product at the touch of a button. Quality Construction: Star's Peristaltic Dispensers are constructed of stainless steel with ABS side panels and door. 0150SiR/40o Warranty: ® C P US 1 Star's peristaltic dispensers are covered by Star's one year parts and OWMCAMN 9 labor warranty. 150 400Io2000 I I k Star Manufacturing International Inc.- 10 Sunnen Drive-P.O. Box 430129-St. Louis, MO 63143-3800 Phone:(800)264-7827-FAX: (800)264-6666-www.star-mfg.com S257/0117 ncri vr-r ";� - Star Manufacturing International , In, c . PERISTALTIC HEATED CONDIMENT DISPENSERS ' Models HPDE1, HPDE1 P, HPDE1 H, HPDE1 HP Models HPDE2, HPDE2P, HPDE2H, HPDE2HP • • C • - d Electrical Dimensions Approximate Weight Width DepthHeight Installed Shipping Nema Inches Inches Inches lbs. lbs. Model Description Volts Motor Watts Amps Plug A cm B cm C cm k k HPDE1 Single Hot Food Dispenser 120V 75 RPM 820 7 5-15P 9-7/16 20-7/16 26-13/16 36 lbs. 45 lbs. 230 3.5 CEE7-7 23.97 51.99 68.10 16.34 20.43 HPDE1P Single Hot Food Dispenser 120V 75 RPM 820 7 5-15P 9-7/16 20-7/16 26-13/16 36 lbs. 48 lbs. w/portion control 230V 3.5 CEE7-7 (23.97) (51.91) (68.10) (16.34) (21.6) HPDE1 H Single Hot Food Dispenser 120V 165 RPM 820 7 5-15P 9-7/16 20-7/16 26-13/16 36 lbs. 46 lbs. High Performance 230V 3.5 CEE7-7 23.97 51.91 68.10 16.34 20.7 HPDE1HP Single Hot Food Dispenser 120V 165 RPM 820 7 5-15P 1 9-7/16 20-7/16 26-13/16 36 lbs. 48 lbs. High Performance 230V 3.5 CEE7-7 (23.97) (51.91) (68,10) (16.34) (21.6) with Portion Control HPDE2 Double Hot Food Dispenser 120V 75 RPM 1000 8.5 5-15P 14-5/16 20-7/16 26-13/16 50 lbs. 61 lbs. 230V 4.5 CEE7-7 36.35 51.91 68.10 22.7 27.5 HPDE2P Double Hot Food Dispenser 120V 75 RPM 1000 8.5 5-15P 14-5/16 20-7/16 26-13/16 50 lbs. 61 lbs. w/portion control 230 4.5 CEE7-7 36.35 51.91 68.10 22.7 27.5 HPDE2H Double Hot Food Dispenser 120V 165 RPM 1000 8.5 5-15P 14-5/16 20-7/16 26-13116 50 lbs. 61 lbs. High Performance 230V 1 4.5 CEE7-7 (36,35) (51.91) (68.10) (22.7) (27.5) HPDE2HP Double Hot Food Dispenser 120V 165 RPM 1000 8.5 5-15P 14-5/16 20-7/16 26-13/16 50 lbs. 61 lbs. High Performance 230V 4.5 CEE7-7 (36.35) (51.91) (68.10) (22.7) (27.5) with Portion Control Peristaltic dispensers have stainless steel construction with high impact plastic side panels and door. Units have adjustable electronic temperature control and an optional adjustable portion control . Dispensers have a patented forced air heating system for precise uni- form temperature. Dispensers have 75 or 165 RPM motor for high output. Units have a lighted on/off switch and removable stainless steel drip tray. Patented peristaltic dispensers are shipped with a 6 foot lead in cord with a molded plug NEMA 5-15P and CEE7-7 for 230V units. Units are listed by UL, CUL and UL-Sanitation Classified to NSF Std.#18. U.S.Pat. No.6,016,935. Printed in the U.S.A. Due to periodic changes in designs,methods,procedures,policies and regulations,the specifications contained in this sheet are subject to change without notice.While Star Manufacturing exercises good faith efforts to provide information that is accurate,we are not responsible for errors or omissions in information provided or conclusions reached as a result of using the specifications.By using the information provided,the user assumes all risks in connection with such use. Star Manufacturing International Inc.- 10 Sunnen Drive-P.O. Box 430129-St. Louis, MO 63143-3800 Phone: (800)264-7827-FAX: (800)264-6666-www.star-mfg.com ' Item 078 TR W/SCO /NOUSTR/ES, /NC_ MODEL 690-16 & 690-25 Model 690-25 2Door Shown Model 690-16 Single door shown These warmers utilize circulating, heated air to maintain food above 150°F for extended periods of time. Their versatility is showcased with a shelving system that allows YOU to adjust the shelves to your specific needs resulting in an endless variety of food items it can accommodate. I -Acrylic display VOLTS: 120 AMPS: 5.3 WATTS: 640 -Adjustable thermostat - Temperatures from 80OF to - Best when operated on an individual branch circuit above 150T. - 6' power cord length - Stainless steel corners and base rZZ131101111,111i in i ill, _ - 2-door "self-serve" option available ® _® - ME _ -Additional shelves (#0016388) available MODEL690-16:, 18 Lx 18 Wx25 H MODEL 690-16: MODEL 690-25• *Available as single door or 2 door pass through unit 18"L x 18"W x 34"H *Total height of available shelf space: 14" *Unit comes with 2 shelves MODEL 690-25: *Available as single door or 2 door pass through unit ;MODEL 690-16: *Total height of available shelf space: 23" SHIPPING DIMENSIONS: 24"L x 24"W x 32"H *Unit comes with 4 shelves SHIPPING WEIGHT: 43 lbs. !� =s C U1. US MODEL 690-25: SHIPPING DIMENSIONS: 26"L x 26"W x 45"H t LISTED SHIPPING WEIGHT: 63 lbs. FP140104-16M % I x L 08-13-14 Rr * Must ship via Freight Truck i• Oregon, 608.835.3106 • : : i oind.com - wiscomade.com Project m TUR • OCHE7 Item No. 082 Z n Quantity O ENCORETM m EXTERIOR CONSTRUCTION ■ Powder coated,corrosion-resistant steel outer wrap ■ Powder coated,corrosion-resistant aluminum front panels and door ■ Cool-to-touch exterior;all surfaces below 122°F (50°C) I ■ Ergonomic door handle INTERIOR CONSTRUCTION ■ 201 stainless steel ■ Fully welded and insulated cook chamber ■ Removable rack and lower jetplate FEATURES ■ Easy to clean PERFORMANCE ■ Integral recirculating catalytic converter for UL(KNLZ) listed The TurboChef Encore oven uses radiant ventless operation heat, high-speed air impingement,and ■ Variable-speed High h recirculating impingement airflow side-launched microwave to cook food ■ Independent bottom temperature offset rapidly without compromising quality. ■ Smart menu system capable of storing up to 256 recipes ■ Light ring provides visual cues for cooking VENTILATION Built-in self-diagnostics for monitoring oven components • UL(KNLZ) listed for ventless operation. and performance ■ Stackable design (requires stacking kit) ■ EPA 2o2 test(8 hr): ■ USB and Smart card compatible - Product:Pepperoni Pizzas - Results:0.13 mg/m3 • Smart Voltage Sensor Technology* (U.S.only) - Ventless Requirement:<5.00 mg/m3 ■ Includes plug and cord (6 ft. nominal) ■ Internal catalytic filtration to limit smoke, ' Warranty— 1 year parts and labor grease,and odor emissions. STANDARD ACCESSORIES ■ 1 Baking Stone (ENC-3012) ■ 1 Oven Rack(ENC-1279) 1 Aluminum Paddle (NGC-1478) 00000000� ■ 1 Bottle Oven Cleaner(103180) ■ 1 Bottle Oven Guard (103181) ■ 2 Trigger Sprayers (103182) (�(© ■ 2 PTFE Baskets (NGC-1331) o CULUS T f ANSIIN- - 815Y f This product conforms to the ventilation recommendations set forth by NFPA96 using © � EPA202 test method. 'y Q Smart Voltage Sensor Technology does not compensate for lack of or over voltage situations.It is the 41. 4responsibility of the owner to supply voltage to the unit according to the specifications on the back of this sheet. � for `�� a!© t Ventless certification is for all food items except for foods classified as"fatty raw proteins."Such foods include bone-in,skin-on chicken,raw hamburger meat,raw bacon,raw sausage,steaks,etc.If cooking these types of foods,consult local HVAC codes and authorities to ensure compliance with ventilation requirements. Ultimate ventless allowance is dependent upon AHJ approval,as some jurisdictions may not recognize the UL certification or application.If you have questions regard,ng ventless certifications or local codes please 1. Impingement Heater 6. Catalytic Converter email ventless.help@turbochef.com 2. Bottom Browning Element 7.Vent Catalyst 3. Side-Launched Microwave 8. Air Filter TurboChef reserves the right to make substitutions of components or change specifications without prior notice. 4. Blower Motor 9. Inlet Air for Cooling 5. Impinged Air Electrical Components DOC-1314/Revision G/ May 2013 TURBOCHEF Item 082 32.7"(831 mm) 21.4"(544 mm 30.2"(767 mm) /w �'�'1'�'�I�I''f'�I�I�I�I4'I,pu •o �0 LL 19" ' O (483 mm) II�WIIW�(7 D 0 o O � V Z IF 4" W4 28.6"(726 mm) (102�mm) DIMENSIONS Encore JK Model 50 Hz(ENC-9500-8-JK)-Japan Single Units JK Model 60 Hz(cNC-9500-10-JK)-Japan Voltage 220 VAC Height 19" 483 mm with legs 23" 584 mm Frequency 50 or 60 Hz Current(Max Circuit Requirement) 30 amps(30 amps) d Width 21.4" 544 mm NEMA L6-50,PSE, Max Input(MW Input) 6.7 kW(3.5 kW) 3-blade Depth(footprint) 28.6" 726 mm with door closed 32.7" 831 mm SPECIFICATIONS-MULTIELECTRICAL with door open 39.4" 1000 mm Encore ED Model(ENC-9500-3-ED)-Europe/Asia Delta Voltage 230 VAC Weight 185lb 84 kg o o O Stacked Units(Stacking Kit Required) Frequency 50 Hz o Height 38.5" 978 mm Current(Max Circuit Requirement) 30 amps(30 amps) with legs(bottom oven) 42.5" 1080 mm Max Input(MW Input) 6.7 kW(3.5 kW) IEC 309,4-pin Width 21.4" 544 mm Encore EW Model(ENC-9500-4-EW)-Europe/Asia Wye Depth(footprint) 28.6" 726 mm Voltage 400 VAC o 0 o 0 with door closed 32.7" 831 mm Frequency 50 Hz O with door open 39.4" 1000 mm Current(Max Circuit Requirement) 16 amps(20 amps) Max Input(MW Input; 6.7 kW(3.5 kW) IEC 309,5-pin Weight 370lb 168 kg Cook Chamber Encore AU Model(ENC-9500-5-AU)-Australia/New Zealand Wye Voltage 400 VAC Height 6" 152 mm O Frequency 50 Hz O o O Width 15.5" 394 mm Current(Max Circuit Requirement) 16 amps(20 amps) O Depth 14.5" 368 mm Volume 0.78 cu.ft. 22.1 liters Max Input(MW Input) 6.7 kW(3.5 kW) Clipsal,5-pin Encore 1D Model 50 Hz(ENC-9500-9-JD)-Japan Delta Wall Clearance (Oven not intended for built-in installation) JD Model 60 Hz(ENC-9500-11-JD)-Japan Delta Top 5" 127 mm Voltage 200 VAC Sides 2" 51 mm Frequency 50 or 60 Hz Q D SPECIFICATIONS-SINGLEELECTRICAL Current(Max Circuit Requirement) 30 amps(30 amps) d NEMA L6-50,PSE, Encore US Model(ENC-9500-1)-North America Max Input(MW Input) 6.7 kW(3.5 kW) 4-blade Voltage 208/240VAC Encore KW Model(ENC-9500-12-KW)-Korea/Middle East Wye Frequency 60 Hz o o Voltage 400VAC Current(Max Circuit Requirement) 30 amps(30 amps) ' Frequency 60 Hz o 0 208:5.99 kW(3.5 kW) NEMA 6-30P Current(Max Circuit Requirement) 16 amps(20 amps) O Max Input(MW Input) 240:6.675 kW(3.5 kW) Max Input(MW Input) 6.7 kW(3.5 kW) IEC 309,5-pin Encore UK Model(ENC-9500-2-UK)-Europe/Asia Encore SD Model(ENC-9500-13-SD)-Korea/Middle East Delta Voltage 230 VAC Voltage 230 VAC Frequency 50 Hz o 0 0 O o O Current(Max Circuit Requirement) 30 amps(30 amps) Frequency 60 Hz o Current(Max Circuit Requirement) 30 amps(30 amps) Max Input(MW Input) 6.7 kW(3.5 kW) EC 309,3-pin Max Input(MW Input) 6.7 kW(3.5 kW) IEC 309,4-pin Encore BK Model(ENC-9500-6-BK)-Brazil "SHIPPING INFORMATION Voltage 220 VAC 0 o U.S.:All ovens shipped within the U.S.are packaged in a double-wall Frequency 60 Hz corrugated box banded to a wooden skid. Current(Max Circuit Requirement) 30 amps(30 amps) O International:All International ovens shipped via Air or Less than Container Loads are packaged in wooden crates. Max Input(MW Input) 6.7 kW(3.5 kW) IEC 309,3-pin Box size:35.8"x 26.4"x 26.3"•,909 mm x 671 mm x 668 mm) Encore LA Model(ENC-9500-7-LA)-Latin America Crate size:40"x 36"x 35"(1016 mm x 914 mm x 889 mm) Item class:85 NMFC#26770 HS code 8419.81 Voltage 220VAC Approximate boxed weight:235 lb.(106.6 kg) Frequency 60 Hz o o Approximate crated weight:310lb.(140.6 kg) Current(Max Circuit Requirement) 30 amps(30 amps)) Minimum entry clearance required for box: 26.8"(681 mm) Max Input(MW Input) 6.7 kW(3.5 kW) NEMA 6-30P Minimum entry clearance required for crate:35.5"(902 mm) TurboChef Global Operations TurboChef requires installing a type D circuit breaker 2801 Trade Center Drive/Carrollton,Texas 75007 USA for all installations. US:800.90TURBO(800.908.8726)/International:+1 214.379.6000 Fax:+1 214.379.6073/www.turbochefcom ©2011-2013 TurboChef Tech nologies,Inc. Project = REFR/GERATORMANUFACTURER 4184 E. Conant St. _ AV Long Beach, CA 90808 Model#: aIr Tel. 310-900-1000 Item#: 083 Qty: Fax.310-900-1077 more durable,efficient,beautiful www.turboairinc.com Available W/H Approval-3 YEAR PARTS & LABOR Model : MUF-28 WARRANTY r__77 I f = FEATURES & BENEFITS= ■ Stainless steel cabinet construction ■ Ergonomically designed doors The Turbo Air M3 model boasts a stainless steel exterior(galvanized steel Customers'fatigue fades away with easy grip handles and doors that back and bottom).Interior is stainless steel floor with AL sides and back.It open effortlessly.These features along with self-closing doors make guarantees the utmost in cleanliness and long product life.It can add a this the ultimate choice in customer convenience.ABS sheet door touch of style to the most refined setting. liners resist water condensation with thermal efficiency. ■ Field reversible hinge ■ Adjustable, heavy duty, PE(polyethylene) coated wire shelves ■ Efficient refrigeration system M3's solid door freezers are designed with oversized and balanced(CFC ■ Magnetic door gaskets Free R-134A,R-404A)refrigeration systems.These include efficient Magnetic door gaskets are of one piece construction,removable evaporators and condensers for faster freezing and greater efficiency. without tools for ease of cleaning and replacement. ■ High-density polyurethane insulation ■ Freezer holds 0°F--10°F for the best in The entire cabinet structure and solid doors are foamed-in-place using frozen food preservation high density,CFC free polyurethane insulation. NSF � � Ce�C 51EAIL ENERGY STAR® \VARNANTY Intertek 1809001:2008 Qualified Swing #of Crated L x D`x Ht Model Door CU./FT. Shelves HP AMPS Weight(tbs.) (inches) MUF-28 1 7 1 113 5.3 163 27v2 x 30 x 305/8 Ver.201509 'Depth does not include 1"for rear spacers.t Height does not include 5"for caster height. Item 083 L -All Model : MUF-28 PLAN VIEW ELECTRICAL DATA (unit:inch) Voltage 115/60/1 Plug Type NEMA 5-15P Full Load Amperes 5.3 Compressor HP 1/3 271/2(699.) Cord Length(ft.) 9 Refrigerant R-134A DIMENSIONAL DATA Net Capacity(cu.ft.) 7 Ext. Length Overall(in.) 271/2(699mm) N b Ext.Depth Overall(in.)' 30(762mm) o Ext.Height Overall(in.)t 305/8(777mm) M E 0 #of Doors 1 #of Shelves 1 Net Weight(lbs.) 146 231/2(598.) e Gross Weight(lbs.) 163 _ Design and specifications subject to change without notice. Q Actual shipping weight may differ due to extra packing materials for product protection. N 'Depth does not include 1"for rear spacers. t Height does not include 5"for caster height. Jr J PLAN VIEW o WARRANTY- 3 Year Parts and Labor Warranty Additional 2 Year Warranty on Compressor ■ Self-contained system ■ Standard 4"dia.swivel casters with locks on the front set o OPTIONAL ACCESSORIES : ❑ 2.5"dia.casters available-t%"diameter&13 TPI 30(762mm) ❑ 5"diameter casters ❑ 6"height ABS plastic legs ❑ Additional stainless steel shelves ❑ Additional PE coated wire shelves ❑ Back splash guard 253/8(645mm) s ❑ Door locks available(extra lead time will apply) e v ❑ External digital thermometer available(extra lead time will apply) N N z o 145/3(372mm) v 0 5(127mm) SIDE VIEW Ver.201509 mP..�. E GY STAR® ■ Turbo Air: 800-627-0032 ■ GK: 800-500-3519 NSF sm. aC a Y.. uz N'ALLAVT{ NER Intertek IS09001:2008 Qualified ■ Warranty: 800-381-7770 ■ AC: 888-900-1002 .. mR.uv�,urra Trbo air GER Kn/FE 11I1RC1OiC1nCc— GREEN WORLD Trbo air Project REFR/GERATORMANUFACTURER 4184 E. Conant St. Long Beach, CA 90808 Model# air Tel. 310-900-1000 Item#: 084 Qty: s Fax.310-900-1077 more durable,efficient,beautiful www.turboairinc.com Available W/H : - _ - = Approval : i e -3 YEAR PARTS & LABOR Model : MUR-28 WARRANTY { �33 = FEATURES & BENEFITS= ■ Stainless steel cabinet construction ■ Adjustable, heavy duty, PE(polyethylene) The Turbo Air M3 model boasts a stainless steel exterior(galvanized coated wire shelves steel back and bottom).Interior is stainless steel floor with AL sides and back.It guarantees the utmost in cleanliness and long product life. It can add a touch of style to the most refined setting. ■ Ergonomically designed doors Customers'fatigue fades away with easy grip handles and doors ■ Field reversible hinge that open effortlessly.These features along with self-closing doors make this the ultimate choice in customer convenience.ABS sheet ■ Efficient refrigeration system door liners resist water condensation with thermal efficiency. M3's solid door refrigerators are designed with oversized and balanced ■ Magnetic door gaskets (CFC Free R-134A)refrigeration systems.These include efficient Magnetic door gaskets are of one piece construction,removable evaporators and condensers for faster cooling and greater efficiency without tools for ease of cleaning and replacement. ■ High-density polyurethane insulation ■ Refrigerator holds 33°F- 38°F for the best The entire cabinet structure and solid doors are foamed-in-place using in food preservation high density,CFC free polyurethane insulation. NSF \1►��9 C6�C 3 5 'EAR ENERGY STAR® A_A w I— ",r Qualified Intertek IS09001:2008 Swing #of Crated L x D'x HI Model Door CU./FT. Shelves HP AMPS Weight Obs.) (inches) MUR-28 1 7 1 1/5 3.3 163 271/2 x 30 x 305/8 Ver.201509 `Depth does not include 1"for rear spacers.t Height does not include 5"for caster height. Item 084 z. w Model : MUR-28 PLAN VIEW (unit:inch) ELECTRICAL DATA Voltage 115/60/1 Plug Type Z t NEMA 5-15P Full Load Amperes 3.3 Compressor HP 1/5 271/2(699mm) Cord Length(ft.) 9 Refrigerant R-134A DIMENSIONAL DATA Net Capacity(cu.ft.) 7 Ext.Length Overall(in.) 271/2(699mm) Ext.Depth Overall(in.)* 30(762mm) c Ext.Height Overall(in.)t 305/8(777mm) M #of Doors 1 #of Shelves 1 Net Weight(lbs.) 146 233/4(604mm) Gross Weight(Ibs.) 163 Design and specifications subject to change without notice. Q Actual shipping weight may differ due to extra packing materials for product protection. `Depth does not include 1"for rear spacers. t Height does not include 5'for caster height. PLAN VIEW ■ WARRANTY; 3 Year Parts and Labor Warranty Additional 2 Year Warranty on Compressor ■ Self-contained system ■ Standard 4"dia.swivel casters with locks on the front set ■ OPTIONAL ACCESSORIES : 30(762mm) ❑ 2.5"dia.casters available-%"diameter&13 TPI ❑ 5'diameter casters ❑ 6"height ABS plastic legs ❑ Additional stainless steel shelves ❑ Additional PE coated wire shelves 253/8(645mm) ❑ Back splash guard = ❑ Door locks available(extra lead time will apply) Gcl o N h M ❑ External digital thermometer available(extra lead time will apply) 1 F 14�/s(37zmm> a 0 5(127—) SIDE VIEW Ver.201509 NSF ■ Turbo Air: 800-627 0032 ■ GK: 800-500-3519 e s CHIC :i YEAR ENERGY STAR® q \\'1nR,,X7 Qualified ■ Warranty: 800-381-7770 ■ AC: 888-900-1002 Wawxry) Intertek [509001:2008 �Wfa� sgncEwrowau�cn� H ,,, Trbo air GER KN/FE III0Rc�f��clllCC- GREEN WORLD T�bo air do- EN FOOD SER,VICE LINE Hot Fob' d DisplaCases FEATURES & BENEFITS Item 085 Shelf Configurations: Adjustable shelves can be arranged to hold products of varying size. Both the HFD and the Combo Serve HFD provide a total of 6 selling Hot Food Display Case (HFD) surfaces and over 6 cubic feet of product space. ti a Food Timers: 12 multi-selection, adjustable timers 30 „ - - -- - - - minutes-4 hours(in 30 minute increments). -v " s; 70 aq i Flexible Temperature: 6 heating zones can be ( µ � x' _ ,x , individually adjusted to the various products being held. { NSF Certified: Quality and safety guaranteed through _•{ NSF certification. i Attractive: Xenon light bulbs create a well-lit product = - display for maximum customer appeal. Serving Ability: The HFD's roll-out front panel and sliding back doors make cleaning and serving easy.The C Combo Serve HFD's swing open front doors and sliding Combo Serve Hot Food back doors make the case perfect for full and/or self serve { applications. Display Case (HFDC) Low Air Flow Dual Fan: Low air flow dual circulation fans help maintain an even and consistent product -- temperature throughout the case. Fans are standard on all models of Combo-Serve and HFD-Models 5 and 7. High Product Capacity & Marketability: Fresh, hot food is one of the fastest growing segments for convenience stores.These well-lit,attractive display cases have plenty of room for custom graphics, menu boards or logos that increase aesthetic appeal and "impulse- buy"sales.The HFD is designed for holding unwrapped , or wrapped food and the HFDC is designed for holding Unwrapped wrapped or boxed food. - z qnda EN • •D SERVICE LINE ...... IMPULSESERIES Hot Food P • Cases 0r�FD Q, cID1i B Hot Food&Combo Serve Hot Food Display Case �L Hot Food Display Name . °{ HFD Combo Serve HFD �M el Number _ - HFDXXXXXX HFDCXXXXX LAApprox.Internal Volume 6 ft3(170 liters) 6 ft3(170 liters) Meig 27.6"(700mm) 27.6"(700mm) External Dimensions fWidth 35.3"(896mm) 35.3"(896mm) �Dep' 19.7"(500mm) ' 19.7"(500mm) (Approx Weight 154lb(70kg) 160 Ib(73kg) Temp.Controlled Hot Plate (6) 141 W ^� (6) 141 W Lamps(heating&illumination) (6)40W Xenon (6)40W Xenon !i Controller(adjustable tempt' 6 temperature controls, 100°F-2550F 1! 12 Timers,programmable 30 min.to 4 hrs.(in 30 min.increments) A Timers _ ILD aal C ulation Fans � ' Standard on Model 5 and 7 only Standard x j Glass ANSI Standard Z97.1 Tempered Power _� a 115VAC 60Hz 115VAC 60Hz AmpRating, 9.2 Amps 9.2 Amps ( (4)Anodized 14"Pizza Pans Standard Accessories (16)Stainless Steel Food Pans (6)Removable Wire Racks ptional Accessories ti, 4"Leg Kit 4"Leg Kit 31 Safety Approvals:; "- UL File#E314888 UL File i#E314888 UL_197,CSA-C22 2 No 109-M81 Panitation Approval: UL File#E314888(f6rHFD000001,2,3) .NSF/ANSI 4, NSF Listing D052450(HFDxxxxxx) I NSF Listing D052450 NOTE.The mdnutdcturerresemes the right to make product imp'rownients and change specifications without notice. C us �T LISTED 0 1 1 • ® - P• : NSF/ANSI STANDARD 4 _ EN y -- - - _ item uun Kan-PA CDG 211 Series Liquid Dispenser CDG Series liquid dispensers are cost-effective refrigerated liquid dispenser: systems capable of dispensing up to two different bag-in-box products. Features: • Simple product dispensing for various liquid oil products including milk,cream,cold coffee, juices and many more! • Manual,lever operated dispensing system ensures maximum`up-time'with no microprocessor issues • Holds two 9.5 Litre/2.5 Gallon bag-in-box products for refrigerated dispensing , ' ' E • Best value on the market delivering the fastest 4 } 1 return on investment and maximum profitability !, • Simple to install and easy to use - remove f from carton and power the unit up ...that's all there is to it! Y Specifications: • Dispenses two products.Manual,lever operated • Capacity:2 x 9.5 Litres/2 x 2.5 Gals • Weight:77 lbs • Dimensions:22"x 12"x 25 1/2"(L x W x H) .F •A/C Supply Voltage: 120VAC/60Hz/1 P/4Amp r • Refrigeration:Compressor cold wall evaporation; accurate to 32°F/0°C • Environmentally friendly 134A refrigerant.CFC-free ', • Stainless steel construction with polyurethane insulation ' Shipping Dimensions:27"x 17"x 30"(L x W x H) " Shipping Weight;84 lbs: • CDG 211 is certified by NSF to both the u�+r y. - NSF/ANSI Standard 20 and UL/ANSI NSF . c us _ - Standard;471 or both Canadian ands e�ECTRicn� " ,;U.S.requirements r For more information. please contact us _ via"phone-or email at 1'-800-378.12G5 , `or sales@kan-pak:com. .r kAN & F` "Please visit us on the web at vvww kan-pak.com_ - �3 Item 089 - n® CDG211 Series Liquid 14 CDG Series liquid dispensers are cost-effective refrigerated liquid dispenser systems capable of dispensing up to two different bag-in-box products. F Features: - • Simple product dispensing for various liquid 1!I v products including milk,cream,cold coffee, _ juices and many more! i • Manual,lever operated dispensing system ensures maximum`up-time'with w no microprocessor issues • Holds two 9.5 Litre/2.5 Gallon bag-in-box products for refrigerated dispensing • Best value on the market delivering the fastest return on investment and maximum profitability t • Simple to install and easy to use- remove from carton and power the unit up - ...that's all there is to it! Specifications: O - k • Dispenses two products.Manual,lever operated _ • Capacity:2 x 9.5 Litres/2 x 2.5 Gals • Weight:77 lbs • Dimensions:22"x 12"x 25 1/2"(L x W x H) _ - •A/C Supply Voltage: 120VAC/60Hz/1P/4Amp F { x # ! • Refrigeration:Compressor cold wall evaporation; pu . accurate to 32°F/0°C • Environmentally friendly 134A refrigerant.CFC-free • Stainless steel construction with polyurethane insulation E" - 1- • Shipping Dimensions:27"x 17"x 30"(L x W x H) -` i Shipping Weight:84 lbs. • CDG 211 is certified by NSF to both the HSF NSF/ANSI Standard 20 and UL/ANSI Pu s Standard 471 or both Canadian and, e�ecrRica� = 7 0 'SUS.requirements Y s �- For more information, please contact us 'vieph ne.or email ai 1-800-3781265 , t4jrisAl�'es@lkan-pak.com AN P� _ Please visit us on the web atwww:kan-p ak.com ' BUNN ITEM# Item 90 Infusion SeriesT"" WX Dispenser PROJECT p with 4 and 5 Hoppers DATE iMIX Dispensers with 4 and 5 Hoppers • Capacity: iMIX-4: Four, 8-pound (3.6 kg) hoppers IiMIX-5: Five, 8-p2und (3.6 kg) ho p • Large, lighted front graphics for merchandising. ®® n n • 7-gallon hot water tank to meet peak serving times. • Cup clearance at 7.25"(18.4 cm) to accommodate popular cup sizes ' (adjustable to 8.12"(20.6 cm)). • Key service components easily accessible through front and top. • High speed, heavy-duty whipper for complete product mixing. iMIX-4 • Front of machine access to tank drain, dump valves, auger and whipper Dimensions:32.8"H x 19.3"W x 24"D motors and control board for easy service. (83.2cm H x 59.5cm W x 61 cm D) • Key lock on the door prevents tampering. • Contemporary styling for striking visual statement. • Low product detection system alerts audibly and with message on display ��'`"����'`�� when hoppers are low. • New digital technology adds night mode to prevent pilferage. • Alphanumeric display communicates advertising messages, machine status and technical support contact information. t,s • Spring-loaded, all metal auger drive system for easy hopper installation. r _ • Machine can be ordered with left or right-hinged doors to support side by side placement. �� }{ r ° • Front of machine set up and calibration. • Auger motors with RPM feedback monitoring assure consistent flavors and !iMIX'5 profits by controlling powder dosing. Dimensions:32.8"H x 19.3"W x 24"D (83.2cm H x 59.5cm W x 61 cm D) For current specification sheets and other information,go to www.bunn.com. Easy Clear®EQ-11-TL 6 t Features deluxe whipper chambers: , Product No.:30344.1001 Dimensions: 1.Robust whipper to ensure full flavor yield. 'l i 15'/8"H x 3%"W x 4"/32"D - 2.Specially designed self cleaning mixing l 40.3cm H x 9.2cm W x 11.5cm D chamber. $� r Easy Clear®ED-11-TL 3.Exhaust fan to siphon off moisture that Product No.:30244.1001 _ Y` can cause powder buildup. Dimensions: 143/,6'H x 51/,6°W x 5'/,g'D "' 4.Hot water dispense for easy clean out. 36cm H x 12.9cm W x 12.9cm D 5.Quick disconnecting parts for thorough , sanitizing. Model Agency Listing International Model Agency Listing iMIX-4 "S` .n• No International Model IiMIX-5' "sF .n- Dimensions & Specifications Model Product# Volts Amps Watts Capacity Cu. Shipping Cord Ft. Weight Attached iMIX-4 BILK 37000.0004 120 15 1800 107-5oz. 16.37 132 lbs. Yes* cups/hr (59.87 Kg) iMIX-4 BLK" 37000.0003 120 15 1800 107-5oz. 16.37 132 lbs. Yes* cups/hr (59.87 Kg) iMIX-5 BILK 37000.0000 120 15 1800 107-5oz. 16.37 135 lbs Yes* cups/hr (61.23 Kg) iMIX-5 BLK** 37000.0001 120 15 1800 107-5oz. 16.37 135 lbs Yes* cups/hr (61.23 Kg) *Power cord(NEMA 5-15P) 15 Amp-120V machine only. —Special order models available with door hinges on right side. Electrical: 120V model requires 2-wires plus ground service rated 120V, single phase, 60 Hz. Plumbing: 20-100 psi (138-690 kPa)from a '/4"(6.4 mm) or larger supply line.A shut-off valve should be installed in the line before the unit. Install a regulator in line when pressure is greater than 90 psi to reduce it to 50 psi.Supplied with 1/4"(6.4 mm) male flare fitting. 0 O 24.99 Ip II 36.89 — �19.30 17.63 22.32 CI 32.82 I I AL o u� BUNN Corporation-1400 Stevenson Drive Springfield, Illinois 62703.800-637-8606.217-529-6601 •Fax 217-529-6644•www.bunn.com BUNN®practices continuous product research and improvement.We reserve the right to change specifications and product design without notice.Such revisions do not entitle the buyer to corresponding changes,improvements,additions or replacements for previously purchased equipment. All dimensions shown in inches. Bunn Corporation owns all copyrights relating to materials in this publication.Please contact Bunn Corporation to request permission to reproduce any portion of this publication. Item 113 FS30 0 PHOTO Description ,`- •,- r Featuring state oi-the-art cold carbonation technology the FS provides a consistently pleasing drink experience- ..bu af'IkGOIC « Enhanced ice dispensing capability allows customers to dispense cube or cubelet ice,on demand. e, _ Flavor Select The FS30 offers over 100 unique flavor combinations,and the interactive self-serve dispensing is entertaining with eye-catching"Lite Touch"buttons. €r Mfg Item Code a�-1;316-00 I } I Product Specifications HEIGHT 40-25'(899 rim) WIDTH 30"(762 nim) OE T H 30.5'(775 nym) Space required Width:32"(812.8 mm)Depih:3t5l(800.1 mm)Top:e,in(152 mm)Access to floor drain suggested Electrical 115V/6O Hz,7AMPs Weight 1:ViihoLlli ice:320 lbs(145 kg) VVith ice:610lbs(281 kg) Shipping-356 Ibs(161 kg) Ice Capacity:290lbs(132 kg) Dispensable:215 Ibs(93 kg) Fillings Soda inlets_3.r8"(0.5 mm)barb Syrup inlets_3;8°(0-5 mm j barb Water Filtered water 50 psi min Valves f 4 Dive type Lancer Flow Control Valves(LFCV) €<ev lock switch Yes Cold Carbonation Yes Beverage over 100 Combinations Beverage Brands 16 Cerrications ETL,ISO 9001,ISO 14001,NSF model FS30 Options Lancer"Lite Touch"user interface panels,ADA kit,legs:4 in(102 n1m) Item 198 REVISION HISTORY 1REVI DESCRIPTION DATE BY B ECN 60269 17/9/2013 1 BSF 30.000 4.688 REF. I 24.000 I 37 2.375 1.193�I II --i 0.500 r1 t--0.500 26.000 33.443 ITEM PART NO. DESCRIPTION OTY 6.250 1 0253024 KIT,SK,I5XI5,FCT,ELKAY,W,SPEC ARTR I 2 0403200 PKG,CONN,CAB,M&F,2 1 29.000 U 3 10012282 KIT,LEG,CNR,04CT,STD,WHDW I REF#23002264 ROVSTONLC The e designs s IA ONE TON Y ROAD are proprietary SURFACE AREA NEXT STEP -!IROYSTO� JASPER,GA 30143 information, SHI p70p35-3456 4 20005457 CS242934SKLTD-CB I property of TRVL DIST SOURCE MATERIAL DESCRIPTION HK ROYSTON LLC. ASY 5 60056471 GRD,SPL,I2.00X16.00X23.88X23.74,MIT2.O,HEM,SS I They shall not be Copied or TOBreRce URIBSS PART DESCRIPTION du licated in an Otherwise Noted SK2-29-30FST-15X15-16HX24AOSG-LTD-CB-HB-33.5-L-CBC P Y _ptX=2.015 6 60057678 A,SF,24.00X30.00,SK-16HX24AOSG I manner without .�=2,030 END DRAwN er OATE PART REV cprior onsent. Anglese.=± PSW PSW 1/30/2013 60057466 B COnSOnt. Hole Oia.=t.003 http://jasspt/JAS/RELEASED/60057/60057466.dft PRINTED 7/9/2013 SHEET 1 OF 1 1.° - - 1"y ® FBD Partnership, LP 1866.323.2777 1 sales@fbdfrozen.com I fbdfrozen.com -_ Item 306 563 SPECIFICATIONS DIMENSIONS ,, Countertop unit:Width: 20.3 in (514 mm) IQPi)p NIT 5140 Depth: 32.4 in (822 mm) Height:41.4 in (1052 mm) (with merchandiser door) CAPACITY(60Hz) TopoPOp�R Barrel size: 176 oz Continuous draw(alternating barrels): 3,840 oz/hour �m Recovery time:4 minutes 4, ELECTRICAL REQUIREMENTS 4 6t," 200 to 245 VAC single phase,3 wire, 20 amp REFRIGERATION 19,000 BTU/Hr, R-404A(50Hz) 15,000 BTU/Hr, R-404A(60Hz) +95mm SPACE REQUIREMENTS Sides and back:2.0 in (51 mm) minimum Top: 12.0 in (305 mm) minimum, F�ooR WEIGHT Operating unit: 390 lb(167.8 kg) Base cabinet: 74 lb(33.6 kg) SYRUP CONNECTION 822mm Bag-In-Box(BIB) \� FLooR MOTORS 60Hz(5OHz) Beater: (3) 1/6 HP(120 w) Fan: (1) 1/4 HP(135 w) 1- WATER REQUIREMENTS Fresh water, minimum 3/8" supply,30 psi flowing(207 kPa) OPTIONAL ACCESSORIES Base cart(Part#12-2516-00,01) Leg kit(set of four) (Part#12-2533-0001) Painted or stainless steel side panels Water-cooled unit Merchandiser options(see spec sheet) Remote condenser(see spec sheet) Bib rack Install kit Frozen Beverage Dispensers • _ EVERYONE LOVES FROZEN' Conforms to LAPC.Conforms to LAMC.C8 Compliant AS/P ZS 3820 Compliant.ROHS Compliant.FBD strives for continuous improvements and engineering innovations.Equipment design and/or specifications may change without notice.FBD-Frozen Beverage Dispensers. 8161 Interchange Parkway,Suite 115•San Antonio.T%78218^210.637.2800.1866.323,2777•F—210.637.2844-www.fhd4ozen.com rd12012 FBD Partnership,LP.FBD'?,the FBD logo,and"Everyone Loves Frozen I are trademarks of FBD Partnership.LP,all rights reserved. Item 306 Frozen Beverage Dispensers EVERYONE LOVES FROZEN- PRODUCT FEATURES • Inline Carbonation'"'—creates a more consistent over-run, quality and yield PROFITABILITY • AccuFreeze'M—maintains product consistency, - delivering the most consistent frozen beverage, LOW drink after drink OPERATING COST • RapidFreezeTM—Cold chamber system improves recovery and draw-time,while reducing the compressor workload, and increasing 00iW� Frozen BeverageDispensers dispenser durability // / Evf.1�0..1 tOVEl�a _', �W_i� , . -- • Electronic Simplicity offers easy-to-use keypad Now � _ � � � � .,,� interface Optimal Use of Counter Space with minimum low ventilation of two inches side or back �'- • Scroll"'Compressor—provides more reliable operation, and fewer moving parts than reciprocating compressors Customizable individual barrels allows for hundreds of different drink profile combinations, including h x sugar free options L FBD Partnership, LP 1866.323.2777 1 sales@fbdfrozen.com I fbdfrozen.com Project REFR/GERATOR IWANUFA-CTURER 4184 E.Conant St. Model# �,� Long Beach,CA 90808 Tel. 310-900-1000 Item#: Qty Fax.310-900-1077 more durable, efficient, beautiful www.turboairinc.com Available W/H Approval PF p - .._ _. ; - b Model : MST 28-711S r p _ NA t i = FEATURES & BENEFITS= ■ Cold air compartment ■ Magnetic door gaskets Our innovative"Cold Air Compartment"maintains temperature evenly Magnetic door gaskets are of one piece construction,removable for each pan to preserve fresh food longer.In addition,the compartment without tools for ease of cleaning and replacement. isolates pans from the reach-in area to prevent food spillage. ■Stainless steel cabinet construction ■ Adjustable, heavy duty, PE(polyethylene) coated wire shelves The Turbo Air M3 model boasts a stainless steel exterior(galvanized steel back and bottom).Interior is stainless steel floor with AL sides and back.It guarantees the utmost in cleanliness and long product life.It ° Ergonomically designed doors can add a touch of style to the most refined setting. Customers'fatigue fades away with easy grip handles and doors that open effortlessly.These features along with self-closing doors make °Efficient refrigeration system this the ultimate choice in customer convenience.ABS sheet door Turbo Air's M3 solid door refrigerators are designed with oversized and liners resist water condensation with thermal efficiency. balanced(CFC Free R-134A)refrigeration systems.These include efficient evaporators and condensers for faster cooling and greater efficiency. ° Refrigerator holds 330F— 39°F for the best in food preservation ■High-density polyurethane insulation The entire cabinet structure and solid doors are foamed-in-place using II__ high density,CFC free polyurethane insulation. V NSF, IYFAR CaC � 5 W "ARRAnTY Intertek ISMI:2008 Swing #of #of Crated L x D"x Ht Model Door CU./FT. Shelves Hood HP AMPS Weight(1bs.) (inches) MST 28-7115 1 7 1 1 1/5 3.3 198 271n x 30 x 30 Ver.201501 'Depth does not include 1"for rear spacers.t Height does not include 6"for leg height. Model : MST 28-711S PLAN VIEW (unit:inch) ELECTRICAL DATA Voltage 115/60/1 Plug Type �I NEMA 5-15P 271/2(698mm) Full Load Amperes 3.3 Compressor HP 1/5 Cord Length ft. 9 O O O 147/8 Refrigerant R-134A O O O O (378mm) s DIMENSIONAL DATA Ext.Length Overall in. 271/2(698mm) Ext. Depth Overall in.* 30(762mm) 233/4(605mm) Ext.Height Overall in t 30(762mm) #of Doors 1 N #of Shelves 1 PLAN VIEW #of Pans 8 Net Capacity cu.ft. 7 281/8(714mm) Gross Weight lbs. 198 Net Weight lbs. 181 Design and specifications subject to change without notice. Actual shipping weight may differ due to extra packing materials for product protection. *Depth does not include 1"for rear spacers. o00 t Height does not include 6"for leg height. ■ WARRANTY: 1 Year Parts and Labor Warranty Additional 4 Year Warranty on Compressor o ■ Center door handle ■ Field reversible door FRONT VIEW w/Sneeze Guard ■ Standard on 6"Legs ■ 30(76zmm) Sneeze guard ■ 119 or 116 pan Size 287/8(734.) ■ Pans not included e o N l� F 235/8(599mm) a O N 127/8 (328mm) SIDE VIEW w/Sneeze Guard Vec201501 � YEAR""" ■ Turbo Air: 800-627-0032 ■ GK: 800-500-3519 O cac P Y ■ Warranty 800-381-7770 ■ AC 888-900-1002 Intertek IS090 5 °'nVT Tr�bo air R GER K/Y/FE III1RIoi ncc-- �NwORLD ur'0 air I BUNN® 400 El.EUEtI ITEM# ®y BrewWISE® Dual ThermoFresh® PROJECT DBC Brewer DATE BrewWISE® Brewing System with ThermoFresh® Servers 9 All • Brews 16.3 gallons (61.7 litres) of perfect coffee per hour. • Stores individual coffee recipes so operator can easily brew many varieties. •:, • Coffee extraction controlled with pre-infusion and pulse brew, digital temperature control, and large sprayhead;coffee strength controlled with variable by-pass. • Operate any combination of BrewWISE°equipment error-free with wireless brewer-grinder interface through the Smart Funnel®. } • SplashGard®funnel and optional funnel locks help improve safety. • ThermoFresh®servers are vacuum insulated to keep coffee hot for hours. • Preventive maintenance kit: 39641.0000. pMKI Model Dual TF DBC with 1 gallon TF Servers (servers sold separately) Dimensions:33.7 H x 21.8"W x 20.2"D (85.6cm H x 55.4cm W x 51.3cm D) Single/Dual Filter Pack , ,z�/ TF Servers Product No.:20138.0000 ! 't f Product No.: 39500.0111 Packed per case:500F'► *+' P • 1 gallon,Stainless Steel, # Dimensions: Digital Countdown Timer Gauge 11 51/4" Base x 41/4"Sidewall M w- 13.3 cm Base x 10.8 cm Sidewall Model Agency Listing Dual TF DBC CC" NSF Item 400 Dimensions S Specifications Model Product# Volts Amps Tank Heater Total Brewing Cu. Shipping Funnel Cord Watts Watts Capacity Ft. Weight Locks Attached !Dual TF DBC; 3460� 0 0027j 120/ 078 27.4 2,@2850 5700; 16.3_gal/hr� 14 6' ,92 bs., Yes o Brewing capacity:based upon incoming water temp of 60 F(140 F rise). Model listed as 1201208V must be connected to 208V electrical service.Please refer to the installation manual. Electrical: Brewer is 3-wires plus ground service rated 120/208V, single phase, 601-1z. Plumbing: 20-90 psi (138-621 kPa). Machine supplied with 3/8" male flare fitting. Tank capacity: 10.6 gallons (40.1 Q 22.7 00 00 00 00 -C� 00 00 00 00 33.7 ® ® 21.2 rT co 00 00 7.1 co 00 00 e e u u u - u 6.4 18.8 WATER SUPPLY CONNECTION 19.0 21.8 20.2 r Bunn-O-Mati&Corporation-1400 Stevenson Drive Springfield,Illinois 62703.800-637-8606.217-529-6601 •Fax 217-529-6644•www.bunn.com BUNN"practices continuous product research and improvement.We reserve the right to change specifications and product design without notice.Such revisions do not entitle the buyer to corresponding changes,improvements,additions or replacements for previously purchased equipment. All dimensions shown in inches. 51100aunn-0-Matic corporation f Item 400 BUNNservee MAfVAGEC SERVICES BUNNserveo Equipment Specifications ������ for P BrewWISE® Dual ThermoFresh® ✓ Electric: 120/208 volt 30 amp 4 wire service Ll--------------------------------------- **two hot, one neutral, one ground** 11 I I 1 ] Neutral--------------------208-240vac ] 1 110vac 1 ] L2-------------------------------------- Must provide L14-30R electrical receptacle for each unit. (9) 1 Connection must be within 4 /2 feet of brewer placement. L14-30R ✓ Plumbing: Minimum 1/2" inch water supply line with either Vor 1/2" supply stop. Plumbing connections must be within 41/2" feet of proposed brewer placement. YY �: NOTE - If a backflow preventer is required by code, a shock arrestor must be installed between backflow preventer and dispenser. ✓ Countertop/walls: Ensure a pre-drilled 2" inch diameter whole is drilled through the countertop for electrical and plumbing needs. Additional access holes Drill f r inside the cabinet must be cut to allow for electrical and plumbing electric& lines between solid walls. plumbing -NY 35.7 IF L 21.8 20.2 BUNN® 401 ITEM# PROJECT TF Servers DATE BUNN ThermoFresh® servers - • Vacuum insulated to keep coffee hot for hours. • Contemporary styling and wrap program for maximum merchandising. • Built-in drip tray is easily removed for cleaning. • Large cup clearance allows for dispensing into cups, decanters and thermal carafes. • Fast flow faucet. • Brew-through lid. • Integrated sight gauge assembly allows for easy cleaning. • Innovative faucet design. • Improved space saving profile. • Ideal for use with Single or Dual TF DBC Brewers. 1 and 1.5 gallon TF Servers Dimensions(1 gal):20.6"H x 9.6"W x 14.1"D (52.3cm H x 24.4cm W x 35.8cm D) Dimensions(1.5 gal): 22.5"H x 9.9"W x 16.3"D (57.2cm H x 25.2cm W x 41.4cm D) For current specification sheets and other information,go to www.bunn.com. Dual TF DBC Single TF DBC TF Server Handle(orange) Brewer/Server Compatibility Product No.:34600.0001 Product No.:34800.0000 Product No.:39081.0001 1.5 Gal TF 1 Gal TF Brewer w/base w/base i L4 ICB No No ICB Twin No No t ICB (tall) Yes Yes a ICB Twin (tall) Yes Yes ITCB No No ITCB(ta/1) Yes Yes SingleTF Yes Yes (servers sold separately) (server sold separately) Dual TF Yes Yes Model Agency Listing TF Server NSF E9001.0030C ' • ' ' ' Item 700 • Each brew button's sweetener may be independently - set and easily adjusted using the Sweet Meter • Includes Quickbrew (Q)funnel tip for easy conversion BUNN • Includes two button graphic overlay for customizing the user interface • Dilution nozzles labeled "Sweet"and"Unsweet" ITB-DBC Dual Dilution w/ • Left side preset with sweetener valve • "Out of Sweetener"indicator-LCD blinks to aid Swtnr operator • Color coded decals help the operator properly align Achieve a variety of • profiles and batch the brew basket, dispenser and choose the correct options with programmable • - Brewer selection • • • Includes rotating brew basket, base platform adapter, dedicated dilution nozzles and brew selection switch C ,@ n • Large tank provides back-to-back brewing capacity and allows 3 or 5gal (11.4 to 18.9L)tea batches _ • Separate inlet for sweetener-use existing CO2 " � - �• •�� systems or external 3rd party pump for sweetener ' _ tF�J delivery • Specifically designed to accommodate and brew into two BUNN 3.5gal Narrow Tea Dispensers (can also - brew directly into standard tea dispensers) • SplashGard®funnel deflects hot liquids away from the hand j products roducts � _ • 03021.0005 Funnel _ • 20100.0000 Tea&Coffee Paper Filters 500/cs • 38029.1002 Drip Tray • 39000.0007 WATER FILTER, EQHP-TEA • 39000.1007 EQHP-TEA Cartridge On Product . Channel IcedTea Server . (Voltage) 41400.0003 Convenience Store Cylinder Narrow Plumbed 120 Full Service Quick Square Serve Restaurant Specialty UPC r Capacity . . Attached 72504117843 Medium Stainless 2 Yes AdditionalPlug Type AD Minimum Input Maximum Inp Available Pressure Pressure A NEMA 5-15P Quickbrew Funnel Tip Yes 20 PSI 90 PSI Inlet Water Fitting Required Water Flow Quickbrew Digital Brewer�Control FunnelType 1/4"Male Flare Fittina 1 GMI Yes Yes Translucent Tea Item 700 Funnel Shipping'Machine Depth Machine Width Machine Height Weight 22.6" 12.2" 34" -- 45.91 lb a ea - r 34.37 23.08 1.93 —► ® maximum dispenser ° depth:15"(TD3-N) 5.02 WATER SUPPLY SWEETENER 7.15 ►� CONNECTION CONNECTION 12.15 .250 OD FLARE 22.57 19.04 E Electric & Capacity Electrical Configuration Option Volts-Factory Wired: 120 Phase-Factory Wired: 1 Watts-Factory Wired: 1700 Hertz-Factory Wired: 60 Amps-Factory Wired: 14 Tea Capacity (Servings/Hour):523 BUNN ITEM# 701 3 . 5 Gallon Narrow PROJECT Iced Beverage Dispenser DATE j Space-saving iced beverage dispenser expands the variety of offerings in limited counter space t'{ - • Dispenser has 3.5 gallon (13.2L)capacity • Sump dispense valve assures complete dispensing of tea Two dispensers, placed side-by-side, allow added flexibility and more than twice the capacity within the same footprint as one TDS-3 �'' • Front-back handles for reduced counters ace usage 1 ; p! 8"cup clearance zq Ships with full-color iced tea decal Model available with feet to help protect countertop surfaces • For use with BUNN TB-3,TB-30,ITB and ITCB brewers with 29"trunk height 13.63 7 � . qq i' - _ - 6. 62 41 TOO-N-3.5 a 1 Dimensions:21.6"H x 6.2"W x 13.5°D a; jo a (54.9cm H x 15.7cm W x 34.3cm D) TOO-N-3.5 with feet Convenient Carry: Dimensions:21.8"H x 6.2"W x 13.5"D rear view.showing back handle Space Saving: (55.4cm H x 15.7cm W x 34.3cm D) Two TDO-N dispensers fit within footprint of one TDS-3. For current specification sheets and other information,go to www.bunn.com. Faucet Assembly TDO-N Locater Guide Product No.:03260.0003 Product No.:39696.0001 Pinch Tube Faucet Kit Product No.:40363.1001 99V Replacement Lid Product No.:40851.0000 Lid Lock Kit Product No.:43692.0000 Model Agency Listing TDO-N-3.5 "sr Item 701 w . Dimensions & Specifications Model Product# Cubic Measure Shipping Weight Capacity Handles TDO-N-3.5! ,39600.0001 1.4 ft3 12�3 lbs. 3.5(' gallo fron k? TDO-N-3.5 (pinch tube faucet*) 39600.0008 1.4 W 12.3 lbs. 3.5 gallons front/back TDO-N-3.5 (with feet) 39600.0025. 1.4 ft3 12.3 lbs. 3.5 gallons front/back *Pinch tube faucet requires bag liner for proper operation. Electrical: No electrical Plumbing: N/A 00 6.2 19.8 O _}_1_ 21.6 " 8.1 .•-------------.---...........................................s............... 396 01 __________________________ ___________________________________________ �+ —5.7 I 13.5 -I .3 6.7 21.8" height for model with feet Bunn-O-Matic®Corporation- 1400 Stevenson Drive Springfield, Illinois 62703.800-637-8606.217-529-6601 •Fax 217-529-6644•www.bunn.com BUNN®practices continuous product research and improvement.We reserve the right to change specifications and product design without notice.Such revisions do not entitle the buyer to corresponding changes,improvements,additions or replacements for previously purchased equipment. All dimensions shown in inches. 10/11 Bunn-o-Matic corporation • Item 728 Large Surface HotRod ; Flat & Slanted Roller Grills Model: ❑HR-45 ❑ HR-75 ❑HR-85 419 IRS-45 ❑HRS-75 ❑HRS-85 PRODUCT: QUANTITY: ITEM#: Designed Smart Equipment Package to fit your High Volume Operation! • The"Super Hot Rod"Roller Grills are designed for high volume. • HR(S)-85(18 rollers and 30-1/2"cooking surface across) • HR(S)-75(16 rollers and 30-1/2"cooking surface across) _ { • HRS 45 16 rollers and 19-1/2'cooking surface across" • HR(S)-85 can cook up to 1500 hot dogs per hour. _ `nPo _ - • Available with"Tru-Turn"textured rollers for maximum roll-ability. • New! HR-75 and HRS-75120V with 2 Power cords now available. } • Units are designed to be used in a"clerk served"operation or in a I customer"self service"merchandising plan. For counters between clerk and customer,some Roller Grills are available with''pass through"sneeze guards. Designed to Deliver Great Tasting Hot Dogs! • Roller Grills heat quickly and have a fast recovery for unexpected •' "• surges in Hot Dog demand. • Heating system has two cooking zones that can be,turned to grilling temperatures for cooking Hot Dogs in less than 4 minutes*and turned down to NSF safe holding temperatures for serving customers. Built Solid *Grill times based on Pre-heated roller grill(about 10 minutes warm guilt To Last up cycle). • Exterior cabinet is constructed of stainless steel for Easy to Operate and Maintain! maximum durability. • "Easy to read"graphics and heavy duty knobs on the control panel • Made with Heavy Duty wiring. make it easier for employees to operate at the correct temperatures. • 'Tru-Turn"coating is 30%thicker than competitive non-stick • Infinite Control system gives operator the maximum ability to adjust coatings. temperatures to a variety of hot dogs,egg roll,or other roll type products. • Teflon seals at end of rollers stop grease from migrating into • The"Super Hot Rod"Roller Grills are designed to require minimal labor: motors and chains. •New"Tru-Turn"coated Rollers just wipe clean with damp rag. Reliability backed by APW Wyotfs Warranty •Raised rollers allow cleaning in"hard to reach"areas. •APW Wyott's Hot Rod Roller Equipment is backed by a • Removable grease collection pan is simple to wash clean. • Easiest Roller Grill in the industry to service: 1 year limited warranty and a one year on-site labor warranty •Unit is supplied with"easy to remove"side and bottom panels. •Certified by the following agencies: •Two dependable, High Torque motors are the most reliable in the industry. e •Warranty includes On-Site repairs, reducing the amount of C ® Nsr �EAR potential down time. LIMITED�LUS Options & Accessories • 6"Tongs • Polycarbonate Sneeze Guards • Pass through Sneeze Guards See reverse side for product specifications. APW Wyott Foodservice Equipment Company• 729 Third Ave., Dallas, TX 75226 Rev. 0612712008 (800)527-2100 • (214)421-7366 •Fax(214) 565-0976 •www.apwwyott.com •info@apwwyott.com Item 728 Large Surface Hot • • Flat & Slanted Roller Grills Model: ❑HR-45 ❑HR-75 ❑HR-85 ®HRS-45 ❑HRS-75 ❑HRS-85 PRODUCT: QUANTITY: ITEM#: Flat Surface Roller Grill m PRODUCT SPECIFICATIONS HRHRDimension Construction: (S)45 23.75" HR(S)75 34.75" Stainless steel exterior, aluminum drip pan and coated steel HR(S)85 34.75" bottom. Available in chrome or"Tru-Turn"textured rollers. Two heavy-duty high torque motors. o/4" Electrical Information: -1 120V units use a 5-15P Plug. Both the 208V and 240V units are provided with a 60"power cord with a Nema 6-15P plug that exits from the bottom on the left rear corner. s A Electrical Specifications: 2s.s/is" HR(S)-45: 120V, 1465W, 12.2 Amps 120V(Two power cords) HR(S)-75: 208V, 1820W,8.9 Amps Polycarbonate Sneeze Guards (SG) 985W, 8.3 Amps,60Hz, 1 phase 240V, 2410W, 10.1 Amps HR(S)-85: 208V,2017W, 9.7 Amps "A"Dimension 240V, 2640W, 11.0 Amps 9 HR(S)45 .5 35 HR(S)75 35.5" Overall Dimensions: i � " HR(S)85 35.5" HR(S)-45: 8 1/2"iH x 23 3/4"W x 29 9/16"D (21.6 cm x 60.3 cm x 75.1 cm) 16 Rollers HR(S)-75: 81/2"H x 34 3/4"W x 29 9/16"D 300o P (21.6 cm x 88.3 cm x 75.1 cm) 16 Rollers HR(S)-85: 8 1/2"H x 34 3/4"W x 29 9/16"D 30 (21.6 cm x 88.3 cm x 75.1 cm) 18 Rollers Shipping: HR(S)-45: 70 lbs. (31.5 kg) 35-1/2 HR(S)-75: 87 lbs. (39.1 kg) HR(S)-85: 89 lbs. (40 kg) 9 Sneeze Guard Dimensions: J SG-45DD: 9"H x 24 1/2"W x 30 21/32"D (22.9 cm x 62.2 cm x 77.9 cm) GuardsPass Thru Sneeze SG-45XP: 8"H x 26 1/2"W x 30 1/2"D (40.6 cm x 67.3 cm x 77.4 cm) SG-75/85: 9"H x 35 1/2"W x 30 21/32"D 0-1/2" (22.9 cm x 90.2 cm x 77.9 cm) "A"Dimension SG-45 24.5" SG-75/85XP: 8"H x 37 112"W x 30 1/2"D A 6-5/32" 8" SG-75/85 37.5" (40.6 cm x 95.2 cm x 77.4 cm) Shipping: HR(S)-45: 70 lbs..(31.5 kg) HR(S)-75: 87 lbs. (39.1 kg) HR(S)-85: 89 lbs. (40 kg) F.O.B. Cheyenne, WY 82007 APW Wyott reserves the right to modify specifications or discontinue models without incurring obligation. APW Wyott Foodservice Equipment Company• 729 Third Ave., Dallas, TX 75226 Rev. 06/27/2008 (800) 527-2100• (214)421-7366 •Fax(214)565-0976 • www.apwwyoft.com-;nfo@apmvyoff.com # 1603 Item #814 REVISION HISTORY IREVI DESCRIPTION DATE I BY D ECN 60269 t7/9/2013 1 BSF ® 30.000 6.688 0 24.000—� 23.875 23.739 16.037 2.375 12.000 1.193�I 0.500 0 26.000 33.443 29.0 ITEM PART NO. DESCRIPTION OTY 1 0403200 PKG,CONN,CAB,M&F,2 I 6.250- 2 10012282 KIT,LEG,CNR,04CT,STD,WHDW I These designs REF Y 23002264 ROVSTON LLC Y ROAD 3 60010392 KIT,SK,PSR1918,ELKA,FCT,MOEN 67315C,CRM I are proprietary SURFACE AREA NEX STEP 00 ROYST®N"' JJASPER AO30143 information, SHI (770)735-3456 4 60020930 A,SF,24.00X30.00,1918SK-12HX24AOSG I property of TRVL GIST SOURCE MATERIAL DESCRIPTION RK ROYSTON I.L.C. ASY 5 60056471 GRD,SPL,I2.00XI6.00X23.88X23.74,MIT2.0,HEM,SS I They shall not be COpled Or Tolefanoe ASS PART DESCRIPTION du licated in an �thervvlsa Noled SK2-30D-19X18-ESF-16HX24AOSG-LTD-OB-33.5-L-CBC p y .>ooc=m.0ts 6 60063649 CS242934LTD-OB-OAS 1 manner without XX=3.D30 ENG DRAWN BY DATE PARTY REV priorwritten Angles=tt° SB SB 10/201201 60020935 D consent. Hole Oia.=S.003 http://jasspt/JAS/RELEASED/60020/60020935.dft PRINTED 7/9/2013 SHEET 1 OF 1 i " da L! SAN EN • •D SERVICE LINEIMPULSE SERIES Refrigerated Display Cases FEATURES & BENEFITS Refrigeration System: Holds desired product temperature and seals FEnergy in freshness to extend product life. RSC refrigeration options include both Efficient. Refrigerated Displays remote outdoor condensing systems and top-mount self contained systems. Depending on the model,remote options are available with hermetic,scroll, or energy saving inverter scroll compressors. Due to the overall combined RSC3 & R$C4 height of the RSC plus condenser,self-contained condensing systems must be installed once the showcase has been placed on location. �a Energy Reducing Auto Defrost:Controllerwill adapt to environmental a conditions and y y y y perform defrost cycles only when absolute) necessary. A typical showcase is programmed to defrost every 2 to 4 hours resulting in 6 !! ] to 12 cycles per day.The RSC performs auto defrost only when required which significantly improves product temperature control and reduces energy -� consumption. - r Monitoring Capabilities: The RSC controller uses MODBus communication protocol allowing for on-line monitoring and set-point __ t adjustments to be made from a central location using an EMS system. t Read/Monitor Adjust 4 • Ambient temperature Temperature set point ; • Evap coil temperature (within limits) _l • Evap air out temperature , • Evap outlet temperature + • Evap outlet pressure • Defrost cycle RSC6 Shelf Configurations(7-14): Increase product capacity with multiple shelf configurations.The RSC3&4 come with 7 adjustable glass shelves and the RSC6 comes with 14(7 per side).Top 5 shelves can be tilted.Metal shelves and peg rack options available. LED Lighting: LED lighting creates an attractive selling environment while - �r reducing energy and maintenance costs. — ----- - d ' t7 y Product Display: Extended depth and low deck allow for increased storage and product capacity. Low deck creates optimum display space for ± gallon jugs,milk,juice&12 or 24 packs of beverages. i Whisper Quiet Operation: Evaporator fans and air flow operate at less than 65dB at 4ft so your customers will focus on the product selection and not the sound of the equipment. d Joinable Design:Allows for a wide variety of unit placement options.The RSC can be joined together with other RSC models to create multiple width i configurations. Meets NSF Tier II Standards:The RSC continues to perform at a higher ambient store temperature (80'F). Rest assured that the RSC will perform — - -� = — •_- --s-_, — NOTE:BlacWelack color standard.white/White color optional. perfectly even On the warmest days. •RSC3 shown with top-mount self con rained condensing system.Self contained sys.ems available for all models. z EN -- I f do" EJ o • o SERVICE LINEIMPULSE SERIES Refrigerated Display Cases Ener Efficient Refrigerated Display Case 9Y _ Model - RSC3 RSC4 RSCI Product Temperature Maintain product temperature at or below 41°F Environmental Conditions _ NSF/ANSI 7Type II Standard maximum indoor 80°F,Relative Humidity 54% Widths 37.9"* 49.9' 73.5"* Width Joined When joining multiple RSC models, subtract(1.35"times 2)for the two side panels External' 11 Cases . not used between each joined display. { Dimensions, " "—``_-- 9} - Depth 36.1" 36.1" 36.1" - -- - ��_- J He!ght _ 75.6" 75.6" 75.6" Outer/InnerBox Powder coated steel/zinc coated steel Structure - `- -- Insulation Rigid Insulating Foam Tr Color - Internal:Black,External:Black(Optional White/White available) — E v 7 shelves I h Ives 14 shelves(7 per side) Shelves Adjustable powder coated steel frame,glass inserts standard(Optional.metal inserts) Fan Motor ECM high efficiency }Electrical Parts I Li htin 1 /1;(3 Amp) ( 9, 9 LED 15/60 Solenoid Valve Hermetic direct acting solenoid valve for refrigeration(24V DC) fi Pipe Size of TILL!9wd Lme 3/8"OD Connection Point- i Suction 5/8"OD - it Rene g ant` - R404A standard(Optional:R410A) _ E rator' _ T� , Fin Tube Type JExpansion Valve _ External Equalized Automatic Thermal Expansion Valve lControllers m Digital programmable controller with Modbus communication protocol Ca stars (4)2"Casters Drain Ploe Dimension _ 1.5"NPT Male Connector tThermometer Product Simulation Thermometer Internal Volume e 20.73 ft3 27.75 ft3 41.46 ft3 -- ilWeight - 368lb. 405Ib. 5981b. Noise Less than 65 dB at 4 ft. ETL File#4007858 Agency Approvals ANSI/L1L 471,NSF/ANSI Std 7Type 11,CAN/CSA C22.2 No.120,Ed:3 NOTE:The manufacturer reserves the right to make product improvements and change specifications without notice. • . , , .� - c�s�o ��4noa�•s ° � us Intertek Intertek EN EN Wndo- FOOD SERVICE LINE Refrigerated Display FEATURES & BENEFITS Refrigeration System: Holds desired product temperature and seals in freshness to extend product life. RSC refrigeration options include both Energy Efficient Refrigerated �ISp�dyS remote outdoor condensing systems and top-mount self contained systems. Depending on the model,remote options are available with hermetic,scroll, or energy saving inverter scroll compressors. Due to the overall combined R$C3 &RSC4 height of the RSC plus condenser,self-contained condensing systems must be installed once the showcase has been placed on location. Energy Reducing Auto Defrost:Controllerwill adapt to environmental i h) conditions and perform defrost cycles only when absolutely necessary. A typical showcase is programmed to defrost every 2 to 4 hours resulting in 6 to 12 cycles per day.The RSC performs auto defrost only when required which significantly improves product temperature control and reduces energy consumption. Monitoring Capabilities: The RSC controller uses MODBus communication protocol allowing for on-line monitoring and set-point adjustments to be made from a central location using an EMS system. I Read/Monitor Adjust • Ambient temperature Temperature set point ) 1 Evap coil temperature (within limits) - - • Evap air out temperature • Evap outlet temperature • Evap outlet pressure + • Defrost cycle RSC6 Shelf Configurations(7-14): Increase product capacity with multiple shelf configurations.The RSC3&4 come with 7 adjustable glass shelves and t ; y the RSC6 comes with 14(7 per side).Top 5 shelves can be tilted.Metal shelves i - and peg rack options available. i LED Lighting: LED lighting creates an attractive selling environment while reducing energy and maintenance costs. Product Display: Extended depth and low deck allow for increased 4 storage and product capacity.Low deck creates optimum display space for + -- -- _�..�. _- -. _ - :- gallon jugs,milk,juice&12 or 24 packs of beverages. I - Whisper Quiet Operation: Evaporator fans and airflow operate at less - - - -— than 65dB at 4ft so your customers will focus on the product selection and not the sound of the equipment. + -- Joinable Design:Allows for a wide variety of unit placement options.The RSC can be joined together with other RSC models to create multiple width i configurations. j Meets NSFTier II Standards:The RSC continues to perform at higher ambient store temperature (80°F). Rest assured that the RSC will perform Noce.etack/elackcolorstandard.whde/whitecoloroptlonal. perfectly even on the warmest days. "RSC3 shown with top-mount self contained condensing system.Self contained sy_tems available for all models. low - © ' ' • •1•• � 1 :1 • k 1 �� EN - . . . . - e o t EN • • D SERVICE LINE IMPULS,�E SER, IES Refrigerated Dis la' PROM 0 10 5pECCUIPTI r_099 Ener Efficient Refri erated Dis la Gase Model. RSC3 RSC4 RSC6 Product Temperature Maintain product temperature at or below 41'F ;Environmental Conditions NSF/ANSI 7 Type II Standard maximum indoor 80°F,Relative Humidity 54% Width 37.9"* 49.9"* 73.5"* l G Width-Joined When joining multiple RSC models, subtract(1.35"times 2)for the two side panels External ! Cases _ not used between each joined display. Dimensions y - Depth 36.1" 36.1" 36.1" -_ ,Liteigh t�_ 75.6" 75.6" 75.6" __ ~lOuter/Inner Box Powder coated steel/zinc coated steel �l Structure- --�-- — — iL �f�Insuletion Rigid Insulating Foam ?�Color Internal:Black,External:Black(Optional:White/White available) 7 shelves 7 shelves 14 shelves(7 per side) Y 56elves Adjustable powder coated steel frame,glass inserts standard(Optional:metal inserts) h Fan tor, ECM high efficiency i1 Electrical Parts . Lt htin I i 5/60/1 (3 Amp) 8• g LED +i solenoid Valve Hermetic direct acting solenoid valve for refrigeration(24V DC) Pipe Size of Liquid Line , 3/8"OD Connection Pointy Suction Line 5/8-OD I Refrigerant R404A standard(Optional:R410A) Evaporator Fin Tube Type i Expo mansion Valve External Equalized Automatic Thermal Expansion Valve ontroller- Digital programmable controller with Modbus communication protocol Casters' , (4)2"Casters Drain Pi a Dimension 1.5"NPT Male Connector Termometer Product Simulation Thermometer Internal Volume, 20.73 ft3 27.75 ft3 41.46 ft3 ss Weight 368lb. �4051b. 598lb. ��-No'ise— r Less than 65 dB at 4 ft. 1 ETL File#4007858 Ai Agency Approvals ANSI/UL 471,NSF/ANSI Std 7 Type II,CAN/CSA C22.2 No.120,Ed:3 g okeproductimprovementsandchangespecificationswithoutnotice. NOTE.The manufacturerreserves the ri ht to ma ` c � � us no Intertek Intertek fl Air REVISION HISTORY REV DESCRIPTION DATEI BY C lIEC061272:REMOVEDSKIRTPKG I1/13117li TS B JECO60916:REMOVE 10008355 11/13/161 CSG A JINITIAL RELEASE 9/23/15 MMS 0 0 39.000 FILLL RIVET HEAD 61.965 WITH NSF CAULK 0 - o 22.850 0 FILLL RIVET HEAD 36.000 WITH NSF CAULK. TOP AND BOTTOM. 18.000 DOOR DETAIL TYP (:UL )(EPH ITEM PART NO. DESCRIPTION CITY These designs are REF N 23021247 ROYSTON LLC ro rieta NEXT STEP =.ROYS�'O N ONE PICKROY ROAD Po P rY JASPER,GA 30143 1 43623 BAG,POLY,GUSSETED,2 MIL,PERFORATED,9BX28X50 1 information,property SHIP (770)735-3456 of ROYSTON LLC. Tolerance Unless PART DESCRIPTION 2 50010742 A,CABT,PSRY,B 1 They shall not be Otherwlse Notea copied or duplicated in ,700(=s.015 CABS/L,UNIT,"B",62H,LED,PSRC,L,NSKT,PFP3621 3 60101610 ESS,PSRC,39.00X35.5OX17.93,LT,LED,5-SHF 1 any manner without .)Ix=:.030 ENG DRgwNev DATE PgRT Hole Dia. a REV prior written consent. Angles prior 003 MMS MMS 09/23/15 60101612 C \\jasspt\unmanaged data\jasspt\JAS\RELEASED\60101\60101612.dit PRINTED 1/13/2017 SHEET 1 OF 1 Town of Barnstable Building Department / Brian Florence, CB Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Pre-application ppli tZon for Business Certificate Date /r2 v Map 4 W Parcel D I Applicant Information Applicants Name Applicants Address Email Address Telephone Number (� ���7 ` DJ l% Listed ❑ Unlisted ®_ Business Information New Business? ����}�-_Y_UE t/` rl� Yes Business is a registered corporation? _______�_ _-_/__-_____�_t___. Ye No If yes Name of Corporation � 6n I 1 A V, Does business operate under the registered corporate name? es� No Is the business a sole proprietorship or home occupation? _________ Yes If yes then a Home Occupation Registration is required—See Building Division Staff Name of Business C P,44 t -�^a M Business Address A�, B,111,1 G�-I r L� G ( t(r�,��-�► �� - Y d�17 b?(a3�— Type of Business 1 a\ Building Commissioner Office Use Only edit'o i <_S` �.. Building Commissi Date Clerk Office Use Only THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) m ^C(�J C DATA ergot `. �002!002 �. TOWN OF FAPNsTA BLE LOC MON C3. g }��I M, h SEWAGE#_2 e '3 _ VILLAGE ,r, �, =ASSESSOR'S MIAP St PARCEL �ao�1 INSTALLER'S NAlbil;&PHONE NO. Ca��,. -� �. �,.� Tom, ja SEPTI IC TANK CAPACITY �iStX? ra� � C--� f't�to„� LEACHING FACILITY:(type) 2 Q3 6.1.[.,L�hre Cl�+3 size) )( � NO, OF BEDROOMS .T3dr f r� OWNERt-t'o PERMIT DATE: [1 : b lc l -- - _ COMPLIANCE DATE: Separation Distance Between the: .tl0 fy/Twm.tw�.far � -MMimum Adjusted Groundwater Tab1e to the Botlom of reaching Facility X►.c •_ a Feet Private Watcr Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) Feet Fdge of Wetland and Leaching Faciility(If any wetlands exist within, -- 300 feet of leaching facility) _ Feet FUM"1 'MD BY C-fi ;J-4- Er. �1" ti L C --~� • i Foor l Shape u + fr A-7- 1 ��.,� E i . I E r I I i k-) UPLAND t ARCHITECTS LIrLA1VCARCHiI'1tCT3lI.00M '"r✓'/(i��/, 250 E.MAIN STREET SURE 13 NORTON,MASSACH US ETTS ` 02766 FINISH SCHEDULE v T 774-430-3390 FLOOR BASE YJALLS cELNG SPECFCATON FA I Ft IF2 IF3 F5 F6 IF7 VWVIN.UPLAN DARCHITECTS.COM ma �Jy w o t O ¢ O U Ur U O m ¢¢W ¢teaa g W LL W %O m w 2ZL. pm w = UIs 'PEGEFK:ATONSARENSTR MFNTS OF PROFESSIONALC m > Z R Z6 O rvj O SERVICE AND SMALL REMAIN TNE PROPERTY OF THE mm� O O sO '<m = ¢ mQ O ARCMRECf.THESE DOCUMDRS ARE NOT TO BE USED. XW N H s Z N p Y Z > _ = 1 PUAPPOSES OR BY ANY O ER PARTIES THAN TNOSEIMOLEORN R FZ R W U6 U Sm W J aUa z2 Y 1 w O W i PROPERTT AlJT1100.QFD BY CONTRAR YMT10Ul THE OFF^FF W I Y > > I _ .._ ........ .... wJ ¢5 w m -- Wi r __. ..._. ...._ W W _ ¢r i IN u 2 A 5ALE5 LL z x zx z x x x x x x x z COOLER .4 BACXROOM VI x FRPIGYP ACT FREEZER C JNE5TR00.I D STORAGE I VI E WALX-N I 1XIX I IFRP FRP ...._.._...._-_.---------------__._............. _....._._..... :i 'rp�rx.�,+r• u ;lu^";�v.ss'rs:pa'.mrssva E Q El F1 REV SKN15:Q F1 aNweER: aEMAaxs: DATE � Ell1 7.11 RE—ONBO50T Ej f 2 FNWIES 102n7 Cv � KIJEE III E WAIL � z � F1 Ell F1 REPAIR FLOOR AS NECESSARY F1 F1 u —� FINISH SCHEDULE F2 1 - F1 ISSUED FOR: DATE SSUEO F'I MARCO MAPLE--N. _ y NEW VCT - { PROJECT mLE RlfERGERANIC:BRRE VITRA FLOOR IN 1 PoLYSLEND.UNSAN nOEDGRWT VAULT _.._...._ F� u`4J U WERGERAMIC:LINEN YARRONE REQUIRED tam .-WJIL'POLYBLEND. F3 SANDED NEWTAUPE GROUT LNE BY BOH NOT FooD1 DRERCERAMIC:BOSTON BEIGE Fy FLOOR TILE WJ> -; POLVBLEN,LEND O.SANDED NEW TAUPE GROUT-LINE EE STAN LESSCORNER TRIM II -- L' 3 .F2 L REPAIR. EPA STAI I WTTETLEASNECES5ARY 7 E L E V E N S T R E NUMBER :M B PANT GECKOGRIEN-SNERW. O E R 7 7 K ID 1 0 W1U."6719 SAT.FINISH F3 CEN TERVILLE.MAS.ACHUSETTS 02 J2 F 1 I DRAWNG TITLE Fti 7-11 MOCK AND STRIPE FINISH PLAN AND NOTES PAINT-BENJAMN MOORE. F1 F1 F1 F1 F1 C) SLEEKER BEIGE)141.USE Z a pERMR—DATE PROJECTNUNBER: EMERALD 00.DURATION HOME C AS EASE. I AV- ml? 1'.. 1 7-Eleven Store Menu 3/27/17 (see attached food operations sheet for additional heating/holding temps and shelf life) Note-All animal proteins are fully pre-cooked under verified HACCP plans in federally inspected production facilities. Fresh and Fast Foods Grocery (Packaged foods) • Refrigerated sandwiches-up to 2-day shelf life • Large assortment of packaged grocery items: • Freeze to thaw sandwiches, burritos, Hot Pockets, burgers and ➢ Cereals sandwiches-up to 7-day shelf life ➢ Canned goods ➢ Condiments • Cut fruits-shelf life up to 5 days ➢ Crackers • Whole fruits-9+ days • Fresh Breads • Green Salads-shelf life up to 48 hours • Ice Cream (take home and novelty) • Pasta/potato salads-shelf life up to 5-days • Frozen Meals • Fresh donuts and pastries-24 hour shelf life • Fresh Dairy • Fresh packaged bakery items-up to 5-day shelf ➢ Fluid dairy • *Pre-cooked (re-heated at store level) p breakfast sandwiches-u ➢ Yogurt ➢ to 2-hours shelf life held >_140°F Butter ➢ Eggs • *Pre-cooked (re-heated at store level) chicken tenders, chicken wings, tacos and m at Patti, s - heated to 140°F with a shelf life Refrigerated Food Products up to 4-hours eld >_140°F ➢ Deli Meats • *Re-thermalized par-cooked potato products, cheese sticks and ➢ Cheese pizzas-heated to 165°F with a shelf life of up to 2 hours held • Snacks >_140°F. ➢ Chips • Pre-cooked (re-heated at store level) hot dogs and Taquitos-up ➢ Dried Meat Jerky to 4-hour shelf life >_140°F ➢ Nuts/seeds • Pre-cooked (re-heated at store level) chili and cheese sauces-up • Confectionary to 48-hour shelf life held >_140°F ➢ Chocolate - -- - -- �- -- - -- -- • Nachos ➢ Non-chocolate ➢ Gums • Fresh condiments ➢ Hard Candies ➢ Onions ➢ Novelty ➢ Tomatoes From the Cold Vault ➢ Pico De galo • Canned/bottled Soda ➢ Pickled relish &jalapenos • Juices ➢ Fresh and/or bottled salsa • Energy Drinks *'Indicates the new items added to our current Fresh Food • Bottled Water assortment in select stores. • Alcoholic Beverages,(not available in all locations) ➢ Beer Beverages ➢ Wine ➢ Hard liquor(some stores with a limited selection) • Coffee • Hot Chocolate Non -Food Items • Iced Coffee • Cigarettes and tobacco • Large assortment of health and beauty items • Fountain • Cleaning products • Slurpee • Auto products ➢ Motor Oil ➢ Antifreeze ➢ Various auto fluids • Home use paper products • Stationary • Film & batteries • Cell phones/accessories General Menu item List specific types(if applicable) List Equipment item(heated Heat Temp List Equipment item (h/cList Equipment item (h/c holding) Hold temp Shelf life Prepck�g_d Prepare Comments Lin I (Y/N) on site? Fresh&Fast Foods: Refrigerated sandwiches Oasis CID/Vendo Sanden Fresh n/a n/a Oasis CID/Vendo Sanden Fresh 33°to 40° 2 day Y N Freeze/thaw sandwiches Oasis CID/Vendo Sanden Fast Turbo, Encore&Microwave +140° Wisco 33°to 40° 7 day Y N Heat on demand Hot Pockets Oasis CID/Vendo Sanden Fast Turbo,Encore&Microwave +140° n/a 33°to 40° 7 day Y N Burritos Oasis CID/Vendo Sanden Fast Microwave +140° n/a 33'to 40° 7 day Y N Heat on demand Burgers/Hot sandwiches Oasis CID/Vendo Sanden Fast Turbo,Encore +140° Hot Sanden case 33'to 40° 1 hour Y N Packaged Burgers/sandwiches Oasis CID/Vendo Sanden Fast Microwave +140° n/a 33°to 40° 7 days Y N Green Salads Oasis CID/Vendo Sanden Fresh n/a n/a n/a 33°to 40° 2 day Y N Cut fruits Oasis CID/Vendo Sanden Fresh n/a n/a n/a 33°to 40° 5 day Y N Whole fruits Oasis CID/Vendo Sanden Fresh n/a n/a n/a 33°to 40° 9+days Y N Pasta/potato salads Oasis CID/Vendo Sanden Fresh n/a n/a n/a 33°to 40° 5 day Y N Fresh donuts and pastries Fresh bakery case n/a n/a n/a n/a 2 day N N Fresh packaged bakery item Gondola inline n/a n/a n/a n/a 5 day Y N Precooked/reheat hot dogs Under counter refrigerator 45/75 AP Wyatt +165° 45/75 AP Wyatt +140° 4 hour y N Precooked/reheat Taquitos Under counter refrigerator 45/75 AP Wyatt +165° 45/75 AP Wyatt +140° 4 hour y N Nachos Y N Chili Chili Cheese Dispenser-8mhpde2-120v 8mhpd2-711-P-K Part number +1650 Part number HPD2-120V +140° 48hour y n Star Manufacturing Int'L Inc Peristaltic Dispenser,Accy Kit HPD2-120V Cheese Sauce Chili Cheese Dispenser-8mhpde2-120v 8mhpd2-711-P-K Part number +165° Part number HPD2-120V +140° 48hour y n Star Manufacturing Int'L Inc Peristaltic Dispenser,Accy Kit HPD2-120V Hot Food n/a n/a n/a n/a n/a n/a n/a n/a See store menu Fresh condiments Onions,Tomato,Pico De gallo,Pickled relish, n/a n/a Condiment station 40°or below Varies Y N Jalapeno,Pickled Relish,Salsa=7 days Jalapenos,Fresh/bottled salsa Pico,tomato,onion=1 day Pizza Under counter refrigerator Turbo&Encore +165° Hot Sanden case +140° 1 hour Y N Beverage: Coffee Bunn BrewWise&Urn Bunn BrewWise&Urn +195° Bunn BrewWise&Urn +160° Varies Y By customer Hot Chocolate Bunn Imix Bunn Imix +195° Bunn[mix +160° n/a Y By customer Iced Coffee Chiller dispenser n/a n/a Chiller dispenser 33°to 40° n/a Y By customer Fountain Drink Lancer Post Mix#115 n/a n/a Lancer Post Mix#115 n/a n/a Y By customer Slurpee FDB Model 563 n/a n/a FDB Model 563 n/a n/a Y By customer d Grocery(Packaged foods): Assorted packaged groceries Cereals,Canned goods,Condiments,Crackers n/a n/a Gondola inline n/a Varies Y N ' I Fresh Breads Gondola inline n/a n/a Gondola inline n/a Varies Y N Ice Cream(take home/novelty) Upright freezer/Novelty case n/a n/a Upright freezer/Novelty case -20° to-10 Varies Y N Frozen Meals Frozen food display freezer n/a n/a Frozen food display freezer -10°to 0° Varies Y N Fresh Dairy Fluid,Yogurt,Butter,Eggs n/a n/a Cold Sanden case,CID&Vault 33°to 40 Varies Y N Refrigerated Food Products Deli meats,Cheese n/a n/a Cold Sanden case,CID&Vault 33°to 40° Varies Y N Snacks Chips,Jerky,Nuts/seeds n/a n/a Gondola inline n/a Varies Y N i Confectionary Chocolate,Gums,Candy,etc. n/a n/a Gondola inline n/a Varies Y N d L 7 WOWS. 7,7 �61 0- own tot too X81 A- "I Sol Vol. VIA 110 Q con, ">ZOO Of All zoo wlw.�S 0 --n "Ian, of ONO V:�_ AWN Cox.. me Ali 1 Gin city __F1gCE1V H TP EAL Dr, ISTA5LE- VAN, TO violas XV ISO Inv! one.; I'l""I""""""""'I'l"""""""""'I'l""""'I............................. tilt M -Toy, es 00D, SHO ,my" now Elmo .191 all slowny Mon— ALE'" OA ymok Vol Wo not, "Koo At lots lqjy�� Asp will