HomeMy WebLinkAboutBuilding Permit #Exception - 267 CHICKERING ROAD 5/1/2018 BUILDING PERMIT V&ORT11
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received AYES)
9SSACHL)
Date Issued:
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Two or more family Industrial
do lte9M No. of units: Commercial
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Repair, replacement Assessory Bldg hers:
Demolition Other
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DESCRIPTION OF WORK TO BE PREFORMED:
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OWNER: Name:-b:-Yz+t,, . tlb+*-V(?9k,4 1* rvVD Phoni-7
Address: q ko-. )Q-0r. 6 u 1-(,!9-- 6
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ARCHITECT/ENGINEER Nvt�bc-Z-i Or-,) Phone: Ln
Address: 1010 Reg. No.
SCHEDULE.BULDINGERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ FEE: $
Check No.: Receipt No.: ---7
NOTE: Persons con .ng with unregistered contractors do not have access to the guaranty fund
Si A 66- i-t/OVbtcontractor
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Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pools
Well Tobacco Sales Food Packaging/Sales
Private(septic tank,etc. Permanent Dumpster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on Signature
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COMMENTS
HEALTH Reviewed on Z— Siqnaturez/, .
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
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Conservation Decision: Comments
Water & Sewer Connection/Signature&Date- Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
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267 CHICKERING ROAD
Complaint Detail Report 046 0-0003
Complaint#: CT-2012-000005 Status: In discovery GIS#' 2681 Printed On:Mon Jul 25,2011
Violator: 99Res
-
�� Address: = - 267 CHICKERING ROAD= ._ =v. - r,
Map: 046.0 Address: 3038 Sidco Drive
�� ¢� Date Recvd.: Jul-25-2011 Time Recvd.: 10:10 AM Block: 0003
Category; Food Handling Nashville, TN 37204
$ Lot: Type: Commercial
a GeoTMS Module: Board of Health
�• :, Districts Trade: food
Recorded By: jPamela DelleChiaie
Description:• Zoning: Structure:Nine Nine Restaurant&Pub
ty-
Complaint: Walk-in complaint from Nick Ippolito-978.857.5097-On Sunday night(7/24/2011.)he ate dinner at the 99 Rest.And ordered a Wedge Salad.
The Wedge Salad was taken out of the refrigerator with bare hands by the manager. I asked him if he should have gloves on,and he said yes. He put tongs in the z rn
refrigerator,and less than a minute later,a waiter did the same thing. I asked him the same question.
xn
I spoke to the manager again. He said we keep our hands very clean,and he would speak to the waiter. Mr.Ippolito requests follow-up about the incident.
Comments: ida x
Inspector Assigned to Complaint: zo
Contacts z
Contact Type DateCCCyyyO�777
Time Name Phone Best Time To Reach Recorded ByRes onse o'
Caller Jul-25-2011 10:10 Nick Ippolito (978)857-5097 Q p 00
a a
AM Pamela DelleChiaie Follow-Up by Health
Inspector
Actions Taken
GeoTMS Module
Status
Board of Health REFERRAL Date Time Response T ype Action Taken Comments
Follow-Up by Health w
Inspector rn m
0000
7
00 w
y ��
0 N
N\D
GeoTMS®2011 Des Lauriers Municipal Solutions, Inc.
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267 CHICKERING ROAD 046.0-0003
Complaint Detail Report
Printed On: Wed Apr 03,2013
Complaint#: CT-2013-000039 Status: 11n discovery JGIS#: 2681 Violator: .99 Restaurant of Boston,LLC
,�rrren.y- Address: 267 CHICKERING ROAD Map: 046.0 Address: 3038 Sidco Drive
�--�� Date Recvd.: Apr-03-2013 Time Recvd.: 10:47 AM Block: 0003 Nashville,TN 37204
Category: Pest Control Lot: Type: Commercial
GeoTMS Module: Board of Health District: Trade: food
+� Recorded By: Lisa BlackburnZoning: Structure:Ninety-Nine Restaurant&Pub
Description-
COmplaint: Anonymous caller wanted to complain about cockroach infestation at the 99 Restaurants.He has friends that work there and they stated that the 99 has sprayed for
cockroaches twice recently and that cockroaches have been observed in honey mustard sauces.He stated that he could see the white spray around the soda machine
and is very concerned about this problem.
Comments:
Inspector Assigned to Complaint.
Contacts
Contact Type Date Time Name Phone Best Time To Reach Recorded By Response
Caller Apr-03-2013 10:47 Anonymous Lisa Blackburn Forwarded to Health
AM Inspector
Actions Taken
GeoTMS Module Status Date Time Response Type Action Taken Comments
Board of Health REFERRAL Apr-03-2013 12:51 PM Follow-Up by Health Michele Grant and Susan
Director Sawyer went out to inspect.
They looks at the inspection
sheets.Manager stated that
they were having a problem
with cockroaches and that
they are working with a pest
control company and the
issue is being taken care of.
GeoTMS®2013 Des Lauriers Municipal Solutions, Inc. Page 1 of I
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THE COMMONWEALTH OF MASSACHUSETTS
* TOWN OF NORTH ANDOVER 1600 Osgood Street, Building 20; Suite 2-36
North Andover, Massachusetts 01845
*'••'"': * Phone-978.688.9540 Fax-978.688.8476.
FOOD ESTABLISHMENT INSPECTION REPORT e-mail: healthdept(a)townofnorthandover.com
Name oLEstablishment Date T e of Operation(s) Tme of Inspection
/ Food Service Routine
Address Risk Level ❑ Retail ❑ Re-inspection
Telephone
El-1
Kitchen PrevPrecious Inspection
l tS ❑ Mobile L] Pre-operation
Owner � ` I 1 HACCP: ❑ Temporary
y / N El Caterer ❑ Suspect l l liiess
El Bed&Breakfast E] General Complaint
Person-in-Charge(PIC) /?h Time 30 F] HACCP
Inspector . z In: 3 e El
Out: Year:
Each violation,c eked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated.
Non-compliance with:
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 Tobacco 590.009(F) ❑
corrective action as determined by the Board of Health. Allergen Awareness 590.009 (GtX
FOOD PROTECTION MANAGEMENT
❑ 12. Prevention of Contamination from Hands
❑ 1. PIC Assigned/Knowledgeable/Duties
EMPLOYEE HEALTH ❑ 13. Handwashing Facilities
PROTECTION FROM CHEMICALS
❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14.Approved Food or Color Additives
❑ 3. Personnel with Infections Restricted/Excluded
FOOD FROM APPROVED SOURCE ❑ 15.Toxic Chemicals
❑ 4. Food and Water from Approved Source TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods)
❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures
❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating
❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling
PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding
❑ 8.Separation/Segregation/Protection
❑20.Time as a Public Health Control
REQUIREMENTS FOR HIGHLY-SUSCEPTIBLE-POPULATIONS(HSP)
❑ 9. Food Contact Surfaces Cleaning and Sanitizing ❑21. Food and Food Preparation for HSP
❑ 10. Proper Adequate Handwashing
CONSUMER ADVISORY
❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories
Violations Related to Good Retail Practices(Blue Items) Number of Violated Provisions Related To
Critical (C) violations marked must be corrected immediately Foodborne Illnesses Interventions and Risk
or within 10 days as determined by the Board of Health. Factors(Red Items 1-22):
Non-critical (N) violations must be corrected immediately or Official Order for Correction:Based on an inspection today,the items
within 90 days as.determined by the Board of Health. checked indicate violations of 105 CMR 590.000/federal Food Code.This
C N
23. Mara 9ement and Personnel FC-2590.003) report,when signed below by a Board of Health member or its agent
constitutes an order of the Board of Health.Failure to correct violations
24. Food and Food Protection (FC-3)(590.004)
cited in this report may result in suspension or revocation of the food
25. Equipment and Utensils (FC-4)(590.005) p y p
26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If
aggrieved by this order,you have a right to a hearing.Your request must
27. Physical Facility (FC-6)(590.007)
be in writingand mi
d sub tted to the Board of Health at the above address
28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days-of receipt of this order.
29. Special Requirements (590.009) DA TE OF RE-INSPEC TION:
30. Other
Inspector's Signat Print: P
PICs Signatur Print: U Paget ofPages
_
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3-501.14(C) PHFs Received at Temperatures
V/o/ations Related to Foodborne Illness Interventions and Risk According to Law Cooled to
Factors(Red items 1-22) (Cont) 41°F/45°F Within 4 Hours.
PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs
1d Food or color Additives 19 PHF Hot and Cold Holding
3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below
3-302.14 Protection from Unapproved Additives*
590.004(F) 410/450 F*
15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above
7-101.11 Identifying Information-Original 140°F.
Containers* 3-501.16(A) Roasts Held at or above 130°F.
7-102.1.1 Common Name-Working Containers* IF20 Time as a Public Health Control
7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control*
7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement
7-202.12 Conditions of Use*
7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-204.11 Sanitizers,Criteria-Chemicals* POPULATIONS(HSP)
7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged,Ju ices and
7-204.14 Drying Agents,Criteria* I Beverages with Wamitig Labels*
7-205.11 Incidental Food Contact,Lubricants* 3-801.11(B) Use of Pasteurized Eggs*
7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and
7-206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served. *
7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-served.
Monitoring*
CONSUMER ADVISORY
TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
16 Proper Cooking Temperatures for Animal Foods That are Raw,Undercooked or
PHFs Not Otherwise Processed to Eliminate
3-401.11A(l)(2) Eggs- 155°F 15 Sec. Pathogens.*Eftcu-"7001
Eggs-Immediate Service 145°Fl5sec' 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs*
3-401.11(A)(2) Comminuted Fish,Meats&Game
Animals- 155°F 15 sec.* SPECIAL REQUIREMENTS
3-401.11(13)(1)(2) Pork and Beef Roast- 130°F 121 min* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in
3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec. catering,mobile food,temporary and
* residential kitchen operations should be
3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections
Stuffing Containing Fish,Meat, above if related to foodborne illness
Poultry or Ratites-165°F 15 sec. * interventions and risk factors. Other
3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail
145°F* practices should be debited under#29-
3-401.12 Raw Animal Foods Cooked in a Special Requirements.
Microwave 165°F*
3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec. * VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
17 Reheating for Hot Holding (Blue Items 23-30)
3-403.11(A)&(D) PHFs 165°F 15 sec.* Critical and non-critical violations, which do not relate to the
3-403.11 B foodborne illness interventions and riskfactors listed above,can be
( ) Microwave- 165°F 2 Minute Standing
Time* found in the following sections of the Food Code and 105 CMR
590.000.
3-403.11(C) Commercially Processed RTE Food- Item Good Retail Practices FC 590.000
140°F* 23. Management and Personnel FC-2 .003
3-403.11(E) Remaining Unsliced Portions of Beef 24. Food and Food Protection FC-3 .004
Roasts* 25. Equipment and Utensils FC_-4 .005
18 Proper Cooling of PHFs 26. Water,Plumbing and Waste FC-5 .006
3-501.14(A) Cooling Cooked PHFs from 140°F to 27• Physical Facility FC-6 .007
70°F Within 2 Hours and From 70°F 28• Poisonous or Toxic Materials FC-7 .008
29. Special Requirements .009
to 41°F/45°F Within 4 Hours.* 30. Other
3-501.14(B) Cooling PHFs Made From Ambient
Temperature Ingredients to 41°F/45°F
Within 4 Hours*
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
THE COMMONWEALTH CF MASSACHUSETTS
TOWN OR CITY OF ��-�� �
(�Qt,
Establishment Name: % -/ S Date: Page:. � . of
Item Code ` C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date
No.:, Reference R—Red Item Verified
Ale)
PLEASE PRINT CLEARLY
01 A
f! —
AAA
wZ
r� L
S G,: A IeLen
Discussion With Person in Charge: Corrective Action Required: ❑ No Yes
it
0 Voluntary Compliance ❑ Employee Restriction/
i Exclusion
\1 Ap4q 0 Re-inspection Scheduled ❑ Emergency Suspension
0 Embargo ❑ Emergency Closure
m� t
❑ Voluntary Disposal 0 Other:
Form 734 B A.M.Sulkin Co.,Boston,MA
,� {. . 4tiw a t,L.,J�rr g ..t: Na r.�,.. .a .f:< .r. w rw�..�.rs)' n f i..., ry.• a.a y #ems:
Vlolations Related to Foodborne Illness
Interventions and Risk Factors(Red Items 9-22) - 41
PROTECTION FROM CONTAMINATION
FOOD PROTECTION MANAGEMENT g Cross-contamination
1 590.(9)3(A) Assi ent of Re nsibili * 3-302.11(AX 1) Raw Animal Foods Separated from
590.003 13Demonstration of Knowledge* Cooked and RIM Foods*
2-103.11 Person in charge-duties - Contamination from Raw Ingredients
3-302.11(Ax2) Raw Animal Foods Separated from Each
EMPLOYEE HEALTH Other'
2 590.003(C) Responsibility of the person in charge to Contamination from the Environment
require reporting by food employees and 3-302.11 A Food Protection*
applicants* 3-302.15 Washing Fruits and Vegetables
590.003(F) Responsibility Of A Food Employee Or An 3-304.11 Food Contact with Equipment and
Applicant To Report To The Person In Utensils*
Charge* Contamination from the Consumer
590.003(G) eporting by Person in Charge* 3-306.14 A B Returned Food and Reservice of Food* "
3 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated
590.003E Removal of Exclusions and Restrictions Food
3-701.11 Discarding or Reconditioning'Unsafe
FOOD FROM'APPROVED SOURCE Fes*
4 Food and Water Fran Regulated Sources 9 Food-Cordact Surfaces
590.004 A-B Com liance with Food Law* 4-501.111 Manual Warewashing-'Hot Water
3-201.12 Food in a Hermetically Sealed Container* Sanitization Tempera S*
3-201.13 Fluid Milk and Milk Products*: 4-501.112 Mechanical Warewashing-Hot Water
3-202.13 Shell Eggs* , ; Sanitization Temperatures*
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH,
concentration and hardness. *
3-202.16 Ice Made From Potable Water* 4-601.11(A) Equipment Food Contact Surfaces and
5-101.11 DrinkingWater from an Approved System* ,
590.006(A) Bottled Water* Utensils Clean*
590.006 B Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Equipment Food-
Contact Surfaces and Utensils*
ShelJish and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils and
3-201.14 Fish'and Recreationally Caught Molluscan Food Contact Surfaces of Equipment*
Shellfish* 1 4-703.11 Methods of Sanitization-Hot Water and
3-201.15 Molluscan Shellfish from NSSP Listed
Sources* iI Chemical* i
lU. Proper,Adequate Handwashing
Game and Wild Mushrooms Approved by
Re ulat A ' 2-301.11 Clean Condition-Hands and Arms*
uth
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* ,
590.004 C Wild Mushrooms* 2-301.14 When to Wash*
3-201.17 Game Animals* 11 Good Hygienic Practices
5 Receiving/Condition 2401.11 Eating,Drinlcing or Using Tobacco*
3-202.111 PIIFs Received at Proper Temperatures* 2401.12 Discharges From the Eyes,Nose and
3-202.15 Package Integrity* Mouth*
3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When T *
6 TagslRecords:Shellstock, iZ Prevention of Contamination from Hands
3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from
3-203.12 Shellstock Identification Maintained* Employees*
Tags/Records:Fish Products 13 Handwash Facilities
302.11 Parasite Destruction* '
Conveniently located and Accessible
3402.12 Records,Creation and Retention* 5-203.11 Numbers and Capacities*
590.004(J) Labeling of Ingredients• 5-204.11 Location and Placement*
Conformance with Approved Procedures 5-205.11 Accessibih tion and Maintenance
MACCP Pians Suppled with Soap and Hand Drying
3-502.11 Specialized Processing Methods* ID®wces
3-502.12 Reduced oxyjen packaging,criteria* 6-301.11 Handwashing Cleanser,Availability
8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision
•Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
� J
I
i
i
r I'1[E?COi\4�tON1lrF..AI,TH OF MASSACHUS61"fS
* * TOWN OF NORTH ANDOVER 1600 Osgood Street,Building 20;.Suite 2-36
* � * North Andover,Illassicli iset'ts 01845
Phone-978.688.9540 Fax-978.688.8476
�sSACH04e1 FOOD ESTABLISHMENT INSPECTION REPORT a-mail: healtlident(a�townnfnorthandover.com
Na to f EstablishmentD�t Ti-L)w6f O eration s 1'ipea 'Ins ec•rion'.
-T. : Food Service oulinr
AddressRiskLevel ❑ Retail
r ,r-, � � .
; ❑ Re-inspcction
Telephone ❑ Residential Kitchen Previous hmpection
q /42 -- C ❑ Mobile nate:
Own/ a HACCP: ❑ Temporary ❑ Pre-operation
Y / N ❑ Caterer ❑Suspect Illness
El/ Time Bed K Breakf��st ElGeocral Complaint
-01Ele(P1 cm�'s
In: ❑ HACCP f
Out: fear: ❑Other,____
Each violation checked requi es an explanation on the narrative page(s) and a citation of specific provision(s)violated.
Non-compliance with:
Vi.ofations Related to Foodborne Illness interventions and Risk Fac.t6rs flied items) Anii•Choking 590.009(E) ❑
Violations marked may pose an imminent health hazard and require immediate Tobacco 590.009(F) ❑
corrective action as determined by the Board of Health. Allergen Awareness 590.009(G)❑
FOOD PROTECTION MANAGEMENT
❑ 12.Prevention of Contamination from Hands
[Q 1. PIC�Assignedlltnowiedgeable/Duties ,
❑13. H':andwashtng Facilities
EMPLOYEE HEALTH e� V'11" 3�
PROTECTION FROM CHEMICALS
❑.2., Reporting of Diseases by Food Employee and PIC E3 !7
14. Approved Food or'Color'Additives
F713. Personnel with Infections RestrictedlExclude.d i!'_
FOOD FROM APPROVED SOURCE ❑'.16.Toxin Chemicals
4. Food and.Water.frorn Appr6v8d'Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods)
❑ 5. ReceivincllCondition (]16.Cooking Temperatures
❑ 6. TagslRecordslAccuracy.of Ingredient Statements ❑17. Rehaating
J. Co'nformar ce:with Approved ProcedureslHACCP Plans ❑18•Cooling
PROTECTION FROM CONTAMINATION ❑19.'Hot and Cold Holding
❑ B.SeparationlSegregation/Protection ❑.20.Time as a Public Health Control
REQUIREMENTS FOR HIGHLY-SUSCEPTIBLE-POPULATIONS(HSP)
El 9. Food'Con'tact'Surface's Cleaning and Sanitizing ❑21.Food;and Food Preparation for HSP
❑ 10. Proper Adequate Handwashing
CONSUMER ADVISORY
❑ 111'.Good"Hygienic Practices ,❑�22.Posting of Consumer.Advisories
Violations Related to Good Retail Practices,(Blue Items) Number of Violated-Provisions Related:Ta
Critical (C)violations marked must be corrected immediately Foodborne Illnesses int
ervenfiions and Risk
or within 10 days as determined by the Board of Health. Factors (Real items �-22J:
Non-critical N violations must be corrected immediately or ,the items i
d s
Official Order for Correction:Baeon an inspection lois
within 90 days as determined by the Board of Health. p y
N checked indicate violations of 105 CMR 590.000/federal Food Code.This
23. Management and Personnel (FC-2)(590:003) report,when signed below by a Board of Health member or its agent
24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health.Failure to correct violations
25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food '
26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations.If
27. Physical Facility aggrieved by this order,you have a right to a hearing.Your request must
y y (F C-7)(5 0.0 8 be in writing nd submitted to the Board of Health at the above address
28. poisonous or Toxic Materials (FC-7)(590.008) within 10 day of receipt of this order.
29. Special Requirements (590.009}
30. Other DATE OF RE-INSPECTION:
/
Inspector's Signature. 11 Print:ul
PICS Signature; Prin : Page_of Pages
3-501.14(C) PHFs Received at Temperatures
Yloladons Related to Foodbome Illness Interventions and Risk According to Law Cooled to
Factors(Reditems 1.22) (Cont.) 41°F/45°F Within 4 Hours. •
PROTECTION FROM CHEMICALS3-501.15 Cooling Methods for PHFs
14 Food or Color Additives 19 PHF Hot and Cold Holding
3.202,12 Additives* 3-501.16(B) Cold PHFs Maintained at or below
3-302.14 Protection from Unapproved Additives*
590.004(F) 41°/450 F*
15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above
7-101.11 Identifying Information-Original 140°F.
Containers* 3-501.16(A) Roasts Heid at or above 130°F. '
7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control
7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control*
7.202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement
7-202.12 Conditions of Use*
'7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-204.11 Sanitizers,Criteria-Chemicals* POPULATIONS(NSP)
7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and
7-204.14 Drying Agents,Criteria* Beverages with Warning Labels*
7.205.11 Incidental Food Contact,Lubricants* 3-801.11(B) Use of Pasteurized Eggs*
.7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and
7,206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served.*
7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-served,
Monitoring*
CONSUMER ADVISORY
TIMEiTEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
16 Proper Cooking Temperatures for Animal Foods That are Raw,Undercooked or
PHFs Not Otherwise Processed to Eliminate
3-401.11A(t)(2) Eggs- 155°F 15 Sec. Pathogens.*fffedl*"1rZ00,
Eggs-Immediate Service 145°FI5sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs*
3.40 1.11(A)(2) Comminuted Fish,Meats&Game
Animals- 155°F 15 sec.* SPECIAL REQUIREMENTS
3.401.11(B)(1)(2) Pork and Beef Roast• 130°F 121 min* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in
3-401.11(A)(2) Ratites,Injected Meats- 155°F 15 sec. catering,mobile food,temporary and
* residential kitchen operations should be
3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections
Stuffing Containing Fish,Meat, above if related to foodborne illness
Poultry or Ratites-165°F 15 sec.* interventions and risk factors. Other
3.40 1.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail
145°F* practices should be debited under 1129-
3-401.12 Raw Animal Foods Cooked in a Special Requirements.
Microwave 165°F+
3.401.11(A)(1)(b) All Other PHFs- 145°F 15 sec.+ VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
17 Reheating for Hot Holding (Blue Items 23-30)
3.403.11(A)&(D) PHFs 165°F 15 sec. * Critical and non-critical violations, which do not relate to the
3.403.11 B foodborne illness interventions and risk factors listed above, can be
O Microwave- 165°F 2 Minute Standing
Time• found in the following sections of the Food Code and l05 CMR
590.000.
3.403.11(C) Commercially Processed RTE Food- Item Good Retail Practices FC 590.000
140°F* 23. Management and Personnel FC-2 .003
3.403.11(E) Remaining Unsliced Portions of Beef 24. Food and Food Protection FC_-3 .004
Roasts* 26. Equipment and Utensils FC-4 .005
1$ Proper Cooling of PHFs 26. Water,Plumbing and Waste FC-5 .006
3-501.14(A) Cooling Cooked PHFs from 140°F to 27• Physical Facility FC-6 .007
70°F Within 2 Hours and From 70°F 28. Poisonous or Toxic Materials FC-7 .008
29. 8
ectal Requirements 009
to 41°F/45°F Within 4 Hours.' 30. Other
3-501.14(B) Cooling PHFs Made From Ambient
Temperature Ingredients to 41°F/45°F
Within 4 Hours*
'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
THE COM •NWE LTH OF MASSACHUSETTS
TOWN OR CIT 1 0
Establishment Name: Y Date; r I Page; of
[tem Code C-CriticRed]al Iten_'r DESCRIPTION OF VIOLATION /PLAN OF CORRECTION
Date
No. Reference R`-Red Item PLEASE PRINT CLEARLYVerified
Z LA r in r`
T r-C) ilJ 1-r\ v`e r 4-- V a
(► r -�-� N--, CA
lcn U Y1 LAL Z
e. /'t r� 4-h I r,r, i s v C CSC? S4-
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- rJ 0-vl I'
,
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Discussion With Person in Charge: Corrective Action Required: p No O Yes
LI Voluntary Compliance ® Employee Restriction
Exclusion
r12
O Re-inspection Scheduled O Emergency Suspension
P )�2_ ye L
L'� 44e� 0 Embargo 0 Emergency Closure
I] Voluntary Disposal Q Other_
Foran 734 B AM.Sulkin Co.,Charlestown,MA
3-501.14(C) PHFs Received at Temperatures
Violations Related to Foodborne Ilness Interventions and Risk According to Law Cooled to
Factors(Redltems 9-22) (Cont.) 41°F/451F Within 4 Hours.*
PROTECTION FROM CHEMICALS3-501.15 Cooling Methods for PRFs
14 Food or Color Additives
11-9 PHF Hot and Cold Holding
3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below
3-302.14 Protection from Unapproved Additives* 590.004(F41°F/45°F*
15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above
7-101.11 Identifying Information-Original 1400F.*
Containers* 3-501.16(A) Roasts Held at or above 1300F.*
7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control
7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control*
7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement
7-202.12 Conditions of Use*
7.203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-204.11 Sanitizers,Criteria=Chemicals* POPULATIONS HSP
7-204,12 Chemicals for Washing Produce Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and
7-204,14 Drying Agents,Criteria* Beverages with Warning Labels*
7-205.11 Incidental Food Contact,Lubricants* 3-801.11(8) Use of Pasteurized Eggs*
7-206..11 Restricted Use Pesticides,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and
7-20_6.12 Rodent Bait Stations* Raw Seed Sprouts Not Served.*
3-801.11(C)
7-206.13 Tracking Powders,Pest Control and Unopened Food Package Not Re-served.#
Monitoring*
CONSUMER ADVISORY
TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
16 Proper Cooking Temperatures for Animal Foods That are Raw,Undercooked or
PHFs Not Otherwise Processed to Eliminate
EEPathogens.*Effective 11112001
3.401.11A(1)(2) Eggs- 155°F 15 Sec. ° * -302.13 Pasteurize Eggs Substitute or Raw Shell Eggs
Eggs-Immediate Service 145'F 15 sec.
3-401.11(A)(2) Comminuted Fish,Meats&Game
SPECIAL REQUIREMENTS
Animals- 155°F 15 sec.* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in
3-401.11(13)(1)(2) Pork and Beef Roast- 130°F121 min.*
3-401.11(A)(2) Ratites,Injected Meats-155°F15 sec. catering,mobile food,temporary And
* residential kitchen operations should be
3-401.11(A)(3) Poultry,Wild Game,Stuffed PRFs, debited under the appropraite sections
Stuffing Containing Fish,Meat, above if related to foodborne illness
Poultry or Ratites-165°F 15 sec.* interventions and risk factors.Other
340LI I(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail
145°F* practices should be debited under#1!29-
3-401.12 Raw Animal Foods Cooked in a Special Requirements,
Microwave 165°F*
3-401.11(A)(1)(b) All Other PHFs- 145°F 15 sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
17 Reheating for Not Holding (Blue Items 23-30)
3-403.11{A)&{D) PHFs 165°F 15 sec.* Critical and noir-critical violations,which do not relate to the
foodborne illness interventions and risk factors listed above,can be
3-403.11(B) Microwave- 165°F 2 Minute Standing found in the fallowing sections of the Road Code and 105 CMR
Time* 590.000.
3-403.11(C) Commercially Processed RTE Food- Item Good Retail Practices FC 590.000
140°F* 23. Management and Personnel FC-2 .003
3-403.11(E) Remaining Unsliced Portions of Beef 24. Food and Food Protection FC-3 .004
Roasts* 25• Eauipment and Utensils __ - .005
18 Proper Cooling of PRFs 26. Water,Plumbing and Waste FC-5_ .006
3-501.14(A) Cooling Cooked PHFs from 140°F to 27. Ph sical Facllit FC-6 _ .007
70°F Within 2 Hours and From 70°F [298. Polsonous or Toxic materials FG-7 .008_
to 41°F/45°F Within 4 Hours.* S ectal Re uirements 009
0. Other
3=501,14(13) Cooling PHFs Made From Ambient
Temperature Ingredients to 41°F/45°F
Within 4 Hours.*
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
DelleChiaie, Pamela
From: DelleChiaie, Pamela
Sent: Monday, August 13, 2012 2:02 PM
To: 'inspections@activeviewhdi.com'
Cc: Sawyer, Susan
Subject: 99 Restaurant-Additional information/correspondence
Attachments: 20120813132250385.pdf
Attached is additional information regarding renovations at the 99 Rest. In North Andover post 6/7/2011.
Pamela DelleChiaie
Health Department
Town of North Andover
1600 Osgood Street I Bldg.20 1 Suite 2-36
North Andover,MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email pdellechiaie@townofnorthandover.com
Web www.TownofNorthAndover.com
4
DelleChiaie, Pamela
From: DelleChiaie, Pamela
Sent: Monday, August 13, 2012 2:00 PM
To: 'inspections@activeviewhdi.com'
Cc: Sawyer, Susan
Subject: 99 Restaurant Inspection Pictures-8/8/2012
Attachments: 20120813132428090.pdf
Attached are inspection pictures of the 99 Rest. From 8/8/2012.
Pamela DelleChiaie
Health Department
Town of North Andover
1600 Osgood Street I Bldg.20 1 Suite 2-36
North Andover,MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email Ddellechiaie@townofnorthandover.com
Web www.TownofNorthAndover.com
I
3
DelleChiaie, Pamela
From: DelleChiaie, Pamela
Sent: Monday, August 13, 2012 1:58 PM
To: 'inspections@activeviewhdi.com'
Cc: Sawyer, Susan
Subject: 99 Restaurant Inspections
Attachments: 20120813132443775 (2).pdf
Here is additional inspection information for the 99 Restaurant as requested post 6/7/11.
Pamela DelleChiaie
Health Department
Town of North Andover
1600 Osgood Street I Bldg.20 1 Suite 2-36
North Andover,MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email pdellechiaiePtownofnorthandover.com
Web www.TownofNorthAndover.com
1
DelleChiaie, Pamela
From: DelleChiaie, Pamela
Sent: Monday, August 13, 2012 1:59 PM
To: 'inspections@activeviewhdi.com'
Subject: FW: 99 Restaurant Inspections
Attachments: 2O12O813132443775.pdf
From: DelleChiaie, Pamela
Sent: Monday, August 13, 2012 1:56 PM
To: 'inspections@activeviewwhdi.com'
Subject: 99 Restaurant Inspections
Here is additional 99 Restaurant inspection information.
Pamela DelleChiaie
Health Department
Town of North Andover
1600 Osgood Street I Bldg.20 1 Suite 2-36
North Andover,MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email Pdellechiaie@townofnorthandover.com
Web www.TownofNorthAndover.com
2
DelleChiaie, Pamela
From: inspections@activeviewhdi.com
Sent: Friday, August 10, 2012 5:12 PM
To: DelleChiaie, Pamela
Subject: Public Information Request: 08/10/2012
Friday, August 10, 2012
1 �
I�
Hi Pamela,
This is a new request for Public Information since our last request. We are working with several national
restaurant chains and food service companies to gather food inspection reports as part of their corporate Quality
Assurance programs. Note that we send these requests every month or so to be sure we do not miss any
complaints or other inspections that may occur between routine inspections.
Please be sure to respond to this and all other requests you receive, as this will avoid us continuing to send you
the same request. If no new inspections have been performed since the date listed for each facility below a
simple reply letting us know is sufficient.
The details of our request are listed below. As always, we appreciate your help with our requests.
1. Fuddruckers/North Andover [Smith]
(North Andover)550 Turnpike Street, Rt 114 North Andover, MA 01845
Please send any inspections performed AFTER 06/07/2011. If there are no inspections after that date,
Please s ed on or before 06/07/2011.
2. 99/N. Andover, MA
267 Chickering Rd. Rte. 125 N. Andover, MA 01845
Please send any inspections performed AFTER 08/05/2011. If there are no inspections after thatdat
please let us know. We do not need any inspections erformed on or before 08/05/2011.
This request is made in accordance with your State's Open Records law and under the Freedom of Information
Act, 5 U.S.C. Sec. 552.
Please advise if there is a cost for copies, and how that needs to be paid. If possible, we would like to receive
the reports in an electronic format or by e-mail or fax. However, if there are too many pages U.S. mail is fine-
we will pay the postage.
Thanks,
Alvin Varughese
Ecolab
300 Tri-State International Drive Suite 200 Lincolnshire, IL 60069
Email: inspections&activeviewhdi.com
Phone: (847) 597-9918
Fax: (800) 724-9178
i
x
xa►x
THE COMMONWEALTH OF MASSACHUSETTS
* TOWN OF NORTH ANDOVER 1600 Osgood Street, Building 20; Suite 2-36
North Andover,Massachusetts 01845
Phone-978.688.9540 Fax-978.688.8476
y'$s�eeusE�,� FOOD ESTABLISHMENT INSPECTION REPORT e-mail: healthdeat(ai)townofnorthandover.com
Name of Establishment DateType of OperationType T pe n Ins pe n
Nt�. ^ h 1 _12
® Food Service
Address 7 ��l `� Risk Level E] Retail Re-inspection
Telephone E] rre Residential Kitchen Previous Inspection
❑ Mobile
❑
Owner _ HACCP: ❑ PPre-operationperationTemporary El suspect Illness
Y / N El Caterer
Person-in-Charge(PIC) Time 3 G ❑ Bed& Breakfast ❑GeneCPComplaint
Inspector I°' 3 a th
Out: , Year:
Each violation the ked requires an explanation on the narrative page(s)and a citation of specific provision(s).v olated.
Non-compliance with:
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 Tobacco 590.009(F) El
corrective action as determined by the Board of Health. Allergen Awareness 59o.009 (G)❑ '
FOOD PROTECTION MANAGEMENT
❑ 12.Prevention of Contamination from Hands i
❑ 1. PIC Assigned/Knowledgeable/Duties
EMPLOYEE HEALTH ❑ 13.Handwashing Facilities
PROTECTION FROM CHEMICALS
❑ 2. Reporting of Diseases by Food Employee and PIC
❑ 14.Approved Food or Color Additives
❑ .3. Personnel with Infections Restricted/Excluded
FOOD FROM APPROVED SOURCE El 15.Toxic Chemicals
❑ 4. Food and Water from Approved Source TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods)
❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures
❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating
❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling
PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding
❑ 8.Separation/Segregation/Protection
❑20.Time as a Public Health Control
REQUIREMENTS FOR HIGHLY-SUSCEPTIBLE-POPULATIONS(HSP)
❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21. Food and Food Preparation for HSP
❑ 10. Proper Adequate Handwashing
CONSUMER ADVISORY
❑ 11.Good Hygienic Practices ❑ 22. Posting of Consumer Advisories
Violations Related to Good Retail Practices(Blue Items) Number of Violated Provisions Related To
Critical (C) violations,marked must be corrected immediately Foodborne Illnesses Interventions and Risk
or within 10 days as determined by the Board of Health. Factors(Red Items 1-22):
Non-critical (N) violations must be corrected immediately or Official Order for Correction:Based on an inspection today,the items
within 90 days as determined by the Board of Health.
C N checked indicate violations of 105 CMR 590.000/federal Food Code.This
23. Management and Personnel (FC-2)(590.003) report,when signed below by a Board of Health member or its agent
24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health.Failure to correct violations
25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food
26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations.If
aggrieved by this order,you have a right to a hearing.Your request must
27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address
28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days-of receipt of this order.
29. Special Requirements (590.009) DA TE OFRE-INSPECTION:
30. Other
Inspector's Signature:— Print:
PICS Signatu VLPrint: Cwe� Page of aages
6A u
II'�
3-501.14(C) PHFs Received at Temperatures F'
V/o/atlons Related to Foodbome Illness Interventions and Risk According to Law Cooled to
Factors(Red Items 1-22) (Cont) 41°F/45°F Within 4 Hours.
PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs
14 Food or Color Additives 19 PHF Hot and Cold Holding
3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below
3-302.14 Protection from Unapproved Additives*
590.004(F) 410/450 F*
15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above
7-101.1.1__._ Identifying Information-Original 140°F.*
Containers* 3-501.16(A) Roasts Held at or above 130°F.
7-102,11 Common Name-Working Containers* 20 Time as a Public Health Control
7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control*
7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement
7-202.12 Conditions of Use*
7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-204.11 Sanitizers,Criteria-Chemicals* POPULATIONS(HSP)
7=204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and
7-204.14 Drying Agents,Criteria* Beverages with Warning Labels*
7-205.11 Incidental Food Contact,Lubricants* 3-801.11(B) Use of Pasteurized Eggs*
7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and
7-206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served.
7-206.13 Tracking Powders,Pest Control and 3-801.11(C) r Unopened Food Package Not Re-served.
Monitoring*
CONSUMER ADVISORY
TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
16 Proper Cooking Temperatures for Animal Foods That are Raw,Undercooked or
PRFs Not Otherwise Processed to Eliminate
3-401.11A(1)(2) Eggs- 155°F 15 Sec. Pathogens.*Effeative111/2WI
Eggs-Immediate Service 145°F15sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs*
3-401.11(A)(2) Comminuted Fish,Meats&Game
Animals- 155°F 15 sec.* SPECIAL REQUIREMENTS
3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 min* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in
3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec. catering,mobile food,temporary and
s residential kitchen operations should be
3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections
Stuffing Containing Fish,Meat, above if related to foodborne illness
Poultry or Ratites-165°F 15 sec. * interventions and risk factors. Other
3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail
145°F* practices should be debited under#29-
3-401.12 Rain Animal Foods Cooked in a Special Requirements.
Microwave 165°F
3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
17 Reheating for Hot Holding (Blue Items 23-30)
3-403.11(A)&(D) PHFs 165°F 15 sec.* Critical and non-critical violations, which do not relate to the
B foodborne illness interventions and risk factors listed above, can be
3-403.11
(B) Microwave- 165°F 2 Minute Standing found in the following sections of the Food Code and 105 CMR
Time* 590.000.
3-403.11(C) Commercially Processed RTE Food- Item Good Retail Practices FC 590.000
140°F* 23. Management and Personnel FC-2 .003
3-403.11(E) Remaining Unsliced Portions of Beef 24. Food and Food Protection FC-3 .004
Roasts* 25. Equipment and Utensils FC-4 .005
IS Proper Cooling of PHFs 26. Water,Plumbing and Waste FC-5 .006
3-501.14(A) Cooling Cooked PHFs from 140°F to 27• Physical Facility FC-6 .007
28. Poisonous or Toxic Materials FC-7 .008
70°F Within 2 Hours and From 70°F 29. Special Requirements .009
to 41°F/45°F Within 4 Hours.* 30. Other
3-501.14(B) Cooling PHFs Made From Ambient
Temperature Ingredients to 41°F/45°F
Within 4 Hours*
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
_n
THE COMMONWEALTH OF MASSACHUSETTS
TOWN OR CITY OF �? i✓
Establishment Name: Date: 1(0/Z Page: of
Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION = Date
No. Reference R—Red Item _ , . _ Verified
PLEASE PRINT CLEARLY
Discussion With Person in�'Charge: - Corrective Action Required: ❑ No IQ Yes
ll: , o
❑ Voluntary Compliance ❑ Employee Restriction/
nii AilExclusion
( ,_, } ` Q i Ll Re-inspection Scheduled ❑ Emergency Suspension
d C ❑ Embargo L3 Emergency Closure
n C no Kt
❑ Voluntary Disposal O Other:
"Form 734 B A.M. kin Co.,Boston,MA fj
I 3-501.14(C) PHFs Received at Temperatures
Vlo/aflons Related to Foodborne Illness Interventions and Risk According to Law Cooled to
Factors(Reditems 1.22) (Cont.) 41°F/45°F Within 4 Hours.
PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs
14 Food or Color Additives 19 PHF Hot and Cold Holding
3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below.
590.004(F) 410/450 F*
3-302.14 Protection from Unapproved Additives* 3-501.16(A) Hot PHFs Maintained at or above
15 Poisonous or Toxic Substances
7-101.11 Identifying Information-Original 140°F.
Containers* 3-501.16(A) Roasts Held at or above 130°F.
7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control
7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control*
7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement
7-202.12 Conditions of Use*
7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-204.11 Sanitizers,Criteria-Chemicals* POPULATIONS(HSP)
7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and
7-204.14 Drying Agents,Criteria* Beverages with Warning Labels*
7-205.11 Incidental Food Contact,Lubricants* 3-801.11(B) Use of Pasteurized Eggs*
7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and
7-206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served.
7-206.13 Tracking Powders,Pest Control and 3-801.11(C) FUnopened Food Package Not Re-served.
Monitoring*
CONSUMER ADVISORY
TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
16
Animal Foods That are Raw,Undercooked or Proper Cooking Temperatures for
PHFs Not Otherwise Processed to Eliminate
3-401.11A(1)(2) Eggs- 155°F 15 Sec. Pathogens.*E"11''-''12001
Eggs-Immediate Service 1450F15sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs*
3-401.11(A)(2) Comminuted Fish,Meats&Game
Animals- 155°F 15 sec.* SPECIAL REQUIREMENTS
3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 min* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in
3-401.11(A)(2) catering,mobile food,temporary and
Ratites,Injected Meats-155°F 15 sec. residential kitchen operations should be
3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections
Stuffing Containing Fish,Meat, above if related to foodborne illness
Poultry or Ratites-165°F 15 sec.* interventions and risk factors. Other
3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail
145°F* practices should be debited under#29-
3-401.12 Raw Animal Foods Cooked in a Special Requirements.
Microwave 165°F
3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
17 Reheating for Hot Holding (Blue Items 23-30)
3-403.11(A)&(D) PHFs 165°F 15 sec.* Critical and non-critical violations, which do not relate to the
3-403.11B foodborne illness interventions and risk factors listed above, can be
( ) Microwave- 165°F 2 Minute Standing
Time* found in the following sections of the Food Code and 105 CMR
590.000.
3-403.11(C) Commercially Processed RTE Food- Item Good Retail Practices FC 590.000
140°F* 23. Management and Personnel FC-2 .003
3-403.11(E) Remaining Unsliced Portions of Beef 24. Food and Food Protection FC-3 .004
Roasts* 25. Equipment and Utensils FC-4 .005
18 Proper Cooling of PHFs 26. Water,Plumbing and Waste FC-5 .006
3-501.14(A) Cooling Cooked PHFs from 140°F to 27• Physical Facility FC-6 .007
28. Poisonous or Toxic Materials FC-7 .008
70°F Within 2 Hours and From 70°F 29. Special Requirements 009
to 41°F/45°F Within 4 Hours.* 30. Other
3-501.14(B) Cooling PHFs Made From Ambient
Temperature Ingredients to 41°F/45°F
Within 4 Hours*
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
I
y I II
THE COMMONWEALTH OF MASSACHUSETTS
* TOWN OF NORTH ANDOVER 1600 Osgood Street, Building 20; Suite 2-36
North Andover,Massachusetts 01845
Phone-978.688.9540 Fax-978.688.8426
y'Bs�oNusE`�s FOOD ESTABLISHMENT INSPECTION REPORT e-mail: healthdept(a townofnorthandover.com
Name of E tablishment Date Type ofOperation(s) Tvpe of Inspection
tf 14b,�2%►'�1L: �_ ,2. Food Service
Address Ifisk Level Ll Retail Re-inspection
Telephone ❑ Residential Kitchen Previous Inspection
El Mobile
Owner HACCP: ❑ El Pre-operationTemporary El suspect Illness
Y / N El Caterer
Person-in-Charge(PIC) �(� �+► Time �d ❑ Bed&Breakfast
❑ General Coi
CAr ACCP110
Inspector I°' Other
out: Year:
Each violation ch ed requires an explanation on the narrative page(s)and a citation of specific p o ated.
Non-compliance with:
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 Tobacco 590.009(F) ❑
corrective 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. Handwashing Facilities
EMPLOYEE HEALTH
PROTECTION FROM CHEMICALS
❑ 2. Reporting of Diseases by Food Employee and PIC
❑ 14.Approved Food or Color Additives
❑ 3. Personnel with Infections Restricted/Excluded
FOOD FROM APPROVED SOURCE El 15.Toxic Chemicals
❑ 4. Food and Water from Approved Source TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods)
❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures
❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17.Reheating
❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling
PROTECTION FROM CONTAMINATION ❑ 19.Hot and Cold Holding
8.Separation/Segregation/Protection ❑20.Time as a Public Health Control
REQUIREMENTS FOR HIGHLY-SUSCEPTIBLE-POPULATIONS(HSP)
❑ 9. Food Contact Surfaces Cleaning and Sanitizing ❑21. Food and Food Preparation for HSP
❑ 10. Proper Adequate Handwashing
CONSUMER ADVISORY
❑ 11. Good Hygienic Practices ❑22. Posting of Consumer Advisories
Violations Related to Good Retail Practices(Blue Items) Number of Violated Provisions Related To
Critical (C) violations marked must be corrected immediately Foodborne Illnesses Interventions and Risk 0
or within 10 days as determined by the Board of Health. Factors(Red Items 1-22):
Non-critical(N) violations must be corrected immediately or Official Order for Correction:Based on an inspection today,the items
within 90 days as determined by the Board of Health.
C N checked indicate violations of 105 CMR 590.000/federal Food Code.This
'
23. Management and Personnel (FC-2)(590.003) report,when signed below by a Board of Health member or its agent
24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health.Failure to correct Violations
25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food
26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations.If
aggrieved by this order,you have a right to a hearing.Your request must
27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address
28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days-of receipt of this order.
29. Special Requirements (590.009) DA TE OFRE-INSPECTION:
30. Other
Inspector's Signature:. - Print:
MIA
PICS SignatuPrint: Pagel of�Pages
Ii-
3-501.14(C) PHFs Received at Temperatures
Vlo/atlons Related to Foodborne Illness Interventions and Risk According to Law Cooled to
Factors(Red/tams 1-22) (Cont) 41°F/45°F Within 4 Hours.
PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs
I4 Food or Color Additives 119 PHF Hot and Cold Holding
3-202.12 Additives* 3-501.16(B) Cold PRFs Maintained at or below
3-302.14 Protection from Unapproved Additives*
590.004(F) 410/450 F*
15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above
7-101.11. `Identifying Information-Original 140°F.
(Containers* 3-501.16(A) Roasts Held at or above 130°F.
7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control
7-201.11" Separation-Storage* 3-501.19 Time as a Public Health Control*
7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement
7-202.12' Conditions of Use*
7-203.11 Tokic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-204.11 Sanitizers,Criteria-Chemicals* POPULATIONS(HSP)
7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and
7-204.14 Drying Agents,Criteria* ,`Beverages with Waring Labels*
7-205.11 Incidental Food Contact,Lubricants* 3-801.11(B) Use of Pasteurized Eggs*
7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and
7-206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served. *
7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-served.
Monitoring*
CONSUMER ADVISORY
TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
16 Proper Cooking Temperatures for Animal Foods That are Raw,Undercooked or
PRFs Not Otherwise Processed to Eliminate
3-401.11A(1)(2) Eggs- 155°F 15 Sec. Pathogens.*E"e°'Ne112001
Eggs-Immediate Service 145°F15sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs*
3-401.11(A)(2) Comminuted Fish,Meats&Game
Animals- 155°F 15 sec.* SPECIAL REQUIREMENTS
3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 min* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in
3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec. catering,mobile food,temporary and
residential kitchen operations should be
3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections
Stuffing Containing Fish,Meat, above if related to foodborne illness
Poultry or Ratites-165°F 15 sec. * interventions and risk factors. Other
3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail
145°F* practices should be debited under#29-
3-401.12 Raw Animal Foods Cooked in a Special Requirements.
Microwave 165°F+ I ,
3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec. + VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
17 Reheating for Hot Holding (Blue Items 23-30)
3-403.11(A)&(D) PHFs 165°F 15 sec.* Critical and non-critical violations, which do not relate to the
3-403.11B foodborne illness interventions and risk factors listed above,can be
( ) Microwave- 165°F 2 Minute Standing
Time* Found in the following sections of the Food Code and 105 CMR
• 590.000.
3-403.11(C) Commercially Processed RTE Food- Item Good Retail Practices FC 590.000
140°F* 23. Management and Personnel FC-2 .003
3-403.11(E) Remaining Unsliced Portions of Beef 24. Food and Food Protection FC-3 .004
Roasts* 25. Equipment and Utensils • FC-4 .005
18 Proper Cooling of PHFs 26. Water,Plumbing and Waste FC-5 :006
3-501.14(A) Cooling Cooked PHFs from 140°F to 27• Physical Facili FC-6 1 .007
70°F Within 2 Hours and From 70°F 28. Poisonous or Toxic Materials FC-7 .008
29. Special Requirements .009
to 41°F/45°F Within 4 Hours.* 30. Other
3-501.14(B) Cooling PHFs Made From Ambient
Temperature Ingredients °
p g edtents to 41 F/45 F
Within 4 Hours*
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
r
DESCRIPTIONCode C-Critical Item OF VIOLATIONOF CORRECTION
Reference R-Red Item
PLEASE PRINT-, Rt-Y
--
PW
9174
slam MIFTI-T-TIT"M191
IM A
w pull
-- tri i � � �` L � �s L��•_i. � �� ���r.
L- s
1 r
r.
KNOWN •• ■ •
t .�_ ,.... .;. ,._ ....� .,. .. ...,.,-.__._____... ,. _.._._.�. �- - :� .,.�.�•.F w u =- :.�4-,� ..�„�.vcc,..�s-a f-�iw^w�.�s^'�^",¢e+-...wsurs.�pvr
3-501.14(C) PHFs Received at Temperatures } JI
Violations Related to Foodborne Illness Interventions and Risk According to Law Cooled to 1
Factors(Red kerns 1-22) (Cont) 41°F/45°F Within 4 Hours.
PROTECTION FROM CHEMICALS3-501.15 Cooling Methods for PHFs
14 Food or Color Additives 19 PHF Hot and Cold Holding
3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below i
3-302.14 Protection from Unapproved Additives* -
590.004(F) 410/450 F*
15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above
7-101.11 Identifying Information-Original 140°F.
Containers* 3-501.16(A) Roasts Held at or above.130°F.
.7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control
7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control*�
7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement
7-202.12 Conditions of Use*
7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-204.11 Sanitizers,Criteria-Chemicals* POPULATIONS(HSP)
7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and
7-204.14 Drying Agents,Criteria* Beverages with Warning Labels*
7-205.11 Incidental Food Contact,Lubricants* 3-801.11(B) Use of Pasteurized Eggs* l
7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(D) • Raw or Partially Cooked Animal Food and
7-206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served.
7-206.13 Tracking Powders,Pest Control and' 3-801.11(C) Unopened Food Package Not Re-served.
Monitoring*
CONSUMER ADVISORY
TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
16 Proper Cooking Temperatures for Animal Foods That are Raw,Undercooked or
PHFs Not Otherwise Processed to Eliminate
3-401.I1A(l)(2) Eggs- 155°F 15 Sec. Pathogens.*Ellecb-1112001
Eggs-Immediate Service 145°F15sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs*
3-401.11(A)(2) Comminuted Fish,Meats&Game
Animals- 155°F 15 sec.* SPECIAL REQUIREMENTS
3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 min* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in
3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec. catering,mobile food,temporary and
* residential kitchen operations should be
3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections
Stuffing Containing Fish,Meat, above if related to foodborne illness
Poultry or Ratites-165°F 15 sec.* interventions and risk factors. Other
3-401.11(C)(3) Whole-muscle,Intact Beef Steaks A 590.009 violations relating to good retail
145°F* practices should be debited under#29-
3,3401.12 Raw Animal Foods Cooked in a Special Requirements.
Microwave 165°F
3=401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
17 Reheating for Hot Holding (Blue Items 23-30)
3-403.11(A)&(D) PHFs 165°F 15 sec.* Critical and non-critical violations, which do not relate to the
foodborne illness interventions and risk factors listed above, can be
3.403.11(B) Microwave- 165°F 2 Minute Standing found in the following sections of the Food Code and 105 CMR
Time* I 590.000.
3-403.11(C) Commercially Processed RTE Food- Item Good Retail Practices FC 590.000
140°F* 23. Management and Personnel FC-2 1 .003
3-403.11(E) Remaining Unsliced Portions of Beef 24. Food and Food Protection FC-3 1 .004
Roasts* 25. Equipment and Utensils FC-4 1 .005
18 Proper Cooling of PHFs 26. Water,Plumbing and Waste FC-5 .006
3-501.14(A) Cooling Cooked PHFs from 140°F to 27• Physical Facility FC-6 .007
70°F Within 2 Hours and From 70°F 28• Poisonous or Toxic Materials FC-7 .008
29. Special Requirements .009
to 41°F/45°F Within 4 Hours.* 30. Other
3-501.14(B) Cooling PHFs Made From Ambient
Temperature Ingredients to 41°F/45°F
Within 4 Hours*
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
i
4:
E
OTHE COMMONWEALTH OF MASSACHUSETTS
TOWN OF NORTH ANDOVER
Massachusetts Department 'of Public Health
Division of Food and Drugs
FOOD ESTABLISHMENT INSPECTION REPORT
NameI Date T of Operation(s) T sof Inspection
�V � 8 Food Service outine
AddressRisk ❑ Retail ❑ Re-inspection
h
Telephone 3. Level ❑ Residential Kitchen Previous Inspection
(9 o ,
o 0'91 ❑ Mobile Date:
❑ Temporary ❑ Pre-operation
Owner 01Of 6uhmn LLC HACCP YM ❑ Caterer ❑Suspect Illness
Person in Charge(PIC) Time ❑ Bed&Breakfast ❑General Complaint
In: k1,45 E] HACCP
Inspector Out: Permit No. ❑Other
Each violation check d _requires an explanation on the narrative page(s) and a citation of specific provision(s)
violated. Non-co npihme WM:
Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Cho" Tonaco
Violations marked may pose an imminent health hazard and require immediate corrective ago-oog(E) ❑ aeo.00g(F) ❑
action as determined by the Board of Health. A-W4 jen
Cl
FOOD PROTECTION MANAGEMENT
❑ 12. Prevention of Contamination from Hands
❑ 1. PIC Assigned/Knowledgeable/Duties
@53. tiandwash Facilities
EMPLOYEE HEALTH
[12. Reporting of Diseases by Food Employee and PIC PROTECTION FROM CHEMICALS
❑ 3. Personnel with Infections Restricted/Excluded 014.Approved Food or Color Additives
❑ 15.Toxic Chemicals
FOOD FROM APPROVED SOURCE
❑ 4. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods)
❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures
❑ 8. Tags/Reoords/Accuracy of Ingredient Statements
❑ 17. Reheating
❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling
PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding
❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control
❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)
❑ 10. Proper Adequate Handwashing [121. Food and Food Preparation for HSP
❑ 11. Good Hygienic Practices CONSUMER ADVISORY
[122. Posting of Consumer Advisories
Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related
items) Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions
immediately or within 10 days as determined by the Board and Risk Factors(Red Items 1-22):
of.Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection
immediately or within90 days as determined by the Board today,the items checked indicate violations of 105 CMR
of Health. 590.000/federal Food Code.This report,when signed below
c n by a Board of Health member or its agent constitutes an
3. Management and Personnel (FC-2)(590.003) order of the Board of Health. Failure to correct violations
24. Food and Food Protection (FG3)(590.004) Cited ini
25. Equipment and Utensils (FC-4)(590.005) th s report may result m suspension or revocation of
the food establishment permit and cessation of food
6. Water, Plumbing and Waste (Fc-5)(5e0.006) establishment operations. If aggrieved by this order, you
27. Physical Facility (Fc-6)(590.007) have a right to a hearing.Your request must be in writing
28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address
29. Special Requirements (590.009) within 10 days of receipt of this order.
30. Other DATE OF REaNSPECTION:
Inspector's Signature: Print: b S /
PC's Signature: Print: a of!!Pages
FORM 734A
{
Violations Related to Foodborne Illness
Interventions and Risk Factors(Red Items 1.22)
PROTECTION FROM CONTAMINATION
FOOD PROTECTION MANAGEMENT g Cross-contamination
1 590.003 A) signment of Responsibility* 3-302.11(AX 1) Raw Animal Foods Separated from E
590.003(13) Demonstration of Knowledge* Cook(A and RTE,Foods*
2-103.11 Person in charge-duties Contamination from Raw Ingreafents
-` 3-302.11(Ax2) Raw Animal Foods Separated from Each
EMPLOYEE HEALTH Other*
2 590.003(0) Responsibility of the person in charge to Contamination from the Environment
require reporting by food employees and 3-302.11 A Food Protection*
applicants* 3-302.15 Washing Fruits and Vegetables
590.003(F) Responsibility Of A Food Employee Or An 3-304.11 Food Contact with Equipment and
Applicant To Report To The Person In Utensils*
Charge* Contamination from the Consumer
590.003(6) Reporting by Person in Charge* 3-306.14 A B Returned Food and Reservice of Food*
3 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated
590.003E Removal of Exclusions and Restrictions Food
3-701.11 Discarding or Reconditioning Unsafe
FOOD FROM APPROVED SOURCE Fes*
4 Food and Water From Regulated Sources F 9 Food Contact Surfaces
590.004(A-0) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water
3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures*
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water
3-202.13 Shell Eggs* Sanitization Temperatures*
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH,
3-202.16 Ice Made From Potable Water* concentration and hardness. *
5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Equipment Food Contact Surfaces and
Utensils Clean*
590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Equipment Food-
590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces and Utensils*
SheB(ish and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils and
3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of Equipment*
Shellfish* 4-703.11 Methods of Sanitization-Hot Water and
3-201.15 Molluscan Shellfish from NSSP Listed Chemical*
Sources* 10 Proper,Adequate Handwashing
Game and wird Mushrooms Approved by
Regulatory Auth ' 2-301.11 Clean Condition-Hands and Arms*
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure*
590.004(0) Wild Mushrooms* 2-301.14 When to Wash*
3-201.17 Game Animals* 11 Good Hygienic Practices
5 ReceivinglCondition 2401.11 Eating,Drinking or Using Tobacco*
3-202.11 PffFs Received at Proper Temperatures* 2401.12 Discharges From the Eyes,Nose and
3-202.15 Package Irate tV* Mouth*
3-101.11 -Food Safe and Unadulterated* 3-301.12 Prevent' Contamination When Tasting*
6 Tags/Records:Shellstock 12 Prevention of Contamination from Hands
3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from
3-203.12 Shellstock Identification Maintained* Em to ees
*
Tags/Records:Fish Products 13 Handwash Facilities
3402.11 Parasite Destruction*
Conveniendy Located and Accessible
3402.12 Records,Creation and Retention* 5-203.11 Numbers and Capacities*
590.004 ) Labeling of Ingredients' . 5-204.)l Location and Placement*
? Conformance with Approved Procedures
5-205.11 Accessibility, tion and Maintenance
IHACCP Plans Suppled with Soap and Hand Drying
3-502.11 Specialized Process' Methods* Devices
3-502.12 Reduced oxygen packaging,criteria* 6-301.1 I Handwashing Cleanser,Availability
8-103.12 Conformance with Approved Procedures* 6-301.12 1 Hand Drying Provision
'
Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
THE COMMONWEALTH CF MASSACHUSETTS
TOWN OR CITY OF NDdn D�
Establishment Name: Date: S1 Page: 2- of
Item Code C—Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date
No. Reference R—Red Item Verified
PLEASE PRINT CLEARLY
1304.1 1 C4 swo 0 S-tyce A i -
SLLL o 1Mt°a�
I a i'(Y-- lsc-wlp kolair S t)IQ
hb V
o[- - d 16-I r s- itf-\
b II NC i i
3.305 I t N C k'v� i n t cxbc - m � e
r t. b . ` _ w
I AQ - GL - h;
C �S tY; r d►`�hw t'
Discussion With Person in Charge: Corrective Action Required: ❑ No Yes
oluntary Compliance ❑ Employee Restriction/
Exclusion
❑ Re-inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary Disposal ❑ Other:
Form 734 B A.M.Sulkin Co.,Boston,MA
3-501.14(C) PHFs Received at Temperatures
Wola>dons Related to Foodborne illness/nterventions'and Risk According to Law Cooled to
Factors(Red/terns 1-22) (Cont) 41°F/45°F Within 4 Hours.
PROTECTION FROM CHEMICALS3-501.15 Cooling Methods for PHFs
14 Food or Color Additives h_9 PHF Hot and Cold Holding
3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below
3-302.14 Protection from Unapproved Additives* 590.004(F) 410/450 F*
15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above
7-101.11 Identifying Information-Original _ 140°F.•
Containers* 3-501.16(A) Roasts Held at or above 130°F.
7-1.02.11 Common Name-Working Containers* 20 Time as a Public Health Control
•7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control*
7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement
7-202.12 Conditions of Use*
7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-204.11 Sanitizers,Criteria-Chemicals* POPULATIONS(HSP)
7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and
7-204.14 Drying Agents,Criteria* Beverages with Warning Labels*
7-205.11 Incidental Food Contact,Lubricants* 3-801.11(B) Use of Pasteurized Eggs*
7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and
7-206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served.'*
7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-served.
Monitoring*
CONSUMER ADVISORY
TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
16 Proper Cooking Temperatures for Animal Foods That are Raw,Undercooked or
PRFs Not Otherwise Processed to Eliminate
3-401.11A(1)(2) Eggs- 155°F 15 Sec. Pathogens.*Eff-6 In2001
Eggs-Immediate Service 145°F15sec• 3-302.13 1 Pasteurized Eggs Substitute for Raw Shell Eggs*
3-401.11(A)(2) Comminuted Fish,Meats&Game
Animals- 155°F 15 sec.* SPECIAL REQUIREMENTS
3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 min* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in
3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec. catering,mobile food,temporary and
* residential kitchen operations should be
3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections
Stuffing Containing Fish,Meat, above if related to foodborne illness
Poultry or Ratites-165°F 15 sec.* interventions and risk factors. Other
3401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail
145°F* practices should be debited under#29-
3-401.12 Raw Animal Foods Cooked in a Special Requirements.
Microwave 165°F
3-401.11(A)(1)(b) All Other.PRFs-145°F 15 sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
17 Reheating for Hot Holding (Blue Items 23-30)
3-403.11(A)&(D) PHFs 165°F 15 sec.* Critical and non-critical violations, which do not relate to the
3-403.11B foodborne illness interventions and risk factors listed above,can be
( ) Microwave- 165°F 2 Minute Standing
Time* found in the following sections of the Food Code and 105 CMR
590.000.
3-403.11(C) ' Commercially Processed RTE Food- Item Good Retail Practices FC 590.000
140°F* 23. Mana ement and Personnel FC-2 .003
3-403.11(E) Remaining Unsliced Portions of Beef 24. Food and Food Protection FC-3 .004
Roasts* 25. Equipment and Utensils FC-4 .005
18 Proper Cooling of PHFs 26. Water,Plumbing and Waste FC-5 .006
3-501.14(A) Cooling Cooked PHFs from 140°F to 27• Physical Facility FC-6 .007
70°F Within 2 Hours and From 70°F 28• Poisonous or Toxic Materials FC-7 .008
29. Special Requirements .009
to 41°F/45°F Within 4 Hours.• 1. 30. Other
3-501.14(B) Cooling PHFs Made From Ambient
Temperature Ingredients to 41°F/45°F
Within 4 Hours*
•Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
THE COMMONWEALTH OF MASSACHUSETTS
t
TOWNOF NORTH ANDOVER 1600 Osgood Street,Building 20; Suite 2-36
.
North Andover,NInssachusetts 01845
Phone-978.688.9540 Fax-978.688.8476
�r�s�cNust`� FOOD ESTABLISHMENT INSPECTION REPORT a-mail: healthdent a townofnortlrandover•.coin
Name of E tablishrnent Date T}fie ofOperntiorr(s1 T, e o itis rc�Ctlal
- 21 Food Service
Address Ifisk Level Retail Re-inspection
Telephone ❑ Residential Kitchen Previous Inspection
❑ Mobile nate:
Owner HACCP: ❑ Temporary ❑Pre-operation
y/ N ❑ Caterer ❑Suspect 111ncss
g (PIC) i 6t d ❑ Bed&Brcakf'ast ❑General Con r
Person-in-Charge PIC je Time 3 ACCP
Inspector pother��
Out: Year:
Each violation eh ted requires an explanation on the narrative page(s)and a citation of specificp o ated.
Noncom liance with:
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 Tobacco 590.009(F) ❑
corrective action as determined by the Board of Health. Allergen Awareness 590.009(G)❑
FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands
❑ 1. PIC Ass IgnedlKnowledgeablelOuties
EMPLOYEE HEALTH ❑13. Handwashing Facilities
PROTECTION FROM CHEMICALS
[:] 2. Reporting of Diseases by Food Employee and PIC
EJ3. Personnel with Infections ResfrlctedlExcluded ❑14.Approved Food or Color Additives
FOOD FROM APPROVED SOURCE
❑15.Toxic Chemicals
❑ 4. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods)
❑ S. Receiving/Condition ❑16.Cooking Temperatures
❑ 6. Tag s/RecordslAccuracy of Ingredient Statements ❑17.Reheating
❑ 7. Conformance with Approved ProcedureslHACCP Plans ❑18.Cooling
PROTECTION FROM CONTAMINATION ❑19. Hot and Cold Holding
S.SeparatlonlSegregation/Prote ction El20.Time as a Public Health Control
REQUIREMENTS FOR HIGHLY-SUSCEPTIBLE-POPULATIONS(HSP)
❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21. Food and Food Preparation for HSP
❑10.Proper Adequate Handwashing
CONSUMER ADVISORY
❑11.Good Hygienic Practices ❑22.Posting of Consumer Advisories
Violations Related to Good Retail Practices(Blue items) Number of Violated Provisions Related To
Critical(C)violations marked must be corrected immediately Foodborne Illnesses interventions and Rlsk
or within 10 days as determined by the Board of Health. Factors(Red Items 1.22),
Non-critical(N)violations must be corrected immediately or Official Order for Correction:Based on an inspection today,the items
within 90 days as determined by the Board of Health.
C N checked indicate violations of 105 CMR 590.000/federal Food Code.This
23.Management and Personnel (FC-2)(590.003) report,when signed below by a Board of Health member or its agent
24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health.Failure to correct violations
25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food
26. Water, Plumbing and Waste (Fc-5}(590,006) establishment permit and cessation of food establishment operations.If
aggrieved by this order,you have a right to a hearing.Your request must
27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address
28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days-of receipt of this order.
29. Special Requirements (590.009) DATEOF'RE-INSPECTION:
30. Other
Inspector's Signature: Print: t`�1ZC
PlCsSignature* 3t' 0 Print: f sG Pagdof4APages
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■
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k-1-
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„Dern THE COMMONWEALTH OF MASSACHUSETTS'
TOWN OF NORTH ANDOVER 1600 Osgood Street, Building 20 Suite 2-36
North.Andover,/Massachusetts 0.1845
*�''• " ',* Phone-978.688.9540 Fax-,978.688.84-76
FOOD ESTABLISHMENT INSPECTION REPORT e-mail: healthdept(i�townofnorthandover.com
NarvdAif Establishment DatQ Tygo,of O eration s T v pe of Inspection
1, Food Service outine
Address j (`I Risk Level LJRetail ElRe-inspection
Telephone El Residential'Kitchen Previous lns'pecfion
❑ Mobile Date:
.Ownf� Jam, HACCP: El Temporary
El Pre-operation
Y 7 N ❑ Caterer ❑ Suspect Illness
Person-in-Char e'(PITime. ❑ Bed& Breakfast El
General Complaint
hAA n,. El HACCP
Ins ecto In:
p _PYXx ❑Other'
Out: Year:
Each violation checked requi es am explanation on the narrative page(s)and a citation of specific provision(s)violated.
Non=compliance with:
Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-cn.oking 59.0.00.9(E) E]Violations marked'.may pose an imminent health hazard and require immediate Tobacco 590.009(E) ❑
corrective action as determined by the Board of Health. Allergen;Awareness590.009 (G)❑
FOOD PROTECTION MANAGEMENT
- • ❑ 12. Prevention of Contamination from Hands
❑ 1. PIC Assigned/Knowledgeable/Duties w�
EMPLOYEE HEALTH ❑ 13.Handwashing Facilities 'V 2'
PROTECTION FROM CHEMICALS 110
❑ 2. Reporting of Diseases by Food Employee and PIC ia' 11
❑ 14.Approved Food or Color Additives
❑ 3. Personnel with Infections Restricted/Excluded
FOOD FROM APPROVED SOURCE El 15.Toxic Chemicals
❑ 4. Food and Water from Approved Source_, TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods)
❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures
❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating
❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18:.Cooling
PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding
❑ 8.Separation/Segregation/Protection
El 20.Time.as a Public Health Control
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
[122.Posting of Consumer Advisories
Violations Related to Good Retail Practices,(Blue Items) Number of Violated Provisions Related To
Critical (C) violations marked must be corrected immediately Foodborne Illnesses Interventions and Risk
or within 10 days as determined by the Board of Health. Factors(Red Items 1-22):
Non-critical (N) violations must be corrected immediately or Official Order for Correction:Based on an inspection today,the items
within 90 days as determined by the Board of Health.
C N checked indicate violations of 105 CMR 590.000/federal Food Code.This
23. Management and Personnel (FC-2)(590.003) report,when signed below by a Board of Health member or its agent
24. Food and Food Protection (i C-3)(590.004) constitutes an order.of the Board of Health. Failure to correct violations
25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food
26. Water, Plumbing and Waste (Fc-5)(590.006) . establishment permit and cessation of food establishment operations. If
27. Facility Physical aggrieved by this order,you have a right to a hearing.Your request must
y y (Fc 6)(59o.007j be in writing nd submitted to the Board of Health at the above address
28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 da -of receipt of this order.
29. Special Requirements (590.009) / DATEOFRE-INSPECTION:
30. Other
Inspector's Signature ` Print: s I�
PICS Signature: Prin : Page_of Pages p
3-501.14(C) PHFs Received at Temperatures
Wo/adons Related to Foodborne Illness Interventions and Risk According to Law Cooled to
Factors(Red Items 1-22) (Cont.) 41°F/45°F Within 4 Hours.
PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs
lit Food or Color Additives 19 PHF Hot and Cold Holding
3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below
3-302.14 Protection from Unapproved Additives* 590.004(F) 410/450 F*
1S Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above
7-101.11 Identifying Information-Original 140°F. *
Containers* 3-501.16(A) Roasts Held at or above 130°F.
7-102.11 Common Name-Working Containers* 20 ,: Time as a Public Health Control
7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control*
7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement
7-202.12 Conditions of Use*
'7-203.11 Tozic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-204.11 Sanitizers,Criteria-Chemicals* POPULATIONS(HSP)
7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and
7-204.14 Drying Agents,Criteria* Beverages with Warning Labels*'
7-205.11 Incidental Food Contact,Lubricants* 3-801.11(B) Use of Pasteurized Eggs*
7-206.11 Restricted Use Pesticides,Criteria* 3-801A I(D) Raw or Partially Cooked Animal Food and
7-206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served. *
7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-served.*
Monitoring*
CONSUMER ADVISORY
TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
16 Proper Cooking Temperatures for Animal Foods That are Raw,Undercooked or
PHFs Not Otherwise Processed to Eliminate
3-401.11A(l)(2) Eggs- 155°F 15 Sec. Pathogens.* Eff-6 1/1,2001
Eggs-Immediate Service 1450F15sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs*
3-401.11(A)(2) Comminuted Fish,Meats&Game
Animals- 155°F 15 sec.* SPECIAL REQUIREMENTS
3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 min* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in
3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec. catering,mobile food,temporary and
* residential kitchen operations should be
3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections
Stuffing Containing Fish,Meat, above if related to foodborne illness
Poultry or Ratites-165°F 15 sec. * interventions and risk factors. Other
3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail
145°F* practices should be debited under#29-
3-401.12 Raw Animal Foods Cooked in a Special Requirements.
Microwave 165°F
3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
17 Reheating for Hot Holding (Blue Items 23-30)
3-403.11(A)&(D) PHFs 165°F 15 sec.* Critical and non-critical violations, which do not relate to the
3-403.11B foodborne illness interventions and risk factors listed above, can be
( ) Microwave- 165°F 2 Minute Standing found in the following sections of the Food Code and 105 CMR
Time* 590.000.
3-403.11(C) Commercially Processed RTE Food- Item Good Retail Practices FC 590.000
140°F* 23. Management and Personnel FC-2 .003
3-403.11(E) Remaining Unsliced Portions of Beef 24. Food and Food Protection FC-3 .004
Roasts* 25. Equipment and Utensils FC-4 .005
18 Proper Cooling of PHFs 26. Water,Plumbing and Waste FC-5 .006
3-501.14(A) Cooling Cooked PHFs from 140°F to 27• Physical Facility FC-6 .007
70°F Within 2 Hours and From 70°F 28• Poisonous or Toxic Materials FC-7 .008
29. Special Requirements .009
li to 41°F/45°F Within 4 Hours.* 30. Other
3-501.14(B) Cooling PHFs Made From Ambient
Temperature Ingredients to 41°F/45°F
Within 4 Hours*
•Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
THE COMFJ VNWIE LTH OF MASSACHUSETTS
T WN OR CIT O /
Establishment Name: Y Date: I Page: of
-a
:,.,, ,, y ,,...x,.,.
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• � �,, r Dater'=
Item-, ,.Code C...Critical Itemu ,, ,
:. _ D,ESCRIPTION OF:F-V>IOLATION L:PLAN.OF CORRECTION.. ,T.
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No.�,.- Reference F n R_,Red,.I n� '; :-�; �,. ;- �• <, . �
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Discussion With Person in Charge: Corrective Action Required: O No Ta—
Yes
O Voluntary Compliance O Employee Restriction/
Exclusion
Ll
Z O Re-inspection Scheduled O Emergency Suspension
O Embargo O Emergency Closure
U Voluntary Disposal U Other:
Form 734 B A.M.Sulkin Co.,Charlestown,MA
it
3-501.14(C) PHFs Received at Temperatures
Violations Related to Foodborne llness Interventions and Risk According to Law Cooled to
Factors(RedItems 1-22) (Cont) 41°F/45°F Within 4 Hours.*
PROTECTION FROM CHEMICALS 3-501.15 . Cooling Methods for PHFs
14 Food or Color Additives E19 PHF Hot and Cold Holding
3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below
3-302.14 Protection from Unapproved Additives* 590.004(F) 41°F/450F*
15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above
1400F.*
7-101.11 Identifying Information-Original
Containers* 3-501.16(A) Roasts Held at or above 1300F.*
7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control
7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control*
7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement
7-202.12 Conditions of Use*
7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-204.11 Sanitizers,Criteria-Chemicals* POPULATIONS HSP
7-204.12 Chemicals for Washing Produce Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and
7-204.14 Drying Agents,Criteria* Beverages with Warning Labels*
7-205.11 Incidental Food Contact,Lubricants* 3-801.11(B) Use of Pasteurized Eggs*
7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and
7-206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served.*
7-206.13 Tracking Powders,Pest Control and L 3-801.11(C) Unopened Food Package Not Re-served.*
Monitoring*
CONSUMER ADVISORY
TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of
Animal Foods That are Raw,Undercooked or16 Proper Cooking Temperatures for
Not Otherwise Processed to Eliminate
PHFs
I
*Effective 1/1/2001 P
° 15 Sec. Pathogens.*3-401.11A 1
( )(2) Eggs- 155F
Eggs-Immediate Service 145°F 15 sec.* 3-302.13 1 Pasteurized Eggs Substitute for Raw Shell
Eggs
3-401.11(A)(2) Comminuted Fish,Meats&Game SPECIAL REQUIREMENTS
Animals- 155°F 15 sec.* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in
3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 min.*
3-401.11(A)(2) Ratites,Injected Meats- 155°F 15 sec. catering,mobile food,temporary and
* residential kitchen operations should be
debited under the ro
3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debPP praite sections
Stuffing Containing Fish,Meat, above if related to foodborne illness
Poultry or Ratites-165°F 15 sec.* interventions and risk factors.Other
3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail
145°F* practices should be debited under#29-
3-401.12 Raw Animal Foods Cooked in a Special Requirements.
Microwave 165°F*
3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
17 Reheating for Hot Holding (Blue Items 23-30)
3-403.11(A)&(D) PHFs 165°F 15 sec.* Critical and non-critical violations,which do not relate to the
foodborne illness interventions and risk factors listed above, can be
3-403.11(B) Microwave- 165°F 2 Minute Standing found in the following sections of the Food Code and 105 CAM
Time* 590.000.
3-403.11(C) Commercially Processed RTE Food- Item Good Retail Practices FC 1 590.000
140°F* 23. Management and Personnel FC-2 1 .003
3-403.11(E) Remaining Unsliced Portions of Beef 24. Food and Food Protection FC-3 .004
Roasts* 25. E ui ment and Utensils FC-4 .005
18 Proper Cooling of PHFs 26. Water Plumbing and Waste FC-5 .006
3-501.14(A) Cooling Cooked PHFs from 140°F to 27. Ph sical Facility FC-6 .007
70°F Within 2 Hours and From 70°F 28. Poisonous or Toxic materials FC-7 .008
29. Special Requirements .009
to 41°F/45°F Within 4 Hours.* 30. Other
3-501.14(B) Cooling PHFs Made From Ambient
Temperature Ingredients to 41017/45017
Within 4 Hours.*
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
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