HomeMy WebLinkAboutMiscellaneous - 535 CHICKERING ROAD 4/30/2018 (5) i 4u�c PIC
535 Chld�f ek
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DelleChiaie, Pamela
From: DelleChiaie, Pamela
Sent: Thursday, May 15, 2008 3:51 PM
To: 'stephen.mancuso@gmail.com'
Cc: Sawyer, Susan
Subject: Dumpster fee
J
Importance: High
Hi Stephen,
I understand from Susan Sawyer that Chickering Properties will be taking care of the dumpster permit for the
plaza at 535 Chickering Road, and this will be the only dumpster for the plaza. Therefore, the fee that you paid
me for a separate Quic Pic permit will not apply. I will put through a request for reimbursement from the
treasurers office for the $60.00. Please call if you have any questions.
8a8f Ragwads,
Paitya�w Da�BaG�liiaria
Health Department Assistant
Town of North Andover
1600 Osgood Street
Building 20,Suite 2-36
North Andover,MA 01845
2978.688.9540-Phone
A 978.688.8476-Fax
http://www.townofnorthandover.com
healthdept@townofnorthandover.com
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PUBLIC HEALTH DEPARTMENT
Community Development Division
,
November 20, 2008
Steve Mancuso
Quic Pic
533 Chickering Road
North Andover, MA 01845
Re: Plan review of new Food Establishment, Quic Pic, 533 Chickering Road
Dear Mr. Mancuso,
This letter is in response to your application for a Food Establishment remodel that was received
by the Health Department on November 18, 2008. The following items were noted either missing
or incomplete from your application. Please revise as needed and resubmit to the Health
Department.
1) Page 5 Food Supplies#4—Please note that dry storage must be 6 inches off the floor.
Porous wood such as pallets should not be used as they are difficult to clean around and
are generally not the right height. Boxes are also porous and not suitable for this purpose.
2) Finish schedule left blank on page 10
3) Do you have your own dumpster?Page 11 #11 If yes, who is your contractor and you
must file for a dumpster permit. Or if you use those already provided on site please
indicate.
4) Page 15 #42 indicates no answer. Is there a grease trap under the 3-bay sink already?
5) Page 17# 53 indicates no sanitizer. Must choose chlorine, quats or iodine and have
sanitizer strips on hand at all times.
Thank you for your commitment to keeping the public safe. We would be happy to meet with
you regarding any of the above-mentioned items, otherwise please submit the needed
information and plan changes as soon as possible.
Sinc ly,
usan Sa er, REH RS
Public Health Director
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fox 978.688.8476 Web www.townofnorthandover.com
��.. ._ M. Sma1l.Equipment Requirements
69. Please specify the num r a4d of each of the following:
Slicers
Cutting boards
Can openers
Mixers
Floor mats
Other
STATEMENT: I hereby certify that the above information is correct,and I fully understand that any deviation
from the above without prior permission from this Health Regulatory Office may nullify this approval.
Signature(s):
owner(s)or responsible representatives
Date:
Approval of these plans and specifications by this Health Regulatory Authority does not indicate compliance
with any other code,law or regulation that may be required—federal,state,or local.It further does not
constitute endorsement or acceptance of the completed establishment -
ep p ted estab shment(structure or equipment).A pre opening
inspection of the establishment with equipment will be necessary to determine if it complies with the local and
state laws governing food service establishments.
E-19
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REGULATORY HEALTH AUTHORITY COMPLIANCE REVIEW CHECKLIST
Insufficient
Satisfactory Unsatisfactory N/A Information
L Finish Schedule [ [ ] ( ] [ ]
Kitchen
Warewashing ( ] [ l [ l [ ]
Food Storage [ ] [ ] [ ] [ ]
Other Storage [ ] [ ] ( ] [ ]
Toilet Rooms [ ] [ ] ( ] [ ]
Dressing Rooms [ ] [ ] [ ] ( ]
Mop Service Area [ ] [ ] ( ] [ ]
2. Insect&Rodent Harborage
3. Garbage and Refuse [ [ ] ( ] [ ]
4. Plumbing [ [ ] ( ] ( ]
5. Water Supply [ [ ] ( ] ( ]
6. Sewage Disposal [ [ ] ( ] [ ]
7. Dressing Rooms
8. Separate Toxic Storage
9. Laundry Facilities
10. Linen Storage [ ] [ ] ( [ ]
11. Exhaust Hoods
12. Hand Sinks [ [ ] [ ] [ ]
13. Dishwashing&Pot Sinks
14. Lighting [ ( ] ( ] [ ]
15. Ventilation [✓� ( ] ( ] [ ]
16. Grease Traps (NA/ [ ] ( ] ( ]
17. Employee Restrooms
Location
Num t cr
Soap ( ] ( ) ( ] ( ]
Hand Drying ( ] [ ] [ ] [ ]
E-20
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Lavatories [ [ ]
[ ] [ ]
Water Closets [ ] [ l [ [ ]
Urinals
Waste Receptacles [ [ ] [ ] [ J
18. Patron Restrooms
Location
Number
Soap
Hand Drying
Lavatories
Water Closets
Urinals
Waste Receptacles
19. Kitchen Equipment
Space between units or wall
closed or adequate space for
easy cleaning
Aisles sufficient
Stora " ff floor
Counte ps&cutting boards
of suitable material [•OJ [ J [• ] [ l
Self serve food area /
adequately protected [✓J [ l [ ] [ l
Built-in external temperature
gauges or provision for separate
internal thermometers noted for
each piece of refrigerated
equipment
ui
�1 P [ l [ ] [ ] [ ]
Utensil&Kitchen Storage
Clean [ ] [ J [ ) { l
Soiled [ ] [ J [ ) [ ]
Counter mounted equipment [ ] [ ] [ ] [ ]
Floor mounted equipment [ ] [ ] [ ] [ ]
Vacuum packaging equipment [ ] [ ] [ ] [ ]
I
Bulk food [ l [ ] [ ] [ ]
Self service
Salad [ l [ J [ J L l
' Hot/Cold Buffet [ ] [ J [ ] [ J
E---21
20. Food Preparation Review [ ] [ l [ ] [ ]
Raw food prep table(s) [ l [ ] [ ] [ ]
(as menu dictates)
Raw food prep sink(s) [ ] [ ] [ l [ ]
(as menu dictates)
Adequate refrigeration [ ] [ ] [ ] [ ]
Adequate cold holding facilities [ ] [ ] [ ] ( ]
Adequate hot holding facilities ( ] [ ] [ ] [ ]
Adequate hot food preparation
equipment [ ] [ ] [ ] [ ]
Vacuum packaging [ ] [ ] [ ] ( ]
HACCP plan
f
F-22
gill •# ,
COMMENTS: (Explain why any item was noted"Unsatisfactory.'
F .
Reviewer Signature Date
! Reviewer Title
APPROVAL: DATE:
DISAPPROVAL: DATE:
REASONS FOR DISAPPROVAL:
B-23
FOOD ESTABLISHMENT GUIDE FOR DESIGN, INSTALLATION,
AND CONSTRUCTION RECOMMENDATIONS
STATEMENT OF PURPOSE
This technical reference is intended to provide guidance and assistance in complying with
nationally recognized food safety standards.It includes design, installation, and construction
recommendations regarding food equipment and facilities. This document can be used by
both the Regulatory Health Authority and food establishment applicant.
The goal is to promote the uniform design and construction of food facilities, which are not
only conducive to safe food handling and sanitary facility maintenance, but which encourage
both.
Section 1—Facilities to Maintain Product Temperature
Sufficient hot-holding and cold-holding facilities shall comply with the standards of NSF or equivalent,and
shall be designed,constructed and installed in conformance with the requirements of these standards.
Refrigeration Facilities Sizing and Design
Refrigeration facilities shall be adequate to provide for the proper storage,transportation,display,and service
of potentially hazardous foods.Specific refrigeration needs will be based upon the menu,number of meals,
frequency of delivery,preparation in advance of service.
If potentially hazardous foods are prepared a day or more in advance of service,a rapid cooling device(s)
capable of cooling potentially hazardous foods from 140°F to 41°F within 6 hours should be provided(140°F
to 70°F in 2 hours&70°F to 41°F in 4 hours).The capacity of the rapid cooling facilities must be sufficient to
accommodate the volume of food required to be cooled to 4?F within 6 hours.
Point-of-use refrigerators should be provided at work stations for operations requiring preparation and
handling of potentially hazardous foods.Refrigeration units,unless designed for such use,should not be
located directly adjacent to cooking equipment or other high heat producing equipment which may tax the
cooling system's operation.
Sizing Consideration for Calculating Total Refrigerated Storage Needs Including Walk-Ins
To plan reserve storage,the following need to be considered:menu,type of service,number of meals per day,
number of deliveries per week,adequate air ventilation in the area where refrigeration system will be located.
E-24
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Island Cheese Merchandiser
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We Listen, Respond...and Deliver!
This island cheese merchandiser provides a continuous I
shopping experience from all sides.Efficient utilization
of space means additional profits from your dairy
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department.This is the perfect merchandiser for a wide
variety of dairy and pre-packaged fresh products.
KEY FEATURES:
Non CFC Foam Insulation
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Hinged Fan Plenum
Aluminum Finned-Copper Tubed Coils
Aluminum Bottom Liner
i \ Heavy Duty Steel Base
Unitized Case
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7DA/dP: Food Establishment Plan Review Guide - Sections I Page I of 19
Food and Drug Administration and Conference for Food Protection
FOOD ESTABLISHMENT PLAN REVIEW
GUIDE
2000
SECTION I
FOOD ESTABLISHMENT PLAN REVIEW APPLICATION TO BE
COMPLETED BY THE OPERATOR AND SUBMITTED TO THE
REGULATORY AUTHORITY
Regulatory Authority
)ate:
FOOD ESTABLISHMENT PLAN REVIEW APPLICATION
NEW REMODEL CONVERSION � � I
dame of Establishment: QW,b c"
�ategory: Restaurant , Institution , Daycare , Retail Market-�' Other
address: .7�3 C 6 l C K°e1^/V&- Rogd N ; A-nt'D 1 e-vl'
'hone if available: 17 9 " 10 6 " 9-WV
,lame of Owner:
vlailing Addressi Vvet4Tw-o rftj Aw A/` ft Dvv&K
Celephone: ! -79- �
applicant's Name:
Citle (owner,manager, architect, etc.): rnj90 W AA
vlailing Address: s4AI1i Ai� W-1-
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Celephone:
have submitted plans/applications to the following authorities on the following dates:
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Y DA/CP: Food Establishment Plan Review Guide - Sections I Page 18 of 19
i9. Are hand and drying facilities (paper towels air blowers etc.) available at all handwashing sinks?YES KNO
( )
70. Are covered waste receptacles available in each restroom?YES;4NO ( )
71. Is hot and cold running water under pressure available at each handwashing sink?YES KNO ( )
72. Are all toilet room doors self-closing? YES k NO ( )
73. Are all toilet rooms equipped with adequate ventilation? YES NO ( )
74. If required, is a handwashing sign posted in each employee restroom?YES'NO ( )
L. SMALL EQUIPMENT REQUIREMENTS
75. Please specify the number, location, and types of each of the following:
Slicers
�utting boards j
�an openers ,
vlixers
i
:loor mats
)ther
STATEMENT: I hereby certify that the above information is correct, and I fully understand that any
leviation from the above without prior permission from this Health Regulatory Office may nullify final
approval.
Signature(s)
>wner(s) or responsible representative(s)
)ate: �_ O
tpproval of these plans and specifications by this Regulatory Authority does not indicate compliance with
my other code, law or regulation that may be required--federal, state, or local. It further does not
.onstitute endorsement or acceptance of the completed establishment (structure or equipment). A
.)reopening inspection of the establishment with equipment in place & operational will be necessary to
letermine if it complies with the local and state laws governing food service establishments.
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DA/CVP: Food Establishment Plan Review Guide - Sections I Page 19 of 19
Nome I Plan Review: Table of Contents
3ypertext updated by dms/ces 2000-MAR-30
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yD JCFP: Food Establishment Plan Review Guide - Sections I Page 2 of 19
Governing Board of Council Plumbing
Zoning Electric
Planning Police
Building Fire
Conservation Other( )
Hours of Operation: Sun 6 Thurs 55=/1
Mon JamFri
Tues Sat
Wed
'lumber of Seats: tq
Dumber of Staff: �–
Maximum per shift)
Cotal Square Feet of Facility: 00 0
dumber of Floors on which
)perations are conducted f
Maximum Meals to be Served: Breakfast
(approximate number) Lunch 0—
Dinner
3rojected Date for Start of Project: Ve,914 I/ ?-W�
?rojected Date for Completion of Project: bev&&Z
Type of Service: Sit Down Meals
(check all that apply) Take Out
Caterer
Mobile Vendor
Other
?lease enclose the following documents:
��� Proposed Menu(including seasonal, off-site and banquet menus)
Manufacturer Specification sheets for each piece of equipment shown on the plan
Site plan showing location of business in building; location of building on site including alleys, streets; and
ocation of any outside equipment(dumpsters, well, septic system - if applicable)
Plan drawn to scale of food establishment showing location of equipment,plumbing, electrical services
and mechanical ventilation
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�DA/(;,FF: Food Establishment Plan Review Guide - Sections I Page 3 of 19
Equipment schedule
�ONTENTS AND FORMAT OF PLANS AND SPECIFICATIONS
l. Provide plans that are a minimum of 11 x 14 inches in size including the layout of the floor plan accurately
lrawn to a minimum scale of 1/4 inch= 1 foot. This is to allow for ease in reading plans.
>.. Include: proposed menu, seating capacity, and projected daily meal volume for food service operations.
3. Show the location and when requested, elevated drawings of all food equipment. Each piece of equipment must
ie clearly labeled on the plan with its common name. Submit drawings of self-service hot and cold holding units
Kith sneeze guards.
1. Designate clearly on the plan equipment for adequate rapid cooling, including ice baths and refrigeration, and
.or hot-holding potentially hazardous foods.
i. Label and locate separate food preparation sinks when the menu dictates to preclude contamination and cross-
;ontamination of raw and ready-to-eat foods.
i. Clearly designate adequate handwashing lavatories for each toilet fixture and in the immediate area of food
)reparation.
7. Provide the room size, aisle space, space between and behind equipment and the placement of the equipment
in the floor plan..
3. On the plan represent auxiliary areas such as storage rooms, garbage rooms,toilets, basements and/or cellars
zsed for storage or food preparation. Show all features of these rooms as required by this guidance manual.
�. Include and provide specifications for:
a. Entrances, exits, loading/unloading areas and docks;
b. Complete finish schedules for each room including floors, walls, ceilings and coved juncture bases;
c. Plumbing schedule including location of floor drains, floor sinks, water supply lines, overhead waste-
water lines,hot water generating equipment with capacity and recovery rate,backflow prevention, and
wastewater line connections;
d. Lighting schedule with protectors;
(1)At least 110 lux(10 foot candles) at a distance of 75 cm(30 inches) above the floor, in walk-in
refrigeration units and dry food storage areas and in other areas and rooms during periods of
cleaning;
(2) At least 220 lux(20 foot candles):
(a)At a surface where food is provided for consumer self-service such as buffets and salad bars
or where fresh produce or packaged foods are sold or offered for consumption;
(b)Inside equipment such as reach-in and under-counter refrigerators;
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DA/CFP: Food Establishment Plan Review Guide - Sections I Page 4 of 19
A
(c)At a distance of 75 cm(30 inches) above the floor in areas used for handwashing,
warewashing, and equipment and utensil storage, and in toilet rooms; and
(3)At least 540 lux(50 foot candles) at a surface where a food employee is working with food or
working with utensils or equipment such as knives, slicers, grinders, or saws where employee safety
is a factor.
e. Food Equipment schedule to include make and model numbers and listing of equipment that is certified
or classified for sanitation by an ANSI accredited certification program (when applicable).
f. Source of water supply and method of sewage disposal. Provide the location of these facilities and submit
evidence that,state and local regulations are complied with;
g. A color coded flow chart demonstrating flow patterns for:
-food(receiving, storage,preparation, service);
-food and dishes (portioning,transport, service);
-dishes (clean, soiled, cleaning, storage);
-utensil (storage, use, cleaning);
-trash and garbage (service area,holding, storage);
h. Ventilation schedule for each room;
i. A mop sink or curbed cleaning facility with facilities for hanging wet mops;
j. Garbage can washing area/facility;
k. Cabinets for storing toxic chemicals;
1. Dressing rooms, locker areas, employee rest areas, and/or coat rack as required;
in. Completed Section 1;
n. Site plan(plot plan)
FOOD PREPARATION REVIEW
heck categories of Potentially.Hazardous Foods (PHF's)to be handled, prepared and served.
CATEGORY* (YES) (NO)
1. Thin meats,poultry, fish, eggs (hamburger; sliced meats; fillets) ( ) W
2. Thick meats,whole poultry (roast beef; whole turkey, chickens, hams) ( ) ()0
3. Cold processed foods (salads, sandwiches,vegetables) ( ) (X)
4. Hot processed foods (soups, stews,rice/noodles, gravy, chowders, casseroles) ( ) (�()
5. Bakery goods(pies, custards, cream fillings&toppings) ( ) (A
6. Other
* A generic HACCP plan for each category of food may be available from the regulatory authority
for reference.
PLEASE CIRCLE/ANSWER THE FOLLOWING QUESTIONS
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?DA/CFP: Food Establishment Plan Review Guide - Sections I Page 5 of 19
FOOD SUPPLIES:'
t. Are all food supplies from inspected and approved sources? /NO
>.. What are the projec d frequencies of deliveries for Fr zen foods e ,
Zefrigerated foods , and Dry goods
3. Provide information on the amount of space (in cubic feet) allocated for:
dry storage ,
Zefrigerated Storage , and WArl.K A) LTJ 4 -O
rozen storage
1. How will dry goods be stored off the floor? QAL
S
ZOLD STORAGE:
1. Is adequate and approved freezer refrigeration available to store frozen foods frozen, and refrigerated
foods at 41°F (5°C) and below? /NO
Provide the method used to calculate cold storage requirements.
2. Will raw meats,po try and seafood be stored in the same refrigerators and freezers with cooked/ready-to-
eat foods?YES /li
If yes, how,will cross-contamination be prevented?
3. Does each refrigerator/freezer have a thermometer?J(P�NO
Number of refrigeration units:
Number of freezer units:
4. Is there a(bulk ice machine available? /NO
THAWING FROZEN POTENTIALLY HAZARDOUS FOOD:
Please indicate by checking the appropriate boxes how frozen potentially hazardous foods(PHF's) in each
category will be thawed. More than one method may apply. Also, indicate where thawing will take place.
Thawing Method *THICK FROZEN FOODS *THIN FROZEN FOODS
Refrigeration
Running Water Less than 707
(21'C)
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iDA/CFP: Food Establishment Plan Review Guide - Sections I Page 6 of 19
Microwaveart as of cooking
( p g
process)
I
Cooked from Frozen state
Other(describe)
*Frozen foods: approximately one inch or less =thin, and more than an inch=thick.
�OOKING:
l. Will food product thermometers be used to measure final cooking/reheating temperatures of PHF's?YES /NO
What type of temperature measuring device: X1'4
Minimum cooking time and temperatures of product utilizing convection and conduction heating equipment.-
beef
quipment:beef roasts 130°F (121 min)
solid seafood pieces 145°F (15 sec)
other PHF's 145T (15 sec)
eggs:
Immediate service 145T (15 sec)
pooled* 155°F (15 sec)
(*pasteurized eggs must be served to a highly
susceptible population)
pork 145°F (15 sec)
comminuted meats/fish 155°F (15 sec)
poultry 165°F (15 sec)
reheated PHF's 165°F (15 sec)
?. List types of cooking equipment.
AOUCOLD HOLDING:
L How will hot PHF's be maintained at 140°F (60°C) or above during holding for service?Indicate type and
lumber of hot holding units.
>.. How will cold PHF's be maintained at 41°F (5°C)or below during holding for service?Indicate type and
lumber of cold holding units.
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DA/CFP: Food EstAblishment Plan Review Guide - Sections I Page 7 of 19
�OOLING:
?lease indicate by checking the appropriate boxes how PHF's will be cooled to 41°F (5°C)within 6 hours(140°F
o 70°F in 2 hours and 70°F to 41'F in 4 hours). Also, indicate where the cooling will take place.
COOLING THICK THIN MEATS THIN SOUPS/ THICK RICE/
METHOD MEATS GRAVY SOUPS/ NOODLES
GRAVY
Shallow Pans
Ice Baths
Reduce
Volume or Size
Rapid Chill
Other
(describe)
REHEATING:
1. How will PHF's that are cooked, cooled, and reheated for hot holding be reheated so that all parts of the food
-each a temperature of at least 165°F for 15 seconds. Indicate type and number of units used for reheating foods.
i
1. How will reheating food to 165°F for hot holding be done rapidly and within 2 hours?
?REPARATION:
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iDA/CFP: Food Establishment Plan Review Guide - Sections I Page 8 of 19
1. Please list categories of foods prepared more than 12 hours in advance of service.
IIIA
?. Will food employees be trained in good food sanitation practices?&S NO
vlethod of training:
II
Jumber(s) of employees:
dates of completion:
3. Will disposable gloves and/or utensils and/or food grade paper be used to prevent handling of ready-to-eat
.'nods?YES /NO
1. Is there a written policy to exclude or restrict food workers who are sick or have infected cuts and lesions?
YES/NO / A-
?lease describe briefly: /V/
Will employees have paid sick leave? YES /NO
i. How will cooking equipment, cutting boards, counter tops and other food contact surfaces which cannot be
,ubmerged in sinks or put through a dishwasher be sanitized?
Memical Type: , A111,k
concentration:
rest Kit: YES/NO 1�
i. Will ingredients for cold ready-to-eat foods such as tuna, mayonnaise and eggs for salads and sandwiches be
)re-chilled before being mixed and/or assembled?YES/NO
f not,how will ready-to-eat foods be cooled to 417?
/V
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'DA/CFP: Food Establishment Plan Review Guide - Sections I Page 10 of 19
Kitchen FLOOR COVING WALLS CEILING
Bar
Food Storage
Other Storage
Toilet Rooms
Dressing Rooms
Garbage &
Refuse Storage
Mop Service
Basin Area
Warewashing
Area
Walk-in
Refrigerators and
Freezers
3. INSECT AND RODENT CONTROL
APPLICANT: Please check appropriate boxes.
YES NO NA
1. Will all outside doors be self-closing and rodent proof? N ( ) ( )
2. Are screen doors provided on all entrances left open to the outside? ( ) ( )
3. Do all openable windows have a minimum#16 mesh screening? ( ) ( ) K
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'DA/CFP: Food Establishment Plan Review Guide - Sections I Page 9 of 19
7. Will all produce be washed on-site prior to use?YES/NO Al/^
s there a planned location used for washing produce?YES/NO
describe
f not, describe the procedure for cleaning and sanitizing multiple use sinks between uses.
3. Describe the procedure used for minimizing the length of time PHF's will be kept in the temperature danger
,one (41 T - 140T) during preparation.
�. Provide a HACCP plan for specialized processing methods such as vacuum packaged food items prepared on-
;ite or otherwise required by the regulatory authority. A-1 1A_
I ✓
III l0. Will the facility be serving food to a highly susceptible population? YES
f yes, how will the temperature of foods be maintained while being transferred between the kitchen and service
area?
!k. FINISH SCHEDULE
kpplicant must indicate which materials (quarry tile, stainless steel, 4" plastic coved molding, etc.)will be used in
he following areas.
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'DA/CFP: Food Establishment Plan Review Guide - Sections I Page 11 of 19
4. Is the placement of electrocution devices identified on the plan? O O (V
5. Will all pipes&electrical conduit chases be sealed; ventilation systems exhaust and ( ) ( ) ( )
intakes protected?
6. Is area around building clear of unnecessary brush, litter,boxes and other M ( ) ( )
harborage?
7. Will air curtains be used?If yes, where? ( ) ( ) ( )
C. GARBAGE AND REFUSE
Inside
8. Do all containers have lids?
9. Will refuse be stored inside? ( ) ( ) ( )
If so, where?
10. Is there an area designated for garbage can or floor mat cleaning? ( ) ( ) ( )
Outside
11. Will a dumpster be used?
Number I Size 15 x3
Frequency of pickup !A5 IJ,&W
Contractor
12. Will a compactor be used? Ay O
Number Size
Frequency of pick up
Contractor
13. Will garbage cans be stored outside? IJ 0 O O ( )
14. Describe surface and location where dumpster/compactor/garbage cans are to be stored
FkAT
15. Describe location of grease storage receptacle
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7DA/CFP: Food Establishment Plan Review Guide - Sections I Page 12 of 19
16. Is there an area to store recycled containers? ( ) ( ) ( )
Indicate what materials are required to be recycled;
O Glass
O Metal
( )Paper
O Cardboard
( ) Plastic
17. Is there any area to store returnable damaged goods? O O ( )
D. PLUMBING CONNECTIONS
I
AIR AIR *INTEGRAL *"P" VACUUM CONDENSATE
GAP BREAK TRAP TRAP BREAKER PUMP
18. Toilet
19.Urinals
20. Dishwasher
21. Garbage
1
Grinder
I /
22. Ice machines
23. Ice storage
bin
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DA/CFP: Food Establishment Plan Review Guide - Sections I Page 13 of 19
I
24. Sinks
a. Mop
b.Janitor
c. Handwash
d.
3 Compartment
e. 2
Compartment
f. l
Compartment
g. Water Station
25. Steam tables
d
26. Dipper wells
27.
Refrigeration
condensate/
drain lines
28. Hose -
connection
29. Potato
peeler
30.Beverage
Dispenser
w/carbonator
31. Other
TRAP: A fitting or device which provides a liquid seal to prevent the emission of sewer gases without
naterially affecting the flow of sewage or waste water through it. An integral trap is one that is built directly into
he fixture, e.g., a toilet fixture. A ?P?trap is a fixture trap that provides a liquid seal in the shape of the letter?P.?
ti / /
u11 .S. traps are prohibited.
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'DA/CFP: Food Establishment Plan Review Guide - Sections I Page 14 of 19
32. Are floor drams provided&easily cleanable, if so, indicate location:
,A/1A
E. WATER SUPPLY
33. Is water supply public or private ( ) ?
34. If private, has source been approved?YES ( )NO ( )PENDING O
?lease attach copy of written approval and/or permit.
35. Is ice made on premises A purchased commercially Q�?
f made on premise, are specifications for the ice machine provided?YES ( )NO ( )
describe provision for ice scoop storage:
3rovide location of ice maker or bagging operation ER t7-6 Zer�i1 G-PIAT `6 d
36. What is the capacity of the hot water generator?
/144
37. Is the hot water generator sufficient for the needs of the establis t?Provide calculations for necessary hot
vater(see Part 5 &Part 9 Under Section III in this manual) /
38. Is there a water treatment device?YES ( )NO ( )
f yes,how will the device be inspected& serviced?
39. How are backflow prevention devices inspected& serviced?
L-1A-V02.jZ
F. SEWAGE DISPOSAL,
W. Is building connected to a municipal sewer? YES NO ( )
11. If no, is private disposal.system approved? YES O NO O PENDING ( )
?lease attach copy of written approval and/or permit.
ittp://www.cfsan.fda.gov/–dns/Prev-l.hftnl 11/12/2008
'DA/CFP: Food Establishment Plan Review Guide - Sections I Page 15 of 19
E2. Are grease traps provided?YES ( )NO ( )
f so where?
?rovi&e,schedule for cleaning&maintenance
s. DRESSINGROOMS
B. Are dressing rooms provided?YES ( )NO M
14. Describe storage facilities for employees'personal belongings (i.e.,purse, coats, boots,umbrellas,etc.)
i
K. GENERAL
15. Are insecticides/rodenticides stored separately from cleaning & sanitizing agents?
fES (' )NO ( ) NIA-
ndicate location:
l6. Are all toxics for use on the premise or for retail sale (this includes personal medications), stored away from
'ood preparation and storage areas?YES�NO ( )
l7. Are all containers of toxics including sanitizing spray bottles clearly labeled?
MVI NO ( )
M Will linens be laundered on site?YES ( )NO
f yes,what will be laundered and where?
f no,how will linens be cleaned?
49. Is a laundry dryer available?YES ( )NO
50. Location of clean linen storage:
>1. Location of dirty linen,storage:
52. Are containers constructed of safe materials to store bulk food products?YES ( )NO ( )
ittp://www.cfsan.fda.gov/—,dms/Prev-l.html 11/12/2008
i
'DA/CFP: Food Establishment Plan Review Guide - Sections I Page 16 of 19
ndicate type:
i
53. Indicate all areas where exhaust hoods are installed:
LOCATION FILTERS SQUARE FIRE AIR AIR
WOR FEET PROTECTION CAPACITY MAKEUP
EXTRACT,40N CFM CFM
DEVICES
I
54. How is each listed ventilation hood syste cleaned?
[. SINKS
55. Is a mop sink present? YES XNO ( )
f no,please describe facility for cleaning of mops and other equipment:
56. If the menu dictates, is a food preparation sink present?YES NO ( )
1. DISHWASHING FACILITIES
57. Will sinks or a dishwasher be used for warewashing?
Dishwasher( )
ittp://www.cfsan.fda.gov/—dms/Prev-l.html 11/12/2008
V
'DA/CFP: Food Establishment Plan Review Guide - Sections I Page 17 of 19
Two compartment sink( )
Three compartment sink
i8. Dishwasher
Cype of sanitization used:
Hot water(temp'. provided)
Booster heater
Chemical type
s ventilation provided?YES ( )NO ( )
59. Do all dish machines have templates with operating instructions?YES ( )NO ( ) A-1/
i0. Do all dish machines have temperature/pressure gauges as required that are accurately working? YES ( )NO /l!�
i 1. Does the largest of and an fit into each compartment of the of sink? YES NO N
g p p p P ( ) ( ) ✓A
f no, what is the procedure for manual cleaning and sanitizing?
i2. Are there drain boar.ds-on`both--e-ndsbf-the-pot siinnk? n
Y
ES 'NO
( )
type of sanitizer is used?
hlorine ( )
Iodine
Quaternary ammonium
Hot Water ( )
Other ( )
A 4etest papers and/or kits available for checking sanitizer concentration?YES O NO ( )
K. HANDWASHING%'TOILET FACILITIES
i5. Is there a handwashing sink in each food preparation and warewashing area? YESNO ( )
i6. Do all handwashing sinks, including those in the restrooms, have a mixing valve or combination faucet? ES
)NO (
i7.
i7. Do self-closing metering faucets provide a flow of water for at least 15 seconds without the need to reactivate
he faucet?YES ( )NO
58. Is hand cleanser available at all handwashing sinks?YES NO ( )
ittp://www.efsan.fda.gov/—dms/Prev-l.htmi 11/12/2008
C �
601
C2V13
Island Cheese Merchandiser
01,1'a .
f I Facing Area 35..4.ft' - 53.4 ft2
P
C2VI Cubic Capacity II 52.2 ft3 81.3 ft3
W
Diimelfii�ii ns
L
Overall Length(w/o ends) 1 98.75' 146.75'
Thickness-Pair Ends 13 3'
Eli
NA NA
` Anti Sweat Amps /
I
P
,. Fan Amps Std_. . 1.06 212
s � 3 ..__... . ..., 3
H
Light Amps(Two rows canopy)....._ 1.91 3 46.
.. ......
�ry .. i Def.Load Amps(if electric-230V) 1 11.30 14.80
., � Evaporator�,_,....
IM
y _ _ ._. Temperature(°F) _ - 1 +1 +15°
.5� �r
BTU/Hr Requirements(lighted shelves) : 12000 18000
1I
• I
; Electric 6 30 min. 55 OF
a 31 °F. . . _..__ ..
125 FPM
C2VI3
All electrical data are based on 115V and unlighted shelves.
27 1� I 98 3–e'CASE
146j–12'CASE
15j
13� 61d 281 GRAIN CONNECTIONS
8'CASE
B 21 66,�– 12'CASE
12� 28q 4 7 ����
66J REFRIGERATION
,,II ALTERNATE fL00R
14� PENETflATION 0 � GRAIN LOCATIONS/�P
36� 74J �� I/I/Illl/101/I 41
�; .� 4J r P
231
33 6
I 21 se u
ELECTRICAL
4� 14� 4� 14 4� PENETRATION 12 KICKPLATE
12 LOCATION
41
60
74
5201 Transport Blvd./Columbus.GA 31907
800-866-5596-Phone/706-568-8990-fax/solutions@kysorwarren.com
E—1 €v -1 S® One Company.Countless Solutions. V KY �J W RRREn• Dual-Jet and Air Defrost are registered trademarks of Kysor//Warren.
Kysor//Warren,a subsidiaryof Enodis,PLC.All Rights Reserved.
Type I refrigerator,intended for use in an area where the environmental conditions are controlled and
maintained such that conditions do not exceed 75'F and 55%relative humidity.Kysor//Warren,whose Kysor//Warren cases are UL and NSF listed.
policy is one of continuous improvement,reserves the right to change at any time,specifications, C2VI3-0805PD
design or prices without incurring obligation.