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Field Report
Client/Project: Archdiocese of Boston
Bioaerosol Sampling
Job Site: Saint Michael School
80 Maple Street
North Andover, Massachusetts
Project No.: 14.00126
Distribution: Kent Wilkins — Claims Manager
Date: January 28, 2014
Site Visit Date: January 22, 2012
Covin Field William Henderson, Industrial Hygienist
Representative(s):
Scope of Work: A representative of Covino Environmental Associates, Inc. collected
bioaerosol samples for total fungal spores in the areas affected by a water
release associated with a sprinkler pipe break in the second floor Computer
Room on January 9, 2014. Covin was informed that the wood floor
beneath vinyl floor tiles remained wet in several classrooms on the first and
second floors since that time. The bioaerosol samples were collected to
determine if there were elevated airborne mold concentrations due to damp
conditions within the building.
Background: Mold growth and subsequent elevated airborne mold concentrations can
occur due to damp conditions within a building. Mold in buildings is not
always visible. It can be hidden in wail cavities, above ceilings, in structural .
flaming materials, subflooring, insulation and other normally covered
building materials.
Mold thrives in damp organic matter and mold growth media can vary
widely. Examples of media that can support mold growth include stagnant
water, damp wood, backing on carpet and carpet pads, cellulose ceiling tiles,
and paper facing on gypsum board. Interior finishes such as vinyl cove base
and vinyl wall covering may hold moisture against gypsum board or wood,
thus enhancing the conditions for mold growth. It is generally
recommended that any porous water -damaged materials (e.g., gypsum
board, carpet) that remain wet for more than 24 to 48 hours be removed to
zaod W96E:1l MZ et uef ZOVUE618LP¢A 1d1ONO81AN3 ONIA03
Results:
Archdiocese of Boston
Covino Project 14.00126
January 23, 2014
Page 2 of 3
minimize the potential for subsequent mold growth.' -2-3
Bioaerosol Sampling for Mold,
There is currently little information available on bioaerosol dose -response
relationships, and there are no recommended allowable exposure limits
established for airborne mold The American Conference of Governmental
Industrial Hygienists (ACG" publication Bioaerosols. Assessment and
Control, indicates that an exposure may be considered unusual when indoor
bioaemsol concentrations are significantly higher than those outdoors, or
when the detected indoor microbial genera and species differ markedly from
those detected outdoors.
It should be noted that mold exposure does not always present a health
problem indoors!. Health effects associated with exposure to mold are not
only a function of the airborne concentration, but also the individual's
health. For example, certain individuals are more susceph'ble5 to developing
symptoms upon exposure to mold. For those individuals, exposure to mold
can cause symptoms including nasal stuti'mess, eye irritation, and
wheezing6.
;ter
Y"4 +it ♦FSS' l jjhh' '�1 ,. �,c
\t4'T._..�y, Is.
Outdoors
<13 and <13
Com user Rom e Floor
<13 and 187.
Room 6A 2 _ Floor
2,307
Room 6B r Floor
373
Room 2B, 1" Floor
280
Room 2A,1 a Floor
107
Basement, at stairwell
200
No fungal spares were detected on the field blank
r American Coafereaee of Governmental Industrial Hygienists (ACGIII), Bioaerosols. Assessment and Control,
Chapter 10: Prevention and Control of Microbial Contamination, p. 10-5,1999_
2 United States Environmental Protection Agency (US EPA), "Maid Remediation in Schools ®nd.Commercial
Buildings", 2001.
3 Occupational Safety and Health Administration (OSHA), Safety and Health Information Bulletin, "A Drief Guide
to Mold in the Workplace", 2003.
' Centers for Iaisease Control and Prevention (C1DC), National Center for Environmental Health, "Questions and
Answers on Staehyboorys chmiarum and other molds," hua:/ .cdc.eov/neem/airnotlution/mold/stachv.htm
s Susceptible individuals include those with chronic inflammatory lung disease (such as persons with asthma, severe
allergies, or hyl=sensitiviry ptreumonitis), compromised/suppressed immune systems (such as persons with
immune -deficiency syndromes or patients receiving therapeutic chemotherapy or radiation therapy). Other
susceptible populations include infants and persons recovering from surgery.
6 CDC, National Ccnttr for Environmental Health, "Molds in the Environment;'
btp:/Avww.cdc.oov/n2eh/airpollutiordmoldfmoidfacts.htm
COVMO
300 Wik wood Avenue, Woburn, MA 01801 *Tel: 781.833.2555 a Fax 781.932.9402 . emm]:mall6covinolne cwm
E00d NOV41 ROZ 8Z URP ZOD6ZE5WL1:Xa3 It11N OHIAN3 ONIAO3
Archdiocese ofBoston
Covino Project 14.00126
January 23, 2014
Page 3 of 3
Conclusions: The airborne concentrations of total fungal spores detected indoors were
greater than the concurrent outdoor concentrations. No spores were detected
on the outdoor samples, which can occur during the winter season,
especially when the ground is frozen and/or snow cover is present.
While most of the indoor total fungal spore concentrations were relatively
low, the concentration in the Room 6A, Id floor was elevated. This may
possibly be due to exposure of the wood subfloor in that room that occurred when
floor tiles were loosened during the water event and were then removed.
Covino recommends repeating the sampling in Room 6A on the 2°d floor to
determine whether total fungal spore concentrations have decreased since the
previous site visit. if elevated total fungal spore concentrations persist, then
corrective measures such as air scrubbing will be recommended.
Attachments: (1) Method
(2) Covino Laboratory Report: Bioaerosol Samples for Total Fungal Spores
WVll10
300Wddwood Avenue. Wobum. MA 01801 • Tet: 781.933.2555 • Fax: 781.932.9402 . emak mall (Mcovfnolnmeom
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ATTACHMENT I
Method
C
300 Wlldwood Avenue, Woburn, MA 01801 • Tel: 781,833,2555 • Fox 781.932.6402 • email:mail6mvinoinmeam
MAW umorIi VtOZ 8Z uor iOV61EUBLI A VINANOMAN3 ONIA03
Bioaerosol Samvline for Mold
Bioaerosol samples for total fungal spores were collected using a vacuum pump to draw air
through Won Air -O -Cell Cassettes and impact it onto a slide. A nominal flow rate of 15 liters
per minute (lpm) was used to collect the samples. The flow rate was determined prior to and
immediately following the sampling period using a calibrated rotameter. The sampling period
for each sample was five minutes. A field blank was prepared for quality control purposes. The
samples were sealed, labeled, and hand -delivered to Covino's in-house laboratory in Woburn,
Massachusetts where they were analyzed to determine the quantity and identity of fungal spore
types using bright field microscopy (magnification 200x, 400X, 600x and/or 1000x).
Covina
• 300 Wildwaed Avenue, Woburn, MA 01801. Tel: 781.933.2655. Fax: 781.932.9402 . email:mai @covinoinacom
filo/good WeoV=ll glob az use ZOPRE618tOxe3 lliiNANONIAN3 ONIAO3
ATTACHMENT 2
Covin Laboratory Report
Bioaerosol Samples for Total Fungal Spores
300 Wildwood Avenue, Wobum, MA 01 BO1 • Tel• 781.933.2555 • Fax 781.932.9902 • emaH:maII@covinoinc.com
ROILOOd amav:a Ptoz 8Z uer ZOME6tSUMA 1OiN3MIAN3 ONIAO3
covino
Ertusttorarrt�r
ga'"s F. -IIIA -mum Total Spore Count Analysis
Contact: Will Henderson
Company: Archdiocese of Boston
Sample tD: M170770
Sample name; Computer Room, 2nd Floor
Sample type; AIr-o-cell (spores/m3)
Sample volJ area: 75 Amount counted {%}; 100
Counts In total
Raw count
Percent
Spores/rn'
Alternaria
0
0
0
Arthrinium
0 :
0
0
ascospores
0 :
0
0
Aureolneldium
0
0 '
0
basidlospares
0
0
0
Botrytis
0
0
0
Chaetowd
0
0
0
Cladosporlum
0
0
0
Curvularia
0
0
0
Drechslera/Eli oiaris
0
0
0
Epicoccum
0
0
0
Fusarium
0
0
0
Geotrichum
0 ,
0
0
Ulociadlurn
0
0 '
0
NI rospora
0 ,
0
0
Oidium/Peronospors
0
0 }
0 l
Penicillium/AsELIllus
0
0
0
Pedconta
0
0
0
Pithom ces
0
0
0
Rusts
0
0
0
smutsimgemxcetes
0
0
0
Sggazzinle
0
0
0
Stachybotrys/Memnonlella
0
0
0
Stemphyllum
0
0
0
Torula
0
0
0
Unclassified spores
0 .
0
0
Total mold
0
0
0
Counts outside total
Debris
Low
Project number. 14.00126
CEA -10:25080
Received:1/23/2014
Completed: U27/2014
Analyst: Ramon Buenaventura
Reviewed by: Raman Buenaventura
t.3eneral comments:
Collected; 1/22/2014
Site: Saint Michael School
80 Maple Street
North Andover, MA
Weather 1N : Temperature
Clear - dry Mild 20 - 30 P
Other comments:
Spore concentration is below the Limit to
Detection of 13 spores/m3,
Outside count comments:
300 Wildwood Avenue Tel: 761.933.2655 Fax: 781.932.9402
Woburn, Massachusetts 01801 mail@covinoino.com
610/000d eBor il, DtOZ BZ usr ZOY6ZE6i.BLI MA 1dION08I413 ONIA00
covino
l tt1lltt4Nh�lEtt7/lL
AELl1GIATES lm" Total Spore Count
Contact: WIN Henderson
Company; Archdiocese of Boston
Sample ID: M170771
Sample name: Computer Room, 2nd Floor
Sample type: Air -o -cell (spores/m3)
Sample vo1J area: Iii Amount counted (Vo): 100
Counts in total
Raw count
Percent
Spores/m'
Alternaria
0
0
0
Arthrinlum
0
0
0
ascus res
0
0
0
Aureobasidium
0
0
0
basidiospores
2 `
14.28
27
Bottytis
0 '
0
0
Chaetomlum
0
0 ,
0
Cladosporium
3
21.42
40
Curvularia
0
0
0
Drechs-leraMpolaris
0
0
0
Epicoccum
0
0
0
Fusarium
0
0 -
0
Geotrichum
0
0
0
Ulocladlum
0
0
0
Nigrospora
0
0
0
Oidium/Peronospom
0
0
0
Penlcillium/As er lllus
9
64.28
120
j Periocni8
D
0
0
Pithomyces
0
0
0
Rusts
0
0
0
Smuts/Myxomycetes
0
0
0
Spegaszinia
0
0
0
Stach botrysMemnoniella
0
0
0
Stemph lium
0
0
0
Torula
0
0 1
0
Unclassifted spores
0
0 1
0
Total mold
14
100
167
Counts outs�te total
Debris
Low
Project number. 14.00126
CEA -ID: 25081
Reoeived:1/23/2014
Completed; U27/2014
Analyst. Ramon Buenaventura
Reviewed by: Ramon Buenaventura
General comments:
J Collected: 112=014
Site: Saint Michael School
80 Maple Street
North Andover, IAA
Weather, lhllt]d: Temperature:
Clear - dry Mild 20.30 F°
Outside count comments
300 Wildwood Avenue Tet: 781.933.2555 Fax: 781.932.9402
Woburn, Massachusetts 01801 mail®covinoinc.com
610/600d leoril VlOZ Bi ugr ZOVUE618LIMA NIONOBIAN3 ONIAOO
covino,
EFaUIRdHR+I�
LEA02ranniza Total• - Count Analysizz
Contact: Will Henderson Project number 14.00126
Company: Archdiocese of Boston CEA -10:25082
Sample 10: M170772 Received: 1/23/2014
Sample name: Room BA, 2nd Floor Completed: 1/27/2014
Sample We: Air -o -cell (spores/m3) Analyst: Ramon Buenaventura
Sample volJ area: 75 Amount counted (°%): 100 Reviewed by: Ramon Buenaventura
Counts in total
Raw count
Percent
Sparesfm'
Alternans
0
0
0
Arthrinium
0
0
0
ascus ares
2
1.16
27
Aureobasidium
0 !
0 1
0 i
basidiospores
0 1
0
0
BOtrytls
0
0 ,
0
Chaetomium
0
0
01
Cladosporium
0
0
0 '
Curvularia
0
0
0
Drechslera/Bipolaris
0
0
0
icoccum
0
0
0
Fusarium
0
0
0
Geotrichum
0
0
0.
Ulocladium
0
0
0
Nigrospora
0
0
0
Oidium/Peronaspora
0
0
0
Panicillium/Asper illus
171
98.84
2280
Perlconta
0
0
0
Pithomyces
0
0
0
Rusts 1
0
0
0
smuts/Myxomycetes i
0
0 1
0
--SpagnEzInia
0
0
0
Stachybotrya/Memnonielin
0
0
0
stemphyllum
0
0
0
Torula
0
0
0
Uncla"ed spores
0
0
0
Total mold
173
100
2307
Counts outside total
Debris
Med
General comments:
collected: 1/2212014
Site: Saint Michael School
80 Maple Street
North Andover, MA
Weather: Wind: Temperature:
Clear - dry Mild 20 - 30 P
Outside count comments:
II
300 Wildwood Avenue Tel: 781.933.2655 FaX 781.W2.9402
Woburn, Massachusetts 01801 mail®covinoinc.com
610/01.0d W81,141, nOZ OZ u¢f ZOPGUMLIMA WINAN081AN3 ONIA03
covino
MEMO tiMEN7AL
ASt}tATES IMCTotal Spore Count
Contact: Will Henderson
Company: Archdiocese of Boston
Sample ID: M170773
Sample name: Room 6B, 2nd Floor
Sample type: Air -o -call (spores/m3)
Sample void area: 76 Amount counted OW! 100
Counts in total
Raw count
Percent
SPorestrif
Alternaria
0
0
0
Arthrinium
0
0
0
ascospores
0
0
0
Aursobasidium
0
0
0 ,
basidiospores
0
0
0
Botrytis
0
0
0
Ch wAomium
0
0
0
Cladosporlum
0 .
01
0
Curvularia
0
Drec halera/91 ofaris
0
E ico=rn
V00
0
Fusarium
0
Geotrichum
01
Ulacladium
.
0
Ni rospom
0
0
0
Otdium/Peronospora
0
0 '
0
Penicillium/Asper Illus
28
100
373
Periconia
0
0
0
Pithomyces
0
0
0
Rusts
0
0
0
Sm!! sN M m oetes
0
0
0
Spegeatnia
0 ;
0 '
0
Stachybot s/Memnoniella
0
0
0
Stemphrylhum
0
0
0
Torula
0
0
0
UnclassUled sporos
0
0
0
Total mold
28
100
373
Counts outside total
. Debris
Low ,
Project number. 14.00126
GEA -ID -.25083
Received: -1=014
Completed: 1/27/2014
Analyst: Raman Buenaventura
Reviewed by: Ramon Buenaventura
General comments:
0011swed:lr 2014
$ite: Saint Michael School
80 Maple Street
North Andover, MA
Weather: Wind: Temoeraiure:
Clear - dry Mild 20 30 F°
Outside count comments:
300 Wildwood Avenue Tel: 781.933.2555 Fax: 781.932.9402
Woburn, Massachusetts 01801 mall0covinoinc.com
61,0/11.0d uetvil glob BZ uer 10PRE60U MA 1d1N3WN0HIAN3 ONIA03
covino
t�ri'n�l�r�r��
A:��O�jATES Total Spore Count
Contact: W13 Henderson
Company: Archd1ocese of Boston
Sample ID: M170774
Sample name: Room 2B, 1st Floor
Sample type: Air -o -cell (sporedm3)
Sample volJ area: 75 Amount counted (%): 100
Counts in total
Raw count
Percent
Spores/m'
Alternaria
0
U
0
Arthrinium
0
0
0
ascospores
0
0
0
Aureobasidium
0
0
0
basidios ores
0
0
0
trot is
0
0
0
Chaetomium
0
0
0
Cladosporium
4
19.04
53
Curvularia
0
0
0
Drechslera/Bipolads
0
0
0
icoccum
0
0
0
Fusarium I
0
0
0
Geotrichum
0
0
0
Ulocladlum
0
0
0
N111rospora
0
0
0
Oidlum/Paronosporn
0.
0 .
0
Penlcillium/As r illus
15
71.42 i
200
Periconia
0
0
0
Pithomyces
0
0
0
Rusts
01
0
0
SmutslM xom ceras
2
8.52
27
Spe az:dnla
0
0 1
0
Stae bot s/Memnonlelfa
0
0
0
Stemphyllum
0
0
0
Torula
0
4
0
Unclassified spores
0
0
0
Total mold
21
100
280
Counts outside total
Debris
Low
Project number. 14.00126
CEA -11): 25084
Received: 1/2312014
Completed: 1/27/2014
Analyst: Ramon Buenaventura
Reviewed by; Ramon Buenaventura
General comments:
Collected. 1/2212014
Site: Saint Michael School
80 Maple Street
North Andover, MA
weather. Wind: Temperature:
Clear - dry Mild 20 - 30 P
Outside count comments:
300 WBdwood Avenue Tel: 781.933.2555 Fax: 781.832.9402
Woburn, Massachusetts 01801 mail®covinoino.com
610/ZIOd 09041 KOZ 8Z uef ZOV6Z£618UMA IVION061AN3 ONIA00
covino
Eti1V1R9tnNAEt{iAL
�4S�Ut�i+47Es IFaC :Total Spore CountAnalysis
Contact: Will Henderson
Company: Archdiocese of Boston
Sample ID: M171633
Sample name: Room 2A, 1st Floor
$ample type: Air -o -cell (spores/m3)
Sample volt area: 75 Amount counted (%): 100
Counts in total
Raw count
Percent
Sporeym'
Alternaria
0
0
0
Arthrinium
0
0
0
ascan res
0
0
0
Aureobasidium
0
0
0
baaidiospores
3
37.5
40
Bot is
0
0
0
Chaetomium
0
0
0
Cladoeporlum
0
0
0
Curvularia
0
0
0.
DrechslenatSi laris
0
0
0
E icaacum
0
0
0
Fusarium
0
0
0
Geotrichum
0
0
0
Ulccledlum
0
0
0
Ni ros ora
0
0
0
Oldium/Peronoepors
0
0
0
Penicilllum/Aspergillus
5
62.5
67
Periconia
0
0 ;
0
Pithomyces
0
0I
0
Rusts
0
0
0
smuts/M om cetes
0
0 I
0
Spegazzinla
0
0
0
sta bo s/Memnoniella
0
0
0
Stemh ium
0
0
0—Is
0 ;
0
0
Unclassified spores
0
0
0
Total mold
a l
100
107
Counts outside total
Rebels
Low
300 Wildwood Avenue
Wobum, Massachusetts 01801
Project number. 14.00126
CEA -ID: 25085
Received: 1/23/2014
Completed: U2712014
Analyst: Ramon Buenaventura
Reviewed by: Ramon Buenaventura
General comments:
Collected: 1/2212014
Site: Saint Michael School
80 Maple Street
North Andover, MA
Weather Wind: Tampgmturg
Clear - dry Mild 20 - 30 P
Outside count comments:
6WEIOd 1112I•P41, VIOa ea U@r ZOVUEfiiBLOR3 10311NOUTAN3 ONIAW
Tel: 781.133.2556 Fax: 781.9329402
mall6covinolne eom
ovino
i WINIF-11
Total Spore Count Analysis
Contact. Will Henderson
Company: Archdiocese of Boston
sample ID: M171634
Sample name: Basement, base of stairwell
Sample type: Air-o-cetl (spores/m3)
Sample volJ area: 75 Amount counted O/c): 100
Counts In total Raw count
Percent
SporeWW
Alternaria
0
0
0
Arthrinlum
0
0
0 °
ascospores
0
" 0
0
Aureobasidium
0
0
0
basidiospores t
3
20
40
Botrylls 1
0
0
0
Chaetomiurn
0
0
0
Cladosporlum
0
0
0
Curvularia
o
0
0
DrechsleraBi olarls ,
0
' 0
0
E ipwount
2 = 13.33
27
Fusarium
0
0
0
Geotrichum
0
0
0
Ulocladlum t
0
0
0
Ni rospom
0
0
0
Oidium/Peronos ora
0
0
0
Penicillium/Aspergillus
10
66.66
133
Periconia
0
0
0
Plthomyces
0 ° 0 1
0
Rusts
0
0
0
smut omycetes
0
0
0
Spegazzinia
0
0
0
Stack botrys/Memnonislla
0
0 '
0
Stemp"Hum
0
0
0
Torula
0
0
0
Unclassified spores
0
0
0
Total matd
15
100
200.
Counts outside tote
Debris
Low
Project number: 14.00126
CEA -113: 25086
Received: 1/2=014
Completed: 1/27/2014
Analyst: Ramon Buenaventura
Reviewed by: Raman Buenaventura
General commmnts:
Coneeted: 1x.02014
Site: Saint Michael School
80 Maple Street
North Andover, MA
Weather. WO; Temperature:
Clear - dry Mid 20.30 P
Other comments:
Outside count comments:
300 Wldwood Avenue Tel: 781.933.2655 Fax: 781.932.9402
Woburn, Massachusems 01801 mail Gcovinoinc.com
611.0/PlOd sewli. 1+i0Z BZ u¢r Z0?6ZE6lSWX9J 103WN081413 ONIA03
-coi,ino
IIWI RIEfifiT I
fi4lATES Ifi��Total Spore Count Analysis
Contact: Will Henderson
Company: Archdiocese of Boston
Sample ID: M1716M
Semple name: Outdoors
Sample type: Air -o -cell (spores/m3)
Sample volJ area: 76 Amount counted (x): 100
Counts in total I
Raw count
Percent ' Spores/rn'
Allemaria
0
0
0
Arthrinium
0
0 ,
0
ascospores
0
0
0
Aureobasldium
0
0
0
basidlospores
0
0
0
Botrytis
0
0
0
Chaetomlum
0
0
0
Cladosporlum
0
0
0 ,
Curvularia
0
0
0,
DrechsleraMpolarls
0
0
0
Eplcoccum
0
0
0
Fusarlum
0 1
0
0
Geotrichum
0
0
0
Ulocladfum
0
0
0
Nigrospora
0
0
0
Oidium/Peronbae2ra
0
0
0
Penicilllum/As er illus 1
0
0
0
Periconia
0
0
0
Pithom ees
0
0 1
0
Rusts
0
0
0
SmutsJM om teles
0
0
0
Spegazzinis
0
0
0
Stachybotrys/Memnoniella
0
0
0
Sternphyllum
0
0
0
Torula
o
0
0
Unclassified spores '
0
0
0
i Total mold
0
0
0
Counts outside total
- DeWs
Low
300 Wlldwood Avenue
Woburn, Massachusetts 01601
Project number. 14.00128
CEA -ID: 25087
Received: 1/23/2014
Completed: 1/27/2014
Analyst: Ramon Buenaventura
Reviewed by: Ramon Buenaventura
General comments:
Collected: 1/2212014
Site: Saint Michael School
80 Maple Street
North Andover, MA
W&ath,pj; ff-I d: Temperature:
Clear • dry Mild 20 - 30 F°
Other comments-,
Spore concentration is below the limit of
Detection of 13 spores/m3.
Outside count comments:
610/510d anril noz 8Z uer ZOV6ZE618Zl:aed IVIGHNNIAN3 ON1A00
Tel: 781.933.2566 F= 781.932.9402
mail@covinoinc.com
covino
ino
Total Spore Count Analysis
Contact: Will Henderson
Company: Archdiocese of Boston
Sample ID: M171W6
Sample name: Outdoors
Sample type: Air -o -cell (spores/m3)
Sample volJ area: 76 Amount counted ("/o): 100
Counts in total
Flaw count
Percent SporWrre
Altemaria
0
0
0
Arthanium
0
0
0
ascospores
0
0
0.
Aursobasidtum
0
0 1
0
becidi
0
0
0
Botrytis
0
0
0
Chaetomium
0
0
0
CladosEnrium
0
0 .
0
Curvularia
0
0
0 i
-Drechalenaffilpolaris
0
0
0
Epicoccum
0
0
0
Fusarium
0 ;
0
0
Geotrichum
0
0
0
Uloclad-rum
0
0 1
0
NiWaspora
0
0
0
OldlunWeronospora
0
0
0
Penlollllum/Aspergillus
0
0
0
Periconla
0
0
0
Plthomyces
0
0
0
Rusts
0
0
0
SmultafflEornycetes
0
0
0
Spegazzinla
0
0
0
Stachybot s/Memnoniella
0
0
0
Stemphyllum
0
0 1
0
Torula
0
0
0
Unclassified spores
0
0
0
Total mold
0
0
0
Counts outside total
Debris
LOW
Project number. 14.00126
CEA -ID: 250813
Received:1/23/2014
Completed: 1/27/2014
Analyst Ramon Buenaventura
Reviewed by: Ramon Buenaventura
General comments:
Collected: 1!22!2014
Site: Saint Michael School
80 Maple Street
North Andover, MA
Weather. Wind: TernWmlure:
Clear - dry Mild 20 - 30 F°
Other comments:.
Spore concentration is below the Limit of
Detection of 13 spores/m3.
Qutside.count comments,,
300 Wildwood Avenue Tel: 781.933.2555 Fax 781.932.9402
Woburn. Massachusetts 01801 mail Ocovincinc.com
610/910d W204t D10Z OZ ssP ZOV6ZE6l,GWXed 1d1N3i MIAN3 ONIA00
Efal/lii(�tih�Etl!7RL
OHIO Total Spore Count
Contact: Will Henderson
Company: Archdfooese of Boston
Sample ID: M171637
Sample name: Field blank
Sample type: AU -o -cell (spores/m3)
Sample volt area: n/a Amount counted (%): 100
Counts in total
Raw count
Percent
SporesJm'
Alternaria
0
0
0
Arthrinium
0
0
0
ascus res
a
0
0
Aureobasidium
0
0
0
basidiospores
0
0
0
Botrytis
0
0
0
Chaetomium
0 ;
0
0
Clados onium
0
0
0
Curvularia
0
0
0
DrechsienaBi larls
0
0
0
E ieoccum
0
0
0
Fusarium
0
0
0
Geotrichum
0
0
0
Ulocladium
0
0
0
Ni res ra
0
0
0
Oidium/Peronoepora
0
0
0
Penlailllum/Aspergillus
0
0
0
Periconia
0
0
0
Plthomyces
0
0
0
Rusts
0
0
0
smuts/Myxomyoetes
0
0
0
. Spegazzinia
0
0
0
Stack baln%Nemnorueile
0
0
0
Stemph liutn
0
0
0
Torula
0
0
0
Unclassified spores
0
0
0
Total mold
0
0
0
Counts outside total
Debris
WA
Project number. 14.00128
CEA -ID: 25089
Received: 1/23/2014
Completed: U27/2014
Analyst: Ramon Buenaventura
Reviewed by: Ramon Buenaventura
General comments:
Collected: 1/22/2014
Site: Saint Michael School
80 Maple Street
North Andover, MA
Weather. Wind: Temperature:
Clear - dry Mlld 20.301=°
(Other comments:
No spores detected
300 Wildwood Avenue Tel: 781.9332565 Fax: 781232.9402
Woburn, Massachusetts 01801 mail®covinoinc.com
610A1,0d wazri.i. viol et ugr ZOVUEUBt_IMA 1dJ.N311NO81AN3 ONIAOO
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Yankee Environmental Services, LLC
(YES] Asbestos Removal, Lead Paint, Mold, Demolition, Etc.
P. 0. Box 1058 • Newburyport, MA 01950 -
June 9, 2010
North Andover Health Department
1600 Osgood Street
Building 20, Suite 2-36
North Andover, MA 01845
Attn: Susan Y. Sawyer, Health Director
Re: Notification of Asbestos Abatement
Dear Ms. Sawyer,
Y -A-
(800) 84676254 • Fax (978) 388-1017
JUN Z010
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT_
This letter is to inform you that our company will be undertaking asbestos removal operations at
the following location:
Saint Michael School
80 Maple Avenue
North Andover, MA
Start Date: 6/22/10
End Date: 6/29/10
Any person entering the work site during removal operations or shutdown of operations can be
exposed to asbestos contamination. In the event that a fire does occur in the work areas, any
person entering to deal with that situation should be wearing an appropriate respirator, and
should be made aware of the conditions.
Sincerely,
Lorry Feeney
Yankee Environmental Services, LLC
April 10, 2007
Michelle Grant
Board of Health
1600 Osgood Street
Building 20; Suite 2-36
North Andover, MA 01845
Dear Michelle:
Saint Michael School
80 Maple Avenue
North Andover, MA 01845
978-686-1862
RECEIVE®
APR 18 2007
TOWN Or NORTH ANDOVER
HEALTH DEPARTMENT
As discussed on the phone last week, here are items that need attention in the kitchen at Saint
Michael School. I have the Property Manager getting quotes on some particular items. The pastor
understands the need for change in the kitchen and will allow us to make some simple and
inexpensive changes immediately. We are going to work with our Parent-Teacher Organization
to see if we can raise funds to completely re -vamp the kitchen to better align ourselves with the
standards of the Board of Health.
Immediate Attention Items:
• The water temperature in the new gym bathrooms has been adjusted.
• The water temperature in the 3 -bay sink in the kitchen was only hot enough to fill the
tanks once. We are getting quotes on purchasing a new hot water tank to address this
issue.
• The milk unit that we were given from Garelick Farms was not holding the correct
temperatures. I've contacted them and have requested a new unit that is UL and NSF
approved. New unit should arrive after April vacation.
• The kitchen does not have hot or cold wells. We are looking at portable units that could
do the job. We have funding to purchase these in the immediate future.
• The kitchen serving counter has no sneeze guards. The Property Manager suggests we
use a "bandaid" solution for now by installing full sheets of plexi -glass across the front of
the serving counter. There would approximately 8 inches of space to slide the food under
this window to the students.
• The school nurse is getting the correct signage for bathrooms and kitchen.
• The ladies from Just Like Home have been instructed to defrost the freezer more
regularly.
Plans for the future:
• No grease trap. The Property Manager is getting quotes to have one installed and
maintained for the upcoming school year.
• The kitchen floor is porous. If we are going to completely re -vamp the kitchen in the
upcoming year(s), a new floor at this time is not wise. The Property Manager will seal up
cracks.
• The hood over the stove needs to be professionally cleaned and maintained. Property
Manager is getting quotes to have it cleaned and maintained. This should be complete
over the summer.
• The cleaning solution sanitizer is not working. Property Manager will contact Eco -Lab to
see if they can repair and maintain for us.
• The electrical plug next to the hand sink in the kitchen is not a GFI. Property Manager
will replace it.
• The dumpster lids must always be closed. The custodian has been instructed to have the
lids closed at all times. Future plans will be to have it enclosed in a locked fence.
• A screen door should be installed in the back kitchen doorway. This can be done this
summer.
• We have no plan for pest control. Property Manager is looking into this for next year.
• Future plans should be replace countertops with stainless steel. This can occur if we are
able to re -vamp the kitchen.
• Future plans should be to replace wooden cabinets to a non -porous material. This can
occur if we are able to re -vamp the kitchen.
• Future plans should be to purchase a spray hose for the kitchen sink. This can be done
this summer.
• The freezer is, not NSF approved. Next time we buy one it should be approved.
• Future plans should be to install a prep. sink in the kitchen. If we re -vamp the kitchen this
can be part of the plan.
A major overhaul of the kitchen is a good possibility if we receive the funding from our PTO.
Please advise us of any changes that need to occur to our food service if the information
provided warrants a change.
Sincerely,
Susan Reidy
Principal
J<
Michelle Grant
Board of Health
1600 Osgood Street
Building 20; Suite 2-36
North Andover, MA 01845
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♦ M NI atu�a ' .tutu¢ �'
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VWNW / / W</ VVIIM�IYV
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80 Maple Avenue
North Andover, MA 01845
.,,.....-..-................
J<
Michelle Grant
Board of Health
1600 Osgood Street
Building 20; Suite 2-36
North Andover, MA 01845
.. cs,,,l,-�,-�'•" :, r' w .. if�!ltit:fl'�f?31lf�i'l�tldl!!lFili�l4itillf!!F!!li!!t!!�!!!li1t�
\T
G-11eChiaie, Pamela
From: Grant, Michele
Sent: Tuesday, March 20, 2007 11:24 AM
To: Sawyer, Susan;=belleChiaie, Pamela
Subject: Saint Michael's datholic School
Hi Sue and Pam,
Saint Michael's has agreed to a meeting on Friday, March 23rd at 1:00pm to discuss a former Satilite Cafe to an
existing Full Service Cafe. The principal (Sue Reidy) and whoever she might like to have accompany her, will be attending
the meeting with us.
DolleChiaie, Pamela
From: Grant, Michele
Sent: Tuesday, March 20, 2007 11:24 AM
To: Sawyer, Susan;°belleChiaie, Pamela
Subject: Saint Michael's Catholic School
Hi Sue and Pam,
Saint Michael's has agreed to a meeting on Friday, March 23rd at 1:00pm to discuss a former Satilite Cafe to an
existing Full Service Cafe. The principal (Sue Reidy) and whoever she might like to have accompany her, will be attending
the meeting with us.
Thanks
Michele J
5
r
Y
FDA/CFP: Food Establishment Plan Review Guide - Sections I
e
Page 1 of 19
Food and Drug Administration and Conference for Food Protection
GUIDE
2000
SECTION I
FOOD ESTABLISHMENT PLAN REVIEW APPLICATION
TO BE COMPLETED BY THE OPERATOR AND
SUBMITTED TO THE REGULATORY AUTHORITY
Regulatory Authority
Date: 3— / q —0-1
FOOD ESTABLISHMENT PLAN REVIEW APPLICATION
NEW REMODEL CONVERSION
Name of Establishment:
Category: Restaur nt , Institution , Daycare , Retail Market ,
Other LLi ndA .,m
Address: ✓r e- IT. AY -0 ► ),gyq 06) OCI�- I M kq
Phone if available:
Name of Owner:
i Ke- f4om(s
�J
Mailing Address: ,5ZY-0W A SEE, SrJ4M t W,
Telephone:
Applicant's
lm)
Title (owner, manager, architect, etc.):_) w%1C-i'S
Mailing Address: % �Srow li S?-, 03 0-79
Telephone: ("3 -' �� B --Z2 L
http://www.cfsan.fda.gov/—dms/prev- l .html
11/8/2006
FDA/CFP: Food Establishment Plan Review Guide - Sections I
I have submitted plans/applications to the following authorities on the following dates:
Governing Board of Council
Plumbing
Zoning
Electric
Planning
Police
Building
Fire
Conservation
Other ( )
Hours of Operation: Sun Thurs
ro (,� Mon Fri
Tues Sat
Wed
Number of Seats:j�
Number of Staff: J�
(Maximum per shift)
Total Square Feet of Facility:
Number of Floors on which
operations are conducted_
Maximum Meals to be Served: Breakfast
(approximate number) Lunch -,2n�
Dinner
Projected Date for Start of Project:
Projected Date for Completion of Project:
Type of Service:
(check all that apply)
Sit Down Meals
Take Out
Caterer
Mobile Vendor
Other
Please 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
Page 2 of 19 '
r
Site plan showing location of business in building; location of building on site including alleys,
streets; and location of any outside equipment (dumpsters, well, septic system - if applicable)
http://www.cfsan.fda.gov/—dms/prev-l.html 11/8/2006
FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 3 of 19
4
Plan drawn to scale of food establishment showing location of equipment, plumbing, electrical
services and mechanical ventilation
Equipment schedule
CONTENTS AND FORMAT OF PLANS AND SPECIFICATIONS
1. Provide plans that are a minimum of 11 x 14 inches in size including the layout of the floor plan
accurately drawn to a minimum scale of 1/4 inch = 1 foot. This is to allow for ease in reading plans.
2. 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 be clearly labeled on the plan with its common name. Submit drawings of self-service
hot and cold holding units with sneeze guards.
4. Designate clearly on the plan equipment for adequate rapid cooling, including ice baths and
refrigeration, and for hot -holding potentially hazardous foods.
5. Label and locate separate food preparation sinks when the menu dictates to preclude contamination
and cross -contamination of raw and ready -to -eat foods.
6. Clearly designate adequate handwashing lavatories for each toilet fixture and in the immediate area of
food preparation.
7. Provide the room size, aisle space, space between and behind equipment and the placement of the
equipment on the floor plan.
8. On the plan represent auxiliary areas such as storage rooms, garbage rooms, toilets, basements and/or
cellars used for storage or food preparation. Show all features of these rooms as required by this
guidance manual.
9. 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;
littp://www.cfsan.fda.gov/—dms/prev- l .html 11/8/2006
FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 4 of 19
(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;
(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;
m. Completed Section 1;
n. Site plan (plot plan)
FOOD PREPARATION REVIEW
Check 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) (fl) ( )
http://www.cfsan.fda.gov/—dms/prev-1 .html 11/8/2006
FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 5 of 19
2. Thick meats, whole poultry (roast beef, whole turkey, chickens, hams)
3. Cold processed foods (salads, sandwiches, vegetables)
4. Hot processed foods (soups, stews, rice/noodles, gravy, chowders, casseroles) (Y) ( )
5. Bakery goods (pies, custards, cream fillings & toppings)
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
FOOD SUPPLIES:
1. Are all food supplies from inspected and approved sources YE / NO
2. What are the projected frequencies of deliveries for Frozen foods �rnpr�%h f
Refrigerated foods w P_ v_ C , and Dry goodsM 0y -)-i ?--,I
/
3. Provide information on the amount of space (in cubic feet) allocated for:
Dry storage ,
Refrigerated Storage , and
Frozen storage
4. How will dry goods be stored off the floor?
COLD STORAGE:
1. Is adequate and approved freezer and refrigeration available to store frozen foods frozen, and
refrigerated foods at 41'F (5°C) and below? YES / NO
Provide the method used to calculate cold storage requirements.
2. Will raw meats, poultry and seafood be stored in the same refrigerators and freezers with
cooked/ready-to-eat foods? YES / NO
If yes, how will cross -contamination be prevented?
3. Does each refrigerator/freezer have a thermometer? YES / NO
Number of refrigeration units:
Number of freezer units:
4. Is there a bulk ice machine available? YES / NO
http://www.cfsan.fda.gov/—dms/prev-l.html
11/8/2006
FDA/CFP: Food Establishment Plan Review Guide - Sections I
THAWING FROZEN POTENTIALLY HAZARDOUS FOOD:
Page 6 of 19
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 70°F
(21 °C)
Microwave (as part of cooking
process)
Cooked from Frozen state
Other (describe)
*Frozen foods: approximately one inch or less = thin, and more than an inch = thick.
COOKING:
1. Will food product thermometers be used to measure final cooking/reheating temperatures of PHF's?
YES / NO
What type of temperature measuring device:
Minimum cooking time and temperatures of product utilizing convection and conduction heating
equipment:
beef roasts 130°F (121
min)
solid seafood pieces 145°F (15 sec)
other PHF's 145°F (15 sec)
eggs:
Immediate service 145°F (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)
http://www.cfsan.fda.gov/—dms/prev- l .html 11/8/2006
FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 7 of 19
2. List types of cooking equipment.
HOT/COLD HOLDING:
1. How will hot PHF's be maintained at 140°F (60°C) or above during holding for service? Indicate type
and number of hot holding units.
2. How will cold PHF's be maintained at 41 °F (5°C) or below during holding for service? Indicate type
and number of cold holding units.
COOLING:
Please indicate by checking the appropriate boxes how PHF's will be cooled to 41°F (5°C) within 6
hours (140°F to 70°F in 2 hours and 70°F to 41°F in 4 hours). Also, indicate where the cooling will take
place.
COOLING
METHOD
THICK
MEATS
THIN
MEATS
THIN
SOUPS/
GRAVY
THICK
SOUPS/
GRAVY
RICE/
NOODLES
Shallow Pans
Ice Baths
Reduce
Volume or
Size
Rapid Chill
http://www.cfsan.fda.gov/—dms/prev-1 .html 11/8/2006
FDA/CFP: Food Establishment Plan Review Guide - Sections I
Other
(describe)
REHEATING:
Page 8 of 19
1. How will PHF's that are cooked, cooled, and reheated for hot holding be reheated so that all parts of
the food reach a temperature of at least 165°F for 15 seconds. Indicate type and number of units used for
reheating foods.
2. How will reheating food to 165°F for hot holding be done rapidly and within 2 hours?
PREPARATION:
1. Please list categories of foods prepared more than 12 hours in advance of service.
2. Will food employees be trained in good food sanitation practices? YES / NO
Method of training:
Number(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 foods? YES / NO
4. Is there a written policy to exclude or restrict food workers who are sick or have infected cuts and
lesions? YES / NO
Please describe briefly:
http://www.cfsan.fda.gov/—dms/prev-1.html 11/8/2006
FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 9 of 19
Will employees have paid sick leave? YES / NO
5. How will cooking equipment, cutting boards, counter tops and other food contact surfaces which
cannot be submerged in sinks or put through a dishwasher be sanitized?
Chemical Type:
Concentration:
Test Kit: YES / NO
6. Will ingredients for cold ready -to -eat foods such as tuna, mayonnaise and eggs for salads and
sandwiches be pre -chilled before being mixed and/or assembled? YES/NO
If not, how will ready -to -eat foods be cooled to 41 °F?
7. Will all produce be washed on-site prior to use? YES / NO
Is there a planned location used for washing produce? YES / NO
Describe
If not, describe the procedure for cleaning and sanitizing multiple use sinks between uses.
8. Describe the procedure used for minimizing the length of time PHF's will be kept in the temperature
danger zone (41'F - 140°F) during preparation.
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FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 10 of 19 f
9. Provide a HACCP plan for specialized processing methods such as vacuum packaged food items
prepared on-site or otherwise required by the regulatory authority.
10. Will the facility be serving food to a highly susceptible population? YES /NO
If yes, how will the temperature of foods be maintained while being transferred between the kitchen and
service area?
A. FINISH SCHEDULE
Applicant must indicate which materials (quarry tile, stainless steel, 4" plastic coved molding, etc.) will
be used in the following areas.
Kitchen
FLOOR
COVING
WALLS
CEILING
Bar
Food Storage
Other Storage
Toilet Rooms
Dressing Rooms
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V
FDA/CFP: Food Establishment Plan Review Guide - Sections I
Page 11 of 19
Garbage &
Refuse Storage
Mop Service
Basin Area
Warewashing
Area
Walk-in
Refrigerators
and Freezers
B. INSECT AND RODENT CONTROL
APPLICANT: Please check appropriate boxes.
YES NO NA
1. Will all outside doors be self-closing and rodent proof ? () () ( )
2. Are screen doors provided on all entrances left open to the outside? () () ( )
3. Do all openable windows have a minimum #16 mesh screening? () () ( )
4. Is the placement of electrocution devices identified on the plan? () () ( )
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 () () ( )
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?
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FDA/CFP: Food Establishment Plan Review Guide - Sections I
Outside
11. Will a dumpster be used?
Number Size
Frequency of pickup
Contractor
12. Will a compactor be used?
Number Size
Page 12 of 19
Frequency of pick up
Contractor
13. Will garbage cans be stored outside? O O ( )
14. Describe surface and location where dumpster/compactor/garbage cans are to be stored
15. Describe location of grease storage receptacle
16. Is there an area to store recycled containers? () () ( )
Indicate what materials are required to be recycled;
( ) Glass
( ) Metal
( ) Paper
( ) Cardboard
( ) Plastic
17. Is there any area to store returnable damaged goods? () () ( )
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FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 13 of 19
D. PLUMBING CONNECTIONS
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AIR
AIR
*INTEGRAL
*"P"
VACUUM
CONDENSATE
GAP
BREAK
TRAP
TRAP
BREAKER
PUMP
18. Toilet
19. Urinals
20. Dishwasher
21. Garbage
Grinder
22. Ice machines
23. Ice storage
bin
24. Sinks
a. Mop
b. Janitor
c. Handwash
d.
3 Compartment
e. 2
Compartment
f. 1
Compartment
g. Water Station
25. Steam tables
26. Dipper wells
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FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 14 of 19
* TRAP: A fitting or device which provides a liquid seal to prevent the emission of sewer gases without
materially affecting the flow of sewage or waste water through it. An integral trap is one that is built
directly into the 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.? Full ?S? traps are prohibited.
32. Are floor drains provided & easily cleanable, if so, indicate location:
E. WATER SUPPLY
33. Is water supply public ( ) or private ( ) ?
34. If private, has source been approved? YES ( ) NO ( ) PENDING ( )
Please attach copy of written approval and/or permit.
35. Is ice made on premises ( ) or purchased commercially ( ) ?
If made on premise, are specifications for the ice machine provided? YES ( ) NO ( )
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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
materially affecting the flow of sewage or waste water through it. An integral trap is one that is built
directly into the 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.? Full ?S? traps are prohibited.
32. Are floor drains provided & easily cleanable, if so, indicate location:
E. WATER SUPPLY
33. Is water supply public ( ) or private ( ) ?
34. If private, has source been approved? YES ( ) NO ( ) PENDING ( )
Please attach copy of written approval and/or permit.
35. Is ice made on premises ( ) or purchased commercially ( ) ?
If made on premise, are specifications for the ice machine provided? YES ( ) NO ( )
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Describe provision for ice scoop storage:
Provide location of ice maker or bagging operation
36. What is the capacity of the hot water generator?
37. Is the hot water generator sufficient for the needs of the establishment? Provide calculations for
necessary hot water (see Part 5 & Part 9 Under Section III in this manual)
38. Is there a water treatment device? YES ( ) NO ( )
If yes, how will the device be inspected & serviced?
39. How are backflow prevention devices inspected & serviced?
F. SEWAGE DISPOSAL
40. Is building connected to a municipal sewer? YES ( ) NO ( )
41. If no, is private disposal system approved? YES ( ) NO ( ) PENDING ( )
Please attach copy of written approval and/or permit.
42. Are grease traps provided? YES ( ) NO (/
If so, where?
Provide schedule for cleaning & maintenance
G. DRESSING ROOMS
43. Are dressing rooms provided? YES ( ) NO (�
44. Describe storage facilities for employees' personal belongings (i.e., purse, coats, boots,
umbrellas,etc.)
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FDA/CFP: Food Establishment Plan Review Guide - Sections I
H.GENERAL
45. Are insecticides/rodenticides stored separately from cleaning & sanitizing agents?
YES( )NO( )
Indicate location:
Page 16 of 19
46. Are all toxics for use on the premise or for retail sale (this includes personal medications), stored
away from food preparation and storage areas? YES ( ) NO ( )
47. Are all containers of toxics including sanitizing spray bottles clearly labeled?
YES( )NO( )
48. Will linens be laundered on site? YES( )NO(
)
If yes, what will be laundered and where?
If no, how will linens be cleaned?
49. Is a laundry dryer available? YES( )NO(
)
50. Location of clean linen storage:
51. Location of dirty linen storage:
52. Are containers constructed of safe materials to store bulk food products? YES ( ) NO ( )
Indicate type:
53. Indicate all areas where exhaust hoods are installed:
LOCATION
FILTERS
SQUARE
FIRE
AIR
AIR
&/OR
FEET
PROTECTION
CAPACITY
MAKEUP
EXTRACTION
CFM
CFM
DEVICES
I
i -i
i - - i
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FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 17 of 19
54. How is each listed ventilation hood system cleaned?
I. SINKS
55. Is a mop sink present? YES ( ) NO ( )
If no, please describe facility for cleaning of mops and other equipment:
56. If the menu dictates, is a food preparation sink present? YES ( ) NO ( )
J. DISHWASHING FACILITIES
57. Will sinks or a dishwasher be used for warewashing?
Dishwasher( )
Two compartment sink ( )
Three compartment sink ( )
58. Dishwasher
Type of sanitization used:
Hot water (temp. provided)
Booster heater
Chemical type
Is ventilation provided? YES ( ) NO ( )
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FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 18 of 19
59. Do all dish machines have templates with operating instructions? YES ( ) NO ( )
60. Do all dish machines have temperature/pressure gauges as required that are accurately working?
YES( )NO( )
61. Does the largest pot and pan fit into each compartment of the pot sink? YES( )NO( )
If no, what is the procedure for manual cleaning and sanitizing?
62. Are there drain boards on both ends of the pot sink?
YES( )NO( )
63. What type of sanitizer is used?
Chlorine ( )
Iodine ( )
Quaternary ammonium ( )
Hot Water ( )
Other ( )
64. Are test papers and/or kits available for checking sanitizer concentration? YES ( ) NO ( )
K. HANDWASHING/TOILET FACILITIES
65. Is there a handwashing sink in each food preparation and warewashing area? YES ( ) NO ( )
66. Do all handwashing sinks, including those in the restrooms, have a mixing valve or combination
faucet? YES ( ) NO ( )
67. Do self-closing metering faucets provide a flow of water for at least 15 seconds without the need to
reactivate the faucet? YES ( ) NO ( )
68. Is hand cleanser available at all handwashing sinks? YES ( ) NO ( )
69. Are hand drying facilities (paper towels, air blowers, etc.) available at all handwashing sinks? YES
()NO()
70. Are covered waste receptacles available in each restroom? YES ( ) NO ( )
71. Is hot and cold running water under pressure available at each handwashing sink? YES ( ) NO ( )
72. Are all toilet room doors self-closing? YES ( ) NO ( )
73. Are all toilet rooms equipped with adequate ventilation? YES ( ) NO ( )
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FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 19 of 19
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
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 final approval.
Signature(s)
owner(s) or responsible representative(s)
Date:
Approval of these plans and specifications by this 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 (structure
or equipment). A preopening inspection of the establishment with equipment in place &
operational will be necessary to determine if it complies with the local and state laws governing
food service establishments.
Home I Plan Review: Table of Contents
Hypertext updated by dms/ces 2000 -MAR -30
http://www.cfsan.fda.gov/—dms/prev-1.html 11/8/2006
Of O pTH
°6 �O
O
y� ;L
'Q_ GOC.YCMMKK ,,'
PUBLIC HEALTH DEPARTMENT
Community Development Division
Att. C/o Nick Ippolito, Maint. Dir,
St. Michael's School
80 Maple Ave.
No. Andover, MA 01845
July 12, 2007
Re: Plan review "St. Michael's School kitchen"
Dear Mr.Ippolito,
TOM
The Health Department has received your application submitted on July 9, 2007 for a remodel of
the kitchen at the St. Michael's School. This plan has been approved. The Building Department
will receive a copy of this approval letter. The following detail is the process going forward.
Once basic construction is complete and the equipment is in place, please contact the health
office for a construction inspection to verify that you have built it to plan. At that time we will
sign off the building permit. The final health inspection should be requested approximately 24-
48 hours prior to opening the establishment. At the final inspection, it is expected that the
premises will be ready for business..
Some items needed to receive the permit to operate are:
1) The establishment will be clean of all construction materials
2) The handsink and bathroom will be stocked with a wall mounted paper towel and soap
dispensers
3) The ladies room will have a covered trash can for feminine item disposal
4) Bathroom must have "employee must wash hands before returning to work" signage
5) Handsinks should be labeled "hand wash only"
6) There must be test strips for the Chlorine sanitizer on site
7) Directions on mixing the sanitizer should be posted.
8) The three -bay should be labeled "wash, rinse, sanitize"
9) Gloves must be on site. Please note that the state does not recommend the use of latex
gloves due to some person's sensitivity to latex that may cause them illness.
10) You must obtain copies of the state and federal food codes and keep them on premises
11) At minimum, employees should be trained on the sick policy and sanitation basics.
1600 Osgood Street, North Andover, Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com
M
Please contact this office if you have any questions. We look forward to continue working with
you through this remodel of your kitchen. Thank you for your cooperation.
Sincer
U Sawyer S
Public Health Director
Cc: Michele Grant, Health Inspector
North Andover Building Dept.
1600 Osgood Street, North Andover, Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com
FDA/CFP: Food Establishment Plan Review Guide - Sections I
0
Page 1 of 19
Food and Drug Administration and Conference for Food Protection
GUIDE
2000
SECTION I
FOOD ESTABLISHMENT PLAN REVIEW APPLICATION
TO BE COMPLETED BY THE OPERATOR AND
SUBMITTED TO THE REGULATORY AUTHORITY
Date: /
Regulatory A
hority
JUL 0 9 aw
.2"00(-
TOWN
2.'od(TOWN OF NtD ANDD'
HEALTH ���t ._.
FOOD ESTABLISHMENT PLAN REVIEW APPLICATION
NEW ' i/ REMODEL CONVERSION
Name of Establishment: -,-Tr m6 C". A fi C-1 - 'Sc A 0 -o -p
Category: Restaurant , Institution Daycare , Retail Market ,
Other
Address: �� /�/1 /} P 14 tic NO Iq JU L) C) L/1.
Phone if available: q79— 6 06:.— /962,
Name of Owner: I1 A—t'. h
Mailing Address: _ / d
Telephone: 617— 25-c/-0/00
Applicant's Name:
v
Title (owner, manager, architect, etc.):
Mailing Address: /9L A�lfi r &0. lqeV l�e 07x---
Telephone:
7/yTelephone: q77— �Y(;—
DM .
7
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FDA/CFP: Food Establishment Plan Review Guide - Sections, I
b
i
I have submitted plans/applications to the following authorities on the following dates:
Governing Board of Council
Plumbing
Zoning
Electric
Planning
Police
Building
Fire
Conservation
Other ( )
Hours of Operation: Sun Thurs
Mon Fri
Tues Sat
Wed
Number of Seats:
Number of Staff:
(Maximum per shift)
Total Square Feet of Facility:
Number of Floors on which
operations are conducted
Maximum Meals to be Served: Breakfast
(approximate number) Lunch
Dinner
Projected Date for Start of Project: z v7
Projected Date for Completion of Project: 2 s U
Type of Service: Sit Down Meals
(check all that apply) Take Out
Caterer
Mobile Vendor
Other
Please 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
Page 2 of 19 '
' l
Site plan showing location of business in building; location of building on site including alleys,
streets; and location of any outside equipment (dumpsters, well, septic system - if applicable)
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FDA/CEP: Food Establishment Plan Review Guide - Sections I Page 3 of 19
Plan drawn to scale of food establishment showing location of equipment, plumbing, electrical
services and mechanical ventilation
Equipment schedule
CONTENTS AND FORMAT OF PLANS AND SPECIFICATIONS
1. Provide plans that are a minimum of 11 x 14 inches in size including the layout of the floor plan
accurately drawn to a minimum scale of 1/4 inch = 1 foot. This is to allow for ease in reading plans.
2. 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 be clearly labeled on the plan with its common name. Submit drawings of self-service
hot and cold holding units with sneeze guards.
4. Designate clearly on the plan equipment for adequate rapid cooling, including ice baths and
refrigeration, and for hot -holding potentially hazardous foods.
5. Label and locate separate food preparation sinks when the menu dictates to preclude contamination
and cross -contamination of raw and ready -to -eat foods.
6. Clearly designate adequate handwashing lavatories for each toilet fixture and in the immediate area of
food preparation.
7. Provide the room size, aisle space, space between and behind equipment and the placement of the
equipment on the floor plan.
8. On the plan represent auxiliary areas such as storage rooms, garbage rooms, toilets, basements and/or
cellars used for storage or food preparation. Show all features of these rooms as required by this
guidance manual.
9. 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;
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FDA/CFP: Food Establishment Plan Review Guide - Sections I I Page 4 of 19
(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;
(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;
m. Completed Section 1;
n. Site plan (plot plan)
FOOD PREPARATION REVIEW
Check categories of Potentially Hazardous Foods (PHF's) to be handled, prepared and served.
CATEGORY*
1. Thin meats, p ultr , fish, gs amb ,�slicedDillets)
(YES) (NO)
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FDA/CFP: Food Establishment Plan Review Guide - Sections I
Page 5 of 19
2. Thick meats, whole poultry (roast beef, whole turkey, chickens, hams) ( ) (✓�
3. Cold processed foods (salads, sandwiches, vegetables)
4. Hot processed foods sou to ice nood ra howders, casseroles)
5. Bakery goods (pies, custards, cream i ings &toppings)
6. Other 1�> tJ N 7) i iV 0
* A generic HACCP plan for each category of food may be available from the regulatory
authority for reference.
PLEASE CIRCLE/ANSWER THE FOLLOWING QUESTIONS
FOOD SUPPLIES:
1. Are all food supplies from inspected and approved sources?o / NO
2. What are the projected frequencies of deliveries for Frozen foods A40A.17-11 (,Y
Refrigerated foods w A /!f , and Dry goods
3. Provide information on the amount of space (in cubic feet) allocated for:
Dry storage ,
Refrigerated Storage , and
Frozen storage
4. How will dry goods be stored off the floor? OP RACK5
COLD STORAGE:
1. Is adequate and approved freezer and refrigeration available to store frozen foods frozen, and
refrigerated foods at 41 °F (5°C) and below? <�O
Provide the method used to calculate cold storage requirements.
2. Will raw meats,oult and seafood be stored in the same refrigerators and freezers with
cooked/ready-to-ea nods? IO' NO
If yes, how will cross -contamination be prevented?
n4 t'3
At+ w e
L �y ti5 c= ��� v►� C �, � e l< L �y rc, c l
MMMMMa
3. Does each refrigerator/freezer have a thermometer?dty NO
Number of refrigeration units: _I
Number of freezer units: I
4. Is there a bulk ice machine available? YES / 10
� L l �&
obs IdlJ( rdt
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FDA/CFP: Food Establishment Plan Review Guide - Sections I .
THAWING FROZEN POTENTIALLY HAZARDOUS FOOD:
Page 6 of 19
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
solid seafood pieces
145°F (15 sec)
Running Water Less than 70°F
(21 °C)
145°F (15 sec)
eggs:
Microwave (as part of cooking
process)
Immediate service 145°F (15
Cooked from Frozen state
pooled* 155°F (15 sec)
Other (describe)
(*pasteurized eggs must be served to a highly
susceptible population)
*Frozen foods: approximately one inch or less = thin, and more than an inch = thick.
COOKING:
&ill food product thermometers be used to measure final cooking/reheating temperatures of PHF's?
/NO
What type of temperature measuring device: 7� C—/Lfn om G &X-6
Minimum cooking time and temperatures ofproduct utilizing convection and conduction heating
equipment:
beef roasts
130°F (121
min)
solid seafood pieces
145°F (15 sec)
other PHF's
145°F (15 sec)
eggs:
Immediate service 145°F (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)
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FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 7 of 19
2. List types of cooking equipment.
UA'Wc'�U 510 -
HOT/COLD HOLDING:
1. How will hot PHF's be maintained at 140°F (60°C) or above during holding for service? Indicate type
and number of hot holding units.
2. How will cold PHF's be maintained at 41°F (5°C) or below during holding for service? Indicate type
and number of cold holding units.
COOLING:
Please indicate by checking the appropriate boxes how PHF's will be cooled to 41'F (5°C) within 6
hours (140°F to 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
THIN
THICK
RICE/
METHOD
MEATS
MEATS
SOUPS/
SOUPS/
NOODLES
GRAVY
GRAVY
Shallow Pans�
/14L
"
�O�G
L% tit✓
�/
b
1504
�(
D
Ice Baths
Reduce
Volume or
Size
Rapid Chill
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FDA/CFP: Food Establishment Plan Review Guide - Sections I
Other
(describe)
REHEATING:
Page 8 of 19
1. How will PHF's that are cooked, cooled, and reheated for hot holding be reheated so that all parts of
the food reach a temperature of at least 165°F for 15 seconds. Indicate type and number of units used for
reheating foods.
u eV / J-
3
4
2. How will reheating food to 1657 for hot holding be done rapidly and within 2 hours? 0 6 &1 v � (I 0h)
9&� Fro o vc--
f AOM oyc-N f�? S' -Cly -F/4 ✓� C
'J') :50 U p 5 A_)�O 5rn,4
PREPARATION: C ►(,� e�v(�CLYI� GUS -�il� k4, 4-o 7o"
1. Please list categories of foods prepared more than 12 hours in advance of service.
2. Will food employees be trained in good food sanitation practices? / NO
Method of training:
Number(s) of employees: 3 Kxx) %�'Iyiu•�L'/N� t.1 rC_
Dates of completion:
3. Will disposab gloves and/or utensils and/or food grade paper be used to prevent handling of ready -
to -eat foods? / NO
4. Is there a writ�olicy to exclude or restrict food workers who are sick or have infected cuts and
lesions? YES / O
Please describe briefly:
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FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 9 of 19
Will employees have paid sick leave? YES NCS
5. How will cooking equipment, cutting boards, counter tops and other food contact surfaces which
cannot be submerged in sinks or put through a dishwasher be sanitized?
Chemical Type:
Concentration:
Test Kit:ES NO
6. Will ingredients for cold ready -to -eat foods such as tuna, mayo se and eggs for salads and
sandwiches be pre -chilled before being mixed and/or assembled?QLFF /NO
If not, how will ready -to -eat foods be cooled to 41'F?
/y.
7. Will all produce be washed on-site prior to use? 16/ NO
Is there a planned location used for washing produce? ES NO
Describe (�= s SLk
If not, describe the procedure for cleaning and sanitizing multiple use sinks between uses.
8. Describe the procedure used for minimizing the length of time PHF's will be kept in the temperature
danger zone (41°F - 140°F) during preparation. `volt
y 71S�G- IJ /-6�—/eco AAnon r�
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FDA/CFP: Food Establishment Plan Review Guide - Sections I,
Page 10 of 19
9. Provide a HACCP plan for specialized processing methods such as vacuum packaged food items
prepared on-site or otherwise required by the regulatory authority.
10. Will the facility be serving food to a highly susceptible population? YES / JCL Fje/j
If yes, how will the temperature of foods be maintained while being transferred between the kitchen and
service area?
A. FINISH SCHEDULE
Applicant must indicate which materials (quarry tile, stainless steel, 4" plastic coved molding, etc.) will
be used in the following areas.
Kitchen
FLOOR
COVING
WALLS
CEILING
—Bar-
BarFood
FoodStorage
/' ,
LV(/
Other Storage
Toilet Rooms
Dressing Rooms
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FDA/CFP: Food Establishment Plan Review Guide - Sections I
Page 11 of 19
Garbage &
Refuse Storage
Mop Service
Basin Area
Warewashing
L��f�
/�,,��
�-p
V F C C
Area
(�
�► VL
Walk-in/
Refrigerators
and Freezers
B. INSECT AND RODENT CONTROL
APPLICANT: Please check appropriate boxes.
YES NO NA
1. Will all outside doors be self-closing and rodent proof ?
2. Are screen doors provided on all entrances left open to the outside?
3. Do all openable windows have a minimum 416 mesh screening?
4. Is the placement of electrocution devices identified on the plan? () () ( )
5. Will all pipes & electrical conduit chases be sealed; ventilation systems exhaust and (tom () ( )
intakes protected?
6. Is area around building clear of unnecessary brush, litter, boxes and other ( () ( )
harborage?
7. Will air curtains be used? If yes, where? () () (0-"-
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? ( ) (� )
http://www.cfsan.fda.gov/-dms/prev- l .html 11/8/2006
FDA/CFP: Food Establishment Plan Review Guide - Sections I,
Outside
11. Will a dumpster be used?
Number Size 'e-4 P
Frequency of pickup 1V&&1<
Contractor/�) �1 `4 ! b L C i�'�
12. Will a compactor be used?
Number Size
Page 12 of 19
("I' O O
Frequency of pick up
Contractor
13. Will garbage cans be stored outside? () ( )
14. Describe surface and location where dumpster/compactor/garbage cans are to be stored
-/,9-r �o,b
15. Describe location of grease storage receptacle P/A
16. Is there an area to store recycled containers?
Indicate what materials are required to be recycled;
( ) Glass
( ) Metal
( ) Paper
( ) Cardboard
( ) Plastic
17. Is there any area to store returnable damaged goods?
O (V�,O
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FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 13 of 19
D. PLUMBING CONNECTIONS
http://www.cfsan.fda.gov/—dms/prev-1 .html 11/8/2006
AIR
AIR
*INTEGRAL
*"P"
VACUUM
CONDENSATE
GAP
BREAK
TRAP
TRAP
BREAKER
PUMP
18. Toilet
1'
19. Urinals
20. Dishwasher
/q/A
21. Garbage
/
I/
Grinder
22. Ice machines
A
23. Ice storage
bin IU/A
24. Sinks
a. Mop
b.4anitor
c. Handwash
d.
3 Compartment
e.2
Compartment
V
E1
Compartment
g. Water Station
25. Steam tables
26. Dipper wells
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FDA/CFP: Food Establishment Plan Review Guide - Sections 1,
Page 14 of 19
* TRAP: A fitting or device which provides a liquid seal to prevent the emission of sewer gases without
materially affecting the flow of sewage or waste water through it. An integral trap is one that is built
directly into the 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.? Full ?S? traps are prohibited.
32. Are floor drains provided & easily cleanable, if so, indicate location:
F /d6)9-1
E. WATER SUPPLY
33. Is water supply public (/®r private ( ) ?
34. If private, has source been approved? YES ( ) NO ( ) PENDING ( )
Please attach copy of written approval and/or permit.
35. Is ice made on premises ( ) or purchased commercially ( ) ? NIPS
If made on premise, are specifications for the ice machine provided? YES ( ) NO ( )
http://www.cfsan.fda.gov/—dms/prev-1.html 11/8/2006
27.
Refrigeration
condensate/
drain lines
28. Hose
connection
29. Potato
peele �/ /A-
30. Beverage
Dispenser V
w/carbonato
31. Other
* TRAP: A fitting or device which provides a liquid seal to prevent the emission of sewer gases without
materially affecting the flow of sewage or waste water through it. An integral trap is one that is built
directly into the 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.? Full ?S? traps are prohibited.
32. Are floor drains provided & easily cleanable, if so, indicate location:
F /d6)9-1
E. WATER SUPPLY
33. Is water supply public (/®r private ( ) ?
34. If private, has source been approved? YES ( ) NO ( ) PENDING ( )
Please attach copy of written approval and/or permit.
35. Is ice made on premises ( ) or purchased commercially ( ) ? NIPS
If made on premise, are specifications for the ice machine provided? YES ( ) NO ( )
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FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 15 of 19
Describe provision for ice scoop storage: N A
Provide location of ice maker or bagging operation N
36. What is the capacity of the hot water generator?
37. Is the hot water generator sufficient for the needs of the establishment? Provide calculations for
necessary hot water (see Part 5 & Part 9 Under Section III in this manual)
38. Is there a water treatment device? YES ( ) NO (,c�
If yes, how will the device be inspected & serviced?
39. How are backflow prevention devices inspected & serviced?
AJ
F. SEWAGE DISPOSAL
40. Is building connected to a municipal sewer? YES ('40 ( )
41. If no, is private disposal system approved? YES ( ) NO ( ) PENDING ( )
Please attach copy of written approval and/or permit.
42. Are grease traps provided? YES ( ) NO (\
If so, where?
Provide schedule for cleaning & maintenance
G. DRESSING ROOMS
43. Are dressing rooms provided? YES ( ) NO (-11�
44. Describe storage facilities for employees' personal belongings (i.e., purse, coats, boots,
umbrellas,etc.)
A//4
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FDA/CFP: Food Establishment Plan Review Guide - Sections I. Page 16 of 19
H. GENERAL
45. Are insecticides/rodenticides stored separately from cleaning & sanitizing agents? P1,A
YES( )NO( )
Indicate location: ✓ld itJO
46. Are all toxics for use on the premise or for retail sale (this includes personal medications), stored
away from food preparation and storage areas? YES ( ) NO ( )
47. Are all containers of toxics including sanitizing spray bottles clearly labeled?
YES(,�'NO ( )
48. Will linens be laundered on site? YES ( ) NO ( ) /VIS'
If yes, what will be laundered and where?
If no, how will linens be cleaned?
49. Is a laundry dryer available? YES ( ) NO
50. Location of clean linen storage: xy
51. Location of dirty linen storage:
52. Are containers constructed of safe materials to store bulk food products? YES (—J'N O ( )
Indicate type:
-SGk1-1e4ii
53. Indicate all areas where exhaust hoods are installed:
LOCATION
FILTERS
SQUARE
FIRE
AIR
AIR
&/OR
FEET
PROTECTION
CAPACITY
MAKEUP
EXTRACTION
CFM
CFM
DEVICES
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FDA/CFP: Food Establishment P.tan Review Guide - Sections I Page 17 of 19
a ,
s
54. How is each listed ventilation hood system cleaned?
OvTs iDC Cony.
I. SINKS
55. Is a mop sink present? YES (o<NO ( )
If no, please describe facility for cleaning of mops and other equipment:
56. If the menu dictates, is a food preparation sink present? YES (�NO ( )
J. DISHWASHING FACILITIES
57. Will sinks or a dishwasher be used for warewashing?
Dishwasher( )
Two compartment sink ( )
Three compartment sink
58. Dishwasher N A-
Type of sanitization used:
Hot water (temp. provided)
Booster heater
Chemical type
Is ventilation provided? YES (V�N'O ( )
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FDA/CFP: Food Establishment Plan Review Guide - Sections 1, Page 18 of 19
59. Do all dish machines have templates with operating instructions? YES ( ) NO
60. Do all dish machines have temperature/pressure gauges as required that are accurately working?
YES( )NO( ) /VIA
61. Does the largest pot and pan fit into each compartment of the pot sink? YES (V�O ( )
If no, what is the procedure for manual cleaning and sanitizing?
62. Are there drain boards on both ends of the pot sink?
YES (,,�<O( )
63. What type of sanitizer is used?
Chlorine ( )
Iodine ( )
Quaternary ammonium ( )
Hot Water (�
Other ( )
64. Are test papers and/or kits available for checking sanitizer concentration? YES ( ) NO (-'�
K. HANDWASHING/TOILET FACILITIES
65. Is there a handwashing sink in each food preparation and warewashing area? YES (:XNO ( )
66. Do all handw shing sinks, including those in the restrooms, have a mixing valve or combination
faucet? YES (VfO ( )
67. Do self-closing metering f cets provide a flow of water for at least 15 seconds without the need to
reactivate the faucet? YES (J4NO ( )
68. Is hand cleanser available at all handwashing sinks? YES (,.�NO ( )
69. re hand drying facilities (paper towels, air blowers, etc.) available at all handwashing sinks? YES
( NO()
70. Are covered waste receptacles available in each restroom? YES (v�NO ( )
71. Is hot and cold running water under pressure available at each handwashing sink? YES (v�N`0 ( )
72. Are all toilet room doors self-closing? YES (v�N' 0 ( )
73. Are all toilet rooms equipped with adequate ventilation? YES (VNIO ( )
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FDA/CFP: Food Establishment Plan Review Guide - Sections I Page 19 of 19
s
74. If required, is a handwashing sign posted in each employee restroom? YES (V�'NO ( )
L. SMALL EQUIPMENT REQUIREMENTS
75. Please specify the number, location, and types of each of the following:
Slicers
Cutting boards
Can openers
Mixers /1 1A
Floor mats % /A.; rk'" D -
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 final approval,
Signature(s)
owner(s) or responsible representative(s)
Date: D7
Approval of these plans and specifications by this 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 (structure
or equipment). A preopening inspection of the establishment with equipment in place &
operational will be necessary to determine if it complies with the local and state laws governing
food service establishments.
Home I Plan Review: Table of Contents
Hypertext updated by dms/ces 2000 -MAR -30
http://www.cfsan.fda.gov/-dms/prev- l .html 11/8/2006
Y wtn bolt lqulpment group Model C x 16L z }Nye ¢ rhe}
it.3=x1&4?'L3ss''f.�.rr:,
Specifications:
■ Organizes can stock and
Type of
Unit
maximizes available space.
;Overall Dimensions
Self-feeding feature keeps
Width Len
stock rotated.
»=439
■ Vertical uprights and cross bracesY=
(mm) (!!!)
are constructed of 1Y2":; ..y
#10'- ._#5 (Ib)r :."(k9) .
aluminum tubing.
Stationary
■ Half size racks available th ._
25% 641 35
stainless steel, aluminum
1,803
poly -top work surfaces._.
=
■ Mobile units are easily mane vered
CR -162M 112512
on two 5" locking swivel and
None
two 5" rigid polyurethane
889 76
plate casters.
162 216 65 29
-7
CR -72M
EXPRES
Model '. Ordering.
Number .Number
Type of
Unit
Type of
T.op
;Overall Dimensions
Can Approx
Ime'ity Strip Weight
Width Len
h HeiqhC
»=439
(in) (mm) {in)',
(mm) (!!!)
:(mm)
#10'- ._#5 (Ib)r :."(k9) .
CR -162 112491
Stationary
None
25% 641 35
869 71
1,803
162 216 60 27
CR-162AJ 112504
Adjustable
CR -162M 112512
Mobile
Work
Station
Swivel
None
2714 699 35
889 76
1,930
162 216 65 29
CR -54M 112521
Aluminum
27Ye 699 35
889 35
889
47 21
54 72 65 29
61 28
CR-54PT 112547
Poly Top
CR-54SS 112555
Stainless
Steel
CR -72M 112563
Aluminum
2714 699 35
5" Polyurethane Whee
889 40
1,016
58 26
72 96 72 33
67 30
CR-72PT 112571
Poly Top
CR-72SS 112580
738A 128784
Stainless
Steel
Plate Caster with
743A 128792 Rigid Plate Caster with 5" Polyurethane Wheel
7112 122180 5" Polyurethane Wheel
0
v
��,..r9,�.:f��, ._ St iV1l�haels Sc�1oo1 '� � a � � � �.lA�ternatl�e,Sales ti. - i� k:..;y�,•r' ��z i„.� at `., � €� �. �,}' ...I, �pR�X&�-i .
Freight Class: 125
LABORATORY CERTIFICATION
AND APPROVAL
SYMBOLS:
$F
REDIBTERED
»=439
Oak Street • Garden City, NY 11530 • Tel: 1-800-444-3595 • Fax: 516-222-0371 s
'.-�.•.
vwvw.winholtcom • sales@winholtcom a
�1 Ar
NEW YORK TEXAS CALIFORNIA MICHIGAN
�fi"lty'!A�'�>EM'T 44�ititsl�
��,..r9,�.:f��, ._ St iV1l�haels Sc�1oo1 '� � a � � � �.lA�ternatl�e,Sales ti. - i� k:..;y�,•r' ��z i„.� at `., � €� �. �,}' ...I, �pR�X&�-i .
Advance Tab.Gv nVLvdel AG` 304 r r` t� {tem', t 7 -
G-tKt0 A)G
STAINLESS STEEL
WORK TABLES
ADVANCE TABCO.
SUPER SAVER Series - Flat Top - UNDERSHELF Style
BMART FABRICATION -
FEATURES:
Top is furnished with 1-5/8" sanitary rolled rim edges on front &
back and square side edges.
To reinforce and maintain a level working surface, 24" wide
tables are supplied with TWO hat channels and 30" and 36"
wide tables are supplied with THREE hat channels.
Pre-engineered welded angle adapters insure ease of future
drawer installation.
Aluminum die cast "leg -to -shelf' clamp secures shelf to leg
eliminating unsightly nuts & bolls. Undershelf is adjustable.
CONSTRUCTION:
All TIG welded. Exposed weld areas polished to match
adjacent surfaces.
Entire top mechanically polished to a satin finish.
Top is sound deadened.
Roll formed embossed galvanized hat channels are secured to
top by means of structural adhesive and weld studs..
Gussets welded to support hat sections.
SAG -Series:
Stainless Steel Legs & Undershelf
Item #: Qty #:
Model #:
Project #:
NEW Featuring as Standard:
Rolled Rim Edges on "TM PROVEN"
Front & Back and ORIGINAL ADVANCE TABCO
Square Side Edges Adjustable Undershelf
with Die Cast Leg Champ
MATERIAL:
SAG -SERIES: Stainless Steel Legs & Undershelf
TOP: 16 gauge stainless steel type "430" series.
SHELF. 18 gauge stainless steel.
LEGS: 1 5/8" diameter tubular stainless steel.
1" adjustable stainless steel bullet feet.
Stainless steel gussets.
AG -SERIES: Galvanized Legs & Undershelf
TOP: 16 gauge stainless steel type "430" series.
SHELF: 18 gauge galvanized steel.
LEGS: 1 5/8" diameter tubular galvanized steel.
1" adjustable plastic bullet feet.
Galvanized steel gussets.
AG -Series:
Galvanized Steel Legs & Undershelf
r Create Your Own Efficient Workstation with the Available Standard
NEW YORK GEORGIA TEXAS NEVADA
dms (800) 645-3166 (800) 832-1218 (800) 527-0353 (800) 446-8684
'`" = Mk Fax: (631) 242-6900 Fax: (770) 775-5625 Fax: (972) 932-4795 Fax: (775) 972-1578
ADVANCE TABCID.
For Assistance with 1-800-498-6634 Fax: 631-586-2933
www.advaricelabw.com _
H-4
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30"
SAG -240
SAG -300
30"
AG -240
AG -300
24"
SAG -242
SAG -302
24"
AG -242
AG -302
36"
SAG -243
SAG -303
SAG -363
36"
AG -243
AG -303
AG -363
48"
SAG -244
SAG -304
SAG -364
Q.
AG -244
AG -304
AG -364
60"
SAG -245
SAG -305
SAG -365
60"
AG -245
AG -305
AG -365
72"
SAG -246
SAG -306
SAG -366
72"
AG -246
AG -306
AG -366
84"
SAG -247
SAG -307
SAG -367
®
84"
AG -247
AG -307
AG -367
96"
SAG -248
SAG -308
SAG -368
96"
AG -248
AG -308
AG -368
108"
SAG -249
SAG -309
SAG -369
108"
AG -249
AG -309
AG -369
120"
SAG -2410
SAG -3010
SAG -3610
120"
AG -2410
AG -3010
AG -3610
132"
SAG -2411
SAG -3011
SAG -3611
132"
AG -2411
AG -3011
AG -3611
144"
SAG -2412
SAG -3012
SAG -3612
144"
AG -2412
AG -3012
AG -3612
r Create Your Own Efficient Workstation with the Available Standard
NEW YORK GEORGIA TEXAS NEVADA
dms (800) 645-3166 (800) 832-1218 (800) 527-0353 (800) 446-8684
'`" = Mk Fax: (631) 242-6900 Fax: (770) 775-5625 Fax: (972) 932-4795 Fax: (775) 972-1578
ADVANCE TABCID.
For Assistance with 1-800-498-6634 Fax: 631-586-2933
www.advaricelabw.com _
H-4
�. Ga � X� b �2 :''•S - ?. ;- e � - � t - iy i'�f 4`'�,'�ty �`,�-`r�'Na ;1- 4'4+r1� ,r;,,{P'«E+t.-. '�Wc� Y AI^tx � x i ,rric i 'x ,� f'3� _ .�pf ^ . tr.
RECOMMENDED
INSTALLATION
PRE -RINSE ASSEMBLY
(Optional Accessory)
BREAKER
!`
f
8 15' Sink Bowlsl
Sink Bowls /
ELECTRICAL
MODEL SS -100
„. wat.,4.f
X
Y
Z
12-14 N.P.T.
WATER INLET
I
6'/i
�— 6'/.'
VALVE OID i =—�- I ve
COLO WATER i
SUPPLY i
i
WATER 7
SHUTOFF VALVE EXTERNAL ELECTRICAL
(Not Supplied) CONNECTIONS
INCOMING
ELECTRICAL IMPORTANT Use dimension chart below for adaptor height In
POWER
place of ISE bowl sink height when mounting directly to a sink.
BOWL
SINKS
WATER
Y
Z
HEIGHT
12”
NOZZLE
12'/4"
12"
61/2"
15"
INLET
151/4"
15"
61/2"
18"
/1far 12'
181/4"
18"
61/2"
21or 1B'
X
Y
Z
HEIGHT
No. 5
Fits Standard Sink
Opening — 31/2" — 4"
23/a „
CONTROLS
713/16"
67/6"
(StarUstop Switch)
13/16"
No. 7
91/8"
t
i
DIMENSIONS
75/8"
X — Flange O.D.
Y — Diameter of Work Table Hole
Z — Flange I.D.
MODEL SS -100
„. wat.,4.f
X
Y
Z
12-14 N.P.T.
WATER INLET
I
6'/i
�— 6'/.'
VALVE OID i =—�- I ve
COLO WATER i
SUPPLY i
i
WATER 7
SHUTOFF VALVE EXTERNAL ELECTRICAL
(Not Supplied) CONNECTIONS
INCOMING
ELECTRICAL IMPORTANT Use dimension chart below for adaptor height In
POWER
place of ISE bowl sink height when mounting directly to a sink.
BOWL
SINKS
X
Y
Z
HEIGHT
12”
131/2"
12'/4"
12"
61/2"
15"
161/2"
151/4"
15"
61/2"
18"
191/2"
181/4"
18"
61/2"
ADAPTORS
X
Y
Z
HEIGHT
No. 5
Fits Standard Sink
Opening — 31/2" — 4"
23/a „
No. 6
713/16"
67/6"
65/8"
13/16"
No. 7
91/8"
77/6"
75/8"
21/16"
1 H.P. COMMERCIAL DISPOSER
SAMPLE SPECIFICATION
ITEM NO. DISPOSER
Quantity: One required (1)
Manufacturer: InSinkErator Division,
Commercial Racine, WI
Model: SS-100-15B/CC101
Electrical Requirements: volts/
phase
Install
NOTE:
• Adaptors are available upon request for all competitor sink bowls or cones.
• Please have sink bowl/cone type with the necessary dimensions when ordering adaptors.
, Item
.iy,-v � .""+ti .Y S :s?. S ,:: R 4� s#. i l..q;•'k'C '?7 �r ,'�•Y di'-�;r Fr'�'2fg.;sa 1"'��. i �,}."G"'�'�': .�y. v �j'`�? i �. a:f'� 'fir' titin,
inSlnkErator} h>s�>
= 3viodlri SS i 00 4� It�t1r1#��i4� �f� i
_,.
- _.... ,..- ,..._: .,,. _.u,l_,.•..Y ..Lax! ._.�.._..,. ._ .. h.. �_.'�: ._� ...,b�.L_�..-i_.ds7�'-i>oeL. xd'?.-w i:.:�°. �1. t ..,,i� �
PROJECT -
ITEM NO.:
1 H.P. heavy duty disposer is designed for continuous operation in 1 H.P. MODEL S 00
In eTBtor restaurants, hotels, hospitals and cafeterias. Food waste including
roiicseavlce steak bones is quickly and efficiently removed with this labor-saving
self-cleaning, environmentally sound disposer.
SPECIFICATIONS
GRIND CHAMBER - Corrosion Resistant Stainless Steel
MOUNTING - 3/4" rubber mounting above grinding chamber isolates
sound and eliminates vibration. Mounting is enclosed in
chrome plated covers for sanitation and appearance.
MOTOR - 1 HP Induction Motor, 1725 RPM's, totally enclosed to
provide protection against outside moisture. Controlled
power air flow cools motor for efficiency and longer life.
Built-in thermal overload protection.
CUTTING ELEMENTS - Stationary and rotating shredding elements made from
cast nickel chrome alloy for long life and corrosion
resistance, designed for reverse action grinding.
MAIN BEARINGS - Double -tapered Timken roller bearings provide a shock
absorbing cushion.
MOTOR SEALS - Triple lip seal protects motor from water damage.
Secondary spring-loaded oil seal provides double
protection against water and loss of grease.
FINISH - All Stainless Steel and Chrome plated. Paint -free for
lasting sanitation.
WARRANTY- 1 year full warranty from date of installation.
BASE DISPOSER/ELECTRICAL REQUIREMENTS
115 volts, 1 phase, 11.6 amps ❑ 208 volts, 3 phase, 2.2 amps
❑ 208 volts, 1 phase, 5.1 amps ❑ 230 volts, 3 phase, 3.0 amps
❑ 230 volts, 1 phase, 5.7 amps ❑ 460 volts, 3 phase, 1.5 amps
NOTE: All amp ratings denote the amp draw during a grind load.
DISPOSMOUNTING ASSEMBLIES
.. ❑ #5 Sink Flange Mounting 6 Collar Adapter for ❑ #7 Collar Adapter for welding
Assemblies for 31/2" - 4" sink welding into trough, into sink, provides 65/e"
opening provides 65rs" opening, opening, includes splash baffle
'Support legs are recommended for includes splash baffle ` and stopper
this unit when using #5 mounting
Select Sink Bowl Assembly Size
❑ 12" with one adjustable water nozzle
❑ Type A Sink Bowl ❑ Type B Sink ❑ Type C Sink ❑ 15" with one adjustable water nozzle
Assembly` Bowl Assembly" Bowl Assembly` ❑ 18" with two adjustable water nozzles
'If using Type A, B, or C, you must specify either a 12", 15' or 18" sink bowl.
ELECTRICAL CONTROLS
❑ Manual Manual ❑ CC -202 ElCC-101 E]AS-101
t Switch Reverse Control Control Control
(Single Switch Center Center Center
Direction) (Dual (Auto- (Auto- "Aqua Saver"
Direction) Reversing) Reversing)r (Auto-
s is Reversing)
WATER CONTROLS
F1Solenoid Valve ❑ Syphon Breaker
❑ Flow Control Valve
Recommended Water Usage
Standard Optional
5 GPM 3 GPM
For additional information, see Commercial Product Information Binder,
A COMMERCIAL DISPOSER PACKAGE INCLUDES:
1 Mounting/Bowl Assembly, 1 Electrical Control, 1 Syphon Breaker, 1 Solenoid
Valve, and 1 Row Control Valve. The standard Flow Control Valve will be sent with
the unit unless the optional valve is specified.
O,�GL Cqp�
Our products appear on The KCL CADalog
CD-ROM based CAD Foodservice Symbol
Library. More information is available from
Kochman Consultants, Ltd. at www.kcicad.com.
4700 21st STREET
RACINE, WI 53406 A*
In erator TEL, 800-845-8345 UL S'A. EMNAMM
c000srnce FAX: 262-554-3620w n.." " The Emerson logo Is a trademark and a EMERSON_
www.insinkeratorcom service mark of Emerson Electric Co. Appliance Solutions
InSinkErator is a division of Emerson Electric Co. ® InSinkErator Printed In USA Form No. F174 -06E-19-02
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MODULAR SERVING SYSTEMS
❑ STAINLESS STEEL - CW ❑ ALUMINUM - CA
HOT FOOD CART y�,►� Item No. 3
Electrically Heated
Individual Controls
DESCRIPTION:
The Cart Line I Hot Food Cart is an attractive,
functional unit designed to keep hot foods hot - at
their peak of serving perfection. The modular cart
base, with its drop-in heated part, will accommo-
date standard steam table pans in individual 12" x
20" hot food wells that can be used wet or dry. Each
well is provided with an individual thermostat
control.
The attractive streamlined design, plus the variety of
laminates give you a wide range of choices to
complement any decor. The unmatched feature of
Cart Line I is the self-locking device which elimi-
nates loose fasteners or molding strips to lock units
together. Simply push the units together; the carts
will automatically lock and the top will be flush and
level, regardless of the floor's condition. It's the right
cart for.your serving line needs.
Quantity
❑
CWIH-2
❑
CWIH-3
❑
CWIH-4
❑
CWIH-5
❑
CWIH-6
❑
CAIH-2
❑
CAIH-3
❑
CAI H-4
❑
CAIH-5
❑
CAIH-6
CWIH-4
Shown with accessories,
Tray Slide, Work shelf, Undershelf, End Panels, Protector Case
FEATURES:
■ .Fully insulated to retain heat - individual, ther-
mostatically controlled 12" x 20" hot food wells
■ Positive self-locking device - keeps tops level and
equipment.in place
■ Fully mobile - each unit is provided with 5" dia.
swivel casters, two with brakes
■ Versatile - available in a wide range of sizes and
a wide variety of finishes and colors
■ NSF certified; UL and CSA recognized
p DESIGNER SERIES: The
popular Designer Series op-
tion provides attractive lami-
nate finishes with stainless
steel trim. A full line of de-
signer accessories is avail-
able including recessed cast-
ers with skirting and laminate
tray slides with runners.
Available as an accessory
a subsidiary of Mercury Aircraft
Atlas Metal 1135 NW. 159 Dr., Miami, Florida 33169
I N D U S T R I E S, I N C. Tel: (305) 625-2451 or (800) 762-7565 • Fax: (305) 623-0475
CW -5
HOT FOOD CART
Electrically Heated Individual Controls
MODEL
"A"
FOOD
WELLS
ELECTRICAL'
CHARACTERISTICS
NEMA
CONFIGURATION
SHIP WT.
(Ibs.)
CWIH-2
36-1/4
2
1.7 KW - 8.2 amps.
6-15P
145
OSC-X/OSDC-X - Buffet style overshelf,
O single/Odual service
�-u ej
{_
F
O
.208 V
6
O
CWIH-3
50
3
2.55 KW - 12.3 amps.
1.6-20P
180
heat lamps, Osingle/Odual service
I iz1-f�
O
208 V
L,4J_J
0
CWIH-4
63-3/4
4
3.4 KW - 16.3 amps.
L6 -30P
230
S - Stainless steel front panel
EPA - End panel rplastic laminate/0 stainless
29I
��� :IJ
208 V
L—ft
7WIH-5
77-1/2
5
4.25 KW - 20.4 amps.
1.6-30P
285
US - Stainless steel undershelf, removable
208 V
f J
=
CWIH-6
91-1/4
6
5.1 KW - 24.5 amps.
L6 -50P
335
Individual drain for each well with manifold to single
valve. (Additional
208 V
=
"NOTE: 1000 watt heating elements are available. All 208 volt units are available in -240 volts;
CWIH-2 & CWIH-3 are also available in 120 volts - contact factory for electrical specifications.
SPECIFICATIONS:
TOP: Constructed of 16 gauge, type 304 stainless steel, die -formed,
welded, ground and polished. Top is provided with an opening to receive
the appropriate sized drop-in hot serving unit. An integral locking device
shall be provided to align and retain cart positioning when two or more
carts are joined.
BODY: Frame construction shall be of hi -tensile stainless steel square
tubing, 1-1/4" x 1-1/4". Frame sections are all welded construction,
ground and polished to a uniform finish. Body is complete with front panel
of plastic laminate on .050 aluminum. Owner to specify finish.
HOT SERVING UNIT: The cart is complete and includes a WIH series
drop-in hotserving unit installed in thetop. Constructed of 18 gauge, type
304 stainless steel with raised perimeter bead and solid vinyl gasket.
Individual 12" x 20" hot food wells are provided, fabricated of 18 gauge
stainless steel, one piece construction, all welded, ground and polished to
a uniform finish. All corners arecoved with a minimum 1/4" radius. Each
well is provided with an 850 watt heating element.
CASTERS: The casters shall be 5" diameter, non -marking rubber tired,
swivel type with ball bearings in both swivel and axle raceways, and
provided with grease fittings. Both casters on operator's side have toe
activated brakes.
ELECTRICAL: The unit is provided with a pre -wired single thermostat
control for each well, with a pilot light. A 6' long, 3 -wire cord and plug
is provided, extending from the control box located under the unit, on
operator's left. Available for single phase power only.
Specifications subject to change without notice.
ACCESSORIES:
❑ SL - Tray Slide, 11-1/4" wide, stainless steel, 2 -rail, fold down'
❑ SIT - Tray Slide, 11-1/4" wide, stainless steel, 3 -rail, fold down
❑ SLS - Tray Slide, 11-1/4" wide, stainless steel, solid, ribbed; fold down
❑ SLIP - Tray Slide, 11-1/4" wide, plastic laminate with S/S runners, fold
down
❑ SH - Work Shelf, 8" wide, stainless steel, fold down
❑ CB -Work Shelf, 8" wide, hardwood maple, fold down
❑ CR - Work Shelf, 8" wide, Richlite, fold down
❑ PRC - Protector Case
CW -6
I I
30Y
L I I
I
8"
T PLAN VIEW
"
14" 0 0 2"ti 4
I I�—JL—JL_JL_JI
0 •0 •9 •o
3I5"
L J
REAR ELEVATION END VIEW
❑
PRCL• - Protector Case with fluorescent lights
O
PRHC' - Protector Case with food warmer
❑
PRHLC• - Protector Case, 18" high, with heat lamps
O
PRVC - Protector Case, sneeze guard only
❑
OSC-X/OSDC-X - Buffet style overshelf,
O single/Odual service
�-u ej
{_
F
O
OSC/OSDC' - Buffet style overshelf with
6
O
fluorescent light, ❑single/❑ dual service
OSHC/OSDHC'
�...
-.Buffet style overshelf with
heat lamps, Osingle/Odual service
I iz1-f�
O
SG - Plexiglas sneeze guard
L,4J_J
0
Plexiglas end guards for protector case
SINGLE SERVICE
and buffet canopy
0
S - Stainless steel front panel
EPA - End panel rplastic laminate/0 stainless
29I
��� :IJ
steel
L—ft
RP - Removable rear panel
j--
0
RPS - Rear sliding doors
-
US - Stainless steel undershelf, removable
Front skirt with recessed casters
f J
=
End skirt
DUAL SERVICE
=
Rear skirt
Individual drain for each well with manifold to single
valve. (Additional
valves may be specified - CONTACT FACTORY.)
=
Stainless steel adapter plate - specify openings
-
Apron mounted remote controls
1000 watt heating elements in lieu of 850 watts*
DESIGNER SERIES:
Designer Series framed front panel
Designer Series framed end panel
Designer Series framed sliding rear panel
Designer Series front/rear skirt, framed, with recessed casters
Designer Series end skirt, framed
' Change in electrical required, CONTACT FACTORY
AAtlas Metal a subsidiary of MercuryAircraft 1135 NW. 159 Dr., Miami, Florida 33169
I N D U S T R I E S, I N C. Tel: (305) 625-2451 or (800) 762-7565' Fax: (305) 623-0475
MODULAR SERVING SYSTEMS
❑ STAINLESS STEEL - CW ❑ ALUMINUM - CA
f
COLD FOOD CART�f'�Q
Refrigerated- Cold Pan
These units have not been
performance tested for use
with potentially hazardous
foods, and must be used with
Item No. (P
Quantity
❑ CWCM-2
❑ CWCM-3
R' CWCM-4
❑ CWCM-5
❑ CWCM-6
DESCRIPTION:
The CWCM series refrigerated cold pan eliminates
the mess and expense of ice in your cold food
display and can be located anywhere in your serving
line. Fully self-contained, just plug it in and turn it
on. The standard depth is 4-5/8"; or, the full depth
of 9-3/4" is available as an accessory. The cold pan
accommodates standard 12" x 20" pans, or frac-
tional size pans with the use of adapter bars.
The attractive streamlined design, plus the variety of
laminates give you a wide range of choices to
complement any decor. The unmatched feature of
Cart Line I is the self-locking device which elimi-
nates loose fasteners or molding strips to lock units
together. Simply push the units together; the carts
will automatically lock and the top will be flush and
level, regardless of the floor's condition. It's the right
cart for your serving line needs.
Self-contained refrigeration system - just plug it
in and turn it on
Positive self-locking device - keeps tops level
and equipment in place
Fully mobile - each unit is provided with 5" dia.
swivel casters, two with brakes
Versatile - available in a wide range of sizes and
a wide variety of finishes and colors
NSF certified and UL recognized
DESIGNER SERIES:
The popular Designer
Series option provides at-
tractive laminate finishes
with stainless steel trim. A
full line of designer acces-
sories is available includ-
ing recessed casters with
skirting and laminate tray slides with runners.
FEATURES: Available as an accessory
■ Fully insulated for maximum efficiency and
energy savings
wa subsidiary of MercuryAircraft
Atlas Metal 1135 NW.159 Dr., Miami, Florida 33169
IN D. LIS T R IES, INC. Tel: (305) 625-2451 or (800) 762-7565 * Fax (305) 623-0475
rw_i i
❑
CACM-2
❑
CACM-3
max,ElCACM-
❑
CACM-5
❑
CACM-6
CWCM-4
Shown with accessories,
Tray Slide, Work shelf, Undershelf, Overshelf
DESCRIPTION:
The CWCM series refrigerated cold pan eliminates
the mess and expense of ice in your cold food
display and can be located anywhere in your serving
line. Fully self-contained, just plug it in and turn it
on. The standard depth is 4-5/8"; or, the full depth
of 9-3/4" is available as an accessory. The cold pan
accommodates standard 12" x 20" pans, or frac-
tional size pans with the use of adapter bars.
The attractive streamlined design, plus the variety of
laminates give you a wide range of choices to
complement any decor. The unmatched feature of
Cart Line I is the self-locking device which elimi-
nates loose fasteners or molding strips to lock units
together. Simply push the units together; the carts
will automatically lock and the top will be flush and
level, regardless of the floor's condition. It's the right
cart for your serving line needs.
Self-contained refrigeration system - just plug it
in and turn it on
Positive self-locking device - keeps tops level
and equipment in place
Fully mobile - each unit is provided with 5" dia.
swivel casters, two with brakes
Versatile - available in a wide range of sizes and
a wide variety of finishes and colors
NSF certified and UL recognized
DESIGNER SERIES:
The popular Designer
Series option provides at-
tractive laminate finishes
with stainless steel trim. A
full line of designer acces-
sories is available includ-
ing recessed casters with
skirting and laminate tray slides with runners.
FEATURES: Available as an accessory
■ Fully insulated for maximum efficiency and
energy savings
wa subsidiary of MercuryAircraft
Atlas Metal 1135 NW.159 Dr., Miami, Florida 33169
IN D. LIS T R IES, INC. Tel: (305) 625-2451 or (800) 762-7565 * Fax (305) 623-0475
rw_i i
COLD FOOD CART
Refrigerated Cold Pan
MODEL
"A"
PAN
OPENINGS
PAN SIZE'
ELECTRICAL
CHARACTERISTICS
SHIP WT.
(lbs.)
CWCM-2
36-1/4
2
19-7/8 X 25-1/2 X 4-5/8
2.3 amps. - 120 V - 1/5 HP
190
CWCM-3
5o
3
19-7/8 X 39-1/4 X 4-5/8
2.3 amps: - 120 V - 1/5 HP
240
CWCM-4 1
63-34
1 4
19-7/8 X 53 X 4-5/8
6.8 amps. - 120 V '- 1/4 HP
300
CWCM-5
77-1/2
5
19-7/8 X 66-3/4 X 4-5/8
9.8 amps. - 120 V - 1/3 HP
350
CWCM-6
91-1/4
6
19-7/8 X 80-1/2 X 4-5/8
9.8 amps. - 120 V - 1/3 HP
440
• 0 FULL DEPTH - pans available CWCMD series, 9-3/4" deep or CWCMD-C with coil on the side and bottom.
rAy
11 r30,14„
- - -11=1-
PLAN VIEW
REAR ELEVATION
r-211� 1
6"
SIDE VIEW
SPECIFICATIONS:
TOP: Constructed of 16 gauge, type 304 stainless steel, die -formed,
welded, ground and polished. Top is provided with an opening to receive
the appropriate sized drop-in cold serving unit. An integral locking device
shall be provided to align and retain cart positioning when two or more
carts are joined.
BODY: Frame construction shall be of hi -tensile stainless steel square
tubing, 1-1/4" x 1-1/4". Frame sections are all welded construction,
ground and polished to a uniform finish. Body is complete with front panel
of plastic laminate on .050 aluminum. Owner to specify finish.
REFRIGERATED COLD PAN: The cart is complete and includes a WCM
series drop-in refrigerated cold pan installed in the top. Constructed of 18
gauge, type 304 stainless steel, with raised perimeter bead and solid vinyl
gasket. The pan is fully insulated with high density polystyrene, 1" thick
on all sides, 1-1/2" thick on the bottom and enclosed by a 22 gauge
galvanized steel outer liner.
The interior liner is fabricated with 1/4" radius coved corners. The liner
has copper tubing firmly soldered to the exterior bottom. A 3/4" dia. drain
with strainer, 4" PVC nipple, and valve is provided.
REFRIGERATION SYSTEM: The compressor housing shall be fabricated
from formed angles and bolted to the base of the unit. A fully self-contained
condensing unit is provided, with hermetically sealed compressor and a
thermostat control. The system is fully charged with CFC free refrigerant
and ready to operate.
ELECTRICAL: The unit will be wired for 15 amps., 120 volt, single phase
operation with an on/off thermostat switch and pilot light. A 6' long, 3 -wire
cord and plug (NEMA 5-15P) will be provided.
CASTERS: The casters shall be 5" diameter, non -marking rubber tired,
swivel type with ball bearings, in both swivel and axle raceways, and
provided with grease fittings. Both casters on operator's side have toe
activated brakes.
Specifications subject to change without notice.
ACCESSORIES:
❑ SL - Tray Slide, 11-1/4" wide, stainless steel, 2 -rail, fold down
❑ SLT - Tray Slide, 11-1/4" wide, stainless steel, 3 -rail, fold down
❑ SLS -Tray Slide, 11-1/4" wide, stainless steel, solid, ribbed, fold down
❑ SLF - Tray Slide, 11-1/4" wide, plastic laminate with S/S runners, fold down
❑ SH - Work Shelf, 8" wide, stainless steel, fold down
❑ CB - Work Shelf, 8" wide, hardwood maple, fold down
❑ CR - Work Shelf, 8" wide, Richlite, fold down
❑ DDC - Double Deck Display Case
❑ DDLC - Double Deck. Display with fluorescent lights
❑ DD -DC - Double Deck Display Case - dual service
❑ DTC - Triple Deck Display Case
❑ DTLC- Triple Deck Display Case with fluorescent lights
❑ OSC-X/OSDC-X - Buffet style overshelf,
❑ single/❑ dual service
❑ OSUOSDC - Buffet style overshelf with L—
1 ut eb
fluorescent light, ❑ single/0 dual service
❑ OSHC/OSDHC - Buffet style overshelf with e
heat lamps, ❑ single/0 dual service la
❑ SG - Plexiglas sneeze guard L_
❑ Plexiglas end guards for display cases I 12aj
and buffet canopies ,4J
❑ S - Stainless steel front panel SINGLE SERVICE
❑ EP - End panel, ❑ plastic laminate/
❑ stainless steel
❑ RP - Removable rear panel
❑ RPS - Rear sliding doors �I I
❑ US - Stainless steel undershelf, removable
❑ Front skirt with recessed casters ��
❑ End skirt
ElRear skirt vt��J
❑ Stainless steel adapter bars "
❑ Stainless steel perforated false bottom DUAL SERVICE
❑ Full Depth Refrigerated Cold Pan - 9-3/4" deep (specify CWCMD
series)
❑ Full Depth Refrigerated Cold Pan - with coils on the sides and bottom
(specify CWCMD-C series)
❑ 5 -year compressor warranty
DESIGNER SERIES:
❑ Designer Series framed front panel
❑ Designer Series framed end panel
❑ Designer Series framed sliding rear panel
❑ Designer Series front/rear skirt, framed, with recessed casters
❑ Designer Series end skirt, framed
f
N a subsidiary ofMercuryids 3 ff
Atlas Metal 113 5 NW. 159 Dr., Miami, Florida 33169
IslaN D U S T R I E S, I N C. Tel: (305) 625-2451 or (800) 762-7565 • Fax: (305) 623-0475
CW -12 10/99 -Sc
f' -
£.. ✓` G N .t e z:t., +�-.1 d ht.'`Y'AY S{�
b Nlotie S]Z 8 2f.Item#...�_E ,
Pur o Aar t t.
. ., _.a... ,.., ,.....n.. .r., _...� ..�. .. ,, ...ria �+1,._d..vu .s�.`_...F •'f:_.awxssta �,� A..a���3�E..�^ �����ti .,: �' l_:.
18
auper Deluxe Series
Solid Door Refrigerator
High Quality Stainless Steel Interior and
Digitally Controlled UpIfar-mYemper,
* Digitally Controlled Temperature
Enables temperature control without
opening the door.
Freshness of products lasts longer
by keeping the correct temperature.
* Bottom Mount Compressor
All units feature a bottom -mounted
compressor for energy savings, hig
efficiency and easy service.
The bottom -mount compressor
also allows the food to be placed in
an ergonomically correct location.
* Self-diagnostic System
Shows the status of the freezer
immediately.
* Self-contained System
No plumbing required. Simple installation.
* Holds 33'F- 38'F
Shows the status of the refrigerator
immediately.
Self-closing and Stay Open Door
Door are equipped with self-closing
and stay open feature.
* Adjustable Stainless Steel Wire Shelves
Durable and easy to adjust.
* Bun Tray Rack Available
All models are available for full door tray racks
but lamp shield will have to be removed prior to
being installed and lamp and lamp
-shield after installing racks.
* CEC. Califomia Energy Commission Certificated
* MEA.CdyofNewYorkBuildingDepartmentApproved
U� �µ UL NSF. {' C E C
4= is oo MEA
rior
REFR/GERA70R MANUFAC7!/RER
u' 0 air
TSR-23SD
Model
Swing
Door
CURT.
#of
Shelves
HP
AMPS
Weight
L D H
List Price
TSR 23SD
1
23
3
1/3
5.5
259
27.0 x 30.8 x 77.9
3,773.00
TSR- a 5—SD
2
35
6
1/3
9.2
340
39.5 x 30.8 x 77.9
Available Soon
�. �R-49SD
49
6
1/3
9.2
412
54.4 x 30.8 x 77.9
5,543.00
TSR 72SD
3
72
9
1
11
595
81.9 x 30.8 x 77.9
7,715.00
• Height does not include S" for caster height
�,, . taa��s � ': � � �., a y ��;, b� r 3£� � ): ,".-,,r .,`.'��c n.°.ef. �4'se'°�-.'i`'r.Y? a'��'..>�� ��' �' u�S g�, -�SaJ' r v. .3 aa�•. .. yam.` .
,j.,c �- t-�chaelS ;�11oo`ip r>.a � e ;:� ° .tr f�'i� .A� $C#�,'dit�re �'$Zesu � is �}�.�`F „� ' �' i �r �s .� .. ^��C'x'�•: i't-:ir ,L�{�� r'�:
' Turbo Air Ivlode) SSR-49SD G rt ter'► F >
s 5
CABINET INTERIOR/EXTERIOR SPECIFICATIONS
ELECTRICALDATA
TSR-23SD
TSR-49SD
SR-72SD
Voltage
115/60.1
115/60-1
115/60-1 .
Feed Wires (With ground)
33
3
Wattage
345
47
690
Amperes
55 A
.2A
11A
SHIPPING DATA
Length -Crated (in)
29.3
56.8
83A
Depth -Crated (in)
33.7
33.7
33.7
Height -Crated (in)
843
843
843
Volume Crated (cuh)
48.1
873
135.7
Net Weight (lbs)
259
412
595
Weight After Packing (lbs)
308.6
485
683A
DIMENSIONAL DATA
# of Doors
1
2
3
Cubic Feet
23
49
72
Rackcapacity
1
2
3
Length Overall (in)
27
54.4
81.8
Depth Overall (in)
30.8
30.8
30.8
Height Overall (in) (with caster) 82.9
82.9
82.9
InWri0rDime11si0n0D"
23x24.8x60A
50Sx24.8x60A
77.9x248x60A
Shelf Size
21bx233
24.4x233
24.4x233
# of Shelves
3
6
9
*Design and specifications can be changed without prior notice for product improvement
ONE DOOR PLAN VIEW
REFR✓OERArORAIA!✓CrFAC,'URE.4
lurbo r
* Other Features
• Solid and sturdy grill design.
Minimum wattage heater in the cabinet
frame to conserve energy and keep your
cabinet water free.
Incandescent interior lighting.
• Foamed with polyurethane, high-density
cell insulation. (CFC free)
• Positive seal with closing doors.
Automatic evaporator fan motor delay
when the door is open.
Left hinged TSF 23SD available.
Door locks.
4"swivel casters. (standard)
18 Month Labor and Parts Warranty for
Super Deluxe Series
1 W V IJV VK rLAn V 1= V V
THREE DOOR PLAN VIEW
19
vJ
b
(unit: inch)
ONE,TWO & THREE DOOR SIDE VIEW
� t ,�' .,_, .,�.' u ,��-s.,.,k.. <,< � aWw x\ as�4 .� "i.ar hs sra ]�,, � :s„d�., •nt . . f, •fi:.,.J " ' :r•�'�<-�
'E X-. -`,'•: 1 A.-::.: -'b- '- i -,+ � F y f � _ i°'ti i b1�' f � r'%' � �KS. �ri
�T"'.� ,CJS � sS . �; Si,' 1Ci12�1� `P.Cll�b) -4: ti 6 `f t-�'F.� a '� 'ts -. f o� -2.s.I �?�"1��.1 ►1[L IVPi F?81es. „fi , ,,c ' "���'Y .iC .+:, � is �+., whys rc � �' ��e � �,' : �;i
y. .fr1. •�; ^j"��S/''� 4. j g, �_ z,. ,.r rs s Y` � r-> s
•�� •``�Nix�.z'���vSi�S:F�'�`.�� -asT`'�Li.6�:mx..� A'd�:ss'"iu��ti�,su. �:_����u..,t�z-:k�'t}��.z+r._',',�� �i�E�ia`�P.'A'{• ."zk��#azin�Y .'�r �t�� ..;.�Fi7:
Ft
5 Model 49
TSF -$D s F
w-
_�,._._._..,,.
16
.... NUFAC7UR
ER
'l AU17rA 0"7Aair
ouper
Deluxe Series
Solid Door Freezer
High Quality Stainless Steel Interior and Exterior
Digitally Controlled
* Digitally Controlled Temperature System
Enables temperature control without
opening the door.
Freshness of products lasts longer
by keeping the correct temperature.
* Efficient Refrigeration System
Turbo Air's solid refrigerators and
freezers are designed with over -sized
evaporators and condensers for faster
cooling and greater efficiency.
* Bottom Mount Compressor
All units feature a bottom -mount
compressor for energy savings, high
efficiency and easy service.
The bottom -mount compressor
also allows the food to be placed in
an ergonomically correct location.
* Self-diagnostic System
Shows the status of the freezer
immediately.
* Self-contained System
No plumbing required. Simple installation.
* Freezer holds -lWF for the best in food
preservation -holds frozen food and ice cream
* Self-closing and Stay Open Door
Door are equipped with self-closing
and stay open feature.
* Adjustable Stainless Steel Wire Shelves
Durable and easy to adjust.
* CEC.Califomia Energy Commission Certificated
* MEA.City of NewYork Building DepartmentApproved
�L�L NSF { CEC
isoi MEA
Model
Swing
Door
CU./FT.
#of
Shelves
HP
AMPS
Weight
L D H
List Price
TSF 23
1
23
3
1/3
7.8
285
27.0 x 30.8 x 77.9
4,891.00
TSF-35SD
2
35
6
3/4
10.3
360
39.5 x 30.8 x 77.9
Available Soon
TSF-49SD
2
49
6
3/4
10.3
462
54.4 x 30.8 x 77.9
6,996.00
TSF-72SD
3
72
9
1
10
670
81.9 x 30.8 x 77.9
9,810.00
' Height does not indude5"for caster height TSF -7250 requires dual voltage 115/208-230V.
3 f •.� <. Kit .: '�';` -. � t y - ti: '1 '. x art' i -r.- z+ fC -�+ � ey � �'B x-�mn,�,,,+:_*�rXt w- _ a ,'..x:. 7'Ny'^¥�, .S� `�' ri ;�,z= �,.,.. ,,k ,,.j,.
ERA MR AMI&IFAC7MER
it
CABINET INTERIOfnXTERW
SPECIFICATIONS
� Bun Tray Rack Available
All models are available for full door tray racks
ELECTRICAL DATA TSF-23SD F-49SD TSF-72SD
Voltage
Feed Wires (With
115/60-1
3
'115/60-1
115/208-230
but lamp shield will have to be removed prior
ground)
Wattage
3
900
4
to being installed and re -assemble lamp and
1100
lamp -shield after installing racks.
Amperes
7.8A
10.3A
10A
SHIPPING DATA
Other Features
Length -Crated (in)
293
56.8
83A
Solid and sturdy grill design.
Depth -Crated (in)
33.7
33.7
33.7
• Minimum wattage heater in the cabinet
Height -Crated (in)
84.3
843
843
frame to conserve energy and keep your
Volume Crated (cu.ft)
48.1
87.3
135.7
cabinet water free.
Net Weight (lbs)
285
462
670
Incandescent interior lighting.
Weight After Packing (lbs)
330.7
529.1
758A
Foamed with polyurethane, high-density
DIMENSIONAL DATA
cell insulation. (CFC free)
# of Doors
1
2
3
Positive seal with closing doors.
Cubic Feet
23
49
72
• Automatic evaporator fan motor delay
Rack capacity
1
2
3
when the door is open.
Length Overall (in)
27
54A
81.9
• Left hinged TSF-23SD available.
Depth Overall (in)
30.8
30.8
30.8
Door locks.
• 4"swivel casters. (standard)
Height Overall (in)(with caster) 82.9
82.9
82.9
hWriorDinlertsionODA-0
23x24.8x60.4
505x24.8x60.4
77.9x248x604
*18Month Labor and Parts Warranty for
Shelf Size
21.6x233
24.4x233
24.4x233
Super Deluxe Series
# of Shelves
3
6
9
'Design and specifications can be charged without prior notice for product improvement
ONE DC
1 WV VVVK rLA"VICW
THREE DOOR PLAN VIEW
17
(unit : inch)
ONE,TWO & THREE DOOR SIDE VIEW
a ..i.'?-YfCli 8XS a..1Q ,�y:.. s a•:rc-' k r !4� ���..tra1�„S` : 7""" ''� -?A4Y. .+' ' - •.
El7UAC-20 Heater/Proofer
Aluminum Non -Insulated Full Size
STANDARD FEATURES:
• Air baffle and circulation air blower provide
even heat distribution
• Aluminum construction
• Set of 5" swivel casters w/brakes
• Lexan door • Lift-off door
• Magnetic door gaskets
• Full length door handle
CONSTRUCTION:
• Welded aluminum construction
• Removable heating console
• Removable universal pan slides
CONTROLS:
• Mechanical controls
DOOR SWING:
• Door swings 270 degrees to the recessed side of the cabinet
SERVICE CONNECTIONS:
• Unit provided with 6 foot detachable cord and plug
• Removable console consisting of blower, two-way toggle switch,
running lights to indicate heater (holding) or proofing mode,
stainless steel water reservoir.
• Element controlled by 180 degree F thermostat.
1500 Watts in heating mode. 1500 Watts in proofing mode.
BASIC UNIT LIST PRICE: .......$2,790.00
OPTIONS:
SHIPPING WEIGHT:
• 140 Pounds, FOB Menominee, MI 49858
• Push Handle ............................. $142.00
• Transport Latch ..........................$112.00
• Solid Door (Order as E17UAC-20-SD) ........ $230.00
• 6" Indoor/Outdoor Casters (set of 4) ........ $132.00
• Also available in 15 amps.
Model # E17UAC-15.
12.5 amps - NEMA 5-15P
DIMENSIONS:
i eight width; :eth:
Exterior 67-1/2" 29-3/16-. 32 -11/16 -
CAPACITY."
I8"at2fxul<Ix'0'22^17*"
Sipe Ali eet Pans Fob^ece Pains:
Proofer 17 34
Spacing 3" 3"
ELECTRICAL:
Amp`raw I18% iQf11 X20/240/3:
Ll 14 n/a n/a n/a
Cord and plug - NEMA 5-20P
Ak
AMW
ADVANCE TABCO
®10 Year Warranty
EPDXY COATED CHROME
WIRE SHELVING
Item #:
Model #:
Project #:
EPDXY COATED
CH ING
wun upuonai gasters
—1
�2
.3
4
5
FEATURES:
Super heavy duty 5 truss design
(14" shelves feature 4 trusses as standard.)
Each shelf holds up to. 1250 lbs. eveningly distributed weight.
NSF approved for dry storage and heated environments only.
10 year warranty.
Posts are numbered for easy assembly
CONSTRUCTION:
Unit assembles using tapered split sleeves.
For mobile units, 5" swivel Rubber or Poly casters includes
set of 4 casters, (2 with brakes) and 4 donut bumpers.
{ MATERIAL:
Chrome plated wire with clear epoxy coating.
S
EPDXY CHROME POSTS
WITH ADJUSTABLE FOOT
Numbered Posts
ECP -14
ECP -34
ECP -54
ECP -64
ECP -74
ECP -86
EPDXY CHROME POSTS
FOR CASTERS
ECPC-14
ECPC-34
ECPC-54
ECPC-64
ECPC-74
ECPC-86
ML
Rubber Caster Poly Caster
OPTIONAL ACCESSORIES
5" Rubber Swivel Stem Caster
EC -25 4�
5" Poly Swivel Stem Caster
EC -26
NEW YORK GEORGIA TEXAS NEVADA
(800) 645-3166 (800) 832-1218 (800) 527-0353 (800) 446-8684
Fax: (516) 242-6900 Fax: (770) 775-5625 Fax: (972) 932-4795 Fax: (775) 972-1578
200 Heartland Boulevard, Edgewood, NY 11717-8380
ADVANCE TABCO e-mail: advancetabco@advancetabco.com www.advancetabco.com
P-1
Turbo Arvlbd�l�TSS 1 Fix 3y teri#rs'11��;#
HAND SINK
44 1
a W
�.
zo
DIMENSION.
Number WIDTH I LENGTH I HEIGHT I WEIGHT(Ibs) I
'� x:?�x�s��'q�y f fdi: �' a r � k ? ;..�:, `'3 � inti. �� �ckYa�, �a }F?�E$sr3�'�`?`_.,.:�.c.Y�.{-• v y �a� � � a ,h„ .,,^s.k. „� w:>a 'o- i.;.'irr,"µ,".. 4a
�� ySt C aels School �:�� _�'� > ,<, • „�. 5�`���`��.Ai�ert�at��e�a1�s.�� �$`�� �''���;�~`�: ri, .a'�',"��, ��:5.
/z--
IVIUUel IVU.
T&S BRASS AND BRONZE WORKS, INC.�` B -0133-A-08 SERIES
2 SADDLEBACK COVE / P.O. BOX 1088 / TRAVELERS REST, SC 29690 ,
PHONE 800-476-4103 -FAX 864- 834=3518 REC.JA2601 RELIABILITY
'�° X9001 BUILT IN
Job Name: Architect/Engineer Approval:'
Notes:
EPAct2005 COMPLIANT
0 1
41 3/8"
[1050mm]
44" FLEX. S.S.
HOSE
B-0108 OR -C
Insulated Spray
i Valve
RM=
MODEL
D
K
H
�
PATTERNLOWRATE
B-0133-AO6-08
6"
7 7/16"
10 1/8"
NO
SHOWER
1.48GPM
8-0133-AOO-08C
6•
7 7/16"
10 1/8"
NO
FAN SPRAY
1.20GPM
B-0133-AOB-BO8
6.
7 7/16"
10 1/8"
YES
SHOWER
1.48GPM
B-0133-AO6-BOBC
6"
7 7/16"
10 1/8"
1 YES
FAN SPRAY
120GPM
B -0133-A08-08
8"
8"
10 3/4"
NO
SHOWER
1.46GPM
B-0133-AOB-OBC
8"
8"
10 3/4"
NO
FAN SPRAY
1.20GPM
B-0133-AOB-BOB
6.
8"
10 3/4"
YES
SHOWER
1.46GPM
B-0133-AOS-B08C
B"
8.
10 3/4"
YES
FAN SPRAY
1.20CP11
B -0133-A10-08
t0"
8 11/16"
11 7/16"
NO
SHOWER
1.48GPM
B -0133 -A10 -OBC
8 11/18"
11 7/16"
NO
FAN SPRAY
1.20GPM
B -0133 -A10 -BOB
10"
8 11/18'
11 7/16"
YES
SHOWER
1.4BGPM
B-0133-A10-BOBC
10"
8 11/18"
11 7/16"
YES
FAN SPRAY
1.20CPM
B-0133-Al2-08
12"
8 13/16-
11 9/16"
NO
SHOWER
1.48GPM
B-0133-Al2-08C
8 13/16"
11 9/16"
NO
FAN SPRAY
11.20GPU
B-0133-Al2-B08
12"
8 13/16"
11 9/16"
YES
SHOWER
11.48GPM
B-0133-Al2-BOBC
B 13/16"
11 9/16"
1 YES
FAN SPRAY
1.20GPM
OPTIONAL WALL BRACKET:
CUT NIPPLE TO I
REQUIRED
I 15 7/8"
I
[403mm]
-- — H
K
LADD-ON FAUCET w/ 3600
SWING NOZZLE
2 3/8"
[61mm] SIDE VIEW
• DIMENSIONS MAY VARY t 1/2" ON EACH INSTALLATION
Product, Description:
EASY INSTALL PRE -RINSE UNIT:
8' C/C WALL MOUNT .BASE FAUCET, 1/2" NPT FEMALE INLETS, 18" RISER, BRACKET(OPTIONAL)
ADD ON FCT., C-12' SWING NOZZLE, SUPPORT SPRING, 44' FLET( HOSE, B -0108(-C) SPRAY
8"
[203mm]
FRONT VIEW
Urawn:
JRM
Tp—prove
JHB
L;nec
GEF
NGER HOOK
/8" NPT x 18"
ISER
DIA. FLANGES
w/ 1/2" NPT
FEMALE INLETS
�)coie:
Date:
8/3/06
woNm s f .•., { :
-� W d
Ji16-L..' p
2_0
4qqe- a`b co; 6 .. ....
Tode AGO` F
0 2
N
DIMENSIONS and SPECIFICATIONS
ALL DIMENSIONS ARE TYPICAL TOL t .500" All Units Shipped Unassembled (KD) for Reduced Shipping Costs.
SAG & AG Series
UNDERSHELF Style
FLAT TOP
Finished size of undershelf = Length minus 5 3/4"
Width minus 5 3/4"
Units 8 ft. and larger are furnished with six (6) legs
L
Square Side Edges
W
L
Rolled Rim Edge Front & Rear
[-4- rrr1 518r _4
.4
4.
Clearance
L-81/2"
35
-91/235 1/2*
T 10,
SAG -Series: Stainless Steel Legs & Undershelf AG -Series: Galvanized Steel Legs & Undershelf
1 1
24" 30go 3615 24" 3091 36's
Wt
Wide Wide Wide Wide Wide Wide
30" SAG -240 49 lbs. SAG -300 65 lbs. 30" AG -240 49 lbs. AG -300 65 lbs'
24" SAG -242 31 lbs. SAG -302 55 lbs. 24" AG -242 31 lbs. AG -302 55 lbs,
36" SAG -243 64 lbs. SAG -303 72 lbs. SAG -363 88 lbs. 36" AG -243 64 lbs. AG -303 72 lbs. AG -363 88 lbs.
48SAG-244 79 lbs. SAG -304 89 lbs. SAG -364 98 lbs. 48" AG -244 79 lbs. AG -304 89 lbs. AG -364 98 lbs.
60 SAG -245 92 lbs. SAG -305 107 lbs. SAG -365 118 lbs. 6o" AG -245 92 lbs. AG -305 107 lbs. AG -365 118 lbs.
72 SAG -246 109 lbs. SAG -306 125 Itis. SAG -366 138 lbs. 72" AG -246 109 lbs. AG -306 125 lbs. AG -366 138 lbs.
84" SAG -247 130 lbs. SAG -307 148 lbs. SAG -367 164 lbs. 84" AG -247 130 lbs. AG -307 148 lbs. AG -367 164 lbs.
96" SAG -248 145 lbs. SAG -308 166 lbs. SAG -368 184 lbs. 96" AG -248 145 Itis. AG -308 166 lbs. AG -368 184 lbs.
108" SAG -249 161 Itis. SAG -309 176 lbs. SAG -369 190 Itis. 1o8" AG -249 161 lbs. AG -309 176 lbs. AG -369 190 lbs.
120" SAG -2410 261 lbs. SAG -3010 287 lbs. SAG -3610 308 lbs. 120" AG -2410 261 Ibs. AG -3010 287 Itis. AG -3610 308 lbs.
132" SAG -2411 293 lbs. SAG -3011 324 lbs. SAG -3611 358 lbs. 132" AG -2411 293 lbs. AG -3011 324 lbs. AG -3611 358 lbs.
144" SAG -2412 308 lbs. SAG -3012 339 lbs. SAG -3612 373 Itis. 144- AG -2412 308 lbs. AG -3012 339 lbs. AG -3612 373 lbs. ,
Ams,
Oak
ADVANCE TABCO.
H -4a 200 Heartland Boulevard, Edgewood, NY 11717-8380
ADVANCE TABCO is constantly engaged in a program of
Improving our products. Therefore, we reserve the right to
change specifications without prior notice.
0 ADVANCE TABCO, SEPTEMBER 2005
s ,,c
3,. E L t S v! }` { ary4 :. A!- a #yn? Z r 'aT ?`, 1.L, it + !k t I
p►dvanct; Taco de;AG 306 ra, `u, �'� #tip# ����
O ti A
a
S 7&
�`•' , ,. ...._ ... .. ...� __ - _. ?s.._...._.�._ .::.;- r. s�, _,...: u�._z.»..>... sz:id'..AN u�:.kV..dr�a..� C''
ADVANCE TABCO®
SMART FABRICATION"
Convert Your Table into a Effective Work Station!
Maximize Your Work Area!
Our TABLE with POT RACK, SHELVING & UTENSIL RACK
Utensil Rack is FULLY
Select the SHELF
WIDTH to satisfy,
your needs
r Stainless Steel 1 5/8" diameter `
t TUBULAR UPRIGHTS \(,
Easy SHELF MOUNTING
for ADDITIONAL RIGIDITY
Plated Pot Hooks
Pot Rack is ADJUSTABLE
Maximum Height = 84" (A.F.F.)
Rolled Rim Front & Rear
& Square Ends
Shelves are ADJUSTABLE
to meet your requirements
�- Only ONE support thru
Table Top ... Maximizes
your working area
\ MID -MOUNT DESIGN
Mix & Match ............ your choice. We offer 3 basic components:
SHELF - POT RACK - UTENSIL RACK.
The Adjustable Solution .... components are adjustable. You set the height
to meet your demanding requirements.
Focus on Function ........ available in 4 shelf widths, 2 pot rack styles,
10 lengths, and I. utensil rack series.
NEW YORK GEORGIA TEXAS NEVADA
(800) 645-3166 (800) 832-1218 (800) 527-0353 (800) 446-8684
Am EN Fax: (631) 242-6900 Fax: (770) 775-5625 Fax: (972) 932-4795 Fax: (775) 972-1578
ADVANCE TABCD.
SMART PABRIGTbN�For Assistance with • , , • • • • 631-586-2933
www.advancelabco.com _
L-1
i�•°�aral:$�.4.".s+i'r�^�3:S�L6J:��xa.,�,-.s5-,�.`.`t-�z-...:il:.sksoakd�c�,'::.>�••'amks...t$..a..' '�r.A.icor'�n'�'�8'�'f�,�w�z:.�I„��':-.a�w��z2:�4.,�t�rvr,�:•rvx'...����:.„a,..'�`lw �i`'..,.�'i�.G'�v3E.�.J ��.xra"v4�s ...,.F'Sz_ .
flUvance'labco M del AG 306 y> k"�$1etn# S
_. r J
..�..1��5C�;,..
DELUXE AND BUDGET DRAWERS
ADVANCE TABCD•
SMART FABRICATION'
• Stainless Steel Front
• Ball Bearing Slides
• Removable Inset
MODELDescription Inset 2015 17 3/4" Stainless Steel 20" x 15" x 5"
GZ-2015 17 3/4" Galvanized 20" x 15" x 5"
SS -2020 22 3/4" Stainless Steel 20" x 20" x 5"
GZ-2020 22 3/4" Galvanized 20" x 20" x 5"
DELUXE AND BUDGET
DRAWER ACCESSORIES
Pad Lock Hasp..............TA-13
Width Description
Drawer Lock ................
TA -14
(Does not apply to Budget Drawers)
20" x 15"x 5"
Drawers Modified to
17 3/4" Galvanized
15" UR x 20" FIB' ............
TA -50
Drawer Adapter/Non Catalog Tables
(specify table width) ...............
TA -90
• Friction Slides
• Die Formed Handle
MODEL#
Width Description
Inset
17 3/4" Stainless Steel
20" x 15"x 5"
FG -2015
17 3/4" Galvanized
20" x 15" x 5"
FS -2020
22 3/4" Stainless Steel
20" x 20" x 5"
FG -2020
22 3/4" Galvanized
20" x 20" x 5"
NEW YORK
� (800) 645-3166
AM Mk Fax: (631) 242-6900
ADVANCE TABCO.
SMART rASRICATpN-
www.advarvetabco.com
Item #: Qty #.-
Model
:Model #:
Project #:
DELUXE SERIES DRAWERS
DETAILS and
SPECIFICATIONS
TOL ± .500" ALL DIMENSIONS ARE TYPICAL
I�-21 1 /211—+I
Width
1 �7/8"
I---- 221/2"---{
611/8'
f (--- 22 1/2"----i
BUDGET SERIES DRAWERS
DETAILS and
SPECIFICATIONS
TOL ± .500"
I+--21 1/2"
Width
~— 221 /2" --{
ALL DIMENSIONS ARE TYPICAL
6_i /8" a
�— 22 1/2"---H
3/4J��
GEORGIA TEXAS NEVADA
(800) 832-1218 (800) 527-0353 (800) 446-8684
Fax: (770) 775-5625 Fax: (972) 932-4795 Fax: (775) 972-1578
ADVANCE TABCO is constantly engaged in a program of improving our products. Therefore, we reserve the right to change specifications without prior notice. ®ADVANCE TABCO, NOVEMBER 2006 K -3A
� .♦ , a ! f ' 7" t : J� �� L % JA. Yv : 2 ,(.Jj` tx F.Y T ' S' � `?✓ g.F� ;` :'i'C•' PL Yyln' ::yG
t"`•" - �. ...:'> -'_` r .. `�'� �i ,.., `: s'- y � '{ t xg --r$. a �� " � i� Y ,�"-`. ?7G% 2T $`_s
'."�4�'v..'�s'��-.t+�s�ao�'•Ln:-..-_..,..at..s.'.s'hcs�u�..:39��C-•n�e__;.?�'..e� -.c rai.%`t��9 _.�. �,r,:.,:.�.dYaa3ss5. ��si�t `��;t,aa�.�3��st5�"'�:tsi�"'��' .� d�-,��� i. �z�. zs.- .�_...< �__,....�.
•J DIE] :a]
r
MODEL SHO -G
Full -Size Gas Convection Oven
OPTIONS AND ACCESSORIES
(AT ADDITIONAL CHARGE)
■ L/casters/stands:
. 6" (152mm) seismic legs
❑ 6" (152mm) casters
❑ 4-1/4" (108mm) low profile casters (double only)
❑ 25" (635mm) stainless steel open stand with
rack guides
■ Venting
❑ Draft diverter
❑ Draft hood
■ Gas hose with quick disconnect and restraining
device:
❑ 48" (1219mm) hose
❑ 36" (914mm) hose
❑ Extra oven racks
❑ Stainless steel solid back panel
_'O' -Gas manifold (for double sections)
❑ Prison package (includes security control panel and
stainless steel back)
❑ Security control panel
❑ Flue connector
Project =
Item No. 0
Quantity
Standard depth baking compartment - accepts five 18" x 26" standard full-
size baking pans in left-to-right positions.
All data is shown per oven section, unless otherwise indicated.
Refer to operator manual specification chart for listed model name.
EXTERIOR CONSTRUCTION
■ Full angle -iron frame
■ Stainless steel front, top, and sides
■ Dual pane thermal glass window on left hand door, solid right hand door
■ Tubular chrome handle with simultaneous door operation
■ Triple -mounted pressure•lock door design with turnbuckle assembly
■ Removable front control panel
■ Solid mineral fiber insulation at top, back, sides and bottom
INTERIOR CONSTRUCTION
■ Double -sided porcelainized baking compartment liner (14 gauge)
■ Aluminized steel combustion chamber
■ Dual inlet blower wheel
■ Five chrome -plated racks, eleven rack positions with a minimum of 1-5/8"
(41mm) spacing
OPERATION
■ Dual Flow Gas system combines direct and indirect heat
■ Electronic spark ignition control system
■ Removable dual tube bumers
■ Pressure regulator and manual gas service cut-off valve located in front
control area
■ Air mixers with adjustable air shutters.
■ Solid state thermostat with temperature control range of 200*F (93°C)
to 500°F (260°C)
■ Two speed fan motor (60 Hz only, not available in 50 Hz)
■ 1/3 horsepower blower motor with automatic thermal overload protection
■ Control area cooling fan
STANDARD FEATURES
■ Solid state manual control with separate dials to control thermostat and timer
■ 25" (635mm) adjustable stainless steel legs (for single units)
■ 6" (152mm) adjustable stainless steel legs (for double sections)
■ One year oven parts and labor warranty"
* For all international markets, contact your local distributor.
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BLODGETT OVEN COMPANY
www.blodgett.com
44 Lakeside Avenue, Burlington, VT 05401
Toll Free: (800) 331-5842 - Phone: (802) 860-3700 - Fax: (802) 864-0183
FiLODGETTI
3-114" 19-1116"
(83) (484) --�
36-7/8"
(937)
17-318"
(411,
2-1/2'(64)
(183)6"
6" (152) dia
3"
U,-38-114.
(972
TOP VIEW
Dimensions are in inches (mm)
MODEL SHO -G
3-1/4'(83)
DRAFT DIVERTER—.,,
57-1116" (1450)-
51-314" (1315)-
35-1/2" (902) 25'(635)
0-
5"(635)0"(0)—
SINGLE
6'(152)
28-3/8"
(721)
6-1
APPROVAL/STAMP
(1794)—
16-14
(413)
DOUBLE
41-15116"
_ (1065)
9-718"
(251)
( ORT FORM SPECIFICATIONS
j fide Blodgett full-size convection oven model SHO -G, (single/double) compartment. Each compartment shall have (porcelainizedlslainless).steel liner and shall accept five 18" x 26"
"-_,andard full-size bake pans. Stainless steel front, top and sides. Right door shall be stainless'steel, left door shall be stainless steel with dual pane thermal glass. Door shall have sin-
gle tubular chrome handle and simultaneous operation. Unit shall be gas healed with electronic spark ignition and shall cook by means of a dual -flow system combining direct and indi-
rect heal. Air in baking chamber distributed by dual inlet blower wheel powered by a two -speed, 1/3 HP motor with thermal overload protection. Each chamber shall be filled with five
chrome -plated removable racks. Control panel shall be recessed with Cook/Cool Down mode selector, solid state (manuaVdigital) infinite thermostat (200- 500°17), and 60 -minute timer.
Provide options and accessories as indicated.
DIMENSIONS:
Floor space 38-1/4" (972mm) W x 36-7/8" (937mm)
Product clearance
Oven Back 0" from combustible and non-combustible construction.
Oven Sides 2" from combustible and non-combustible construction.
Interior 29" (737mm) W x 20" (508mm) H x 24-1/4" (616mm) D
If oven is on casters add to all height dimensions:
Single 4-112" (114mm)
Double 2-1/4" (57mm)
'OWER SUPPLY: Pi)
115 VAC,1 phase, 6 amp, 60 Hz., 2 -wire with ground,
A13 H.P., 2 speed motor,1140 and 1725 RPM
✓. 2230, 220/240VAC, 1 phase, 3 amp, 50 Hz., 2 -wire with ground,
X13 H.P., 1 speed motor, 1425 RPM
A.-6' (1.8m) electric cord set furnished on 115 VAC ovens only.
MINIMUM ENTRY CLEARANCE:
Uncrated 32-1116" (814mm)
Crated 37-112" (953mm)
GAS SUPP
314" NPT SHIPPING INFORMATION:
Manifold Pressure: Approx. Weight:
• Natural — 3.5" W.0 •Propane —10" W.C. Single 535 lbs. (243 kg)
Double 1070 lbs. (485 kg)
Inlet Pressure:
� Crate sizes:
• Natural — 7.0" W.C. min. —10.5" W.C. max: "
• Propane —11.0" W.C. min. —13.0" W.C. max. 37-112 (952mm) x 43-112 (110.5mm) x 51-3/4"(1315mm)
AXIMUM INPUT:
Single 50,000 BTU/hr (14.6 Kw)
'rouble 100,000 BTUIhr (29.2 Kw
"OTE: The company reserves the right to make substitutions of components without prior notice
BLODGETT OVEN COMPANY
www.blodgett.com
44 Lakeside Avenue, Burlington, VT 05401 Toll Free: (800) 331-5842 • Phone: (802) 860-3700 • Fax: (802) 864-0183
Printed in U.S.A. NOTE: FOR COMMERCIAL USE ONLY P/N 36946 Rev G (5/06))
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St. Michael's Caterers
30 Momunent Square
Char l ont awn, MA. 02129
May 30, 1990
Steven Vali:
After reviewing your kitchen's plans for the
Site, the following requests must be'met:
-The toilet facility should not open directly into the kitchen
area unless vented. The bathrooms should have self-closing
doors (105 CMR 590.018 C)
-Where are the floor drains in respect to the equ= tment hat ,
will need to be drained. (105 CMR 590.017F)
-Tho walls, ceilings and floors are to be constructed of non-
absorbent, easily cleanable material, what material is to be
used.(105 CMR 590.020 A & F)
-Where is the dumpster area located compared to the kitchen.
(105 CMR 590.020)
-All movable equipment must be on wheels or casters. (105 CMR
590.012 3 a)
I can be reached at (682-6483) so that we can set up an
appointment for you to discuss the revised plans. At the time of
the appointment you should have with you a chock for 025.00 that
will cover the plan review fee.
Sincerely,
Stephanie J. L. Foley
N. Andover Health Dept.
V4 46� V-0
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