Food Establishment Inspection Report |
||||||||||||||||||||||||||
Page 1 of ????????? | ||||||||||||||||||||||||||
|
|
FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS |
Circle designated compliance status (IN, OUT, N/O, N/A) for each numbered item IN=in compliance OUT=not in compliance N/O=not observed N/A=not applicable Mark "X" in appropriate box for COS and/or R COS=corrected on-site during inspection R=repeat violation |
Risk factors are important practices or procedures identified as the most prevalent contributing factors of foodborne illness or injury. Public health interventions are control measures to prevent foodborne illness or injury. |
|
|
GOOD RETAIL PRACTICES |
Good Retail Practices are preventative measures to control the addition of pathogens, chemicals, and physical objects into foods. Mark "X" in box if numbered item is not in compliance Mark "X" in appropriate box for COS and/or R COS=corrected on site during inspectionR=repeat violation |
|
|
IOCI 17-356
![]() |
Food Establishment Inspection Report |
|
Page 2 of ?????? | |
Establishments: BROCK LAKE CONCESSION STAND | Establishment #: 1599 |
Water Supply: Public Private Waste Water System: Public Private | ||
Temperature Documentation: NO | License Posted: NO | Complaint Number: |
Sanitation Information | ||
Name: NATOSHA NOYES | ||
Name: SARAH FOGLER | ||
Name: ADAM NOYES |
SANITIZER OBSERVATIONS |
|||||
Location | Location Desc. | Method Used | Chemical Sanitizer Used | PPM | Water Temp |
3-Compartment Sink | sanitizer bucket | Chemical Sanitizer | Chlorine | 200.00 | 0.00 |
3-Compartment Sink | sanitizer bucket | Chemical Sanitizer | Chlorine | 100.00 | 0.00 |
TEMPERATURE OBSERVATIONS |
Item/Location |
Temp |
Item/Location |
Temp |
Item/Location |
Temp |
pretzel/fridge corner right | 41.70°F | Pork/fridge corner right | 13.50°F | Pork/hot holding | 168.00°F |
OBSERVATIONS AND CORRECTIVE ACTIONS |
Item Number |
Violations cited in this report must be corrected within the time frames below. |
16 |
*** Sanitizer bucket was 200 ppm. *** COS PIC diluted the bucket, and it tested at 100 ppm. Had a discussion about using one cap of bleach instead of two. - 4-501.114 (A): (A) A chemical SANITIZER used in a SANITIZING solution for a manual or mechanical operation at contact times specified under ¶4-703.11(C) shall meet the criteria specified under §7-204.11 Sanitizers, Criteria, shall be used in accordance with the EPA- registered label use instructions, and shall be used as follows: (A) A chlorine solution shall have a minimum temperature based on the concentration and pH of the solution as listed in the following chart in the Food Code. - V,COS |
Inspection Comments | Discussed labeling pickles with date when they are pre-wrapped in the fridge. |
HACCP Topic: sanitizer concentration |
Person In Charge (Signature)Sarah Fogler |
Date:06/23/2023 |
InspectorEmerson Roden |
Follow-up: Yes No Follow-up Date: |