Domino's Pizza (2)DEVELOPMENT SERVICES DEPARTMENT
HEALTH DIVISION
100 SCHERTZ PARKWAY
SCHERTZ, TEXAS 78154-1b34
619-1771
RETAIL FOOD ESTABLISHMENT INSPECTION REPORT
Z
~,~~f~a
,~
1~
~ ~~ .
/ Yes No R ~ ~~ r ~) `~
3m Code Mo t]ey Yr isap Time FPM Certltild
_......_... CFN Permit Na ~~
Cat
PurposeofInspedion: 1-Compliance [2-12outine:) 3-Field [nvestigation 4-Visit 5-0th~
Establishment: ~~ ~I1 ~ j~ ~ 1, ( Owner:
Physical Address: ~ ~ ~ ~~ .~,~ ~ ~ Zip: Phone; ( )
DEMERITS
5 Pts Food (PHF) Ternperatarrli'inte 1Regttirenrents Remarks
Violations uire Immediate Corrective Action COS
1. Proper Coaling for Coaked/Pr d Food
2. Cold Hold {41 F/4S 1~
3. Hot Hold (140 F)
4. Proper Cookin Tempcxalures per PHF
5. id Reheatin 165 F in 2 Hrs)
Retnerks
DEMERITS
4 Pts PersannellHsndling/Source Requirements
Violations wire Immediate Corrective Action Remarks COS
b. Personnel with Infections Restricted/Excluded
7. Proper/Adequate Harxi washing
8. Good Hygienic Practices (Satin inkin SmokinglOther)
9. Ap ved Soureell.abeling
10. Sound Condition
11. Fro rHandlin of Re -Ta-EatFaods
i2, Cross-Contamination of Raw/Cooked FoodslOther
13. roved 5 terns (HACCP Plansmme as Public Health Gornrol}
14, Water Supply -- Ap roved SourreJSufficient CapacityMot and Cold Under Pressure
DEM>/RI7`S
3 Fts Facilfty and Equipment iRequirementa
Violations uire Immediate Corrective Action Not to Exceed lfl Da Remarks C05
15, Equi went A ate Tn Maintain Product Tem nature
16, Hand Wash Facilities uate and Accessible
17. Hand Wash Facilities with Soo and Towels
,~ 18, No Evidence of Insecc;t Contamination
19. No Evidence of Rodents/Other Animals
2D, Toxic Items P rl I.abeled/Stvfed/IJsed
21. Manual Ware Washing and Sanitizing at ( ) temperature
22, Mechanical Ware Washin and Sanitizin at ) nUtem ure
23. Ap roved SewagelWastewater Disposal S tern, Pr r Disposal
24, 'Il~et°ntometers Frovided/AccuratelPro 1 Calitxated ~ 2
25. Food Contact Surfaces of uipment and Utensits Cieantxl/Sanitized/Gond Re 'r
26, Posting of Consumer Advisories (Heimlich/Itaw Shellfish W~ni uffet Plate)
27. Food Establishment Permit - C,rade Catificaie Pasted -Fond Handler Treinirsg
Other Violations -Violations Require Corrective Actions, Not Ta Exceed 40 Days Or The Next Inspection,
Whichever Came First
Total [~
Demerits ~ ~~; j
i t ~ ~ ~,
~ ~. ~ ~~ ~~!.'~._1 ~ I~l(~ ~~}l ,-~~ ,( {`, ~.~ ~ L i. iL~l.~~~~ (.`L:1 ~ ~ };?~ ~? ~Il1~r'PC~- ~~
~~
S~r+e `~ (~
Ins edB ~ z °(:t1tiE t.,? < Prird: f` CF~~~ ~ r:y - ~ ! / t-,
Follow-Up
~„Inspection
DES
NO
..
iteceived 6y ~~ ~ ~t f ~~
_~
~~ ~.~..
i
Pint. ~, ~/,~,( ~ `'~
,,,~ 1 <,;
`
,
tie:
j~
WHITE - Customer Posting YELLOW ~-City File PINK -Consultant Fite
J
~ 'hA
to ~`~, a
~.
CITY OF SCHERTZ
MARSHAL'S OFFICE
ENVIRONMENTAL HEALTH DIVISION
1400 SCHERTZ PARKWAY
SCHERTZ, TEXAS 78154-1634
OFFICE: 619-1671 or 619-1672
NOTICE OF ADDITIONS OR CORRECTIONS
l
JOB ADDRESS: ~ )1~1/~1 f ~" )fJ~S (/~.> ~~
TYPE OF INSPECTION: ~ t~ ~~~ (~_
1~~ ~
~~.
`>•~ ~"~ Date: ~~ , `~ ~.~ ~ Inspector:
F
,,7 t,r
;~~~ Date: ~~ :~ ~_~~ ~'" Signature:
,;-,
%-
r-
JUN
NION TUBS WE'D TMURS FRI SAT SUN
INS-~ERS 25 26 27 23 29 30 ?
JUSTIN XX XX O-C ®-C ®-R O-R O-5
MARTlN O-C O-R )OC )OC 5-R 5-C 5-C
ANGIF XX 5-C 5-R 5-C 5-C 5-R XX
JOHN 5-R XaC XX XX 4-R 4-R 4-R
13RlVERS
DA ~1 D / ~ ~ O-R O-R ®-R O-R ®-R / V
PATTY 5-R X XaC 5-R 5-R 5-R 4-R
RA FA FL O-R X XX XX 5-R 5-R 5-R .
KURTIS X X 5-C 5-R 4-R 3-R 5-C
CURTIS 5-R 5-R X 5-R 4:30-R X XX
~RANDDN X 5-R 5-R X 5-R ~-R 5-R
JORDAN 5-C 5-C X X 5-R 5-C O-5
DR~NDAN X X 5-R 5-R 5-C X XX
Z
3
~~
~r
I'
fr
,SCHEDU~~ _IS SUBJ~~T ~1.alANGE
IF-YOU ARE UNABLE TO=COVER YOUR SHIFT YOU :MUST FIND A REPLACEMENT
DO NOT CLOCK [N EARLY UNLESS ASKED:~TO SY MANAGER ON DUTY
'~ ~ ! 1F-YOU CAI=L iN YOU MUST HAVE A DOCTORS-NOTE.
__ _N.i® DOCTORS.NOTE-..WRITE UP. 2. WRITE. UPS=TERMINATION
a ~J ~. ~ _i,-., ~. _.
~---- _ ---_ - - - -- _ . ..'~ ~_ _.._..-_ ._ _t ... _ _ J
~/ ~ ~i -' i ~~/~ .- -. ..
~ --~ i E ~~ ~ - -
., t
i ~
- ~• _.
._ ,
- -- -- ~-- -_ - - I-- ~ -- ~- -- - ~ --- - ~.
4 _
~ -
_. _...-_ -- -'-' - - '_ .. t ~ ~.