Critical Item History - ALL

Name of Est Nature Business Street City/Town Permit

Number
Critical Item Description Inspected By
Date C I Marked Follow-up Date LAG Time:
Designated Employee: Beard
Campbell's Texaco Food Service Establishment 3075 Hwy 237 Phil Campbell 33 FS 2245 Beard

27 no available toilet paper in the restroom-10 day notice given and owner informed-abated, supplied 10/21/2019 10/24/2019 3
on followup

Gasmart West Food Service Establishment 23791 Hwy 24 W Russellville 33 FS 2268 Beard

07 prep cooler holding eggs, sliced tomatoes and lettuce at 48-52 F-3 day notice 10/25/2019

15 mold on fountain nozzles, dishes not being sanitized-3 day notice 10/25/2019

Jack's #148 Food Service Establishment 13640 Highway 43 Russellville 33-FS-1421 Beard

16 dirty chicken rack pans stored with clean dishes-10 day notice 10/25/2019

La Fogata Guerrerense Food Service Establishment 412 Madison Street Russellville 33 FS 2279 Beard

02 no proof of foodhandlers employee reporting agreement-not permitted at this time 10/25/2019

Monday, October 28, 2019 Page 1 of 1