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Subject: Food Facility Inspection Report
Date: Tue, 9 Feb 2010 13:00:21 -0500
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<TABLE border=3D0 cellSpacing=3D0 cellPadding=3D0 width=3D750>
  <TBODY>
  <TR>
    <TD class=3DborderRightBottom width=3D500 align=3Dmiddle>
      <TABLE border=3D0 cellSpacing=3D0 cellPadding=3D0>
        <TBODY>
        <TR>
          <TD vAlign=3Dbottom width=3D75><IMG=20
            =
src=3D"http://ga.state.gegov.com/_templates/87/DHR_71x83.gif"> </TD>
          <TD class=3DArialEleven vAlign=3Dtop width=3D425 =
align=3Dmiddle><B>GEORGIA=20
            DEPARTMENT OF HUMAN RESOURCES <BR>Food Service Establishment =

            Inspection Report=20
            <TABLE class=3DArialEleven border=3D0 cellSpacing=3D0 =
cellPadding=3D0>
              <TBODY>
              <TR>
                <TD height=3D20 vAlign=3Dbottom =
width=3D125><B>Establishment=20
                  Name:</B> </TD>
                <TD class=3DborderBottom height=3D20 vAlign=3Dbottom=20
                  width=3D275>&nbsp;C.R. Bard Urological Cafeteria=20
            </TD></TR></TBODY></TABLE>
            <TABLE class=3DArialEleven border=3D0 cellSpacing=3D0 =
cellPadding=3D0>
              <TBODY>
              <TR>
                <TD height=3D20 vAlign=3Dbottom =
width=3D75><B>Address:</B> </TD>
                <TD class=3DborderBottom height=3D20 vAlign=3Dbottom=20
                  width=3D325>&nbsp;8195 Industrial BLVD=20
          </TD></TR></TBODY></TABLE></B></TD></TR>
        <TR>
          <TD width=3D500 colSpan=3D2>
            <TABLE class=3DArialEleven border=3D0 cellSpacing=3D0 =
cellPadding=3D0>
              <TBODY>
              <TR height=3D20>
                <TD vAlign=3Dbottom width=3D30><B>City:</B> </TD>
                <TD class=3DborderBottom vAlign=3Dbottom =
width=3D100>&nbsp;COVINGTON=20
                </TD>
                <TD vAlign=3Dbottom width=3D50 align=3Dright><B>Time =
In:</B> </TD>
                <TD class=3DborderBottom vAlign=3Dbottom width=3D40=20
                  align=3Dmiddle>&nbsp;10 </TD>
                <TD vAlign=3Dbottom width=3D5><B>:</B> </TD>
                <TD class=3DborderBottom vAlign=3Dbottom width=3D40=20
                  align=3Dmiddle>&nbsp;05 </TD>
                <TD class=3DArialSeven vAlign=3Dbottom width=3D30=20
                  align=3Dmiddle><B>AM</B> </TD>
                <TD vAlign=3Dbottom width=3D70 align=3Dright><B>Time =
Out:</B> </TD>
                <TD class=3DborderBottom vAlign=3Dbottom width=3D40=20
                  align=3Dmiddle>&nbsp;11 </TD>
                <TD vAlign=3Dbottom width=3D5><B>:</B> </TD>
                <TD class=3DborderBottom vAlign=3Dbottom width=3D40=20
                  align=3Dmiddle>&nbsp;55 </TD>
                <TD class=3DArialSeven vAlign=3Dbottom width=3D30=20
                  align=3Dmiddle><B>AM</B> </TD></TR></TBODY></TABLE>
            <TABLE class=3DArialEleven border=3D0 cellSpacing=3D0 =
cellPadding=3D0>
              <TBODY>
              <TR height=3D20>
                <TD vAlign=3Dbottom width=3D100><B>Inspection Date:</B> =
</TD>
                <TD class=3DborderBottom vAlign=3Dbottom =
width=3D30>&nbsp; </TD>
                <TD class=3DborderBottom vAlign=3Dbottom=20
                  width=3D50>&nbsp;<STRONG>02/02/2010</STRONG> </TD>
                <TD class=3DborderBottom vAlign=3Dbottom =
width=3D30>&nbsp; </TD>
                <TD vAlign=3Dbottom width=3D50 =
align=3Dright><B>CFSM:</B> </TD>
                <TD class=3DborderBottom vAlign=3Dbottom =
width=3D180>&nbsp; Doyle M.=20
                  Irons 6813573 12-8-14 </TD></TR></TBODY></TABLE>
            <TABLE class=3DArialEleven border=3D0 cellSpacing=3D0 =
cellPadding=3D0>
              <TBODY>
              <TR>
                <TD class=3DborderRightBottom width=3D360><B>Purpose of=20
                  Inspection: &nbsp;&nbsp; Routine <IMG =
align=3DabsMiddle=20
                  =
src=3D"http://ga.state.gegov.com/_templates/87/circle_filled_10x10.gif"> =

                  &nbsp;&nbsp; Followup <IMG align=3DabsMiddle=20
                  =
src=3D"http://ga.state.gegov.com/_templates/87/circle_10x10.gif">=20
                  &nbsp;&nbsp; Complaint <IMG align=3DabsMiddle=20
                  =
src=3D"http://ga.state.gegov.com/_templates/87/circle_10x10.gif">=20
                  <BR>&nbsp;&nbsp; Preliminary <IMG align=3DabsMiddle=20
                  =
src=3D"http://ga.state.gegov.com/_templates/87/circle_10x10.gif">=20
                  &nbsp;&nbsp; Other <IMG align=3DabsMiddle=20
                  =
src=3D"http://ga.state.gegov.com/_templates/87/circle_10x10.gif">=20

                  <TABLE class=3DArialEleven border=3D0 cellSpacing=3D0=20
                    cellPadding=3D0><TBODY>
                    <TR height=3D20>
                      <TD vAlign=3Dbottom width=3D175><B>Risk Type: =
&nbsp; 1 <IMG=20
                        align=3DabsMiddle=20
                        =
src=3D"http://ga.state.gegov.com/_templates/87/circle_10x10.gif">=20
                        &nbsp; 2 <IMG align=3DabsMiddle=20
                        =
src=3D"http://ga.state.gegov.com/_templates/87/circle_filled_10x10.gif"> =

                        &nbsp; 3 <IMG align=3DabsMiddle=20
                        =
src=3D"http://ga.state.gegov.com/_templates/87/circle_10x10.gif">=20
                        </B></TD>
                      <TD vAlign=3Dbottom width=3D50 =
align=3Dright><B>Permit#:</B>=20
                      </TD>
                      <TD class=3DborderBottom vAlign=3Dbottom=20
                        width=3D125>&nbsp;FSP-107-000016 =
</TD></TR></TBODY></TABLE>
                  <TABLE class=3DArialSeven border=3D0 cellSpacing=3D0=20
                    cellPadding=3D0><TBODY>
                    <TR>
                      <TD class=3DborderAll width=3D225>Risk Factors are =
food=20
                        preparation practices and employee behaviors =
most=20
                        commonly reported to the Centers for Disease =
Control and=20
                        Prevention as contributing factors in foodborne =
illness=20
                        outbreaks. Public Health Interventions are =
control=20
                        measures to prevent illness or injury. </TD>
                      <TD class=3DborderAll width=3D125>Good Retail =
Practices are=20
                        preventive measures to control the introduction =
of=20
                        pathogens, chemicals, and physical objects into =
foods.=20
                      </TD></TR></TBODY></TABLE></B></TD>
                <TD width=3D140>
                  <TABLE class=3DArialSix border=3D0 cellSpacing=3D0 =
cellPadding=3D0>
                    <TBODY>
                    <TR height=3D43>
                      <TD class=3DborderAll vAlign=3Dtop width=3D46=20
                        align=3Dmiddle>Last Score<BR><BR>
                        <DIV style=3D"FONT-SIZE: 16pt" =
align=3Dcenter></DIV></TD>
                      <TD class=3DborderAll vAlign=3Dtop width=3D46=20
                        align=3Dmiddle>Grade<BR><BR>
                        <DIV style=3D"FONT-SIZE: 16pt" =
align=3Dcenter></DIV></TD>
                      <TD class=3DborderAll vAlign=3Dtop width=3D46=20
                        align=3Dmiddle>Date<BR><BR>
                        <DIV style=3D"FONT-SIZE: 8pt"=20
                        align=3Dcenter><STRONG></STRONG></DIV></TD></TR>
                    <TR height=3D43>
                      <TD class=3DborderAll vAlign=3Dtop width=3D46=20
                        align=3Dmiddle>Prior Score<BR><BR>
                        <DIV style=3D"FONT-SIZE: 16pt" =
align=3Dcenter></DIV></TD>
                      <TD class=3DborderAll vAlign=3Dtop width=3D46=20
                        align=3Dmiddle>Grade<BR><BR>
                        <DIV style=3D"FONT-SIZE: 16pt" =
align=3Dcenter></DIV></TD>
                      <TD class=3DborderAll vAlign=3Dtop width=3D46=20
                        align=3Dmiddle>Date<BR><BR>
                        <DIV style=3D"FONT-SIZE: 8pt"=20
                        =
align=3Dcenter><STRONG></STRONG></DIV></TD></TR></TBODY></TABLE></TD></TR=
></TBODY></TABLE></TD></TR></TBODY></TABLE></TD>
    <TD class=3DborderAll vAlign=3Dtop width=3D250>
      <TABLE class=3DArialEleven border=3D0 cellSpacing=3D0 =
cellPadding=3D0>
        <TBODY>
        <TR bgColor=3D#cccccc>
          <TD class=3DborderBottom width=3D125 align=3Dmiddle><B>CURRENT =
SCORE</B>=20
          </TD>
          <TD class=3DborderBottom width=3D125 align=3Dmiddle><B>CURRENT =
GRADE</B>=20
          </TD></TR>
        <TR height=3D188>
          <TD class=3DborderRightY width=3D125 align=3Dmiddle>&nbsp;
            <DIV style=3D"COLOR: black; FONT-SIZE: 55pt"=20
            align=3Dcenter><STRONG>91</STRONG></DIV></TD>
          <TD class=3DborderAll width=3D125 align=3Dmiddle>&nbsp;
            <DIV style=3D"COLOR: black; FONT-SIZE: 55pt"=20
            align=3Dcenter><STRONG>A</STRONG></DIV></TD></TR>
        <TR>
          <TD class=3DborderAll width=3D250 colSpan=3D2>
            <TABLE class=3DArialSeven border=3D0 cellSpacing=3D0 =
cellPadding=3D0>
              <TBODY>
              <TR>
                <TD class=3DborderRight bgColor=3D#cccccc =
width=3D100><B>SCORING AND=20
                  GRADING:</B> </TD>
                <TD vAlign=3Dbottom width=3D150><B>A=3D90-100 =
&nbsp;&nbsp; B=3D80-89=20
                  &nbsp;&nbsp; C=3D70-79 &nbsp;&nbsp; U&lt;69=20
            =
</B></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY=
></TABLE>
<TABLE style=3D"PAGE-BREAK-AFTER: always" class=3DscreenSpace border=3D0 =
cellSpacing=3D0=20
cellPadding=3D0 width=3D750>
  <TBODY>
  <TR>
    <TD>
      <TABLE border=3D0 cellSpacing=3D0 cellPadding=3D0 width=3D"100%"=20
        bgColor=3D#000000><TBODY>
        <TR>
          <TD bgColor=3D#cccccc align=3Dmiddle>
            <P class=3Dblacktitle>FOODBORNE ILLNESS RISK FACTORS AND =
PUBLIC HEALTH=20
            INTERVENTIONS</P></TD></TR>
        <TR>
          <TD bgColor=3D#ffffff>
            <TABLE border=3D0 cellSpacing=3D0 cellPadding=3D0 =
width=3D"100%">
              <TBODY>
              <TR class=3Dnine>
                <TD align=3Dmiddle><B>IN</B>=3Din =
compliance&nbsp;&nbsp;&nbsp;=20
                  <B>OUT</B>=3Dnot in compliance&nbsp;&nbsp;&nbsp; =
<B>N/O</B>=3Dnot=20
                  observed&nbsp;&nbsp;&nbsp; <B>N/A</B>=3Dnot applicable =
</TD>
                <TD>&nbsp;&nbsp;</TD>
                <TD align=3Dmiddle><B>COS</B>=3Dcorrected on-site during =

                  inspection&nbsp;&nbsp;&nbsp; <B>R</B>=3Drepeat =
violation=20
              =
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR>
  <TR>
    <TD>
      <TABLE border=3D0 cellSpacing=3D0 cellPadding=3D0 width=3D"100%" =
align=3Dcenter>
        <TBODY>
        <TR>
          <TD vAlign=3Dtop width=3D"50%" align=3Dmiddle>
            <TABLE border=3D0 cellSpacing=3D1 cellPadding=3D0 =
width=3D"100%"=20
            bgColor=3D#000000 height=3D330>
              <TBODY>
              <TR class=3Dnine bgColor=3D#ffffff>
                <TD class=3Dblacktitle colSpan=3D3><B>Compliance =
Status</B></TD>
                <TD class=3Dblacktitle width=3D20 =
align=3Dmiddle>COS</TD>
                <TD class=3Dblacktitle width=3D20 =
align=3Dmiddle>R</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>1. =
Supervision</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>4 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>1-2</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Person in charge present, demonstrates knowledge, =
and=20
                  performs duties</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>2. =
Employee=20
                  Health, Good Hygenic Practices, Preventing =
Contamination by=20
                  Hands</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>9 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>2-1A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Proper use of restriction &amp; exclusion</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>2-1B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Hands clean and properly washed</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>2-1C</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>No bare hand contact with ready-to-eat foods or =
approved=20
                  alternate method properly followed</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>2. =
Employee=20
                  Health, Good Hygenic Practices, Preventing =
Contamination by=20
                  Hands</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>4 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>2-2A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Management awareness; policy present; reporting</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>2-2B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Proper eating, tasting, drinking, or tobacco =
use</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>2-2C</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>No discharge from eyes, nose, and mouth</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>2-2D</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Adequate handwashing facilities supplied &amp;=20
                accessible</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>3. =
Approved=20
                Source</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>9 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>3-1A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Food obtained from approval source, parasite=20
destruction</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>3-1B</TD>
                <TD width=3D20 align=3Dmiddle>N/O</TD>
                <TD>Food received at proper temperature</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>3-1C</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Food in good condition, safe, and unadulterated</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>4-1A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Food separated and protected</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>4-1B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Proper disposition of returned, previously served,=20
                  reconditional, and unsafe food</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>4. =
Protection from=20
                  Contamination</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>4 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>4-2A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Food stored covered</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>4-2B</TD>
                <TD width=3D20 align=3Dmiddle><B style=3D"COLOR: =
red">OUT</B></TD>
                <TD>Food-contact surfaces; cleaned &amp; sanitized</TD>
                <TD width=3D20 align=3Dmiddle>X</TD>
                <TD width=3D20 =
align=3Dmiddle>&nbsp;</TD></TR></TBODY></TABLE></TD>
          <TD width=3D5>&nbsp;</TD>
          <TD vAlign=3Dtop width=3D"50%" align=3Dright>
            <TABLE border=3D0 cellSpacing=3D1 cellPadding=3D0 =
width=3D"100%"=20
            bgColor=3D#000000 height=3D330>
              <TBODY>
              <TR class=3Dnine bgColor=3D#ffffff>
                <TD class=3Dblacktitle colSpan=3D3><B>Compliance =
Status</B></TD>
                <TD class=3Dblacktitle width=3D20 =
align=3Dmiddle>COS</TD>
                <TD class=3Dblacktitle width=3D20 =
align=3Dmiddle>R</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>5. =
Cooking and=20
                  Reheating of Potentially Hazardous Foods, Consumer =
Advisory</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>9 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>5-1A</TD>
                <TD width=3D20 align=3Dmiddle>N/O</TD>
                <TD>Proper cooking time and temperatures</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>5-1B</TD>
                <TD width=3D20 align=3Dmiddle>N/O</TD>
                <TD>Proper reheating procedures for hot holding</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>5. =
Cooking and=20
                  Reheating of Potentially Hazardous Foods, Consumer =
Advisory</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>4 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>5-2</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Consumer advisory provided for raw and undercooked=20
foods</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>6. =
Holding of=20
                  Potentially Hazardous Foods, Date Marking Potentially=20
                  Hazardous Foods</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>9 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>6-1A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Proper cold holding temperature</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>6-1B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Proper hot holding temperature</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>6-1C</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Proper cooling time and temperature</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>6-1D</TD>
                <TD width=3D20 align=3Dmiddle>N/A</TD>
                <TD>Time as a public health control; procedures and =
records</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>6. =
Holding of=20
                  Potentially Hazardous Foods, Date Marking Potentially=20
                  Hazardous Foods</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>4 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>6-2</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Proper date marking and disposition</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>7. =
Highly=20
                  Susceptible Populations</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>9 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>7-1</TD>
                <TD width=3D20 align=3Dmiddle>N/A</TD>
                <TD>Pasteurized foods used; Prohibited foods not =
offered</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>8. =
Chemicals</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>4 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>8-2A</TD>
                <TD width=3D20 align=3Dmiddle>N/A</TD>
                <TD>Food additives; approved and properly used</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>8-2B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Toxic substances properly identified, stored, =
used</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>9-2</TD>
                <TD width=3D20 align=3Dmiddle>N/A</TD>
                <TD>Compliance with variance, specialized process and =
HACCP=20
                  plan</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20=20
        =
align=3Dmiddle>&nbsp;</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>=
</TD></TR>
  <TR>
    <TD>
      <TABLE border=3D0 cellSpacing=3D0 cellPadding=3D0 width=3D"100%"=20
        bgColor=3D#000000><TBODY>
        <TR>
          <TD class=3Dblacktitle bgColor=3D#cccccc align=3Dmiddle>GOOD =
RETAIL=20
            PRACTICES</TD></TR>
        <TR>
          <TD class=3Dnine bgColor=3D#ffffff align=3Dmiddle>Good Retail =
Practices=20
            are preventative measures to control the addition of =
pathogens,=20
            chemicals, and physical objects into=20
    foods.<BR></TD></TR></TBODY></TABLE></TD></TR>
  <TR>
    <TD>
      <TABLE border=3D0 cellSpacing=3D0 cellPadding=3D0 width=3D"100%" =
align=3Dcenter>
        <TBODY>
        <TR>
          <TD vAlign=3Dtop width=3D"50%" align=3Dmiddle>
            <TABLE border=3D0 cellSpacing=3D1 cellPadding=3D0 =
width=3D"100%"=20
            bgColor=3D#000000 height=3D330>
              <TBODY>
              <TR class=3Dnine bgColor=3D#ffffff>
                <TD class=3Dblacktitle colSpan=3D3><B>Compliance =
Status</B></TD>
                <TD class=3Dblacktitle width=3D20 =
align=3Dmiddle>COS</TD>
                <TD class=3Dblacktitle width=3D20 =
align=3Dmiddle>R</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>10. =
Safe Food and=20
                  Water, Food Identification</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>3 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>10A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Pasteurized eggs used where required</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>10B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Water and ice from approved source</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>10C</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Variance obtained for specialized processing =
methods</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>10D</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Food properly labeled; original container; required=20
                  records available; shellstock tags</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>11A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Proper cooling methods used; adequate equipment for=20
                  temperature control</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>11B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Plant food properly cooked for hot holding</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>11C</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Approved thawing methods used</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>11D</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Thermometers provided and accurate</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>12A</TD>
                <TD width=3D20 align=3Dmiddle><B style=3D"COLOR: =
red">OUT</B></TD>
                <TD>Contamination prevented during food preparation, =
storage=20
                  display</TD>
                <TD width=3D20 align=3Dmiddle>X</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>12B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Personal cleanliness</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>12C</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Wiping cloths; properly used and stored</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>12D</TD>
                <TD width=3D20 align=3Dmiddle><B style=3D"COLOR: =
red">OUT</B></TD>
                <TD>Washing fruits and vegetables</TD>
                <TD width=3D20 align=3Dmiddle>X</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>13. =
Postings and=20
                  Compliance with Clean Air Act</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>1 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>13A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Posted: Permit/Inspection/Choking =
Poster/Handwashing</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>13B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Compliance with Georgia Smoke Free Air Act</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 =
align=3Dmiddle>&nbsp;</TD></TR></TBODY></TABLE></TD>
          <TD width=3D5>&nbsp;</TD>
          <TD vAlign=3Dtop width=3D"50%" align=3Dright>
            <TABLE border=3D0 cellSpacing=3D1 cellPadding=3D0 =
width=3D"100%"=20
            bgColor=3D#000000 height=3D330>
              <TBODY>
              <TR class=3Dnine bgColor=3D#ffffff>
                <TD class=3Dblacktitle colSpan=3D3><B>Compliance =
Status</B></TD>
                <TD class=3Dblacktitle width=3D20 =
align=3Dmiddle>COS</TD>
                <TD class=3Dblacktitle width=3D20 =
align=3Dmiddle>R</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>14. =
Proper Use of=20
                  Utensils</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>1 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>14A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>In-use utensils; properly stored</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>14B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Utensils, equipment and linens; properly stored, =
dried,=20
                  handled</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>14C</TD>
                <TD width=3D20 align=3Dmiddle><B style=3D"COLOR: =
red">OUT</B></TD>
                <TD>Single-use/single-service articles; properly stored, =

                used</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>X</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>14D</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Gloves used properly</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>15A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Food and nonfood-contact surfaces cleanable, =
properly=20
                  designed, constructed, and used</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>15B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Warewashing facilities; installed, maintained, used; =
test=20
                  strips</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>15C</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Nonfood-contact surfaces clean</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>16. =
Water,=20
                  Plumbing and Waste</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>2 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>16A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Hot and cold water available; adequate pressure</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>16B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Plumbing installed; proper backflow devices</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>16C</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Sewage and waste water properly disposed</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>17. =
Physical=20
                  Facilities</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>1 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>17A</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Toilet facilities; properly constructed, supplied,=20
                cleaned</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>17B</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Garbage/refuse properly disposed; facilities =
maintained</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>17C</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Physical facilities installed, maintained, and =
clean</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>17D</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Adequate ventilation and lighting; designated areas=20
used</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD></TR>
              <TR bgColor=3D#cccccc>
                <TD class=3Dblacktitle colSpan=3D3 align=3Dmiddle>18. =
Pest and=20
                  Animal Control</TD>
                <TD class=3Dblacktitle colSpan=3D2 align=3Dmiddle>3 =
points</TD></TR>
              <TR class=3Deight vAlign=3Dtop bgColor=3D#ffffff>
                <TD width=3D20 align=3Dmiddle>18</TD>
                <TD width=3D20 align=3Dmiddle>IN</TD>
                <TD>Insects, rodents, and animals not present</TD>
                <TD width=3D20 align=3Dmiddle>&nbsp;</TD>
                <TD width=3D20=20
        =
align=3Dmiddle>&nbsp;</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>=
</TD></TR>
  <TR>
    <TD>
      <TABLE border=3D0 cellSpacing=3D1 cellPadding=3D1 width=3D"100%"=20
        bgColor=3D#000000><TBODY>
        <TR class=3Deleven height=3D30 bgColor=3D#ffffff>
          <TD vAlign=3Dbottom><B>Person in Charge (Signature)</B> =
&nbsp;&nbsp;
            <OBJECT id=3Dsignature_object=20
            =
codeBase=3D"http://java.sun.com/update/1.5.0/jinstall-1_5-windows-i586.ca=
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            codeType=3Dapplication/java width=3D200 height=3D30><PARAM =
NAME=3D"code" VALUE=3D"SignatureCapture.class"><PARAM NAME=3D"codebase" =
VALUE=3D"/jre/"><PARAM NAME=3D"type" =
VALUE=3D"application/x-java-applet;version=3D1.5"><PARAM =
NAME=3D"scriptable" VALUE=3D"false"><PARAM NAME=3D"coordinates" =
VALUE=3D""><PARAM NAME=3D"imgheight" VALUE=3D"30"><PARAM =
NAME=3D"imgwidth" VALUE=3D"200">
            																																<embed
            					type=3D"application/x-java-applet;version=3D1.5" \
            					code=3D"SignatureCapture.class" \					=
codebase=3D"/jre/" \
            					width=3D200 \					height=3D30					scriptable=3Dfalse
            					=
pluginspage=3D"http://java.sun.com/products/plugin/index.html#download">
            					<span class=3D"small" =
style=3D"font-size:13px;font-weight:bold;">
            						<br>Please install the proper version of Java on your =
machine
            					</span>				</embed>				</OBJECT><INPUT id=3Dsignature =
type=3Dhidden=20
            name=3Dsignature> <B>(Print)</B> &nbsp; </TD>
          <TD vAlign=3Dbottom width=3D150><B>Date:</B> &nbsp;=20
    </TD></TR></TBODY></TABLE></TD></TR>
  <TR>
    <TD>
      <TABLE border=3D0 cellSpacing=3D1 cellPadding=3D1 width=3D"100%"=20
        bgColor=3D#000000><TBODY>
        <TR class=3Deleven height=3D30 bgColor=3D#ffffff>
          <TD vAlign=3Dbottom><B>Inspector (Signature)</B>
            <OBJECT id=3Dsignature_object=20
            =
codeBase=3D"http://java.sun.com/update/1.5.0/jinstall-1_5-windows-i586.ca=
b#Version=3D1,5,0,0"=20
            classid=3Dclsid:8AD9C840-044E-11D1-B3E9-00805F499D93=20
            codeType=3Dapplication/java width=3D200 height=3D30><PARAM =
NAME=3D"code" VALUE=3D"SignatureCapture.class"><PARAM NAME=3D"codebase" =
VALUE=3D"/jre/"><PARAM NAME=3D"type" =
VALUE=3D"application/x-java-applet;version=3D1.5"><PARAM =
NAME=3D"scriptable" VALUE=3D"false"><PARAM NAME=3D"coordinates" =
VALUE=3D""><PARAM NAME=3D"imgheight" VALUE=3D"30"><PARAM =
NAME=3D"imgwidth" VALUE=3D"200">
            																																<embed
            					type=3D"application/x-java-applet;version=3D1.5" \
            					code=3D"SignatureCapture.class" \					=
codebase=3D"/jre/" \
            					width=3D200 \					height=3D30					scriptable=3Dfalse
            					=
pluginspage=3D"http://java.sun.com/products/plugin/index.html#download">
            					<span class=3D"small" =
style=3D"font-size:13px;font-weight:bold;">
            						<br>Please install the proper version of Java on your =
machine
            					</span>				</embed>				</OBJECT><INPUT id=3Dsignature =
type=3Dhidden=20
            name=3Dsignature> &nbsp;Jason Reagan </TD>
          <TD vAlign=3Dbottom width=3D350 =
align=3Dmiddle><B>Follow-up</B> YES <IMG=20
            align=3DabsMiddle=20
            =
src=3D"http://ga.state.gegov.com/_templates/87/circle_10x10.gif">=20
            &nbsp;&nbsp;NO <IMG align=3DabsMiddle=20
            =
src=3D"http://ga.state.gegov.com/_templates/87/circle_filled_10x10.gif"> =

            &nbsp;&nbsp;&nbsp;&nbsp;<B>Follow-up Date:</B>=20
            &nbsp;<BR><STRONG>Discussed With:</STRONG> Doyle Irons=20
            &nbsp;&nbsp;&nbsp;&nbsp;<B>Title:</B> Manager=20
  </TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>
<TABLE=20
style=3D"BORDER-BOTTOM: black 1px solid; BORDER-LEFT: black 1px solid; =
BORDER-TOP: black 1px solid; BORDER-RIGHT: black 1px solid"=20
border=3D0 cellSpacing=3D0 cellPadding=3D0 width=3D750>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: black 1px solid; BORDER-TOP-COLOR: black; =
BORDER-RIGHT-COLOR: black; BORDER-LEFT-COLOR: black"=20
    class=3Dtitle height=3D30 align=3Dmiddle>
      <TABLE border=3D0 cellSpacing=3D0 cellPadding=3D0 width=3D"100%">
        <TBODY>
        <TR>
          <TD class=3Dtitle2 align=3Dmiddle><B>Food Establishment =
Inspection=20
            Report Addendum</B></TD></TR>
        <TR>
          <TD=20
          style=3D"BORDER-BOTTOM: black 1px solid; BORDER-RIGHT-COLOR: =
black; BORDER-LEFT-COLOR: black; BORDER-TOP: black 1px solid"=20
          class=3Deleven><B><I>Violations cited in this report must be =
corrected=20
            within the time frames specified below, or as stated in the =
Georgia=20
            Department of Human Resources <BR>Rules and Regulations Food =
Service=20
            Chapter 290-5-14, Rule .10 subsections (2)(i) and=20
        (j).</B></I></TD></TR></TBODY></TABLE></TD></TR>
  <TR>
    <TD>
      <TABLE border=3D0 cellSpacing=3D1 cellPadding=3D2 width=3D"100%"=20
        bgColor=3D#000000><TBODY>
        <TR class=3Dnine vAlign=3Dtop bgColor=3D#ffffff>
          <TD height=3D28><B class=3Deleven>Establishment</B><BR>C.R. =
Bard=20
            Urological Cafeteria</TD>
          <TD height=3D28 width=3D150><B class=3Deleven>Permit=20
            #</B><BR>FSP-107-000016</TD>
          <TD height=3D28 width=3D110><B =
class=3Deleven>Date</B><BR>02/02/2010</TD></TR>
        <TR class=3Dnine vAlign=3Dtop bgColor=3D#ffffff>
          <TD height=3D28><B class=3Deleven>Address</B><BR>8195 =
INDUSTRIAL BLVD=20
</TD>
          <TD height=3D28 width=3D150><B =
class=3Deleven>City/State</B><BR>COVINGTON=20
            GA</TD>
          <TD height=3D28 width=3D150><B=20
        =
class=3Deleven>Zipcode</B><BR>30014</TD></TR></TBODY></TABLE></TD></TR>
  <TR>
    <TD bgColor=3D#000000>
      <TABLE border=3D0 cellSpacing=3D1 cellPadding=3D2 width=3D"100%">
        <TBODY>
        <TR>
          <TD class=3Dblacktitle bgColor=3D#cccccc colSpan=3D6=20
            align=3Dmiddle>TEMPERATURE OBSERVATIONS </TD></TR>
        <TR bgColor=3D#ffffff>
          <TD class=3Dten width=3D180 =
align=3Dmiddle><B>Item/Location</B></TD>
          <TD class=3Dten width=3D60 align=3Dmiddle><B>Temp</B></TD>
          <TD class=3Dten width=3D180 =
align=3Dmiddle><B>Item/Location</B></TD>
          <TD class=3Dten width=3D60 align=3Dmiddle><B>Temp</B></TD>
          <TD class=3Dten width=3D180 =
align=3Dmiddle><B>Item/Location</B></TD>
          <TD class=3Dten width=3D60 =
align=3Dmiddle><B>Temp</B></TD></TR>
        <TR bgColor=3D#ffffff>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Therm. Calib. =
Atkins / Ice=20
            Water</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>32.4 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Sliced Tomatoes =
/ Reachin=20
            cooler-glass front-cooling 15 min</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>44.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Milk / Reachin =
cooler-glass=20
            front</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>43.0 =C2=B0 F</TD></TR>
        <TR bgColor=3D#ffffff>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Skim Milk / =
Reachin=20
            cooler-glass front</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>43.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Chicken (r) / =
Reachin=20
            cooler-serve line-cooling 1 hr</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>48.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Chicken (r) / =
Reachin=20
            cooler-serve line-cooling 1 hr</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>44.0 =C2=B0 F</TD></TR>
        <TR bgColor=3D#ffffff>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Ham (c) / =
Reachin=20
            cooler-serve line-cooling 30 min</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>44.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Turkey (c) / =
Reachin=20
            cooler-serve line-cooling 30 min</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>45.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Tuna / Prep =
cooler-serve=20
          line</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>43.0 =C2=B0 F</TD></TR>
        <TR bgColor=3D#ffffff>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Grilled Chicken =
/ Prep=20
            cooler-serve line-cooling 30 min</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>44.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Sliced tomatoes =
/ Prep=20
            cooler-small unit</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>39.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Shred Cheese / =
Prep=20
            cooler-small unit</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>39.0 =C2=B0 F</TD></TR>
        <TR bgColor=3D#ffffff>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Ham (c) / Prep =
cooler-bottom=20
          </TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>38.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Shred Cheese / =
Cooler=20
            drawers at grill-cooling 30 min</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>54.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Onions / Hot =
holding unit</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>147.0 =C2=B0 F</TD></TR>
        <TR bgColor=3D#ffffff>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Bell peppers / =
Hot holding=20
            unit</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>154.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Ground Beef (r) =
/ Reachin=20
            cooler</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>38.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Cheese / Reachin =
cooler</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>40.0 =C2=B0 F</TD></TR>
        <TR bgColor=3D#ffffff>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Turkey / Reachin =
cooler</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>41.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Bean Soup / Hot =
holding=20
          unit</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>155.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Rice / Hot =
holding=20
cabinet</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>167.0 =C2=B0 F</TD></TR>
        <TR bgColor=3D#ffffff>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Green Beans / =
Hot holding=20
            cabinet</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>149.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Ground beef (c) =
/ Hot=20
            holding cabinet</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>112.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Milk / Reachin =
Cooler</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>39.0 =C2=B0 F</TD></TR>
        <TR bgColor=3D#ffffff>
          <TD class=3Dten bgColor=3D#ffffff width=3D180>Butter / Reachin =
Cooler</TD>
          <TD class=3Dten bgColor=3D#ffffff width=3D60 =
align=3Dmiddle>54.0 =C2=B0 F</TD>
          <TD class=3Dten bgColor=3D#ffffff>&nbsp;</TD>
          <TD class=3Dten bgColor=3D#ffffff>&nbsp;</TD>
          <TD class=3Dten bgColor=3D#ffffff>&nbsp;</TD>
          <TD class=3Dten =
bgColor=3D#ffffff>&nbsp;</TD></TR></TBODY></TABLE></TD></TR>
  <TR>
    <TD>
      <TABLE border=3D0 cellSpacing=3D1 cellPadding=3D2 width=3D"100%"=20
        bgColor=3D#cccccc><TBODY>
        <TR>
          <TD class=3Dten width=3D60 align=3Dmiddle>Item<BR>Number</TD>
          <TD class=3Dblacktitle bgColor=3D#cccccc colSpan=3D2=20
            align=3Dmiddle>OBSERVATIONS AND CORRECTIVE ACTIONS</TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle>4-2B </TD>
          <TD class=3Dten>Violation of Code: <SPAN=20
            style=3D"COLOR: red">[.05(7)(a)1]</SPAN> Can opener dirty, =
Slicer (top=20
            piece) is dirty-Need to wash, rinse and sanitize, COS=20
            &nbsp;Corrected On-Site. &nbsp;New Violation. </TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle>12A </TD>
          <TD class=3Dten>Violation of Code: <SPAN=20
            style=3D"COLOR: red">[.04(4)(u)]</SPAN> Food displayed but =
not=20
            protected (ex. Sout cream, tarter sauce, salsa)-need to =
protect food=20
            on display properly &nbsp;Corrected On-Site. &nbsp;New =
Violation.=20
        </TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle>12D </TD>
          <TD class=3Dten>using vbege sink to thaw raw chicken-must use =
vege=20
            sink for preparing fruit/veges only. &nbsp;Corrected =
On-Site.=20
            &nbsp;New Violation. </TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle>14C </TD>
          <TD class=3Dten>Violation of Code: <SPAN=20
            style=3D"COLOR: red">[.05(10)(e)]</SPAN> Single use =
containers stored=20
            on floor in cabinet with no floor-must store 6" off floor - =
repeat=20
            &nbsp;Repeat Violation. </TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle>Remarks </TD>
          <TD class=3Dten>Notes<BR>-Keep proper time control docs if you =
start=20
            using time control<BR>-Need dispenser for large =
cups<BR>-Store=20
            personal items properly<BR>-Keep eye on hot holding and cold =
holding=20
            temps </TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR>
        <TR height=3D22 bgColor=3D#ffffff>
          <TD class=3Dten width=3D60 align=3Dmiddle></TD>
          <TD class=3Dten></TD></TR></TBODY></TABLE></TD></TR>
  <TR>
    <TD>
      <TABLE border=3D0 cellSpacing=3D1 cellPadding=3D1 width=3D"100%"=20
        bgColor=3D#000000><TBODY>
        <TR class=3Deleven height=3D30 bgColor=3D#ffffff>
          <TD vAlign=3Dbottom><B>Person in Charge (Signature)</B> =
&nbsp;&nbsp;
            <OBJECT id=3Dsignature_object=20
            =
codeBase=3D"http://java.sun.com/update/1.5.0/jinstall-1_5-windows-i586.ca=
b#Version=3D1,5,0,0"=20
            classid=3Dclsid:8AD9C840-044E-11D1-B3E9-00805F499D93=20
            codeType=3Dapplication/java width=3D200 height=3D30><PARAM =
NAME=3D"code" VALUE=3D"SignatureCapture.class"><PARAM NAME=3D"codebase" =
VALUE=3D"/jre/"><PARAM NAME=3D"type" =
VALUE=3D"application/x-java-applet;version=3D1.5"><PARAM =
NAME=3D"scriptable" VALUE=3D"false"><PARAM NAME=3D"coordinates" =
VALUE=3D""><PARAM NAME=3D"imgheight" VALUE=3D"30"><PARAM =
NAME=3D"imgwidth" VALUE=3D"200">
            																																<embed
            					type=3D"application/x-java-applet;version=3D1.5" \
            					code=3D"SignatureCapture.class" \					=
codebase=3D"/jre/" \
            					width=3D200 \					height=3D30					scriptable=3Dfalse
            					=
pluginspage=3D"http://java.sun.com/products/plugin/index.html#download">
            					<span class=3D"small" =
style=3D"font-size:13px;font-weight:bold;">
            						<br>Please install the proper version of Java on your =
machine
            					</span>				</embed>				</OBJECT><INPUT id=3Dsignature =
type=3Dhidden=20
            name=3Dsignature> </TD>
          <TD vAlign=3Dbottom width=3D150><B>Date:</B>=20
    &nbsp;</TD></TR></TBODY></TABLE></TD></TR>
  <TR>
    <TD>
      <TABLE border=3D0 cellSpacing=3D1 cellPadding=3D1 width=3D"100%"=20
        bgColor=3D#000000><TBODY>
        <TR class=3Deleven height=3D30 bgColor=3D#ffffff>
          <TD vAlign=3Dbottom><B>Inspector (Signature)</B> Jason Reagan
            <OBJECT id=3Dsignature_object=20
            =
codeBase=3D"http://java.sun.com/update/1.5.0/jinstall-1_5-windows-i586.ca=
b#Version=3D1,5,0,0"=20
            classid=3Dclsid:8AD9C840-044E-11D1-B3E9-00805F499D93=20
            codeType=3Dapplication/java width=3D200 height=3D30><PARAM =
NAME=3D"code" VALUE=3D"SignatureCapture.class"><PARAM NAME=3D"codebase" =
VALUE=3D"/jre/"><PARAM NAME=3D"type" =
VALUE=3D"application/x-java-applet;version=3D1.5"><PARAM =
NAME=3D"scriptable" VALUE=3D"false"><PARAM NAME=3D"coordinates" =
VALUE=3D""><PARAM NAME=3D"imgheight" VALUE=3D"30"><PARAM =
NAME=3D"imgwidth" VALUE=3D"200">
            																																<embed
            					type=3D"application/x-java-applet;version=3D1.5" \
            					code=3D"SignatureCapture.class" \					=
codebase=3D"/jre/" \
            					width=3D200 \					height=3D30					scriptable=3Dfalse
            					=
pluginspage=3D"http://java.sun.com/products/plugin/index.html#download">
            					<span class=3D"small" =
style=3D"font-size:13px;font-weight:bold;">
            						<br>Please install the proper version of Java on your =
machine
            					</span>				</embed>				</OBJECT><INPUT id=3Dsignature =
type=3Dhidden=20
            name=3Dsignature> </TD>
          <TD vAlign=3Dbottom width=3D150><B>Date:</B>=20
      =
02/02/2010</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></BODY></HT=
ML>

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