HomeMy WebLinkAbout1998 Aug 05 - MA DPH Division of Food and Drugs HACCP Risk Assessment�SACHUSETTS DEPARTMENT OF PUBLIC HEALTH DIVISION OF FOOU ANU UKUU5
' HACCP RISK ASSESSMENT
FOOD ITEM:
ESTABLISHMENT;N `/e
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INGREDIENTS:
PERSON IN CHARGE:
�16 VL c-
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CONDUCTED BY: &&0p, e av& DATE:
WEIGHTNOLUME:
1
24ITERVIEW AND ON SITE INSPECTION
0Z-
p PREPARATION OBSERVED
CERTIFIED FOOD MANAGER: YW NOvim. V%A1.0vif
. SAMPLES COLLECTED:
DATE OF LAST ROUTINE INSPECTION: 6�o
TAKEN:
Page No. Of
HRAFORM1.D0008103198
Page No. Of
HRAFORM1.D0008/03/98
10
_YI.A,SSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
HACCP RISK ASSESSMENT
DIVISION OF FOOD AND DRUGS
FOOD ITEM:
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ESTABLISHMENT NAME:
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INGREDIENTS:
t 1
� l
PERSON IN CHARGE: I " ' i?!1
Cam/✓
q'cw
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CONDUCTED BY g 'S (� l� DAa10
WEIGHTNOLUME:
ee
l5 r �� t
NTERVIEW AND ON SITE INSPECTION
p PREPARATION OBSERVED
CERTIFIED FOOD MANAGER: NO
SAMPLES COLLECTED:
DATE OF LAST ROUTINE INSP ON:
)y, -tt> r fiao �"vl� � m
kiwi
Ilected.
Page No. Of
HRAFORM1.D0008103/98
Page No. Of
HRAFORMI.D0008/03/98