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<br /> <br />Establishment is to meet all standards of Chapter 509. Part t Florida Statutes. and Chapter 61 C-4. Florida Administrative Code <br /> <br /> <br />SPECIFICATION WORKSHEET <br /> <br /> <br />.. Establishment Name: (l h\ ,,) CJo.,~ LA.. )& <br /> <br />'_ll1LllfJljJl~1;ljlWJ}JlljjfSl~lJAlllrR'Gq$ll?'l€JlEJJlIJtjltgiJ1JllllllltrflfJj$fjltIlEfla.;~;li~! <br />F OR" WALL CEILING <br /> <br />o ew construction <br /> <br />Conversion <br /> <br />o Remodeled <br /> <br />o Closed at least one year <br /> <br />License Number: <br />(if applicable) <br /> <br />~.dS4\ ~ <br /> <br /> <br />Food Storage <br />Wash Area <br /> <br />Restrooms <br /> <br />Worksheet Code Key <br /> <br />E Comments: <br /> <br />S Satisfactory <br />U Unsatisfactory <br />NA Not Applicable <br />E Existing <br />C Caution: Information inadequate <br />or potential operational violation, <br />will be checked during inspection. <br /> <br /> <br />'..-Y7iEllffli'i#I!%B~t#<ti <br />Jl~~;_LLJ. ~~~U';r-.' <br /> <br />Portable extinguishers provided as required by NFPA 10 <br /> <br />IE S Hood automatic fire suppression system meets NFPA 96; <br />no mesh filters allowable <br /> <br />1m .s Exit doors open outward <br /> <br />1m .s Public access to exit does not go through kitchen. storage <br />- rooms. or restrooms \ p v..b \ \ t.., <br /> <br />11/ Number of exits, a: \ 't-YVl pLO.je <br /> <br />IE Square footage of establishment: , <br /> <br />IE ~ All gas appliances shall have a nationally recognized test. <br />ing laboratory seal such as AGA or UL <br /> <br /> <br />. S itizing facilities provided <br />three compartment sink 0 dishmachine <br /> <br />IIlI ~ Wash sinks with drainboards <br /> <br />. ~tJer shown: D 4 03 D 2 compartments <br /> <br />III f'J One/two compartment food prep sinks <br /> <br />Nu. er shown: <br />- <br /> <br />.:11 _ Hand sin~ in food prep area(s) <br />Number shown: <br /> <br />E ~ Hand sink in remote mechanical dishmachine area <br /> <br /> <br />1m Comments: <br /> <br />II!] <br /> <br /> <br />* local fire department is the final authority having jurisdiction, <br /> <br />II) Dishmachine type: <br />IE Comments: <br /> <br /> <br /> <br /> <br />II] ~Approved local exhaust ventilation installed at or over all <br />cooking units such as ranges. griddles. deep-fat frying units. <br />and other units of equipment which release appreciable <br />quantities of steam. odors. grease. or smoke. <br /> <br />D ~ Restrooms ventilated or provided with windows to the out. <br />side <br /> <br />DBPR Form HR 5021-011 (Formerly BPR 21-011) <br /> <br />Renumbered 1999 May 25 <br />