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City Of Santa Ana <br />FSE Best Management Practices (BMP) <br />Permit No: <br />Name of Facility: <br />Address: <br />Name and Title of Facility Contact: <br />FACILITY INSPECTION <br />1. Removal of food grinder <br />2. Drain Screens Installed/Maintained <br />3. Kitchen Signage (BMP Poster) posted <br />4. Scraping practices <br />5. Food Waste Practices <br />6. Emergency Spill Response Materials <br />7. Utilization of Additives <br />8. Waste cooking oil and properly stored <br />9. Grease Collection Log Maintained <br />10. Employee Training Log Maintained <br />11. Lateral Cleaning and Spill Log Maintained <br />Comments: <br />Inspection Report <br />Inspection Date: <br />Inspection Type: <br />Inspector: <br />Citation Type: <br />Installation/usage prohibited per ordinance <br />Must be present and in working condition <br />BMP Poster visible in food prep/dishwashing areas <br />Pots, pans, and plates to be scraped of food debris prior to washing <br />Food waste to be placed in plastic bags for trash, not in sink(s) <br />Grease absorbent materials present and accessible in event of a spill <br />Additives for emulsifying or biological/chemically treating Fats, Oils, and Grease (FOG) <br />prohibited — unless approval by FOG Control Program Manager <br />Waste cooking oil not disposed of in drains; and waste grease container present, not <br />leaking, and properly labeled <br />Must be kept current and accessible at all times <br />Must be kept current and accessible at all times <br />Must be kept current and accessible at all times <br />INSPECTION RESULTS <br />❑ Facility is in COMPLIANCE. No corrective action is required at this time. <br />❑ NOTICE OF NONCOMPLIANCE <br />Facility is in noncompliance ` <br />Y N of the items checked below: <br />❑❑ Food grinder (garbage disposal) installed <br />❑❑ Drain screens missing/damaged/clogged <br />❑❑ BMP poster missing/obscured/damaged, etc. <br />❑❑ Employees observed not following scraping practices <br />❑❑ Food waste in sink(s) and not in <br />enclosed plastic bag or garbage <br />❑❑ Missing/inadequate or inaccessible <br />absorbing materials <br />❑❑ Additives utilized without approval of FOG Program Manager <br />❑❑ Grease container leaking, not <br />present, or improperly labeled <br />❑❑ Evidence of waste cooking oils in drains <br />❑❑ Grease Collection Log missing or not current <br />❑❑ Employee Training Log missing or not current <br />❑❑ Lateral Cleaning and Spill Log missing or not current <br />❑❑ Other: <br />Required corrective action includes <br />any or all of the following: <br />❑ Remove food grinder (garbage disposal) <br />❑ Install/repair/clean drain screen(s) <br />❑ Post/repair/replace BMP poster <br />❑ Train employees on scraping practices <br />❑ Train employees on proper disposal of food waste <br />❑ Make available/accessible grease absorbent grease <br />material for spills <br />❑ Discontinue Additive use or obtain approval <br />❑ Provide, properly label, & maintain waste grease <br />container <br />❑ Train employees on proper disposal of FOG <br />❑ Make available/accessible and <br />update Grease Collection Log <br />❑ Train employees on all BMPs & update Training Log <br />❑ Make available/accessible and Lateral <br />Cleaning and Spill Log <br />❑ Other: <br />The above checked item(s) must be corrected within days of receipt of this Notice of Noncompliance. <br />AKNOWLEDGEMENT OF RECIEPT OF BMP INSPECTION REPORT <br />Signature of Facility Contact <br />Signature of Inspector <br />Date <br />Date <br />FOR OFFICE USE ONLY <br />19F-282 <br />Revised 28/12/2006 <br />