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: Beavers
Dairy Queen Grill & Chill - Ma Food Service Establishment 11128 County Line Madison 44FS1693 Thompson

7 Reach-in with cheeses, tomatoes, lettuce 46-52F 9/8/2023

9/11 Tomatoes, lettuce 50-52F. Manager advised ECOLAB had just left. Will return in two days to
check.
Greenbrier Restaurant Food Service Establishment 27028 Old Hwy 20 Madison 44FS75 Beavers

7 Entire TCS contents of make table cooler @ 61-67F: cheese, lettuce, tomato, slaw, butter. PIC 9/5/2023
discarded all items. LCB
9/8 Reach-in is not in use until repaired. Owner will call when ready to use. SBT
Sui Guru 3 Inc ( Chevron) Food Service Establishment 6725 Swancott Rd. Madison 44FS348 Beavers

15 Build up present inside ice machine. LCB 9/6/2023 9/8/2023 2

9/8 Ice machine clean. Abted. SBT

Wendy's - Madison #515 Food Service Establishment 11300 County Line Madison 44FS1698 Beavers

5 Numerouse packs of strawberries found in walk in cooler with white, fuzzy substance present on 9/6/2023 9/6/2023 0
food's surface. PIC discarded items. Abated. LCB

Designated Employee: Johnson

Athens Bible School School Lunchroom - Private 700 US Hwy 31 N Athens 44SLF238 Johnson

15 Ice machine has black substance in it. COS. Corrected by mgmt. 9/7/2023 9/7/2023 0

McDonald's - 72 E Food Service Establishment 1529 Hwy. 72 E. Athens 44FS109 Johnson

27 Hand sink inaccessible for use. 9/6/2023

15 Black residue found in the soda nozzle. COS. Corrected by mgmt. 9/6/2023 9/6/2023 0

Designated Employee: Thompson

Twice Daily / White Bison # 310 Limited Food 22048 US Hwy 72 Athens 44LF1884 Thompson

7 Tomatoes, lettuce, diced onions 60F 9/5/2023 9/12/2023 7

9/12 Tomatoes, lettuce, onions 38-40F. Abated.
16 No food probe thermometer. Damaged cutting boards. 9/5/2023 9/12/2023 7
9/13 Food probe available. Damaged equipment on order.

Thursday, September 14, 2023 Page 1 of 1