HomeMy WebLinkAboutB and B Outdoors 730892 08 20 15.LS.PDFTime im 1 0 : 3 3
B A N} B
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Time Out: 1 0 4 5 arn Total Time: 12 minutes
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D 0 0 R S
EENew
F�Transifional
Name of Establishment
a 0 1 M 0 R G
A N
A V E
Address 1
ress Z.
L I T T L E R
I V E
R
S C D
9 5 6 6
City:
state:
zlp:
B A N D B
0 U T
D 0 0 R S
Permittee
M anager or Person in charge
[E Ivi ailing Address Same
B A N D B 0 U T D 0 0 R S
14 ailing Elaine
1 0 1 M 0 R G A N A V E
14 ailing Address I
M ailing Address 2
L I T T L E R I V E R s C .1 9 5 6 6
City'. pp State;ZIP:
Phone Fax Emergency Phone Number
1 8 Catawba
Email Address, CoMy #
5-5 - Municipal/Community 3-3 - Muni cipaUCommunity N/A 01
Water Supply Wastewater System Risk Category Territory # Capacity�
0 8 9 a 44M'Enter last 4digdsonly; 73 - Temporary Food I
esokliq4�#"AF4
Facility H) 0 to Facility ID: Operate a: Status Code
14 ap # Parcel'ID Ft
0 8 0 0 1 5
Let Long, Date:
Push Cart or MFU [:]Pushcart E] M FU
Pushcarliklobile Food Unit operating in conjunction with: Restaurant or Commissary ID.,
Transitional Permit Conditions: Permit Expires: 0 days 180 days U*
Conditions) am arks Non-po"pliant items completed by;
VALID FOR 8.20.15 ONLY
3978
Non -Compliant R emarVs C)rk the checkbox to add non-comptaor rtmarks
Estaptishment Assigned To�
1896-Sears, Luke
tl Esignature:
1896-Sears, Luke 0 8 0 / 2 0 1 5
EHSID Date:
Tire
M anageriPerson in Charge
0 8 1 01 0 0 1 5
Date:
NG Deparlment of He a Rh and Human Services [j]Perrnit F—]TransitionalPernnit
D iv ision of Public I I ealth
Environmental Floalth Soction Date: 081202,015
N @me of Establishment: B AND B OUTDOORS P erm ittee: B AND B OUTDOORS
DaWNTMI
Cly: LITTLE RIVER
state - Sc Z ip: 29566 Managior/Piorson in Charge:
BE In N am e- BANDS OUTDOORS County Catawba
BfirngAddress_ 201MORGANAVE
City, LIT TLERIVER State:,SC Zip: 29566 Status code: I
E m all Add re ss: Establishment ID, 2018730892
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Phone- - Fax: MOP #: - - - - - - - - - - - - - - . Parcel ID -- - - - - - - - - - - - -
Emergency phone Number Lat ................ . Lon ................
Permission is granted to operate a 73 - Temporary Food Establishment as defined in G S. 13OA-,24?(I) and 1 MA-248,
Regulation of Food and Lodging FaCifities, See permit requirements in Rules. f his permit is not, transfew,re and may be revoked for faruir-a to
comply wth all requi,-ements.
WastexeaterSysterns; murlcovcr rnnrlunk, []on -site System Capacty:
category #: 91 E ff]
Water Supply: [Elm uricipalIC)mmunity E]On-Sits Systern 11 IE
Fushc3tt'Notolle Food Unitope'ating in conjunvion with Restaurant Or COMM SSa'y Name an -3-i665W - - - - - - - - - -
Cc nd it! on &Rem a rk&
E etablishrre nt 3 ssig nod to: 1,896-Sears, Luke
VALID FOR 8.20.15 ONLY
- ----- - ---------- ---
$i tion a I Pentin it Condition%
-his permit $hall expire 01 and is not renewahle. All min-comrlian° items listed herein and on attached Darles of
anali--ablP0 must de cDrmAeteJwilhln 90 /E] 180 doYs days. This establishment mast close if all noncomaliant items are not corrected bv the
expiration date.
RP,rP.lvPri Py Tit n,
M 3nageriPerson in Charge
nAtpr 08rM2015
Sioned BY: REHS#: 1896-Sears, Luke Date: 08/2012015
isio �f Publi Health
PUT-e- Cen4,!ft Statute 13 t.k slat_`} "No tmtablisbrnmit sliall _-om.inenw. orcontinueopecafion �.N%tlhout a pern-ut of Lnnsiaonrt permit issued b%, the D"artment-
'Mepttrnitortransitioral pen -nit 4WI b& issued to theo,,imer or operator of the establisIrnentanid aliall not bepansfeble- If the establi stment is I'mwd, the perrrit of
transitonal pemt shall be. issued to the lessee and shall not bettrmsferablt.lf he locatian of an establi shment changes, a neNN' pffrnn Shall be obtained for the
establishmt,,nt-ApeTTnit3,hallbe, issued o,nl3,�N,bent:i,-establishmant satisfies all of the requirements cf the rules - Tire Corntnimon shilt adopt rules establishing the
requirements du t must be met before a transitional perrat nnsy be issued; slid the per for winch a trans.tional perinit may be issued. The Dtpannent n2v also inpose
cunlit unsryas thrn;suanct Ufa pairlit UT tlarnnula FrITIlit 11all tic, irillirdiaLdy
revoked its accordance mitt G_S_ [3,GA-23(M for fiiRureof the establishment to maintm-ra narnitrurn gradt, of C_ A perratit or, trarsiticrAl permit may ohitnxise be
susperded or revoked inacccrdarce i-,kith G_S_ l30A-L3__" preparation Laml erxivornnental InetIth specialists shall issue, a pernut every time a cliange in pennit status is
indicated. Prepare xi onginal and one cop77 for I . Onginal to be [ett,,Raththe mmeT or cperztor. 2. Copt, far kite local health departnrant. Di spoation: Pteaw refer to
Records Retenton and Disposition Sditclule 813 6, for ount�7,Distnct Health ]Depa-Mrmts,,;hizh is pub:ished bytheNorth Crohna avisien ofArcbives & Histon,,:
Additionai fiarnis may be ordered from: E mcronineatal Hea Ita Sector, 1 CY32 Mail Senice Center, Raleigh, -.\,C 2 7 699 -1,6,32, t�Courinr 5 2 -0 1 9:�r
EH 3 1341 (revises, 07912)
Ery iron m enta] Health Section
Comment Addendum - Attachment
EstaWln�jTrevt Va-ft�e: 9 ANn 8 OUMOORS
Location Address,: 201MORGANAVE
ity: L MILE RIVER
�lounty, Catawba
Wastewater System: (j) klunicipavCornnuniV C) On-Sita System
Water Supply: @ C, 'fin-sitL� sysksm
Permiltee: BANDBOUTDOORS
gum=
Condlllons/RemarKs ilcontlnue,3):
Mon---orrpliait Items:
Data: 08t2C,/2015
Status Code:
Cate gory 4.,