HomeMy WebLinkAboutEHPR-06-2016-24106.TIF Catawba County Public Health
• ®? www.catawbacountync.gov/environmentalhealth
COUNTY Environmental Health
P.O.Box 389, 100-A South West Blvd., Newton, NC 28658
`v^"-"•v • North Cai
Phone (828) 465-8270. Fax (828) 465-8276
Mobile Food Unit/Hot Dog Pushcart Compliance Agreement
We, the undersigned parties, acknowledge by signature that the parties have read and understand the Rules
Governing the Sanitation of Restaurants and Other Foodhandling Establishments, ISA NCAC IBA,section .2600, as
pertains to the operation of a mobile food unit/pushcart and that the parties understand the responsibilities of each
party as required in .2670 - .2672 of the rules and must meet requirements from the 2009 NC FDA Food Code
Manual, which include:
"Pushcarts or mobile food units shall operate in conjunction with a permitted restaurant or
commissary and shall report at least daily to the restaurant or commissary for supplies, cleaning, and servicing.
Facilities, in compliance with this section, shall be provided at the restaurant or commissary for storage of all
supplies. The pushcart shall also be stored in an area that protects it from dirt, debris, vermin and other
contamination. Water faucets used to supply water for pushcarts and mobile food units shall be protected to
prevent contact with chemicals, splash and other sources of contamination. Solid waste storage and liquid
waste disposal facilities must also be provided on the restaurant or commissary premises."ILL
This, the day ofeac* ,20 G'
I, }fc o10,3 FOSS , 4/11 c„, of
(Restaurant Owner or Manager) (Title)
/� I
T. AAc rosUays 4r`�SG Pt.6 a,Gp 6—rn ( located at
(Name of Establishment) Z oIkQ l\'t"
1 /23 2gf1 Ave Ii. ill&: yc<try ./VC, 2 e66 ID# X30
(Address)
certify that I have read and understand the above regulations and hereby authorize
t:70. \ I l t(� ,cyto i , Mobile Food Unit Operator
(Name)
to operate a push cart/mobile food unit in conjunction with my facility, as required by the rules.
I certify that I am authorized to enter into this agreement on behalf of the above listed establishment. I understand
that the rules require the unit to visit my establishment each day the mobile food unit operates or pushcart, for
supplies, cleaning, and servicing, including replenishing of water and disposal of all solid and liquid waste. I agree
to post and maintain a log to be signed and dated by the mobile food unit or pushcart operator upon each visit to my
establishment, to produce the log upon request, and to accurately report its contents upon inquiry. I agree to allow
all supplies for the unit to be stored in the above listed premises. I agree to provide access to my establishment by
the mobile food unit operator or pushcart for these purposes. I understand that the area in my establishment used by
the mobile food unit operator is subject to any inspection performed by the local environmental health department l:. '(i
agree that if this approval is rescinded, the Catawba County Environmental Health Division steal'bg�n rilie.d1
immediately. ,,. .\ »..,1
, �v13 2d ' _
(Signature) — ` Permitted Operator n rlpk „,�.n t"�u4L,0 a :'.
(Signature)( , i� ��� Mobile Food Umt/Pushcart Operillek, ',� fk,,1k'i? +�
(Signature) 7 Notary Seal
My commission expires 3`I –/ 7
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"Leading the Way to a Healthier Community"
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