HomeMy WebLinkAboutJeff Jackson Permit 610087 10 05 09gk.pdf
Division of Environmental Health N.C. Department of Environment and Natural Resources X New Transitional Name of Establishnemt JEFF JACKSON Permittee: JEFF JACKSON Location Address:
STUDIO 258 Manager/Person in Charge: City: CONOVER State: NC County: Catawba Billing Name: Status Code: Billing Address: Establishment ID: City: State: Map #: Parcel ID: Email Address:
Lat: Long: Phone: Fax: Emergency Phone Number: 2018610087 H -Permit Invalid Zip: Zip: 28613 Regulation of Food and Lodging Facilities. See permit requirements in Rules. This permit is
not transferable and may be revoked to failiure to comply with all requirements. Permission is granted to operate a 61 -Tattoo Artists as defined in G.S. 130A-247(I) and 130A-248, Wastewater
Systems: Water Supply: Municipal/Community Municipal/Community On-Site System On-Site System Capacity: Category #: Pushcart/Mobile Food Unit operating in conjunction with: Restaurant
or Commissary Name and ID number /1 Conditions/Remarks: Conditions: Remarks: Attachments Transitional Permit Conditions This permit shall expire on and is not renewable. All non-compliant
items listed herein and on attached pages (if applicable) must be completed within 90 /180 days. This establishment must close if all noncompliant items are not corrected by the expiration
date. Received By: Title: Date: Manage/Person in Charge Signed By: RS#: Date: Division of Environmental Health Purpose: General Statue 130A-248(b) states "No establishment shall commence
or continue operation without a permit or transitional permit issued by the Departm conditions on the issuance of a permit or transitional permit in accordance with rules adopted by
the Commision. A permit or transitional permit shall be immediatel The permit or tranistional permit shall be issued to the owner of operator or the establishment and shall not be transferable.
If the establishment is leased, the permit transitional permit shall be issued to the lessee and shall not be transferable. If the location of an establishment changes, a new permit
shall be obtained for the establishment. A permit shall be issued only when the establishment satisfies all of the requirements of the rules. The Commission shall adopt rules establishing
the requirements that must be met before a transitional permit may be issued, and the period for which a transitional permit may be issued. The Department may also imp revoked in accordance
with G.S. 130A-23(d) for failure of the establishment to maintain a minimum grade of C. A permit or transitional permit may otherwise be indicated. Prepare an original and one copy for:
1. Original to be left with the owner or operator. 2. Copy for the local health department. Disposition: Please refer t suspended or revoked in accordance with G.S. 130A-23." Preparation:
Local environmental health specialists shall issue a permit every time a change in permit status Additional forms may be ordered from: Division of Environmental Health, 1632 Mail Service
Center, Raleigh, NC 27699-1632, (Courier 52-01-00) Records Retention and Disposition Schedule 8.B.6., for County/District Health Departments which is published by the North Carolina
Division of Archives &History. DENR 1341 (revised 02/08) Environmental Health Services Section (review 7/08)