HomeMy WebLinkAboutEHPR-01-2016-23011.TIF C 4J'j\\\7]3j\. Catawba County Public Health
www.catawbacountync.gov/environmentalhealth
COUNTY Environmental Health
P.O. Box 389, 100-A South West Blvd.,Newton,NC 28658
North Carolina 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, 15A NCAC I8A, 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."
This, the, l)C day of Vk/ y2 Q(6
I, 6-,W5 / L I k z / t\ of
(Restaurant Owner or Manager) (Title)
�J
k's SAt„uLtck 5-42D located at
(Name of Establishme
(Address)
certify that I have read and understand the above regulations and hereby authorize
6 U kl.ipt Alm7' I /1 6- , 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 ,' c for the I nit to he stnr:.l in the ',boy:: listed) remises 1 -, r,-r- ti, provide access to M.• establishment k••
r--...-.--- ._b.-- -:..:..-_ a :.. :: Ju... .. j
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 sub;ect to any ins—eel:on performer' b. . l^ al environmental health department. I
agree that if this approval i - cinded, the County iron rntal Health Division shall be notified
immediately. •
(Signature) n — r iued Operator
(Signature, / p i '/t ADAM, j/( ■t � f Mobile Food Unit'Pushcart Operator
(Signati tifi at��! -
�•� `t/ ` 1111111 r/i
��� My commission Qcpires o�`S_VC\
<> "Leading the Way to a HeaRt er Cwj+ ttlnity" 0?k
���)a J ;; 5