HomeMy WebLinkAboutSonic #4804 Permit 011471 12 05 17.SC.PDF
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Sonic#4804
Name of Establishment
500BoundarySt
Address 1:
Address 2:
NewtonNC28658
ZIP:
City:State:
SDMissouri
Permittee
KarenClark
Manager or Person in charge
Mailing Address Same
SDMissouriDBASonic#4804
Mailing Name
131ELincolnAve
Mailing Address 1
Mailing Address 2
FortCollinsCO80524
City:State:ZIP:
() -() -() -
82869514457046180975
PhoneFaxEmergency Phone Number
Catawba
dladish@sd-holdings.com
18
County #
Email Address:
01
5-5 - Municipal/Community3-3 - Municipal/CommunityIII
40
Capacity:
Water SupplyWastewater SystemRisk CategoryTerritory #
1 - RestaurantT
Enter last 4 digits only
1471
Old Facility ID:Nodq`sd `9Rs`str Bncd
Facility ID
Map #Parcel ID #
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12082017
Lat.Long.
C`sd9
Otrg B`qs nq LET
PushcartMFU
Pushcart/Mobile Food Unit operating in conjunction with:
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90 days180 days
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//
06062018
Non-Compliant items completed by:
Conditions/Remarks
NEED TO REPLACE/FIX FREEZER ICEREAM UNIT - RIGHT NOW NO REFRIGERATION (MECHANICAL) AND LIQUID IS ON
ICE IN A BUCKET
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REPLACE ANDY TORN GASKETS ON FREEZERS AND COOLERS
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CLEAN INSIDE OF ALL FRYER UNITS
3803
Non-Compliant Remarks
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4000
Establishment Assigned To:
1711-Carpenter, Scott
EHS Signature:Manager/Person in charge
1711-Carpenter, Scott
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1208201712082017
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EHSID C`sd9
Title
Print
NC Department of Health and Human Services
PermitTransitional Permit
Division of Public Health
12/08/2017
Date:
Environmental Health Section
Sonic #4804SD Missouri
Name of Establishment:Permittee:
500 Boundary St
Location Address:
NewtonNC28658Karen Clark
City:State:Zip:Manager/Person in Charge:
SD Missouri DBA Sonic #4804Catawba
Billing Name:County:
131 E Lincoln Ave
Billing Address:
T
Fort CollinsCO80524
City:State:Zip:Status Code:
dladish@sd-holdings.com2018011471
Email Address:Establishment ID:
(828) 695-1445
Phone:Fax:Map #:Parcel ID:
(704) 618-0975
Emergency Phone Number:Lat:Long:
1 - Restaurant
Permission is granted to operate aas defined in G.S. 130A-247(I) and 130A-248,
Regulation of Food and Lodging Facilities. See permit requirements in Rules. This permit is not transferable and may be revoked for failure to
comply with all requirements.
40
Capacity:Category #:012
Municipal/CommunityOn-Site System
Wastewater Systems:
Water Supply:Municipal/CommunityOn-Site System
34
Pushcart/Mobile Food Unit operating in conjunction with:
Restaurant or Commissary Name and ID number
Conditions/Remarks:
Establishment assigned to:1711-Carpenter, Scott
NEED TO REPLACE/FIX FREEZER ICEREAM UNIT - RIGHT NOW NO REFRIGERATION (MECHANICAL) AND LIQUID IS ON ICE IN A BUCKET
REPLACE ANDY TORN GASKETS ON FREEZERS AND COOLERS
CLEAN INSIDE OF ALL FRYER UNITS
Attachments
Sq`mrhshnm`k Odqlhs Bnmchshnmr
06/06/2018
This permit shall expire onand is not renewable. All non-compliant items listed herein and on attached pages (if
90180 days
applicable) must be completed withindays. This establishment must close if all noncompliant items are not corrected by the
expiration date.
12/08/2017
Received By:Title:Date:
Manager/Person in Charge
1711-Carpenter,12/08/2017
Signed By:REHS#:Date:
Division of Public Health
Purpose: General Statute 130A-248(b) states "No establishment shall commence or continue operation without a permit or transitional permit issued by the Department.
The permit or transitional permit shall be issued to the owner or operator of the establishment and shall not be transferable. If the establishment is leased, the permit or
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 impose
conditions on the issuance of a permit or transitional permit in accordance with rules adopted by the Commission. A permit or transitional permit shall be immediately
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
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 is
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 to
Records Retention and Disposition Schedule 8.B.6., for County/District Health Departments which is published by the North Carolina Division of Archives & History.
Additional forms may be ordered from: Environmental Health Section, 1632 Mail Service Center, Raleigh, NC 27699-1632, (Courier 52-01-00)
EHS 1341 (revised 07/12)
Environmental Health Section
Sonic #4804
2018011471
Date:
12/08/2017
T
500 Boundary St
Status Code:
Location Address:
NewtonNCIII
City:State:Category #:
28658
Catawba
County:Zip:
Municipal/CommunityOn-Site System
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V`sdq Rtookx9 Municipal/CommunityOn-Site System
SD Missouri
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(828) 695-1445
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Conditions/Remarks (continued):
Non-Compliant Items: