HomeMy WebLinkAboutLanoria H Sheet 030056 09 29 10.KM.pdf
Name Change Verification of Closure Status Change Inspection Re-inspection Pushcart Mobile Food Unit Visit Community Transient Non-Community Non-Transient Non-Community Non-Public Water
Supply N.C. Department of Environment and Natural Resources Division of Environmental Health Health Department Inspection of Pushcart or Mobile Food Unit Old Facility ID Current Facility
ID Water Approval: Water sample taken today? State: NC Date of Insp/Chg: Score: Status Code: City: Zip: City: State: Zip: Name of Facility: Location Address: Mailing Addr. Report Received
by: Purpose: General Statute 130A-248 requires the Commission for Health Services to adopt rules governing the sanitation of facilities where food or drink is provided for pay. This
form is developed be used in making inspections of pushcarts and mobile food units. Approval may be suspended or revoked in accordance with General Statute 130A-23. Preparation: Local
environmental health specialists shall complete the form every time they conduct an inspection. inspection. Prepare an original and two copies for: 1. Original to be left with the responsible
person. 2. Copy for the local health department. 3. Copy for the Environmental Health Services Section, Division of Environmental Health. Disposition: This form may be destroyed in accordance
with Standard 8.B.6, Inspection Records, of the Records Disposition Schedule published by the N.C. Division of Archives and History. Additional forms may be ordered from: Division of
Environmental Health, 1632 Mail Service Center, Raleigh, NC 27699-1632, (Courier 52-01-00) DENR 2902 (Revised 7/05) Environmental Health Services Section (Review 7/08) Inspection by:
EHS Permittee: GENERAL REQUIREMENTS (.2638): 1. Pushcart/mobile food unit operated in conjunction with an approved (permitted) restaurant ........................................ 2.
Pushcart/mobile food unit reporting at least daily to restaurant location for cleaning and servicing ...................... 3. All foods from approved sources stored, handled, or served
so as to prevent contamination or adulteration........ 4. All potentially hazardous foods maintained at 45° F (7° C) or below or 140° F (60° C) or above, or as required, thermometer
available .............................................. 5. Single-service eating and drinking utensils used, properly stored and handled ...................................................
6. Garbage and other solid waste properly stored and disposed of in an approved manner ....................................... 7. Employees clean as to their person and foodhandling
practices, hair restraints, clean outer clothing ...................... 8. All equipment and utensils of easily cleanable construction, kept clean and in good repair ..........................
9. Pushcart/mobile food unit kept in a clean and sanitary condition, free of vermin ........................................................... 10. Food and utensils properly protected
against flies, dust, and other contamination ................................................. PUSHCART REQUIREMENTS (.2639): 1. Only hot dogs prepared on carts ......................................
........ 2. Food protected by glass, or otherwise, on front, top, and ends ................................................................................................ 3. Single-service
towels provided .................................................. MOBILE FOOD UNIT REQUIREMENTS (.2640): 1. Potable water supply under pressure provided; adequate; inlet clean, capped
...................................................... 2. Hot water heating facilities provided ......................................... 3. Handwashing lavatory, hot and cold water,
soap, and single-service towels provided ................................................... 4. At least a single vat sink with drainboard space on each end to accomodate drying provided
.......................................... 5. Approved sewage disposal ......................................................... Yes No N/A Comment Sheet Attached? 12 34 1 2 12 V Yes
No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Comments: ** SEE COMMENT SHEET ATTACHED ** Yes No Yes No //18
0 9 2 9 1 0 2018030056 H LANORIA MARIA PEREZ ANORVE 1106 MOORESVILLE RD SALISBURY 28147 149 HINKLE DRIVE MOCKSVILE NC 27028 2259 -Michaud, Kenneth
N.C. Department of Environment and Natural Resourses Division of Environmental Health COMMENT ADDENDUM Time In: Time Out: Total Time: City: Street: ID: Name: :: am pm am pm LANORIA 2018030056
1106 MOORESVILLE RD SALISBURY 0 1 1 0
N.C. Department of Environment and Natural Resourses Division of Environmental Health COMMENT ADDENDUM City: Street: ID: Name: LANORIA 2018030056 1106 MOORESVILLE RD SALISBURY
N.C. Department of Environment and Natural Resourses Division of Environmental Health COMMENT ADDENDUM City: Street: ID: Name: General Comments: LANORIA 2018030056 1106 MOORESVILLE RD
SALISBURY MOBILE FOOD UNIT HAS NEW HOME RESTAURANT OWNER AND WAS ISSUED NEW MOBILE FOOD UNIT PERMIT