HomeMy WebLinkAboutBandys Athletic Boosters Concession 140142 08 13 10py.pdfTlme M 0 9 : a 8, []am Tame Out [Dam Total Tne- N]New [:]Transitiona�
B A, N D Y S A T H L E T 1 C B 0 0 S T E R S C 0 N C E S S
Name Gf E stablishment
5 0 4 0 E B A N D Y S R D
Address:
C A T A W B A N C a 8 6 0 9
cft� y State: z0v
B A N D Y S A T H L E T I C B 0 0 S T E R S
Permillee
T 0 D D G 0 1 N S
IA anager or Person in charge
1j] M aiJing Address q-anne
B A N D Y S A
T
H L E T I C 8 0 0 S
T E R S
M afling Name
5 0 4 0 E B
A
N D Y S R D
M uing Aadress
C A T A W B A
N C a 8
6 0 9
Phone
Fax
Emergency Phone Number
828-461-059,2
Catawba
Email Address:
Fo—. n—t 7;-
5-5 - MurildpaMornmunrly
3-3 - Muni cipaMommunily 11
01 0
Water Supply
Wastewater System Risr, Category
Territory raps 7ct,--
1 8 1 4 0 1
4
7
14 - Limited Food
f
Facility ID E]ExvnhngFarildvr
0 to F acifity [D.
Operate a
Status Code
[:]Aftachments
M ap #
Parcet lD
0 8 / 1 3
/ 2 0, 1 0
rat;.
t -Ori —9
Date;;
ft�j �Q3 �rFQ []Pushcad
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Push Carl or M F V Name,
Transitional Permit Conditions, permitExpifes: E390 Days [] 1 so 03Y $
Non-CornpfiaM items Completed by:
Condibonv'Renrrarks
Est S Sigi`Uure.
0 8 / 1 3 a 0 1 0
EH M Gate
Estatlishrnenl Assigned To;
2031
--- -- ------
M anag7rMerson in charge
1 0
# Title, 0 s te,
N G Department of Environmental & Natural Resources [ENew [:]Transitional
Division of Environmental Heallth
Date: 0811312010
NameofEstablist iTien BANDYS ATHLETIC BOOSTERS GONCESS po ,rMiltee- BANDYSATHLETIC BOOSTERS
Locatizin Address, 5040 E BANDYS RD Manager Prs n in Charge: TODD G011NS
Cty: CATAWBA
Strate,_�C Zip- 28609
County-2-18
1311ingNarne, BANDYSATHLETIC BOOSTERS Status Code- '
611inAddreSS, 0ENDD stblishment lD: --2--81-4---------
------ -------
Email address, 828A61,0592 Lat'— ----------- . LoriT .................
Phone- Fax:_ Emergiency Phone Number
Perrnission is granted to operate a 14 - Limited, Food as defined in G S, 13OA-2,47(l) and 13OA-248,
RegOation 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,
'N astowater sy stems: *hJunicipaUCommand y On -Site system cariacllr� 0 calagorytit
Water suppir hi unrcipauCornmrmair, On -Site System
H ED E
Pusticarighlobde Food Unit operating in cotsunclon with.
Restaurant of COMMiSsaf`X rune aria 0 number
C ondliion sad eras arl,,S:
Establishmeni assigned to: 2D31
C]Aftachments
HE V-11 142,11OUVERSOM 8,11
This pennit shall expue on and is not renewable. At[ non-compfiant items tasted' herein and an a"ached pages (if
apolkable) must be corrittieted within 13 0 E] 180 days days This establishment must ciose if all1inoncomphant items are not corrected, by the
expiration dale.
L
0&1=010
Received By tan nu �Sl L - �harge �_� TOW Date, —
A- L OW1342010
�RS#�_ Dale� Signed::
Pyupose, General Statute 130A-248ib) states "'No enablish)4ra shall cionimenot or coritiaw roWationxithout a permit or ualiv,tional pnma issued by, the, Departirent.
Thepeitnit ortransifionall psmfit shall be issued to the crier or opffatar of the establishnrmt and sbafl trotbe transferable. the pernut or
trat-wional permit shall be, issued zothe less" and shall not be tm'sferWe' If ditlocaTion of an eezab4sh'm M-t drangm's' a Vew per, mit shall be obtained for the
estalatislunent. A pern-iia shall be iesued GnlV wheri the, establishment satisfies all of the reqiArements of the n3les, The Coturnisson shall adopt rules establishing the
requirenrents that mustbe met Isel[bre a transitional permt may be issued, and the penod fbrsirch a nusitional permit may be issued. The Depantritnt rmy also impose
corshoonson theissuawceofapernxt iortmnsiaoval pennin in Apermt ortiansitional pemrit shall to' ITnio'e4areiv
revLikedin,acc,ordance ,,,,tthG.S. 130A-23(d) for faflarre of the establishaferato mairamn aummurn grade of ., A fie at cy uo:nsiniowl perfilltmavothemse be
m-Teridedorrevokedin actor danctriff G-S, 130A�23..'Preparation i Local entiromnenta] health specialists shall issue aper-anteveryb,mea, range in pennit katusis
indicared, Pirtpare, an originall and one copy for, I,Ongiisal tobeleft xith the altar r o€operator. 2, Copy for the local bealth dtpwuaent. Dispoinoal Please refer to
Records Resm and asposidon Scliedule 8,B, .6_, for Counry'Distra Health Diepartmentsstudi is published by the'Narth Carolina Division ofArduvts k, Hisrorv,
Additional, fomtsmavbe Merest fronr Division ofEnvironnknia1Hea1tb, 1,632 'Mail, Ser%ic± Center, Raleigh,.\C 276.414-16322, (Count'r-52-01-00)
Cr E i',1 R 13 41 (rev i s e, 0, O'�5 ) 0 8)
Environmental Health Services Sechon (reviiew 7W)