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Home My WebLink AboutEHPR-08-2022-41967 ENVIRONMENTAL HEALTH Catawba County Government Center catawba county 25 Government Drive I P.O. Box 389 I Newton, NC 28658 public health Phone: (828) 465-8270 I Fax: (828)465-8276 u[uc.uru0. Email: EHAdmin@CatawbaCountvNC.aov H-P -oS- ) - tir767 Plan Review Application for a Mobile ood Unit Submit application form, a complete proposed menu of food items fot. ale, and a scaled drawing to the Health Department for approval before beginning any construction or renovation. Applications must be reviewed and approved before we can look at your unit. Insufficient information will delay plan review. 0hi1ic! a Coin rn i scary • Attach a proposed menu of food items for sale. • Attach a diagram of unit containing location of all equipment, storage areas, sinks, and tanks. • Does supporting restaurant or commissary have a well and septic system? If so, a tank check and water sample will be required. A "mobile food unit"means a vehicle-mounted food service establishment designed to be readily moved. All units must report daily to the restaurant or commissary for supplies, cleaning and servicing. Facilities shall be provided at the restaurant or commissary for all aspects of function of a mobile unit including food storage, dry storage, obtaining fresh water, sewage disposal and garbage disposal.An operator is not allowed to maintain foods and products sold in a mobile unit to be stored at their personal residences. If a permitted restaurant or food stand is not capable of handling the extra needs of a mobile food unit a permit will be denied. l Name of Business: J �� S l'J a I ko' t s lY a L.LCI Owner's Name: I Thk (P ba tfeb Mailing address: 5-QD sONS r City: c l State:&le— ZIP: r YU1Dt 510 Telephone#(s): 0�0— �4'S 5� 1 r,,28-?51 -al4"1 Email Address: ,' S c 1L 1 ITY6ii e Vie) ('La '. (.J 'Y1 Restaurant or Commissary supporting unit: il\rAr 1 1 LiC j IJ iu- Q. " State ID#of Restaurant or Commissary: 0 I 1r(d Q`7 q Applicant Signature r Date: / i 41/0?2. CO CATAWBA COUNTY 100A SOUTHWEST BLVDTON,NORTH CAROLINA 28658 ti�' RECEIPT NEW tO��►� PHONE:828.465.8399 Tuesday,August 16, 2022 1 R 4 2 srn www.catawbacountync.gov PAYOR: JB's Rolling Bistro JI3's Rolling Bistro(Boston,Elliot) PAYMENTS TRANSACTION NUMBER: TRC-45404890-16-08-2022 PAYMENT DATE: 08/16/2022 PAYMENT TYPE: Credit Card 293827523 INVOICE NUMBER ACCOUNT • FEE NAME FEE AMOUNT 08-22-410621 110-580200-663000 FLI Mobile Food Unit/Push Cart $75.00 Plan Review Fee TOTAL PAYMENTS: $75.00 EHPR-08-2022-41967 CASE TYPE: Environmental Health Plan Review WORK CLASS: Other FLI SITE ADDRESS: 307 S MCLIN CREEK RD A,CONOVER NC 28613 Applicant JB'S ROLLING BISTRO,520 8TH ST NE,HICKORY NC 28601 H:8287812067C:8287855700 JBSROLLINGBISTRO@GMAIL.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 08/16/2022 10:32 Page 1 of I catawba county public health Mobile Food Unit/Hot Dog Pushcart Agreement We, the undersigned parties, acknowledge by signature that the parties have read and understand the Rules Governing the Sanitation of Restaurants and Other Food Handling Establishments, 15A NCAC 18A, 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 w:sk disposal facilities must also be provided on the restaurant or commissary premises."e` pr This, the day of— �� e - Y71b P,_ , 20_92 . 1, _ JCS C.0 bc> L�� -- --- u l ►� r� e� .-- of (Restauiant Owner or Manager) (Title) 1 J S 2.M\‘ t) � tl� IY �Z-L- located at (Name of Est blishment) L� 3 6 —7 SL)LA.\ C' I it) Citcf -, NC 2otA 1 3 ID# (Address) (ZIP) certify t ave read and understand the above regulations and hereby authorize 5/7.!/-) , Mobile Food Unit Operator to operate (Name) a push ca or 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 catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. contents upon inquiry. I agree to allow all supplies for the unit to be stored in the above listed premises. I agree to provide access to my establishment by 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 subject to any inspection performed by the local environmental health department. I agree that if this approval is rescinded, Catawba County Environ ental Health shall be notified immediately. , Permitted Operator (Signature) q , Mobile Food Unit/Pushcart Operator (Signature) , Notary Seal (Signature) My commission expires afruft Q2(1/ c):2 V ,o C H A, ` O Qt� Notary Public y y 0 Catawba to m County v. My Comm. Exp. 04-24-2024 %��'9�H fCApk& `\`��