HomeMy WebLinkAboutEHPR-09-2022-42263.tif . AIN\ ENVIRONMENTAL HEALTH
NV' 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
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Plan Review Application for a Mobile Food Unit
Submit application form, a complete proposed menu of food items for sale, 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.
• 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.
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Owner's Name: It,if SG 0)0 /,, Au►1 f)r
Mailing address: 1C' it 1.: l uC
City: lveivkA ., State: ZIP:
Telephone #(s): g25?" il t i OU9 -I / g-Z k 3 Sl I 7 15-c}
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Email Address: l��r^ 7 ( �'M O. t
Restaurant or Commissary supporting unit: �1 c ( 't`f`a r'aS C v,c, '' -L.
State ID #of Restaurant or Commissary:
Applicant Signature k'n.'1A l A1-( :--- Date: /5A
Food Handling Procedures
Explain the following with as much detail as possible. Provide descriptions of the specific areas of the kitchen and
corresponding items on the plan where food will be handled. Explain the handling procedures for the following food
categories. Describe the process from receiving to service including:
• How the food will arrive (frozen, fresh, packaged, etc.)
• Where the food will be stored
• Where (specific pieces of equipment with their corresponding equipment schedule numbers) and how the food
will be handled (washed, cut, marinated, breaded, cooked, etc.)
• When (time of day and frequency/day) food will be handled
(edible without additional preparation necessary, e.g. salads, cold sandwiches, raw molluscan shellfish)
"-tape 117 i 1"
Will produce be washed or rinsed prior to use? Yes ❑ N- o ❑
Is there an approved location used for washing or rinsing produce? Yes n N- o n
Will it be used for other operations? Yes I I No n
Please indicate location of produce washing equipment and describe the procedures. Include time of day and frequency
for washing or rinsing the produce at this location:
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Will poultry be washed or rinsed prior to use? Yes n No ❑
Is there an approved location used for washing or rinsing poultry? Yes ❑ No n
Will that location be used for other operations? Yes n No n
Please indicate location of poultry washing equipment and describe the procedures. Include time of day and frequency
for washing or rinsing the poultry at this location:
Will pork and red meats be washed or rinsed prior to use? Yes ❑ No n
Is there an approved location used for washing or rinsing pork and red meats? Yes ❑ No ❑
Will it be used for other operations? Yes F. No ❑
Please indicate location of seafood washing equipment and describe the procedures. Include time of day and frequency
for washing or rinsing the seafood at this location:
Will seafood be washed or rinsed prior to use? Yes 7 No ❑
Is there an approved location used for washing or rinsing seafood? Yes n No n
Will it be used for other operations? Yes 7 No 7
Please indicate location of seafood washing equipment and describe the procedures. Include time of day and
frequency for washing or rinsing the seafood at this location:
Draw to scale, identifying and describing all equipment, including handwash facilities, equipment,
washing facilities, cooking equipment, refrigeration, worktables, storage, hot and cold holding
units, water source and storage. Describe the floor, wall and ceiling surfaces of the unit.
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Checklist for Permitting a Mobile Food Unit (MFU)
(Please keep this checklist and turn in the rest of this form)
Submitted completed application form
Submitted menu
Submitted diagram of equipment layout
Permits and sc"ii.e iuie notification,
1. Mobile food units (MFU) must work in conjunction with a permitted restaurant or commissary within
Catawba County and you must report daily to the facility for supplies, cleaning and servicing. A log sheet must be kept
at the facility which shows this.
2. MFU permits shall be posted at all times. A copy of the last inspection shall also be kept on site and the
grade card shall be posted and visible at all times.
3. Operators must provide a list to the Health Department of all locations the MFU will operate on a routine
basis. If the MFU travels to other counties, the operator must notify that county prior to operation. Such lists must be
kept current or permit could be suspended!
4. Storage of any and all extra supplies must be kept at the restaurant or commissary rather than your
personal homes or vehicles. Adequate storage areas must be established and provided at the base commissary prior to
permitting.
Cleaning:
5. Cleaning of the unit and extra utensils, coolers, equipment must be done at the restaurant or commissary.
The MFU must be kept clean.
Water
b. All units must have a potable water system under pressure with water heating facilities.
7. Your unit's potable water tanks must be filled with a potable water hose at the restaurant or commissary at
a clean and protected fresh water connection other than an exterior can/ mop wash facility. If the restaurant and/or
commissary uses well water as its water source, a sample must be taken prior to issuance of permit.
8. The water inlet on the MFU should be located above the sewage outlet connection, have a different
connection & size than the sewage disposal connection and it must be kept capped (covered) for protection unless being
used.
Sew:"'
4. Your unit's sewage storage or gray water tanks must be 15 % larger than the potable water tanks.
10. The tank(s) must be emptied and thoroughly flushed at the restaurant or commissary at an established
dump station connected to a properly sized and approved on-site sewage system or public sewer system.
11. All waste connections on the MFU for servicing the waste lines and tanks must be a different size or type
than those used for the potable water and should be located lower than the potable water taps on the unit.
12. All garbage and other solid waste shall be stored and disposed of in an approved manner.
Equipment and Interior:
13. All equipment and utensils must be NSF or other approved commercial equipment with the exception of
toasters, mixers, microwave ovens, water heaters and hoods which can be residential type.
14. All cooking equipment must be located within the enclosed unit.
15. All utensils, tables, sinks, cabinets and shelves must be clean and in good repair. All surfaces must be
smooth, not readily corrodible and have no open cracks or joints that will collect food particles and slime.
16. Shelves, tables and counters cannot be covered with paper, cardboard, or other absorbent material.
17. Hot and cold holding as well as cooking equipment must be provided as needed.
18. All floors, walls and ceilings shall be smooth, non-absorbant and easily cleanable.
19. At least a single-compartment commercial sink with (2) integral drainboards, rounded corners,
backsplash protection and hot/ cold water is required for utensil washing (see attached picture). The sink must be of
sufficient size to submerge, wash, and rinse your largest utensils or pots. Domestic sinks are not approved for this use.
Two compartment sinks are recommended.
20. A separate hand wash sink with hot/ cold water, combination supply faucet, soap, and single-service
towels is required.
21. Insect and dust protection must be provided as necessary at windows, doors and equipment.
22. All foods shall be obtained from approved sources and handled in a sanitary manner.
23. All potentially hazardous foods must be maintained at or below 45°F, or at or above 135°F. Cold
temperatures shall be 41 °F on or after January 1, 2019.
24. An accurate metal stemmed thermometer that goes from 0°F -220°F (+/-2°F) must be provided to
check food temperatures.
25. Gloves must be worn when touching ready-to-eat food (RTE) or use another non direct food contact way
to touch food.
26. Employees shall be clean and wear clean outer clothing and effective hair restraints. No tobacco should be
used in any form while in the foodservice area.
27. The person in charge (PIC) on-site must have completed a certified food safety protection class within 210
days of issuance of permit unless you already have one that is valid.
Disease and Illness:
28. No person who has a communicable or infectious disease that can be transmitted by foods, or who is a
carrier of organisms that cause such a disease, or who has a boil, infected wound, or an acute respiratory infection
with cough and nasal discharge, shall work in a temporary food establishment in any capacity in which there is a
likelihood of such person contaminating food or food-contact surfaces, with disease-causing organisms or transmitting
the illness to other persons. An employee health policy agreement must be in place for all employees.
Art example of a sink which complies with the requirement in ISA NCAC 18A, section .2672(e), Specific
Requirements for Mobile Food Units which requires:
(e)At least a one-compartment sink shall be provided. The sink shall be of sufficient size to submerge, wash,
rinse, and sanitize utensils and shall have splashback protection. Drainboards shall be provided as specified in
Section 4-301.13 of the Food Code as amended by Rule .2654 to accommodate the drying of washed utensils.
Splashback protection and drainboards must be an integral part of, and continuous with, the sink. These
drainboards shall be of sufficient size to accommodate the drying of washed utensils.
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4' • CAIAWBA COUNTY
'{� G 100A SOUTHWEST BLVD
NEWTON,NORTI I CAROLINA 28658 RECEIPT
* �r PHONE:828.465.8399
Wednesday,September 14,2022
8 4 2 sM www.catawbacountync.gov
PAYOR: Cali Street Eatz
Cali Street Eatz
PAYMENTS
TRANSACTION NUMBER: TRC-47206706-14-09-2022
PAYMENT DATE: 09/14/2022
PAYMENT TYPE: Cash
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
09-22-412152 110-580200-663000 FLI Mobile Food Unit/Push Cart S150.00
Plan Review Fee
TOTAL PAYMENTS: $150.00
EHPR-09-2022-42263
CASE TYPE: Environmental Health Plan Review WORK CLASS: Other FLI
SITE ADDRESS: 1901 NORTHWEST BLVD,NEWTON NC 28658
Applicant CALI STREET EATZ, 102 ANN AVE,NEWTON NC'28658
**NO PEOPLESOFT ACCOUNT ASSIGNED**
receipt 09/14/2022 12:46 Page 1 of 1
IlliAll,
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 waste
disposal facilities must also be provided on the restaurant or commissary premises."
This,the (.0 day of 0 c - b .,------ , 20 2 a ,
I, Jf(ivcer � Q , c�'C65co�0C,1 -- CCi(V`of
Restaurant Owner or Manager) J '7 (Title)
OS au ra 614 �1 {�(�S 1(d t,��[ J located at
f(Name of Establishment)� ,� r
/ /(1( - G - Nr(xi (� v !JCC/1I �;� v1c / - ID# 70 0 t 0-12k
(Address) (ZIP)
certify that I have read/and u derstand the above regulations and hereby authorize
Krvi ' / U G f t� 1^u`e ( p.—Ui1�4 Mobile Food Unit Operator to operate
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a push cart 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
Cotowbu 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
Enviro ntal Health shall be notified immediately.
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, Permitted Operator
(Signature)--
P. L,
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i.p, 5-23-2027 , Mobile Food Unit/Pushcart Operator
�' A „ ,H• (Signature)
� ) �,�v- /`�c��.•�� l n.h n_c 2 - , Notary Seal
(Signature) / ff �7
My commission expires 0 /.Z3/� /