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HomeMy WebLinkAboutEHPR-09-2022-42359.tif ENVIRONMENTAL HEALTH ''tll/.r�''+ 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 ruua. c.SETTER. Email: EHAdmin@CatawbaCountyNC.gov Pi -ill- )) -t/)3.c7 Food Establishment Plan Review Application Type of Construction: New ❑ Remodel ❑ Existing ❑ Senshi Ramen Name of Establishment: If existing,please give name of old establishment if known: Address: 1510 Tate Boulevard SE STE A City: Hickory State: NC ZIP Code: 28601 Phone (if available): 828-661-7983 Fax (if available): Clifford and David Napier Owner or Owner's Representative: Address: 46 32nd Ave NW City: Hickory State: NC ZIP Code: 28601 Phone (if available): 828-661-7983 Fax(if available): E-mail Address: dnapier@ssg-us.com Submitter: David B Napier Company: Senshi Ramen Contact Person: II David Napier Address: 32nd Ave NW City: Hickory State: NC ZIP Code: 28601 Phone (if available): 469 271 9193 Fax(if available): E-mail Address: dnapier@ssg-us.com Title(owner, manager, architect, etc.): Owner I certify that the information in this application is correct, and I understand that any deviation without prior approval from this Health Regulatory Office may nullify plan approval. (Owner or esponsible Representative)e), Signature & Date: �1 �v T �.� '�� 0 ! 2.... ri Hours of Operation Sun Mon Tue Wed Thu Fri 5_9 Sat 11-9 Projected number of meals served between product deliveries:Breakfast Lunch 20 Dinner 30 Number of Seats: N/A Facility total square feet: 800 Projected construction start date: N/A Projected construction completion date: N/A Type of Food Service (check all that apply) CI Restaurant ❑Catering Single-service (disposable): ❑ Plates ❑Glassware l Silverware bowls ❑Food stand ❑Sit-down meals ❑Drink stand El Take-out meals Multi-use (reusable): ❑Plates ❑Glassware ❑Silverware ❑Commissary Cl Meat market Other(explain) Specialized Processes Please indicate if any specialized processes will be used. ❑Curing ❑Acidification (sushi, etc.) ❑Reduced oxygen packaging (vacuum seal) ❑Smoking ❑Sprouting beans ❑Other Explain checked processes: Populations Server N/A Indicate any of the following highly susceptible populations that will be catered to or served: ❑Nursing home ❑Child care center ❑School with pre-school aged children ❑Assisted living center ❑Health care facility Please Fnrinse the Following Documents: • Proposed menu items (including seasonal variations in the menu). • Manufacturer specification sheets for each piece of equipment shown on plans. • Site plan showing location of business in building, location of building on site including alleys, streets and location of any outside facility(dumpster,walk-ins,etc.). • Plan of facility drawn to scale showing location of equipment, plumbing, electrical service and mec ' 1 ventilation,including location of all electrical panels. Menu Toppings . onkatsu Ramen Bowl 1. Pork Belly Slice 2. Miso Ramen Bowl 2. Marinated soft-boiled egg 3. Scallions 4. Nori (seaweed) Equipment & Facility Plan - See southern sideboard file for plans and equipment Contents and Format of Plans and Specifications 1. The plans should he a minimum of 11 x 14 inches in size and the layout of the floor plan accurately drawn to a minimum scale of 1/4 inches= 1 foot. This is to allow for ease in reading. 2. Information accompanying the plans should include the proposed menu,seating capacity,and projected daily meal volume for food service operation. 3. The plans should show the location and,when requested,an elevated drawing of all food service equipment.Each piece of equipment shall be clearly labeled on the plan with its common name. 4. Adequate rapid cooling including ice baths and refrigeration,and hot-holding facilities for potentially hazardous food(PHF)should be clearly designated on the plan. 5. When the menu dictates,separate food preparation sinks should be labeled and located to preclude contamination and cross-contamination of raw and ready-to-eat foods. 6. Adequate hand washing facilities used for no other purpose should be designated for each toilet facility and in the immediate area of food preparation and dish washing area. 7. The plan layout should contain room size,aisle space,space between and behind equipment,and the placement of the equipment on the floor. 8. Auxiliary areas such as storage rooms,garbage rooms,toilets, basements and/or cellars used for storage or food preparation should be represented on the plan and all features of these rooms shown as required by the standards. 9. The plans and specifications should also include: A. Entrances,exits, loading/Unloading areas and docks B. Completed finish schedules for each room to include floors,walls,ceilings and coved juncture bases approved materials for food preparation, handling and storage areas include quarry tile,ceramic tile,sealed concrete,commercial linoleum,fiberglass reinforced panels,stainless steel, wall hoard painted with washable,nonabsorbent paint,vinyl coated ceiling tiles,and brick,cinder blocks,slag blocks,or concrete blocks,if glazed,tiled,plastered or filled so as to provide a smooth surface.If specifying the use of a material not on this list, include a sample of the material for evaluation. C. Plumbing schedule to include location of the floor drains,floor sinks and water supply lines,overhead waste water lines,hot water lines, hot water generating egrpment with capacity and recovery rate,back flow prevention,waste water line connections.Electrical layout,electrical panels and disconnects. 10. Lighting Requirements A. Surfaces where a food employee is working with food or working with utensils or egtipment such as knives,slicers,grinders or saws where employee safety is a factor at those levels:50 foot candles(540 lux) B. In walk-in refrigeration units and dry food storage areas and in other areas and rooms during periods of cleaning at a distance of 30 inches(75 cm)above the floor:10 foot candles(108 lux) C. Lighting In hand washing,ware washing,equipment and utensil storage and toilet rooms shall be measured at 30 inches(75 cm)above the floor and/or at the work levels and ecpipmertt and utensil storage and toilet rooms:20 foot candles(215 lux) D. At surfaces where food is provided for consumer self-service such as buffets and salad bars or where fresh produce or packaged foods are sold or offered for consumption,inside equipment such as a reach-in and under-counter refrigerators:20 foot candles(215 lux) E. Light bulbs in food preparation,storage,and display areas shall be shatter-proof or shielded so as to preclude the possibility of broken bulbs or lamps falling into food.Shatter-proof or shielded bulbs need not be used in food storage areas where the integrity of the unopened packages will not be affected by broken glass falling onto them and the packages,prior to being opened,are capable of being cleaned.Heat lamps shall be protected against breakage by a shield surrounding and extending beyond the bulb, leaving only the face of the bulb exposed in food preparation area. 11. Insure that all food serviceAcitchen ecpipment is NSF International(NSF)listed,underwriters Laboratories Inc.,Classified for Sanitation or if not NSF or UL listedAlassified,be constructed to meet NSF standards as specified according to 15A NCAC 18A.2600,2009 NC Food Code 4-lhorough 4-3. 12. Source of water supply and method of sewage disposal.The location of these facilities should be shown and evidence submitted that state and local regulations are to be complied with. 13. As specified according to 15A NCAC 18A.2600,2009 NC Food Code 4-903.11 (A)-(D),3-305.11(A)and(B).All items stored in rooms where food or single-service items are stored shall be at least 12 in(30.48 cm)above the floor when placed on stationary storage units or 6 in(15.24 cm)above the floor when placed on portable storage units or otherwise arranged so as to permit thorough cleaning. 14. Ventilation schedule for each room. 15. Garbage can washing area,facility.As specified according to 15A NCAC 18A.2600,2009 NC Food Code Manual 5.203.13, Plumbing Systems, adequate facilities shall be provided for the washing and storage of all garbage cans.The cleaning facilities shall include a combination faucet,hot and cold water,a threaded nozzle and a curbed impervious pad,a minimum recommended size of 36 x 36 x 4 with walls finished being easily cleanable and nonabsorbent to a height of 48 inches.A shelf may also be provided for the storage of cleaning supplies andbr chemicals. If the unit is utilized as a combination can wash/mop sink then the minimum recommended size for this unit is 36 by 36. 16. Dumpster pad and location as specified according to 15A NCAC 18A.2600, 2009 NC Food Code Manual 5-5 Refuse,Recyclables and Returnables. 17. Grease traps and,6r grease interceptor location. 18. Grease storage containers and storage location. 19. Cabinets,'helves for storing toxic chemicals. 20. Dressing rooms, locker area,employee rest area,and,6r coat rack as required. 21. Completed checklist. 22. Site plan(plot plan) Cold Storage Equipment & Facility Plan - See southern sideboard file for plans and equipment Method used to determine cold storage requirements: Cubic feet of reach-in cold storage Cubic-feet of walk-in cold storage: Reach-in refrigerator storage: ft Walk-in refrigerator storage: ft Reach-in freezer storage: ft Walk-in freezer storage: ft Number of reach-in refrigerators: Number of walk-in refrigerators: Number of reach-in freezers: Number of walk-in freezers: Hot Holding List foods that will be held hot: Broth Cold Holding List foods that will be held cold: All meats and veggies Cooling N/A Indicate by checking the appropriate boxes how cooked food will be cooled to 450F (70C) within 6 hours. Cooling Process Meat Seafood Poultry Other Shallow Pans ❑ ❑ ❑ ri Ice Baths ❑ ❑ ❑ ❑ Rapid Chill ❑ ❑ ❑ ❑ If Other is checked indicate type of food: Thawinu N/A Indicate by checking the appropriate boxes how food in each category will be thawed. Thawing Process Meat Seafood Poultry Other Refrigeration ❑ ❑ ❑ ❑ Running Water less than 70 F (21C) ❑ n ❑ n Cooked Frozen ❑ ❑ ❑ ❑ Microwave ❑ ❑ El ❑ If Other is checked indicate type of food: 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 categories of food. 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 Ready-to-Eat Food Handling (edible without additional preparation necessary, e.g., salads, cold sandwiches, raw molluscan shellfish) N/A Produce Handling Will produce be washed or rinsed prior to use? ®Yes ❑No Is there an approved location used for washing or rinsing produce? ®Yes ❑No Will it be used for other operations? CYes ❑No 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: Prep sink (as noted by southern sideboard files) wash 2 evenings, 2 times per week. Poultry Handling Will poultry be washed or rinsed prior to use? ®Yes ❑No Is there an approved location used for washing or rinsing poultry? ®Yes DNo Will it be used for other operations? CYes ❑No 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: Prep sink (as noted by southern sideboard files) wash 2 evenings, 2 times per week. Meat Handling Will pork and red meats be washed or rinsed prior to use? DYes ❑No Is there an approved location used for washing or rinsing pork and red meats? ®Yes ❑No Will it be used for other operations? LIYes ❑No Please indicate location of meat washing equipment and describe the procedures. Include time of day and frequency for washing or rinsing the meat at this location: Prep sink (as noted by southern sideboard files) wash 2 evenings, 2 times per week. Seafood Handling Will seafood be washed or rinsed prior to use? DYes ❑No Is there an approved location used for washing or rinsing seafood? DYes ❑No Will it be used for other operations? DYes ❑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: N/A Dry Storage Provide information on the frequency of deliveries and the expected gross volume that is to be delivered each time: N/A Square feet of dry storage shelf space: ftl Where will dry goods be stored? See Southern Sideboard Equipment/Facility Plan Finish Schedule See Southern Sideboard Equipment/Facility Plan Indicate floor, wall and ceiling finishes(e.g.,quarry tile,stainless steel, vinyl coated acoustic tile) Area Floor Base Walls Ceiling Kitchen Bar Food Storage Dry Storage Toilet Rooms Dressing Rooms Garbage and Refuse Storage Service Sink (mop/trash can wash) Other Other Water Supply and Sewage Water supply: ❑Municipal 0 Well See Southern Sideboard Equipment/Facility Plan Sewer: 0 Municipal Leptic See Southern Sideboard Equipment/Facility Plan Ice: L Made on premises III Purchased See Southern Sideboard Equipment/Facility Plan Water Heater Tank Type See Southern Sideboard Equipment/Facility Plan Manufacturer: Model: Storage Capacity: gallons Electric Water Heater: kilowatts (kW) Gas Water Heater: BTUs Water heater recovery rate (gallons per hour at 80F/90F temperature rise): GPH (See Water Heater Calculator on the Plan Review Unit website to calculate recovery rate needed) Tankless Manufacturer: Model: Quantity of tankless water heaters: Check the appropriate box indicating equipment drains: Indirect Waste Direct Waste Plumbing Fixtures Floor sink Hub Drain Floor Drain Warewashing Sink ❑ ❑ Prep Sinks Handwashing Sinks ❑ Warewashing Machine ❑ Ice Machine Garbage Disposal ❑ Li U Dipper Well Refrigeration Steam Table Ti Other ❑ Other 111 See Southern Sideboard Equipment/Facility Plan Warewashing Equipment See Southern Sideboard Equipment/Facility Plan Manual Warewashing(must be 3-compartment sink) Size of sink compartments: Length in Width in Depth in What type of sanitizer will be used? Chlorine Iodine Qaternary Ammonium n Hai Water Other (specify): Mechanical Warewashing See Southern Sideboard Equipment/Facility Plan Warewashing machine manufacturer: Model: Type of sanitization: Hot water(180 F) Chemical General Describe how cooking equipment, cutting boards, slicers, counter tops and other food contact surfaces that cannot be submerged in sinks or put through a dishwasher will be cleaned and sanitized: See Southern Sideboard Equipment/Facility Plan Describe location and type (drainboards, wall-mounted or overhead shelves, stationary or portable racks) of air drying space: See Southern Sideboard Equipment/Facility Plan Square feet of air drying space: ft Handwashing Number of handwashing sinks: Locations: See Southern Sideboard Equipment/Facility Plan Employee Accommodations Location for storing employees' personal items: See Southern Sideboard Equipment/Facility Plan Refuse and Recyclables Will refuse be stored inside? x No Yes, at Provision for refuse disposal: x Dumpster Compactor Provision for cleaning dumpster/compactor: x On-site Off-site cleaning Off-site cleaning contractor: Describe location for storage of reryclables(cooking grease, cardboard,glass,etc.): Exterior of Building - See Southern Sideboard Files Service Sink Location and size of service (mop)sink/can Exterior 4x4 wash: Is a separate mop storage area provided? x No Yes, at Insect and Rodent Control How is protection provided on all outside doors? © Self-closing door ❑ Fly fan ❑ Screen door How is protection provided on windows? ® Self-closing ❑ Fly fan ❑ Screening Linen Indicate location of clean and dirty linen storage: N/A Poisonous or Toxic Materials Indicate location of poisonous and/or toxic materials (chemicals, sanitizers, etc.) storage: N/A �4'A • CATAWBA COUNTY 100A SOUTI IWEST BLVD d Hk.) 0 7 NEWTON,NORTE{CAROLINA 28658 RECEIPT PHONE:828.465.8399 Monday,September 26,2022 1842 5M www.catawbacountync.gov PAYOR: Senshi Ramen Senshi Ramen(Napier,David) PAYMENTS TRANSACTION NUMBER: TRC-47943473-26-09-2022 PAYMENT DATE: 09/26/2022 PAYMENT TYPE: Credit Card 295504107 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 09-22-412717 110-580200-663000 Food and Lodging Review Fee S250.00 TOTAL PAYMENTS: S250.00 EHPR-09-2022-42359 CASE TYPE: Environmental Health Plan Review WORK CLASS: Other FLl SITE ADDRESS: 1510 TATE BLVD SE,HICKORY NC 28602 Applicant SENSHI RAMEN,45 32ND AVE NW,HICKORY NC 28601 C:4692719193 DNAPIER@SSG-US.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 09/26/2022 10:55 Page 1 of I