HomeMy WebLinkAboutEHPR-10-2022-42426.TIF 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
Edtalrlftshments, 15A NCAC 18A, section .2600, as pertains to the operation of a mobile food
it/puart and that the parties understand the responsibilities of each party as required
in .2 ;3672 of the rules and must meet requirements from the 2009 NC FDA Food Code
V )nMltnua 'vhich include:
P OP f
Pcnrt or mobile food units shall operate in conjunction with a permitted restaurant or commissary and shall report at least
oily t�olffe restaurant or commissary for supplies, cleaning, and servicing. Facilities, in compliance with this section, shall be
Env! ed 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(( V t V'' ('�` `
premises."� � �`
This, the U day of ° \oe I , 20 l ,
I, � of
(RestaurantiOwner or Manager) (T e)
poo �0 `l \ located at
q\amt VI%
((Nam a of Ess�tablishment) n�}W\ 1 VV Ov , NC g/ 1X v I ID# ZD nZv (I}-1
(Address) ZI
certify that I have/� readlj and+'r understand/ n the above regulations` � ti and hereby authorize
e)e�l �U �O c/r 4 v V` �U 1 'es r Mobile Food Unit Operator to operate
(Name)
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
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
Environmental Health shall be notified immediately.
0, , Permitted Operator
(Signatu
—' G9--- - , Mobile Food Unit/Pushcart Op UINub
Signature) ,1S EpHAI10 '''' i
4,` a 1.
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, Notary Seal +> MON 0 St
t
(Signature) _ I a
My commission expires ����Q� NCj```7,47
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