HomeMy WebLinkAboutEHPR-10-2022-42623.TIF ENVIRONMENTAL HEALTH
Cotawbn County Government Cuter
catawba county 25 Owernmeat ire I P.O.Box 389 I Newton,NC 28658
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Plan Review Application for a Mobile good Tint
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`inforsr»adan will delay plan review.
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A"mobile food unit"means a vehicle-mounted food service establishment designed to be readily.
moved.AU 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 MI6 G
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.
Name of Business: .H 6+S kr-s H0i o q.s'
Owner's Names D eul in Clivi 5 I n✓►n
Mailing address: I�00 pr-5 0 v Ce....vAv r a
City: N t 1.0-6 n State:. N C ZIP: 3.169 r
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Entail Address:: 1t 04 3 ka-k-k h of w� (1o.Gto v, Co wt
Restaurant or Commissary supporting unit: I kr- U 3 7 /"t // 1l (wIz 12d
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State ID#of Restaurant or Commissary: o(d I.00 c)q3/ Conover
oii.� Date. •F-
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iT mik(4,... o CATAWBA COUNTY
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�, 100A SOUTHWEST BLVD z
f„3 NEWTON,NORTH CAROLINA 28658 RECEIPT
�.�r PHONE:828.465.8399
Thursday,October 27,2022
:18 42 SM www.catawbacountync.gov
PAYOR: Hotshots Hotdog
Hotshots Hotdog(Chislom,Devin)
PAYMENTS
TRANSACTION NUMBER: TRC-49965792-27-10-2022
PAYMENT DATE: 10/27/2022
PAYMENT TYPE: Cash -;
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT ' F
10-22-414004 110-580200-663000 FLI Mobile Food Unit/Push Cart $75.00 _?
Plan Review Fee
TOTAL PAYMENTS: $75.00
EHPR-10-2022-42623
CASE TYPE: Environmental Health Plan Review WORK CLASS: Other FLI
SITE ADDRESS: 307 S MCLIN CREEK RDA,CONOVER NC 28613
Applicant HOTSHOTS HOTDOG,,
C:8283038403 HOTSHOTSHOTDOGS@YAHOO.COM
**NO PEOPLESOFTACCOUNTASSIGNED**
receipt 10/27/2022 16:07 Page 1 of 1
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 l P D day of /401/01.1--&-."4---- , 20 ,
/ f4 i/12i7L� — --- DCy/ L-`77i of
�(Restaurant Owner or Manager) �f (Title)
EA-s74-/ t'47-� located at
(Name of Establishment)
i $,Q -b
U , y lU- G , NC 261,13ID# -- kuzek-tccj
(Address) t-A/Wk.1X— (ZIP)
certify that I have read and understand the above regulations and hereby authorize
jIIen `�'1 i SLd, 1 , 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 1828.465.827C
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.
, Permitted Operator
(Signature)
(A I i Cii., Le ''''\- , Mobile Food Unit/Pushcart Operator
7.(Signature)
_ 1"/-,
L� , Notary Seal(Signature)
.•`'',�p.DEN p
c<9% My commission expires ��C-06tvr [�"l f2 e•=_�
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