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Home My WebLink AboutEHPR-11-2022-42693.tif Catawba Couty Government Cuter catawba county 2S Govonmest Drive I P.O.Box 384 I Hewton,NC 28658 public health none:(828)4654270 I Fax:(828)465-8276 „S Mae Email: EHAdmin@CotawbaCouatyNC.gov 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. 1,`` 'f ,' '7 l�Jci ell • Attach a proposed menu of food items for sale. • Anoch a diagram of gait coataialeg location of all equipment,storage areas,sinks,mad teaks. • Does sapportiag nsnaeraet or commissary leave a well oad septk system? if sa,a task cbck and water sample wi8 b respired. 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 ail 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. Nome of Business: 3cJ tArvy t•A 1 ? 7(..) Owner's Name: Mailing address: ✓� kcC., �.,� 1,� z c y \� • City: a�nr�.l r:"A State: is, ZIP: Zt,c;! Z_ Telephoneg(s): -. ?• _cic f;c1 Lt4 Sc I—Z_ Email Address: \c-,A{ t--`� ��'yLJic. Restaurant or Commissary supporting unit: �l l Z U Q Gt £G,s-f/c t C'j State fD#of Restaurant or Commissary: ZQ%�-o z` d 1 Sc Applicant Signa Date: i c Food Handling Procedures Explain the following with as mods detail as possible. Provide descriptions of the specific areas of the kitchen and corresponding items or the pier where food will be bandied.Explain the baudUng procedures for the following food categories. Describe the process ham receiving io service indadlug: • 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 bow the food will be handled(washed,cut,marinated,breaded,cooked,etc.) • When(time of day and frequency/day)feed will be handled Ready-to-Eat Food Handling (edible without additional preparation necessary,e.g.salads, cold sandwiches, raw molluscan shellfish) Produce Handling Will produce be washed or rinsed prior to use? Yes g._ Ho_❑_ is there an approved location used for washing or rinsing produce? Yes WIU it be used for other operations? Yes__ ] Please indicate location of produce washing equipment and describe the procedures.include time of day clad frequency for washing or rinsing the reduce at this locatio �{ � �� /c /A2 l �l GN 'L sr nr-. (As_ (IA' Poultry Handling Will poultry be washed or rinsed prior to use? Yes _ is there an approved location used for washing or rinsing peaftry? Yeses No El Will that location he used for other operations? Yes_El 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: \--V , .��\ c,\NA\,h Meat Handling Will pork and red meats be washed or rinsed prior to use? Yes_a_ Nol _ Is there an approved location used for washing or rinsing pork and red meats? Yes n No ❑ Will tt be aced for other operations? Yes_a_ No ❑ Please kulicate location of seafood washing equipment and describe the procedures.Include time of day and frequency for washing or rinsing the seafood at this location: Seafood Handling Will seafood be washed or rinsed prior to use? Yes El No ❑ Is there an approved location used for washing or riesiag seafood? Yes El No El Will it be used for other operations? Yes_E No_El Please indicate{ocatioe of seafood washing equipment and describe the procedures. Include time of day and frequency fer washing or rinsing the seafood at this location: Nl� jix'- CcricA_ �r�fur \ Draw to scale, identifying and describing all e ipment, including hadwash facilities, equipment, washing fa�ities, coolcin e , refry workfables, storage, hot and cold holding units,water source an storage. Describe the floor, wall and ceiling surfaces of the unit. F.MNT" .1 3 � ._►s_,,... .,.. • �Ili sull • III liarmIII BSI MN 111 10 Iliii;•14 I 1 _ ik411 vMal1• 1 III '1■ ■■ ■ IMI 6 '� ■■■ PI - I. ■■ ■ 111 3). 1 1!! ,0. , ,, ‘?„,,, tioor : S4-tet 1►Q.4, Ge,ln ; li,r..4 QAi cjimul s • CYNE .1RGY, VIi /17 i I Serial tt !_ Date Ordered: �-_-_-. Ordered by: Date needed: Advanced Model 7x16TA Standard Specifications: 2-12V Dome ON with awlich 15"Radial Tire 2 5116"coupler Non.powered roof vent Silver Mod Wheel Aluminum Fenders wlLights LED Strip tall lights Wall members 16"P.C- Rounded V-Nose with vertical ATP trim floor cros$members 16"Q,C. 1"x1 112"steel tube in walls and ceiling Root members 24"O.C. 35001b spring axles with 4"drop and 54-Interior height Screwed metal exterior EZ Labe Hubs-Dexter Axles 2000 lb tongue jack Galvalume roof 24"Stonoguard on front 2Xd TVSE FRAME --;_ 7-way Round else.plug Structure: Ex or:- Rounded V-Nose w/ATP Vertical Trim I .080 METAL OT")J,9� $ <`' EXT TRIPLE TUBE TONGUE S �,`: '4FT EXT V-NOSE $ ' ;:. STEEL FLOOR £ — Fjg: 2X6 TUBE FRAME 3X5 CON WINDOW W/GLASS $ III PASS CENTERED Interior: - •• 84"INTERIOR HEIGHT $ INSULATED WALLS&CEILING $ Thermo Ply Ceiling ..� .080 SILVER INTERIOR WALLS $ AND CEILING: - NO PLYWOOD WALLS&FLOOR• 4-DROP DOWN JACKS S _ 2-FOLD DOWN SHELVES $ 1-INSIDE,1-OUTSIDE WATER PACKAGE - - • $ Tires&Wheels TRIPLE SINK,HW.SINK,BASE CAB ,-, /' h };4s Silver Mod Radial Tires WATER HEATER,TANKS: ' �; Grid'' ?Sand Foot O��✓ ham`' , Chrome Center Lug Covers Electrical: LED EXTERIOR . . 1 50AMP ELECT PACKAGE $ Doors,Ram s,Windows BSPACEBOX,LIFELINE,2-110RECPT' 5 36"RV DOOR REAR WALL CENTERED S 2-4FT LED LIGHTS on NO SIDE DOOR 6FT RANGE HOOD $ .w 50 AMP MOTOR;BASE PLUG:•••: $ rC _ � 13500 BTU A/C a :: $ ; L. `D n Vents&MC :i.; - CV 1 y ,3!. 4M1 .4 � ., . ... r ;o ', gu-W''. ' Base Price 0t< ;>1Xq44 'r L Spec shoot is basod on latest product and pricing information. • ',!-4n�C ''j rrx . 11F' ai"l ,1' ti Cy.."Cargo Trailers LLD.,reserves the right to make changes In Options " af{!li-"tF' K u_ • sit �10F ` '` 1 I pricing.colors.materiels,equipment,specifications and models:and to j� • u .,•'.-. _ ':. discontinue models without notice or obligation. • Total .' alekltE ` i F . �y s t 'P_T'lY � Y 'fir ... 3`'A?!` �- — ..._r4.L' r gti t v. i S` ,'f.. :1rti r' '°..,. Menu Red Pizza: A classic tomato sauce White Pizza: An olive oil and garlic infused sauce Toppings Onions Peppers Sun dried tomatoes Spinach Sausage Pepperoni Fresh Basil Fresh Mozzarella Ricotta Cheese Coffee Black Half and Half Oat Milk Drinks Canned Soda Ingredients Canned red tomatoes Fresh garlic Salt/ pepper Olive oil Butter Dough Onions Peppers Pepperoni (local?) Spinach Sun dried tomatoes Fresh mozzarella cheese (Trader joe's) (local?) Fresh basil Ricotta cheese (Trader joe's) (local?) Coffee Decaf Half and Half Oat Milk Sugar "WE MAKE THE KITCHEN BETTER!" APoll Free: 855-855-0399 Email: info@atosausa.com �� www.atosa.com www.atosausa.com California, Colorado, Florida, Georgia, Illinois, Massachusetts, New Jersey, Ohio, Texas, Washington MODELS: MPF8201GR/MPF8202GR/MPF8203GR Refrigerated Pizza Prep Tables Standard Features 11111111 • Side mount compressor with environmentally • friendly R290 refrigerant bk; • Stainless steel exterior & interior MPF8201GR • Dixell digital controller • Maintains temperatures between 34°F — 40°F • Stainless steel 1/3 size pans included • 19" cutting board standard r-, — • Self-closing door(s) with stay open feature 5„ S 05 • Recessed door handle(s) • Magnetic door gasket(s) standard for positive door seal • Two(2) pre-installed shelves per section MPF8202GR • Pre-installed casters Optional Accessories • Extra shelves — includes 4 shelf clips per shelf r- 1 r� f•"'� MPF8201GR shelf part #: W0402572 MPF8202GR shelf part #: W0402573 rao Wiz, MPF8203GR shelf part #: W0402573 left/right shelf, part #: W0402572 middle shelf MPF8203GR For the best results of food preservation we recommend setting your refrigerator between 33°F to 38°F 1. Don't forget to leave the unit some room to breathe! 2. Please clean the condenser frequently to give the unit more fresh air. o..�s,° n� R290 rP 9 ---- 2 YEAR PARTS ANL)LABOR WARRANTY(US ONLY) ETA IY�: n R29 r+ ti ^ •a 5 YEAR COMPRESSOR PART'WARRANTY(US ONLY) Intertek Inter[ekligef:ralt 51 "WE MAKE THE KITCHEN BETTER!" AraTA Toll Free: 855-855-0399 Email: info@atosausa.com www.atosa.com I www.atosausa.com California, Colorado, Florida, Georgia, Illinois, Massachusetts, New Jersey, Ohio, Texas, Washington SPECIFICATIONS Capacity Casters Amps Voltage Exterior Net Gross Models Door (Cu.Ft.) Shelves (inch) (A) (V/Hz/Ph) Ill 12cfri,..crxrlt Dimensions Weight Weight (inch) (lbs) (lbs) MPF820IGR 1 9.7 2 5 2.3 115/60/I 1/7 R290 44x33''10x44 238 295 MPF8202GR 2 18.5 4 5 2.8 115/60/1 1/5 R290 67x3311°x44 335 406 MPF8203GR 3 28.4 6 5 3.1 115/60/1 1/4 R290 93x33''1Dx44 428 527 PLAN VIEW 331/10 MPF8201GR MPF8202GR MPF8203GR .5/16 63P8 165116 \ = = =1 4 ..--. t- in linta - NA c� M M �n -L 44 67 93 _ 11/16' 42518 1/16 425'8 21718 2118 21718 425/8 21718 2118 ah 11.31.11, g ~ ' .Y Y 41 7N 11 b I Itl II V -ir ( , ) I4 ■ YI IM II 11 1 .I 1 13 'J I 3 I� M l 111 I''II II III Y III IY' �I - 1 1 : III E I w ,„ { �, interior Dimensions n M . _ � L.,q_ 11{•'pl„q„ry,_I�II I� Iq /J II l�{ l 'lll !�� 1'l l l l�l,../ 1 �' I iI iO i *741.1/1r ;l i I 4 a 1-----.4 o M. 1 L-- ' v LO 223116 ' 223116 223116 ' 221116 II 223l16 N315116 N - 315/16 I315/16 N 23/6 145/e 5515/16 263/6 14" Casters 4 Epoxy shelves Stainless steel•pans Temperature control I ,,, . . „ _, , ___ __ ---____ NEMA 5-15P I NEMA 15A/125V Atosa International I Atosa USA www.atosa.com www.atosausa.com *Atosa is continuously improving products.Specifications are subject to change without notice.* 52 , 9'C1 FY f A ,t, ti`C“^1`j Lir i R� t`ryrd'c 1 1 4v. - MBF8519GR—Bottom Mount One(1) Door Low Height Reach-in Refrigerator Standard Features: • Bottom mount compressor units with environmentally friendly R290 refrigerant • Stainless steel exterior&interior • Digital controller • Maintains temperatures between 33°F—40°F • LED interior light(s) • Recessed door handle(s) • Door lock(s)standard • Magnetic door gasket(s)standard for positive door seal • Pre-installed casters • Three(3)pre-installed shelves per section • • Down duct refrigeration to to ensure even distribution of air Optional Features: • Extra shelves—includes 4 shelf clips per shelf • MBF8519GR shelf part U:W0402316 MBF85 115/60 24 1/4 19GR 1 8.3 3 2" 2.1 /1 1/7 R290 x 24 x 176 209 63 1/4 M PF8202GR—67" Refrigerated Pizza Prep. Table Standard Features: • Side mount compressor with environmentally friendly R290 refrigerant • Stainless steel exterior&interior • Dixell digital controller • Maintains temperatures between 34°F—40°F • Stainless steel 1/3 size pans included • 19"cutting board standard • Self-closing door(s)with stay open feature • Recessed door handle(s) • Magnetic door gasket(s)standard for positive door seal • Two(2)pre-installed shelves per section • Pre-installed casters MPF82 115/60 67 x 33 02GR 2 18.5 4 5" 2.8 /1 1/5 R290 1/10 x 335 406 44 LAVANTURE T167 30 GALLON POTABLE RV FRESH WATER TANK - 34 INCHES X 18 INCHES X 12 INCHES Br ancls: LaVanture Products Company Inc Product Number: T167 Vendor Number: T167 SIS127.rI $111.99 You Save $15.96 (12.5%) This product can only be picked up in stores Steibel-Eltron SHC-6 GALLON MINI-WATER HEATER SHC TECH SPECS 235089 120 v 11.3 A 26.5 lb(12.0 kg)15'/A(385 mm)150 psi(10 bar)45 minutes brass 1/2"NPT HEARTHBAKE SERIES COUNTERTOP GAS OVENS BAKERS SERIES: GP PRIDE Mindio ..._:,..,,„,,..413211,....,... ...H. . i ps,t II N •- - w If : ) ID odoie 1 . .. .., , 01.101.,, ,.._, . • , . i„ _,. . , .. . . 4. .iii 1-1 i , Bakers Pride' GP series ovens are designed for baking pizza, pretzels, flat breads, or other bakery items and offers a wide range of options suit any need. Models ii are available with your choice of standard or high- FEATURES AT A GLANCE OPTIONS & ACCESSORIES performance burners,two or four baking chambers, and either Cordierite or brick-lined decks in two sizes. •40,000 or 45,000 BTUH burners •16"(406 mm)legs or casters(grey) •60,000 BTUH burners on HP models •16"(406 mm)legs or casters The lower deck is perfect for rapid baking while the •Natural gas or liquid propane(CE (stainless steel) upper deck offers precision for slower baking. For more for natural gas only) •30°(762 mm)legs or casters(grey) flexibility,the upper decks can be easily removed to •Energy-efficient,modulating •30"(762 mm)legs or casters create a single 12"tall deck. Doors are bottom-hinged thermostat and (stainless steel) with field-reversible handles for left-or right-hand •Combination gas control valve •550°F(287°C)baking thermostat with pilot safety and gas regulator .Single door in lieu of double doors operation. You also have the option of ordering single •300-650°F(149-650°C) doors in lieu of double doors. temperature range •Direct vent flue diverter •Two aluminized steel baking •Stainless steel undershelf for 30" These ovens can be double-stacked or stacked with (762 mm)legs chambers the Cyclone series for the ultimate cooking and baking •Standard flue •Cordierite decks solution. This series comes standard with stainless •Automatic oven starter •Stackable steel exterior and 4" adjustable legs and is available •Lightsonestone •5"(127 mm)upper deck height; for use with natural gas or liquid propane. A standard 6"(152 mm)lower deck height •Stacking kits combination valve incorporates a manual gas valve, pilot •Bottom-hinged doors with field- •48"(1219 mm)quick disconnect safety, and gas regulator. reversible handles(right or left) gas hose •4"(102 mm)adjustable chrome- plated legs •All stainless steel exterior •Slide-out flame diverter •Front-mounted,hinged control- valve access panel •One-year limited warranty W www.bakerspride.com I p:800.431.2745 BAKERS 1307 N.Watters Rd.Suite 180 Allen TX,75013 : Standex PRIDE HEARTHBAKE SERIES COUNTERTOP GAS OVENS BAKERS SERIES: GP PRIDE. EQUIPMENT DIMENSIONS I ( 5. I GP51 4l Uk VcNI ;IAA 6'(152mr) (3]Bnfml S37ST nw.ff]va cr61 i13]1RA) 1 • )675' (,24801m) 715 (1 r(4011 BI M/A) � 4825' +06]5' r--- r l J, GAS INLET 87 IS' (GL]1mn) 003..1 34 8750' 54 2S- 1 (deb urq 1 oremm) 'deck size }171 ].25- , __}_________ 73.175 1 /l (18d Mill) ,' �,.' I (587mn) I � 1 � 4.7S' _. _. l See ro0aei wmU15 m c531:below (24810.( FRONT VIEW TOP VIEW 4'(107 mm) ' I L 4 ]5 nA 1a 05(73urml) STACKED UNIT SIDE VIEW MECHANICAL SPECIFICATIONS Model# Overall Dim Deck Deck Size Decks Baking Thermostat Carton Dim Cubic Cubic Ship (W x H x D)* Height (W x D) Chambers Range (W x H x D) Feet Meter Wt. GP51 32.62"x 25.12"x 31.25" 6"(1 52)/ 20.62"x 76.25" 2 2 1 300°-650°F 52"x 36"x 39" 43,8 1 7 414 GP51-BL (829 x 638 x 794) 5"(127) , (524 x 667) (149-343°C) (1321 x 915 x 991) (188kg) GP52 32.62'x 50.25"x 31.25" 6"(152)/ 20.62"x 26.25" 4 4 300°-650°F 52"x 36"x 39" 43.8 1.2 828 GP52-BL (879 x 1276 x 794) 5"(127) (524 x 667) 149-343°C) 1321 x 915 x 991) (376kg) GP61 41.62"x 25.12"x 31.25' 1 6' 152 / 29.62"x 26.25" 2 2 300°-650°F 52' x 36"x 39" ' 43.8 1.2 493 GP61-BL (1057 x 638 x 794) 1 5"(127) (752 x 667) (149-343°C) (1321 x 915 x 991) (224kg) GP61-HP i GP62 41.62"x 50.25"x 31.25" . 6"(152)/ 29.62"x 26.25" ' 4 4 ' 300°-650°F 52"x 36"x 39" 43.8 1.2 986 GP62-BL (1057 x 1276 x 794) ! 5"(127) (752 x 667) (149-343°C) 1 (1321 x 915 x 991) (447kg) GP62-HP , *Height excludes legs REQUIRED CLEARANCES GAS SUPPLY • Non-Combustible Construction Combustible Construction Model# BTUH ' kW Left 0"(0 mm) 1"(25 mm) Right 2"(51 mm) 2'(51 mm) GP51 f 40,000 11.72 Back 2"(51 mm) 5"(127 mm) - GP52 80,000 23.44 Bakers Pride Oven Company,LLC is a wholly owned GP61 45,000 13.19 subsidiary of Standex International Corporation. -- — — Bakers Pride reserves the right to modify specifications or discontinue GP62 90,000 26.37 _ models without incurring obligation.Dimensions nominal. GP61-HP 60,000 17.58 Va E Freight Class:110 GP62-IIP 120,000 35.16 FOB:Allen,75013 www.bakerspride.com I p:800.431.2745 BAKERS 1307 N.Watters Rd.Suite 180 Allen TX,75013 !:Standex PRIDECooking Solutions Group Bakers Pride GP-61 Liquid Propane Countertop Oven - 45,000 BTU Bakers Pride GP-61 LP GAS Details This Bakers Pride liquid propane heated countertop oven features two Cordierite ceramic hearth stone decks, ideal for baking pizzas between 300 degrees and 650 degrees Fahrenheit. It also features a convenient dual-deck design and unique heat flow system that optimizes both top and bottom heat. The 6" tall bottom deck is best for rapid baking, while the upper 5" tall deck is perfect for slower baking. Each deck will easily accommodate a full size sheet pan lengthwise. For superior heat retention, each countertop oven is designed with a durable stainless steel exterior and an 18 gauge, type 304 stainless steel interior combustion chamber. Two independent stainless steel bottom hinged doors are designed with field reversible handles for left or right hand operation. Includes 4" adjustable chrome plated legs. Overall Dimensions: Width: 41 5/8" Depth: 31 1/4" Height: 29 1/8" Ceramic Hearth Baking Deck: 20 5/8W x 26 1/4"D Interior Baking Chambers: 26 1/4"D BAKERS PRIDE GP-61 LP GAS SPECS Quantity 1/Each Width 41 5/8 Inches Depth 31 1/4 Inches Height 29 1/8 Inches Deck Width 20 5/8 Inches Full Width 30-42 Inches Baking Chamber Depth 26 1/4 Inches Deck Depth 26 1/4 Inches Full Depth 30-42 Inches Control Type Thermostatic Deck Style Pizza Stone Door Type Solid Exterior Material Stainless Steel Features NSF Listed Gas Inlet Size 3/4 Inches Heating Source Radiant Interior Material Aluminized Steel Maximum Temperature 400-600 Degrees F Number of Chambers 2 Number of Decks 2 Number of Doors 2 Doors Pizza Size 18 Inches Power Type Liquid Propane Style Deck Style Temperature Range 300- 500 Degrees F Total BTU 45,000 BTU Type Deck Ovens Usage Fresh Product CATAWBA COUNTY lY 100A SOUTHWEST BLVD RECEIPTOLINA 28658 , TH 5 828.6 8399v7 Oy� Monday,November 7,2022 I8 4 sM www.catawbacountync.gov PAYOR: Journey Pizza Journey Pizza(Lendof,Henry) PAYMENTS TRANSACTION NUMBER: TRC-507095 95-07-1 1-2022 PAYMENT DATE: 11/07/2022 PAYMENT TYPE: Credit Card 297232062 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 11-22-414349 110-580200-663000 FLI Mobile Food Unit/Push Cart $150.00 Plan Review Fee TOTAL PAYMENTS: $150.00 EH PR-11-2022-42693 CASE TYPE: Environmental Health Plan Review WORK CLASS: Other FLI SITE ADDRESS: 307 S MCLIN CREEK RDA,CONOVER NC 28613 Applicant JOURNEY PIZZA,2718 ENGLISH OAK DR,LINCOLNTON NC 28092 C:9783359689 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 11/07/2022 15:10 Page 1 of 1 J°11" NOV 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 shalt 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_ ISTI4 /V day of_ UVt:Yf'l L-712.-- , 20 , I, —_ �6�1J /Z� ---, !'W A C V of (Restaurant` Owner or Manager) (Title)V-46 DV Ul= kr 6:4�l �/L�(= / �i —_located at L �(� �t (Name of Establishment) ,� -3t)� J , /"`C��.'�2 Ul ��(► & ?--NC 26�I3_ID#C.�L ��1'd0Z Lic9 (Address) (ZIP) certify that I have read and understand the above regulations and hereby authorize Mc Q C1 �.-cA 4 � , 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 Cotowbo 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. , Permitted Operator (Si ture) --- , Mobile Food Unit/Pushcart Operator (Signature) , Notary Seal (Signature) My commission expires DIdArlit.4.41iLi 2C7 Crystal Kay Mcti;:i'an NOTARY PUBI IC C<t(vta County.NC My Commission Expires Dacernoer 11,2024