HomeMy WebLinkAboutEHPR-11-2022-42725.tif ENVIRONMENTAL HEALTH
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
MII IM6.I I VI116.I E I H I
Email: EHAdministrativedssistants@Cato,. . eumyN(MR /I-X»).11)7)5—
Plan Review Application for a Mobile Food nit
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 eguipmeat,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.
Name of Business: CARNICERIA HERNANDEZ LLC "EL PARAISO"
Owner's Name: RAMON HERNANDEZ
Mailing address: 102 KEEVER ST.
City: LINCOLNTON State: NC ZIP: 28092
Telephone#(s): 704-465-0833
Email Address: dario04h@hotmail.com
Restaurant or Commissary supporting unit:
State ID#of Restaurant or Commissary:
j I / / / 1 - )
Applicant Signature I\ 0 UC:Y}U Cqv�nS � C?.1�� �t Ccr/�1 / —e,Sbate: C G
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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. Desmie tie process from receiving to service including:
• Now 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 Rand!ia cr
(edible without additional preparation necessary, e.g. salads, cold sandwiches, raw molluscan shellfish)
Already prepared from"El Paraiso" Restaurant:
*Radish *Limes *Cucumbers *Lettuce *Cilantro *Onions *Tomatoes
`) oduce Handling
Will produce be washed or rinsed prior to use? Yes t No[_
Is there an approved location used for washing or rinsing produce? Yes No n
Will it be used for other operations? Yes n No 1
Please indicate location of produce washing equipment and describe tie procedures.Include time of day and frequency
for washing or rinsing tie produce at this location:
First I will wash and dry my hands with a disposable paper towel. Then I will wash and sanitize
my sink poor to prepanng all me produce.
Poultry HandlingT
Wi poultry be washed or rinsed prior to use? Yes lI No ❑
Is there on approved location used for washing or rinsing poultry? Yes 1 No n
WiH that location be used for other operations? Yes n No f1
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:
Poultry will he purchased frozen ready to use A separate cutting heard will he used for poultry
When poultry needs to be thawed out, it will be thawed in a designated sink with cold running
water. All poultry will be cooked at 165 F and stored under 40F. If the sink needs to be used for
other bppeerations, is MIT oe washed and sanitizes prior to use to avoia cross contamination.
Meat Ha. F ling
Will pork and red meats be washed or rinsed prior to use? Yes ® No 0
Is there an approved location used for washing or rinsing pork and red meats? Yes ® No
Will it be used for other operations? Yes n 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:
Pork and red meats will be purchased frozen ready to use. A separate cutting board will be used
for pork and red meats. The meats will be thawed out at a designated sink with cold running water.
Both pork and red meats will be cooked at 145 F. Sink will be washed and sanitized before and after use
to avoid any cross uontamtnatton_
Seafood Handling
Will seafood be washed or rinsed prior to use? Yes 11 No ❑
Is there an approved location used for washing or rinsing seafood? Yes 11 No n
Will it be used for other operations? Yes 11 No n
Please indicate location of seafood washing equipment and describe tie procedures. ledade time of day and
frequency for washing or rinsing tie seafood at this location:
No seafood will be used at this location_ N/A
•
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
ner -=¢- 4`-'1' ': ule notifications.
X 1. Mobile food units(MFU)must work its 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.
X 2. MFU permits shall be posted at all times. A copy of the last inspection shall also be kept on site and the
grade cord shall be pasted and visible at all times.
X 3. Operators must provide a list to the Health Deportment 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!
X 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:
X S. Cleaning of the unit and extra utensils, coolers, equipment must be done at the restaurant or commissary.
The MFU must be kept clean.
Water Suppf
X 6. AM units must have a potable water system under pressure with water heating facilities.
X 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.
X 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.
Sewage Disposal-
X 9. Your unit's sewage storage or gray water tanks must be 15 % larger than the potable water tanks.
X 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.
X 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.
Garbage D;
X 12. All garbage and other solid waste shall be stored and disposed of in an approved manner.
Equipment and Interior:
X 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.
X 14. All cooking equipment must be located within the enclosed unit.
X 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 partides and slime.
X 16. Shelves, tables and counters cannot be covered with paper, cardboard, or other absorbent material.
X 17. Hot and cold holding os well as cooking equipment must be provided as needed.
X 18. All floors, walls and ceilings shall be smooth, non-absorbant and easily cleanable.
Sinks
X 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.
X 20. A separate hand wash sink with hot/ cold water, combination supply faucet, soap, and single-service
towels is required.
Food Protection:
X 21. Insect and dust protection must be provided as necessary at windows, doors and equipment.
X 22. All foods shall be obtained from approved sources and handled in a sanitary manner.
X 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.
X 24. An accurate metal stemmed thermometer that goes from 0°F -220.F (+/-2 F) must be provided to
check food temperatures.
X 25. Gloves must be worn when touching ready-to-eat food (RTE) or use another non direct food contact way
to touch food.
rmµ loyee
X 26. Employees shall be clean and wear dean outer clothing and effective hair restraints. No tobacco should be
used in any form while in the foodservice area.
X 27. The person in charge (PIC) on-site must hove 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:
X 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.
An example of a sink which complies with the requirement in I SA NW ISA, section.2672(e), Spedlk
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 emits and shag have splashback protection. Drainboards shall be provided as specified in
Section 4-301.13 of the Food Code as amended by Role.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.
MENU
Tacos
Choice of meat, cilantro, onion, lime, and salsa.
Gorditas
Choice of meat, beans, cheese, and salsa.
Quesadillas
Choice of meat, cheese, onion, cilantro, and salsa.
Burritos
Choice of meat, beans, rice, sour cream, cilantro, tomato, and salsa.
Tortas
Mexican Telera bread with your choice of meat, beans, lettuce, tomato,
mayonnaise, and cheese.
Hamburgers
Choice of lettuce, tomato, mayonnaise, and cheese.
Chicken Tenders
AVAILABLE SIDES
o French Fries
o Rice
o Beans
AVAILABLE MEATS
o Asada
o Grilled Chicken
o Al Pastor (Pork)
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�$A • CATAWBA COUNTY
�' 100A SOUTHWEST BLVD
04 2/ NEWTON,NORTI-1 CAROLINA 28658 RECEIPT
V O yl PHONE:828.465.8399
Wednesday,November 9,2022
184 5M www.catawbacountync.gov
PAYOR:
Mejia Calleja,Roberto
PAYMENTS
TRANSACTION NUMBER: TRC-50854405-09-11-2022
PAYMENT DATE: 11/09/2022
PAYMENT TYPE: Credit Card
297321220
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
11-22-414514 110-580200-663000 FLI Mobile Food Unit/Push Cart $150.00
Plan Review Fee
TOTAL PAYMENTS: S150.00
EHPR-11-2022-42725
CASE TYPE: Environmental Health Plan Review WORK CLASS: Other FLI
SITE ADDRESS: 1205 16TH ST NE,HICKORY NC 28601
Applicant ROBERTO MEJIA CALLEJA, 149 15T11 ST SE,HICKORY NC 28602
B:8285149934
**NO PEOPLESOFT ACCOUNT ASSIGNED**
Establishment EL PARAISO, 1205 16TH ST NE,HICKORY NC 28601
C:7044650833 DARIO0411@HOTMAIL.COM
receipt 11/09/2022 16:43 Page 1 of 1
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Acuerdo de Cumplimiento para Unidad Mobil /
Carretilla de alimentos/Hot Dogs (perros calientes)
Nosotros,las partes firmantes reconocemos con nuestras firiitas querambos hemos leido y
entendido las reglas que rigen el saneamiento-de restaurantes y otros establecimientos que
manejan o manipulan alimentos, 15A NCAC AA,section 2600, como pertenece a la
operation de una carretilla o unidad movil de alimentos y que las partes firmantes
entienden la responsabilidad de cada parte como requiere en.2670- .2672 de las reglas y
debe cumplir con los requisitos del Codigo Manual de Alimentos de Carolina del Norte FDA
del 2009, que incluyen:
"Las carretillas o unidades moviles deberan operar en conjuncion con un restaurante que tenge permiso o un comisario y deben de
reportarse por Io menos una vez al din al restaurante o comisario para suministros,limpieza,y servicio. Las instalaciones, en
cumplimiento con esta section,deben de proveerse del restaurante o comisario de almacenamiento pare todos los suministros.Las
carretillas o unidades moviles deberan de ser guardadas en un area que las proteja del polvo, basura,insectos,y otros
contaminantes.Las(laves del agua que se usan para suplir o abastecer agua a las carretillas o unidades moviles de alimentos
deberan ester protegidas para prevenir el contacto con quimicos,salpicaduras y otras fuentes de contamination.Almacenamiento
de residuos solidos,e instalaciones-pare la elimination de residuos liquidos deberan ser proporcionados por las instalaciones del
restaurante o comisario." / /
Hoy, dia o.__r del mes de l ( , del 20,9 :)
Yo, (.✓LLD e, fit.ernflYer:s...:, ��) f/ del
( ombre del dueno o c4,ezente :lel restaurante) (Titulo)
t�
t19��•��ocalizado end OS S /6 -075 f-rec / / I C AS
(Nombre del establecimiento) (Direction)
Numero de ID certifico que he leido y entendido los reglamentos arriba
mencionadas y (por la)/ Cpresente
Autorizo a R.Ob�'�?o c des McJ,Y*.r,Operador de la unidad movil de alimentos,
(Nombre)
pars que opere una Carretilla o unidad movil de alimentos en conjuncion con mi
establecimiento,tal y como to exigen las normal.
Yo certifico que estoy autorizado de entrar en este acuerdo en nombre del establecimiento
antes mencionado,y entiendo que las reglas requieren que la unidad visite mi
establecimiento cada dia que la carretilla o unidad movil opere,para su limpieza,
catawbacountync.gov
Environmental Health
Catawba County Government Center
25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270
7V
mantenimiento y suministro, incluyendo reposicion de agua y eliminacion de todos los
residuos sdlidos y liquidos. Estoy de acuerdo de tener y mantener un registro para que el
operador de la carretilla o unidad movil to firme y escriba la fecha en cada visita a mi
establecimiento, para producir el registro solicitado,y que informe con precision el
contenido del mismo. Estoy de acuerdo de permitir que se almacenen todas las provisiones
para la unidad movil en el local o establecimiento arriba mencionado. Estoy de acuerdo de
proveerle acceso a mi establecimiento al operador de la carretilla o unidad movil de
alimentos para este proposito. Entiendo que el area en mi establecimiento que use el
operador de la unidad movil de alimentos esta sujeta a cualquier inspeccion hecha por el
Departamento Local de Salud Ambiental. Estoy de acuerdo que si esta aprobacion es
cancelada, se debe notific nmediatamente a la Division da Salud Ambiental del Condado
de Cat .
, Operador Autorizado
rma)
4Obu►/e Cif,I6 /1A•/4 dperador de la Carretilla o Unidad Movil de Alimentos
( irma)
, Sello del Notario
(Fi a)
Mi comision se vence 10 `2 Z' to 43
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Acuerdo de Cumplimiertto para Unidad Mobil /
Carretilla de alinenttos/}lot Dogs (perros calien es)
Nosotros, las partes firmantes reconocemos con nuestras finaas que ambos hemos leido y
entendido las reglas que rigen el saneamiento de restaurantes y otros establecimientos que
manejan o manipulan alimentos, 15A NCAC 18A, seccion 2600, como pertenece a la
operation de una carretilla o unidad movil de alimentos y que las partes firmantes
entienden la responsabilidad de cada parte como requiere en .2670 - .2672 de las reglas y
debe cumplir con los requisitos del Codigo Manual de Alimentos de Carolina del Norte FDA
del 2009, que incluyen:
"Las carretillas o unidades moviles deberon operar en conjuncion con un restaurante quo tenga permiso o un comisario y deben de
reportarse por to menos una vez al din al restaurante o comisario pare suministros, limpieza,y servicio. Las instalaciones, en
cumplimiento con esta seccion, deben de proveerse del restaurante o comisario de almacenamiento pore todos los suministros. Las
carretillas o unidades moviles deberon de ser guardadas en un area que las proteja del polvo, basura, insectos,y otros
contaminantes. Las(laves del agua que se usan porn suplir o abastecer ague a las carretillas o unidades moviles de alimentos
deberon ester protegidas pare prevenir el contacto con quimicos, salpicaduras y otras Fuentes de contamination.Almacenamiento
de residuos solidos,e instalaciones pore In elimination de residuos liquidos deberon ser proporcionados por las instalaciones del
restaurante o comisario."
Hoy, dia C) del mes de /7 , del 20 r�..�"�
�_ 1_
Yo, t!vLd Y`_fiteril-COr.- `Z g°2Jn e,.// del
( ombre del duerto o tr_rente 'z1 restaurante) (s itulo)
-;�a.� n rCc �<<. l :�jlt i1.��c".;-•� localizado en
(Nombre del estabieciriientot (Direction)
Numero de ID_. ._ certifico que he leido y entendido los reglamentos arriba
mencionadas y por la presente
Autorizo a j'`eboc. a recerk M i)r'r•l;0perador tie la unidad movil de alimentos,
;Nombre)
para que opere una Carretilla o unidad movil de alimentos en conjuncion con mi
establecimiento, tal y como to exigen las normas.
Yo certifico que estoy autorizado tie entrar en este acuerdo en nornbre del establecimiento
antes mencionado, y entiendo que las reglas requieren que la unidad visite mi
establecimientr, cat', dia que la carretilla o unidad movil opere, para su limpieza,
Environmental Health
Catawba County Government Center
25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270
mantenimiento y suministro, incluyendo reposicion de agua y eliminaciOn de todos los
residuos sondes y liquidos. Estoy de acuerdo de tener y mantener un registro para que el
operador de la carretilla o unidad mOvil to firme y escriba la fecha en cada visita a mi
establecimiento, para producir el registro solicitado, y que informe con precision el
contenido del mismo. Estoy de acuerdo de permitir que se almacenen todas las provisioner
para la unidad movil en el local o establecimiento arriba mencionado. Estoy de acuerdo de
proveerle acceso a mi establecimiento al operador de la carretilla o uniciad.movil_ de
alimentos pare este propmsito. Entiendo que el area en mi establecimiento que use el
operador de la unidad movil de alimentos esta sujeta a cualquier inspeccion hecha por el
Departamento Local de Salud Ambiental. Estoy de acuerdo que si esta aprobacion es
cancelada, se debe notific nmediatamente a la Division da Salud Ambiental del Condado
de Cat
, Operador Autorizado
tram)
)Gri C4ti/oj j/ 0-perador de la Carretiila o Unidad Movil de Alimentos
( irma)
-- , Sella del Notario
(Fi a)
7vli comision se vence l0 ^ 2 2-- La 43
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