HomeMy WebLinkAboutEHPR-12-2022-42939.TIF a
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_ t0 day of j L J�(f,01 RY , 20 Z 3
of
(Restaurant Owner or Manager) 7?4>4 (Title)LLE?, located at
(Name of Establishment) r/
307 5./1�-LN�iI�tt �o OC/VOV O /�, NC f O-- ID# ��1 L O2-0
(Address) (ZIP)
certify that I have read and understand the above regulations and hereby authorize
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 { 828.465.827G
MAKING. LIVING. BETTER,
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contents upon inquiry. I agree to allow all supplies for the unit to be stored in the above
ent by
food unit
listed premises. I agree to provide
u� nnderstand my lthattthe area u►mobile my establishment
operator or pushcart for these purposes. I
used by the mobile food unit operator is subject
that if this approval is rescinded,y inspection Catawba local
County
environmental health department. g
Environmental Health shall be notified immediately.
A.:11.4).... , Permitted Operator
( 'gnature)
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- , Mobile Food Unit/Pushcart Operator
(Signature)
````tototun ztostoi,,,�, , Notary Seal
`` , ,HO �o (Signature)
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North Carolina, County of Lincoln
I certify that the following person(s) personally appeared before me this day, and;
each acknowledging to me that he or she voluntarily signed the foregoing
document for the purpose stated therein and in the capacity indicated:
Estefania Saa Izquierda
Name(s) of principal(s)
,5 „ L.; day oQ , 20
Witness` �. official seal, this the
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ficial fficial Si natur o Notary
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ionime ��"'�,`��� Anny Henchoz, Notary Public
My commission expires: 02/22/2027