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HomeMy WebLinkAboutEHPR-04-2023-44136.tif ENVIRONMENTAL HEALTH Catawba County Government Center catawba county 25 Government Drive I P.O. Box 389 I Newton, NC 28658 public heCilth Phone: (828) 465-8270 I Fax: (828) 465-8276 MAKING HYING BtIIIP Email: EHAdmin ,CatawbaCountyNC.yov �/I4 piz. q )i)3 .01.5u, PP Plan Review Application for a Mobile FoocUnit 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 sole. • Attach a diagram of unit containing location of all equipment, 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: Owner's Name: ' Mailing address: S I 0 £, )t q City: , �c t t L' ti State:+ —' ZIP: 7&Q631-� Telephone#(s): � 1aC' l\-1 I Email Address: Tilug k EA- -0 )114 . e� � Restaurant or Commissary supporting unit: J k . E* State ID#of Restaurant or Commissary: 2't 1s b Z 04 cci Applicant Signature Date: ENVIRONMENTAL HEALTH INIOrr Catawba County Government Center Catawba county 25 Government Drive ( P.O. Box 389 I Newton, NC 28658 public health Phone: (828) 465-8270 1 Fax: (828) 465-8276 MAPING.uvixc.eU1U. t;tuwt: Ei iktilEit'1.'!isiTativeAssi5taats@Cotawba ,mi iPik,,,00v Food Establishment Plan Review Application Type of Construction: New Remodel ❑ Existing ❑ RTAP*❑ `Revivoas to Approved Pions:Prove a list of all changes to the previously approved plans.Revise application as relatod For REMODEL,spedfy the scope of work: Name of Establishment: C 11c' 2 ,'I cii e, i / Mc i!e (-1700 1 c If existing, please give mama of old establ'iskmeut if known: Address: 5 10 C ct) in r& s �1 City: L i ( C Oft ) t i State:NC ZIP Code: 2 U4 tr �-It Phone(II available):(51) ( QU1 1/7 I Fax(if available): i. n-e( r�7)/7 t-h ye. Owner or Owner's Representative: ' 'f r'(' !" r't�' S SO ��p12c 16-2 Address: 51° C ee rc r Gf t L C•ty: 1 r n C 0111- -on 'I State:NC ZIP Code: 2 C7 2- Phone(if avallable):( 5-4 UZ Fax(if available): E-mail Address: GC.Laic rcxxpl3 Submltter. A k c IJL-La Company: t°1iia:/ rM( 'Th le �- L U Contact Person: ,4 t'j 5 U i7C.�.-a-tt;4'' Address: n(0 (rc�i(i rz. City: ii 11Ct)1 f1+t7 f State:NC ZIP Code: 2 �� Phone(R available): 51 UUJ- 1 (7 I Fax(R available): E-mail Address: PL6t coy )2) C-? -=Gi 1- Q„Sm Title(owner, manager,architect,etc.): (%\ R. I certify that the information in this application is correct, and I understand that any deviation without prior approval from this Health Regulatory Office may nullify plan approval. 1) (Owner or Responsible Representative) C/ Z Signature &Date: $ i 4L'' r°r r. Daily Hours of Operation: ,r,, 47-. 62.-, 4rn !{:yr Sun l 3j,,n Mon x, TueWed ,,Thu 7-5f._Fri F f tffi t 7 8 Projected number of meals served daily; Breakfast: 2 5 Lunch: 2 5 Dinner: 2 Number of food deliveries received per week: 2 tJ Number of seats: 2 Facility total square feet: Projected start date of construction: Projected completion date: Type of food service: (Select all that apply) ❑ Restaurant 0 Sit-down meals IX Food Stand 0 Take-out meals 0 Drink Stand 0 Catering/ 0 Delivery 0 Commissary 0 Custom Self-Service Area ❑ Meat Market rneYNQ Eiqbther(explain): -1"C( 1 "Tv U( V Type of utensils used: Single-service (di>posable): Multi-use (reusable): 18111 Plates Glassware Silverware 0 Plates 0 Glassware 0 Silverware Will specialized processes be used as specified in Section 3-502.11 of the North Carolina Food Code? ❑Yes V.] No If YES, indicate which processes will be used: 0 Curing ❑Acidification (sushi, etc.) 0 Reduced Oxygen Packaging (eg: Vacuum) ❑ Smoking 0 Sprouting Beans ❑ Other Explain checked processes: Indicate any of the following highly susceptible populations that will be catered to or served: ❑ Nursing Home ❑ Child Care Center 0 Health Care Facility 0 Assisted Living Center ❑ School with pre-school aged children 2 N/A nany virtual brands be provided? Yes ❑ No n� (' 1 If YES, list brand names: j)O S} r"`ct t'� LI be( e a�5 G (� f is b Menu to be served: Estimated number of meals per week: J 0�) + North Carolina Department of Health&Human Services • Division of Public Health • Environmental Health Section •Food Protection Program 5605 Six Forks Rd•1632 Mail Service Center •Raleigh,NC 27699 Page 2 Revised 01/2023 11 Cold Storage: How was the volume of cold storage indicated below determined to be adequate? Reach-in cold storage (in cubic feet): Walk-in cold storage (in cubic feet): Reach-in refrigerator storage: 2 1 ft3 Walk-in refrigerator storage: ft3 Reach-in freezer storage: 2`] ft3 Walk-in freezer storage: f Number of reach-in refrigerators: .5 Number of reach-in freezers: Cold Holding: List foods that will be held cold: (include equipment used) rCCZty� Y.vz t'tn +=Y A 1.-( ( 4 Ch."an . W 4c' +—r 61 { 2- g 9-ah 1) fir. J io ye ie js Hot Holding: List foods that will be held hot: (include equipment used) Ver'y+h try 5 blade +v 0rii—er- Cooling: Indicate by checking the appropriate boxes how cooked food will be cooled to 41°F (7°C)within 6 hours. If"Other"is checked indicate the type of food: Cooling Process Meat Seafood Poultry Other Shallow Pans a ❑ ❑ ❑ Ice Baths ❑ 0 0 Rapid Chill** _ ❑ ❑ 0 ("Check only if rapid chill equipment such as blast chillers are provided.) Thawing: Indicate by checking the appropriate boxes how food in each category will be thawed. If"Other"is checked indicate type of food: Thawing Process Meat Seafood Poultry Other . Refrigeration Running Water less than 70°F(21°C) 0 ❑ 0 ❑ Cooked Frozen ❑ 0 0 ❑ Microwave ❑ ❑ ❑ 0 North Carolina Department of Health&Human Services • Division of Public Health • Environmental Health Section •Food Protection Program 5605 Six Forks Rd •1632 Mail Service Center •Raleigh,NC 27699 Page 3 Revised 01/2023 Food Handling Procedures: (Should be provided by owner/owner's representative) 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 categories of food. Describe the process from receiving to service including: • 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 how the food will be handled (washed, cut, marinated, breaded, cooked, hot held, etc.) • When (time of day and frequency/day) food will be handled 1. Ready to eat foods: Edible without additional preparation necessary. e_g.,salads, cold sandwiches,raw molluscan shellfish Han W,i t a(r1 ve j Ii cecI cinCI ec.a(S'j .to be .,_)crved n c, 5anzku. c. . S-1t eed �rn -1-he r�e.l�vr jev cr, Ito crt} n c�c�d t�k dui,n . lnn�n( k et t r �.1 2. Produce; grains and pasta: e.g., beans,rice, macaroni ail ve e4a� wall be vrecJ . i1"id-eii Cow► "T✓i�lg� S-eatr vid can ci Scx nCt VV.' Chi 7d_/um —7 �n - c� /1-7 l ScJa P 3. Poultry: W, )1 /4r' Vc —ret h folcd i - 4Grd Li(p =Y,oi t, , t�-B5+K-ed on Alf G ;,d d k r a>„ 15,,,� �1 4. Meat: Wi K W V 5h C0o0 On 9, Jdle . StfUed CO 0 SW\06 ch cj' C pia-tt W +h Tice airS 5. Seafood: A// North Carolina Department of Health&Human Services • Division of Public Health • Environmental Health Section • Food Protection Program 5605 Six Forks Rd •1632 Mail Service Center • Raleigh,NC 27699 Page 4 Revised 01/2023 Dry Storage: Provide information on the frequency of deliveries and the expected gross volume that is to be delivered each time: l o p end Oa) 04- &silvered Lveekl 4 Where will dry goods be stored? in1� h+ d S Y C 'Y TS under CaunlP,t' c Square feet of dry storage shelf space: Finish Schedule: Indicate floor, wall and ceiling finishes (e.g., quarry tile, stainless steel, vinyl coated acoustic tile) Area Floor Base Walls Ceiling Kitchen U Si 'P R;�bntr Co ' b +rhocth�ems,/yy yz~s fy jecr,n q t ►�t�� ,l��hf�r Co or Bar �c�f Food Storage I g Sd p� -60 Dry Storage Toilet Rooms Dressing Rooms Garbage& Refuse Stora e 6,5tc{ G nLl p cf en{ !c c+ t�r>ve rfcf gcri9a`1e g9 (;Ic,1 i(A, n or Q+f G,c bfd ft) 0 f01 JV 114 Service Sink Sf cl n kis l5-fr Other: Other: Water Supply and Sewage: Water supply: aMunicipal ❑ Well Sewer: ❑ Municipal IS eptic Will ice be: ❑ Made on premises ❑ Purchased Water heater(s): Ta.ank type:Manufacturer and model: 'h-e{'lr\ pd l ni Q{ AS rY1 ode( XEO(..o 1/ b. Storage capacity: ri gallons Electric water heater. 12 c kilowatts (kW) Gas water heater: NIA BTU's c. Water heater recovery rate (gallons per hour at 80°F temperature rise): . lv Z I GPH Tankless: a. Manufacturer and model: b. Quantity of tankless water heaters: c. Water heater recovery rate (gallons per minute at 80°F temperature rise): GPM • • (See Water Heater Calculators on the Plan Review Unit website to calculate recovery rate needed) • North Carolina Department of Health&Human Services • Division of Public Health - Environmental Health Section • Food Protection Program 5605 Six Forks Rd• 1632 Mail Service Center • Raleigh,NC 27699 Page 5 Revised 0112023 Check the appropriate box indicating equipment drains: Indirect Waste Direct Waste Plumbing Fixtures Floor sink Hub Drain Floor Drain Warewashing Sink ❑ ❑ 0 ❑ Prep Sinks ❑ ❑ Er ❑ Handwashing Sinks ❑ ❑ [1f ❑ Warewashing Machine ❑ ❑ ❑ ❑ Ice Machine ❑ ❑ ❑ ❑ Garbage Disposal ❑ ❑ ❑ ❑ Dipper Well ❑ ❑ ❑ ❑ Refrigeration ❑ ❑ ❑ [ Steam Table ❑ ❑ ❑ 0 Other: ❑ ❑ ❑ ❑ Other: ❑ ❑ ❑ ❑ Warewashing Equipment: Manual Warewashing: Size of each sink compartment(inches): Length: . J Width: i 5 Depth: E 2. WVetype of sanitizer will be used? [Chlorine ❑ iodine ❑Quaternary Ammonium ❑ Hot Water ❑ Other(specify) Mechanical Warewashing: Will a warewashing machine be used? r}'fe3 Ar . Q No Warewashing machine manufacturer and model: /V 3 F .. Sc:M flky5- Type of sanitization: ❑ Hot water(180°F) LS chemical General: Describe how cooking equipment, cutting boards, slicers, counter tops, other food contact surfaces and clean in place equipment that cannot be s bmerged in Sillks or put through a„dishwa her will be cleaned and sanitized: 1nak 04. :) SaaK In u_ Describe location and type (drainboards,wall-mounted or overhead shelves, stationary or portable racks)of air-drying space: { In ,ve 61. Ca- h -ric '}- [S4 eI�►M ' h t- Square feet of air drying space: 1' L ft2 North Carolina Department of Health&Human Services • Division of Public Health • Environmental Health Section •Food Protection Program 5605 Six Forks Rd•1632 Mail Service Center •Raleigh,NC 27699 Page 6 Revised 01/2023 Handwashing: Indicate number and location of handwashing sinks: erry01-2-e s4 c:h u i 1 S ID c a-Id i n +ha w: f h 0 6 h d o p rbU'd—e. . Employee Accommodations: Indicate location for storing employees' personal items (ex. coats, purses, medication, etc.): LAPd€r CU rter bin. Refuse and Recyclables: Will refuse be stored inside? ❑ Yes No If yes,where: z Provision for refuse disposal: U"Dumpster ❑ Compactor Will a contract for off-site cleaning of the dumpster/compactor be ob ained? Yes El No If yes, indicate name of cleaning contractor: V- 11i. f' {G Sfii e l " it Will the dumpster/compactor be cleaned at the establishment? ' Yes ❑ No Describe location for storage of recyclables (cooking grease, cardboard, glass, etc.): Loca/ Service Sink: Location and size of service (mop) sink/can wash: 51--breCi l rl - nr ]-t 4t,t.A.00( Describe location for storage of cleaning implements (e.g. mops, brooms, hoses, etc.): Insect and Rodent Control: How is protection provided on all outside doors? ❑ Self-dosing door ❑ Fly Fan El<creen Door How is protection provided on windows (including drive-th dows)or other openings to the outer air? ❑ Self-closing ❑ Fly Fan D Screening ❑ N/A Linen: Indicate location of clean and dirty linen storage: !/A (no linen storage on site) Poisonous and Toxic Material: Indicate location of poisonous and/or toxic materials (chemicals, sanitizers, etc.) storage: to d e r ?) 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(ALL DOORS WILL REMAIN CLOSED) • The name of business (greater than 3" in height) displayed on both sides of truck. • All openings to the outside, including serving windows and entrance doors, are screened, or kept closed. • Screening is at least 16 mesh/inch. • ALL DOORS & WINDOWS WILL REMAIN CLOSED. • Exhaust Fan with grease catch pan on the outside of the truck. • Concession Window: Has overhead protection on outside extending at least 33" with 16 mesh inch screen • Atmospheric Vent that terminates above the sink level and in a downward direction with 16 mesh. • Fresh Water Inlet 3/4" Diameter with a Valve measuring 3/4" with screen & protective cap on the outside of unit • Insect and rodent proof covered garbage container attached to exterior the MFU for patron use. • 48 Gal. Waste Water Tank sloped to drain and capable of being completely emptied. Waste water tank constructed of NSF certified plastics. Tank is mounted to frame of trailer. • Drain valve: PVC 2" WATER PLUMBING • THE VENT OPENING IS COVERED WITH 16 MESH PER INCH SCREENING. • 3 Compartment (15" Lx 15" W x 12" D) with Hand Sink (15" Lx 15" W x 5 1/2" D) NSF: Stainless Steel. Rounded internal angles, free of sharp corners or crevices. All plumbing covered by stainless steel aluminum cabinet. ELECTRICAL • Power source: plug at site, also generator with 50amp connection. • 240 Power Cord in capacity from the electrical box for plug • The Cord plugs from the outside of unit on Driver front side for doors to remain close. • Interior Lights: (4) 8ft. LED Lights with proper shielding to protect from breaking and at least 50-foot candles of light to all working surfaces. PROPANE PLUMBING • Propane lines will be black steel pipe 1/2" extension • 3A" pipe will be under the truck EQUIPMENT/TABLES • Worktables/Counters NSF: Stainless steel • Equipment Tables NSF: Stainless steel • Shelving NSF: Stainless steel • A TIGHT LIQUID SEAL WILL BE PROVIDED BETWEEN EQUIPMENT AND MOUNTING SURFACES. • A SEAL IS PROVIDED BETWEEN EQUIPMENT AND ADJACENT WALLS IF EXPOSED TO SEEPAGE • ALL EQUIPMENT MENTIONED IS COMMERCIAL GRADE. • TYPE 1 Stainless Steel Commercial Vent Hood with removable filters installed at an angle between 45 degrees and vertical with a drain and a removable catch pan along the back • Hood roof attachment has an outlet for grease or liquids with a drainpipe and removable covered catch-pan on the outside of the unit. • No open spaces around the vent hood. • Ventilation is adequate for equipment. • Light under vent hood with proper shielding to protect from breaking and at least 50- foot candles of light to all cooking equipment. FINISH SCHEDULE • Walls & Ceiling: smooth, easily cleanable and light in color. • Stainless Steel Walls, 22-gauge thickness, no exposed wiring and utility. • Stainless Steel 22-gauge 304 finish, behind equipment under the hood. • All wiring is behind walls, enclosed in conduit. • FLOOR: Rubber coin flooring Linoleum , with no sharp edges. 14-gauge thickness. 1J MI, 44. DU SERIES UPBLAST EXNAUST FANS (UL705) JTATIN2PQ• """"` -DIRECT OPZVE CONSTRUCTION(NO BELTS,PUL EYDI 0 M -ROOF NOUN TED FUNS -UL705 -VARIABLE SPEED CONTROL •INTERNAL WIPING -WEATHERPRCOF DISCONNECT C,Upd •THERMAL OVERLOAD PROTECTION IS NGLE PW18E1 OPTIONS; E `� Mil."."4111 BACKDRAFT DAI.PHT. /HT HINGED FAN i�•'I PITCHED CURB BACKDRAFT DAMPER INSTALLATION ` `' 20rraOGE I' F Lam PROFILE OP > NOD SCREEN AIR FLOM CUISIRUCTLN Lam LE OPTIpI ^ _ GI I? 9IGNORXT DiI.1oER 3'RJWGC Will /' B ��• RD ROOF OPEXING 1 iC��—,�IS mhEH810Ns R- NOTE'GREASE UIOUHFNOT PEOD -.-. FO PITCHED R W&AlA4ABLE© 7 PD ONSUIOUHFA —" FOR PITCHED CURBS ARE •'LOW/PRWRE'HT OMENSON C CHANCES SPOOR PITCH 12 PC ROOF OPENINR EXAMPLE:7/12 PITCH=SYSLOPE DU DIPECTORIVE CENTRIFUGAL U ROAST EXHAUST FANS DIMENSIONAL DATA CURB OINENSIONAL DATA FAN MODEL HT "HT 1V B C F R PO HEIGHT LB FAH 11LDEL D E D010 1412 NIA 17314 2 19 912 8116 13 30 WSC 1712 12 W12 18 17 22 2 19 1412 105E 13 40 . W12 7712 12 O 1.130 25114 20114 2512 2 21 1812 12118 16 50 - 0143 2512 201M 2512 2 21 1812 1212 16 50 W30 1912 12 DUST 2712 2112 28 76 2 21 2112 13114 16 55 DUST 1972 2 O 3012 2312 31 ON 2 24314 D 940E 20 60 WW 1612 12 1185 062180 3132 NIA 3934 2 28 2252 1612 24 160 01.165 23 12 1)11200 3334 NIA 38718 2 28 2912 18 24 195 01.1180 2612 12 00240 3712 NIA 4932 2 33 905E 23718 28 270 011200 2612 12 DU240 3112 12 0U300 44 NIA 5234 2 40 3312 24 36 410 - 0U300 3812 _12 0(130 46106 NIA 695116 2 44 437/16 251/4 40 470 0U380 4212 12 $A • CATAWBA COUNTY 100A SOUTHWEST BLVD 1'1 NEWTON,NORTH CAROLINA 28658 INVOICE/RECEIPT ) 7PHONE:828.465.8399 Monday,April 24,2023 18 4j SM www.catawbacountync.gov Invoice Number: 04-23-42 1 63 1 Invoice Date: 04/24/2023 EH PR-04-2023-44136 CASE TYPE: Environmental Health Plan Review WORK CLASS: Other FLI SITE ADDRESS: 307 S MCLIN CREEK RD A,CONOVER NC 28613 Applicant CHEF RANCHERA, 19318 CAI,IENI'E CREEK RD,CALIENTE CA 93518 **NO PEOPLESOF'F ACCOUNT ASSIGNED** PAYOR: Chef Ranchera Chef Ranchera(Delater,Corey) FEES EHPR-04-2023-44136 FEE AMT I)UE AMT FLI Mobile Food Unit/Push Cart Plan 110-580200-663000 04/24/2023 $150.00 $0.00 Review Fee FEES: $150.00 S0.00 TOTAL FEES: $150.00 $0.00 PAYMEN'1'S INVOICE NUMBER FEE NAME FEE AMOUNT TRANSACTION NUMBER: TRC-62591857-24-04-2023 PAYMENT DATE: 04/24/2023 PAYMENT TYPE: Credit Card 304252014 04-23-421631 FLI Mobile Food Unit/Push Cart $150.00 Plan Review Fee TOTAL PAYMENTS: $150.00 invoiccreceipt 04/24/2023 14:40 Page 1 of 1