HomeMy WebLinkAboutEHPR-09-2023-45564.tif 1( 1 ENVIRONMENTAL HEALTH
Catawba County Government Center
25 Government Drive I P.O.Box 389 I Newton, NC 28658
catawb county
health
public health Phone: (828)465.8270 I Fax: (828)465-8276
SAC CO 11.1....��,�;-` Email: EHAdministrativeAssistants@CatawbaCountyNC.gov
� N Pg-0- )022- qss1
Food Establishment Plan Review Application for Ownership Change
(Note:If the establishment has been closed for more than one year, then applicant must fill out
short form instead of this form)
Name of wan Es eitishmse: Of Great Taste
Nam of New fit: of Great Taste, HFM
ash,„e11,.,Aaron:2220 Hwy 70 Southeast
city: Hickory stare:NC nP; 28602
hoes: 828-244-4666Fma
New°wines Neste Laurie Roberts
Please Enclose the Following Documents
• Proposed menu items(including seasonal variations in the menu).
• Manufacturer specification sheets for each piece of equipment that may be added or replaced.
• Plan of facility drawn to scale(min i4".1')showing location of equipment,plumbing,
electrical service and mechanical ventilation,including location of all electrical panels only if
complete remodel and/or replacing,adding/moving equipment.That will be determined by
plan reviewer.
Hours of Operation timber of Seams 50
Sue Maim Nervier ei SMf'er Sift: 3
MN 11-3 Willy Total Sties Feet:
Tes 11-3
wed 11-3 rrsfsdsd Start Deis:
The 11-3
Fri Prsleded limber of Moth is it Served(Agrsximste eemier):
se 11-4 keeled wed 15 Maw
Type of Service
(Clack at that apply)
r❑ Sit Down Meek ❑ Posh Cart
Ei Take Out ❑Limited Feed Sonia
❑ Caterer ❑Single Senior Uteasid Only
❑ Melillo Feed Unit ❑✓ Mehl-Use Utensil Senior Only
❑ Other
Items that Need to be Addressed
1. leformatien plans should Ldede;the proposed mend,nesting cupedty,projected doily meal volume for food sinks
o peration.
2. Adoquste raid cooing Wad*is halts sad reMgeretioe,end het-bolding Whim for poteatially hazardoes food
(PHF) should he dearly dosigmuled a the plan.
S. Whoa woo dktstes,salient,food preperaties slob shield be labeled sad located to predude coatamitation and
aess-costasiaaHhs of rear sad ready to oat feeds.
4. Auxiliary or sack as stem*rooms,,gerbille rooms,toilets,bssesiorts end/or cellars used for storage or food
preparation should be repraseneed en■plan.
5. lases that al feed seniat/Idkbee e11efpmeat is Natiosul Sonitatha Foundation latersatiesal(NSF)istod,
Underwriters Lsbonieries Inc.,Classified ter Ssaituie*or if sot NSF or UL listed/dessified,he reminded to moot
NSF/ANSI standards es specified acceding to ISA NCAC 1$A.2600,Rule.2654 old 2009 NC Food Colo Maned
Chapter 4.
6. As specified eccerdimg te 2009 NC Feed Cede Monad 4-4 all Taos stead to rooms where food or singb-serria has
on shred ski Is at seed 6 Ia.(15.24 a.)sieve the(leer whet plead se stationary storage units or whom placed
es portable sarnge omits er otherwise.ranged so as to permit thoreogh deaf g.
Existing Finish Schedule
Floor,wall and ceiling finishes(vinyl tile,acoustic tile,vinyl baseboards,FRP,etc.)
Area Floor Base Walls Ceiling —e
Etches tile vinyl plastic plastic
Bar
Feed Storage concrete and file plastic plastic
concrete brick brick metal
Dry Storer
Reams tile
Garbage>i<Can Wyk Ares tile vinyl plastic plastic
Wok Station Area tile vinyl plastic plastic
Other
Other
Food Preparation Review
Check categories of Potentially Hazardous Food(PHI')to be handled prepared and served.
Category
❑✓ Yes ❑No Ilk soots,pooltry,fish,Nfs(hewhergws,dddua least,fish filet,etc.)
❑v Yes 0 Ne Tic moots,wink poultry(wiselo roasts,perk,chlduo,meat heal,oft)
Q Yes ❑No Net processed hods(seeps,news,chowders,casseroles)
Ej You ❑N, Lawry goods(piss,adonis,croons)
Other:
Supplies & Storage
Food Supplies
Are a1 Fad supplies From inspected Ned approved sources?❑✓ Yes nee
Cold Storage
Aro adequsto mad approved honor sad refriprdlee voluble to store fracas foods at 00 F aid below,;ad refrigerated foods at 450 f
(700t)and hdew?{]Yes nii.
Provide the method used to adropkaids cold drop regtlr.aen= Manufacturer
Space dedicated to wa1-ia cold stomp: hs Specs dedicated to roads-la cold stomp: h2
WIN raw meats,peuhry used seafood he stored is the sere s.h1 .raters or honors with coded/ready-to-eat foods? ✓nY.s nee
If yes,how will cress-cautusiseutin he promise
Does each refrigerator/frooror havo o thormowd r? []Yes[]Ns
Number of refrigeratio.weft£ NNNsh.r of hearer oaks:
Thawing f=2./
Please indicate by checking the appropriate box how PHP(potentially hazardous food)in each
category will be thawed.More than one method may apply.
Thawing Process Thick Meats Thin Meats Fish Seafood Poultry Products Baked Goods
trrmi
R Water toss thou 700 F 210 C -
Cooked Frans(indicate wt.lbs.) ■ ■ i■l
Miasmas
Other(desaibs):
Cooking Process
WII food Predict Thormerihrs(0e—212'F)be used to mousers deal Geoid. r.heosNy tempormeres of PHF(p sotfslly ba rd'ss food)?
Yes ❑ No
Minimum cooking time and temperature of product utilizing convection and conduction heating
equipment:
Product Time&Temperature Product
Time&Temperature
Beef rust _ 1301 F(121 mi.) Comminied wags 1558 F(15 sec)
&e 145e F 15 sec Peary 1656 F(15 sec)
PK* 155a F(15 sec) Other PHF '
10'1E115 sec)
145 F(1S sec) *nheaN.g PHF 165 F(15 sic)
Hot Holding
How will hot PHF(ptwtiry harmless food)he moi.hoiood of 1350 F(570 C)or.bmi duly biding fir sinks? ledkots type sod
.ember of hot hoidi.g wits.
We have 2 1st Sables.,2 boated soup holders arid 1 owner worrier b maMall Iced et or atoms 135 degrees F
Ws tees 2 heel tubes„2 heeled soup holders and 1 corer wirnw 10 r eintrn food r or above 135 degrees F
We hems 2 test folios„2 healed sup toidrs and 1 courier warms'10 oe Moir food et or abovs 135 decrees F
We have 2 lest lebbs..2 heeled soup holders and 1 canter wemt to m el ee bed at or shove 135 decrees F
We here 2 heel 1shies„2 tweed soup holden sod 1 nosier wanner fo meirlelr bad et ar stove 135 deprave F
Cold Holding
How MN cold PHF(posed*haulm feed)be eaidoieed of 450 F(70 C)or helm doing holding for service? !strum'type esd
umber of cold holding vas.
We have 3 cold strorage prep tables that are kept at 40 or below for holding service
We have 3 cold strorage prep tables that are kept at 40 or below for holding service
We have 3 cold strorage prep tables that am kept at 40 or below for holding service
We have 3 cold strorage prep tables that are kept at 40 or below for holding service
We have 3 cold storage prep tables that are kept at 40 or below for holding service
Cooling
Ph.s.Macao by dwchin the"prunes box how PHF(pitietiriy haerdees food)will be cooled to 450 F(70 C)wdhit 6 boors(1350 F
to 70°F f.2 boors nd 700 F to 450 F l 4 hems).
Cooling Process Thick Meats Thin Moab Fish seafood Poultry Products Baked Goods
Sbelew Pus CS: rig,
Ia tt.Ihhs ■ ■ ■
Is'ld Chill ■ ■. ■ ■ ■.
other(describe):
Food Preparation
Moue list moieties of feed prepared were tbee 12 been h mime of mice.
SAke
S to
sKe
C sera Cs,
Wr&spud&sieves a awls ers /sr fowl rule ptrw be used Wolin budget of reedy-to-..t hells?❑✓ Yes ❑ No
h there r atebisied poly to.x lede a nstrid fad worker:wile ors sick or bee infected arts oaf lessees?❑✓ Yes ❑ No
Moen desails precoiwe:
oa-b� � u-.n.e I av-e-0 t t)-,_ w ern S { -
f l anti (�ccr�tt�-s D-c re -lrre - dc ,
Li)? - Q0. t R v'1i e)..4 i iS-le d cln ,-..'t a c e -crx --f,a-4
1.Ah 0 e s..e- lc '
Her we aoki,ertui s c*h bowls,awe*tops mod otter fad ceded arias width mot be submerged i sWcs or pa
u dishwasher 1e bred mid stead?Moose Jeanie paellas:
LUs. pre e-} . <`k o a-rrrnb+- be iu_b rn2r ry S;tIL S d
•. s St cvi .vichbr k a A , t( tint
.Er- k-i 7 e a Ac-1 lk Lll�.��1 � ck`r-fin /
Hew wi invalids fur odd reedy-to-oi foods such es fare,womanise owl alas hr sleds owl srdwiclas be pro-tiioi Were mixed
rdf or esse■iled?
(a cz-a4Zi
`\ ),it( e6 - �c1 +��<-e�
IIIINCOS Or spechized process that wil Me plow:
❑teri., ❑AddiBcedon(sesii,etc.) []smelde,
Ei Reduced Ozy,e.Packaging(e.g.mum passiu,,sees vide,auk-dd1..k.)
Food Preparation Procedures for Facilities
Food preparation procedures are needed to obtain information on how the food is prepared and to
help determine that adequate facilities are available. The food preparation procedures should
include types of food prepared.time of day and equipment used for service in the facility.
(Attached is Food Item Preparation Worksheet Supplement for additional food items prepared in
the facility.)If your company has food preparation procedures already developed,these can be
submitted as part of the plan review approval process.
Produce Preparation Procedures
Val produce be washed or rinsed prier is nu? '$ ❑ Ne
Is there w approved bakes used hr washing or rinsing produce? 'Yss El N.
Wit N Is used for ether operations? ❑ Yes 151,44
Nesse Wilcai%boon of produce washing eguipwest end describe the procedures. ladsde lime of day sad fregsesq for washing or
rinsing the proem r Yids bailee:
n k
New dawdle de prduce pr.p.ati.0 precedents ad iodate bags''of equipment to supped this*potation. The preparation
premiere should iodide dues(proposal was items)in which the produce will he used,end should fade&tins'of day and fregeeacy
of preparalioe ter the pnba.t its
4'D U_)(6--LCL-C-1 \ Lv cs,r s
�r-rcP ►CA - c o L S ow
Seafood Preparation Procedures
Will sashed h.washed or rinsed prier is ssl? Yes ❑No
\c„)p
Is there se sprawl kasha used for mail*er riss1 salad? \s) 7o, ❑Yes ❑IN
Will it be iced for ether opsrslieas? ❑Yes ❑No
Moose brdksie WAN of seafood washing.geipmest and Mails'the procedures. Wade time of day sad'regency for washing or
&stag the seafood st this basks:
Please describe the seafood remake preaduns sad brdkute loathes of equipmosl to support this spared... like preparation
procedure should Wolfe dishes(proposal srese items)is which the seafood will be used,wed shou d time of ivy cad Mgwacy
.f rowdies for the sashed st this hcsties:
Poultry Preparation Procedures
W arry heweshd ar rimed prior t.one? /!t�' Ni
I p
b there so apprwd loathe and for wail"or&slag paltry? Igr
011
WI it 4e and far albr operation? - es
Plo.s.Wham loathe of paltry weals%geipmot ad desaae the pnadms. Iodide tine of day inquiry for wising er
th afa'd at this locatia.:
Please descrike the paltry prepaetia.prouder*:end Made location of quipaaat to sapped flits operetta. The prop.retioe
prouder'dread Wade dishes(proposed were inns)la which the paltry wit be.sal,end Auld Whale timed day owl
6gaw.cy of prop.retd,u fw the peaky et ids hcatlur
Pork and/or Red Meat Preparation Procedures
WI perk and rod Nods Ire weabd ar dosed prior t.ow? [f Yes ❑Ni
Is then w manna Imam aged for washing er rinsing pork ad rod eras? ❑Yes [Jul.
WI it h Si.ed for offer.p.rulis s? []Yes ❑No
Neese Whew locrafo of snowed washing ogdpmot aid dasafb the procedures. Inch&time of day.ad froq.o.cy for washing or
rinsing the wand et this Widow
--Oek( 'QUA-40 WELA
Mom desalt'the perk end rod moots praparaliw premieres ad kndicab leaflet of mimes'to support this minutia.. 11a
prsporollos procedure skald Inds&disk..(prepaid was heats)the whisk the pork ad red mods wit I.sad,and shield d.deds
time of day end Impiety of preperetion ler Ws perk end red was et this feudist:
1
nPcinn Tr.t...... .a�
Poultry Preparation Procedures
WM p.e y be washed or nosed prier to use? 12 Ni
h there so approved Wades used for washfag or&slog prlhy? to
W I it be nod hr ether operathes? ;•.. es
Plano Wats had a.f poultry washing egelp.*t soil describe the pr°ad.ns. ladle time of dirt fngee.cy fir weshies.r
*! d ibis u, G� r 1-,)_de,,?ks.Arch
•
�. .
Phewdesoribo the y MMso prowler'ssod indigoshatl.a.f Jgeipweet to sopped this.pennies. lb.remain'
premiere shoed loded°dishes(proposed moues Mau)t.which the poultry wit M as.d,oil skald Wide time of icy sod
frogu acy of p'.pwa ge for the poultry a this ha in:
Pork and/or Red Meat Preparation Procedures
WA perk and rod laws be washed°r chased prier to net ❑Yes ❑N.
Is*do so wooed Iced*used for wasbiq.r rinsing perk and red meets? ❑Yes ❑M°
WI It be awl for ether epwawle.s? ❑Yes ❑lee
Phase hdkak ha8a of seabed wasbiag equipment sod describe the proadans. laded.thee of day ad fngmmy for washing or
riasiag the seafood d its Imam C:COrke—A-
-QA--itO
Pfeese desai°io perk sod red Naas pr.pwalou procedures sod baited bath*of.quipmeot I.sopped this opsruloa. The
propordioa procedure ahead Was disks(proposed woo Mews)in%Ado the perked rd moats wit be and,and'bald Code&
time of day and hammy of pr.pariiea fur the perk ad red woes at this Imam
Design Information
Dry Goods Storage
Is epprepiite dry pod swop spa provided br used epos mesa,nods sod frequency of deliveries? [ Ns
Provide Ishmael'ea the fraqu■ry of deliveries aid tie expected erns velews that Is to I.delivered tech thee.
Water Supply
Weer sapply: El Wet(aaapalty) �I
if the water sap*is ether dial a Meicipsd sap*,ht wi N retired to Ile belayed with hhtc Water Sep*.
if water sapply is from a C.eeesity Watsr*ply system is it registered aid ,t`
Yes if yes,please stiadr copy of twines approved as pahlic water supply? l. ,�•s El No
approved s d/er permit.
Ice: 'Made.s premises ❑pw,hased ceamecdJj
N aide ea praeises,ties specificities ter the is ssidrise will seed to he provided.
Denali.provides for ha scoop stonier
Garbage and Recyclables
Wit■da■psier he ased'! ( s D .
Nobler of Dowsers Sizx Pick"Frequency: .
WIN ON damps*he dossed ea site? ❑Yes ❑N.
If the daepmer hs to he dossed es site,then the waster water free the deathly gentles wi a regayed to he dtsdtareed to the
dreary sewer system. i�.Z eVik_oke47 GAO, !Y'WrZ ‘cy —` \—t
is the daarpster to he dossed by se off sib catr■cted deals.:orrice? ❑Yes ❑N. U
If yes,please provide sam sad address of the this winded for ifs service. T- C U' 'r S
Now
ate: Stagy NC $Cede:
Tsleph.se:
I I T--r - 7 i ;-
1 _ 1tf I I
A 1 \1 . \ V1. V..
Will trash tewolaen he steed eatridei ❑Yes 'die)
If yes,plows describe location:
Recycling
Typo of wore cookia.grease storage warted':
location of wash cookie'grouse storage reaptads:
Is there as area to store recycled centiliters? ❑
Sizew of groan tra d
p: l ((k I'
Location of grease trip: (��kti{ e i ii "-
Sewage Disposal
Is baAdimg connected to a.amidpd sewer? )t. 0 No
If no,is private disposal system approved(sop*system)? 0 Yes ❑No ❑ Pemdlmg
If yes,please attach o copy of the wines approval sad/or permit.
I hereby certify that above information is correct, and I fully understand that any deviation
from the above wi ut prior approval m this Health Regulatory Office may n this
approval.
Signature: Date: 2- 2 2-3
Owner or R e Representative
i.s- \ 1-1 1 .,.. _----:- . i.---.
_ I
r . -ir I 1 i f . , . 1
i
! 1 i 1
i
.
i_ I__ t _
i
l
i
i , I •
-- -i-• -!-- -..1_. .i. ...----' .. .!. +. _.i...._t_
L J I-�
t-- - �--1 -�- a
, I
_L-F,..-'...1117.4L-- .0)1:"\-L I c'(-0 c.‘: HN:\e''s '94e e6 --------I-------
)t-
- I I- i . : 1 ,-----7,A-- \\)(1),A)1 i L- 1 U t —r----'
r
j i ' , , _ j
T ,
1 ' 1 I ! I I :---1- 1 -r- ' - (-). (.6--)P
i , ,
, _
. .... MINI .
Ilan __ ,‘. ,,__I_ .
1111mimmn1luktlitilliawar _,_:- , 7,,:g.: _k_[.-___-,., 1 , Li _
i • • - -.-- - -
______ __ _ . . ._
\.f._/ 1 L
_____ , .
, f iiki i .
„la VI
i I ..0V,"' . ,
i
ai: 71Mulnallat - 1 1 i i . .
i
•
.___+_ _. ,
- —�— , -Ii 1
■■M1111
Onma 0 r_ i_ 1
______,_ ...1____ asmilimmom 4_ 1
i l J4 -t-_!'
It
1i
-�- 11
i i--- __ \; - .... .- .I 1 .._._._
_�__ ; ;__I i . _ , _ _._ . _. < <
lii �
i i
• .- ! . , _r_.; �_.� _i- 1
I I — -- -I --.__ !._ _
, ItAr
)Fa ilR Menu
TASTE c-- \
- ccurlio
riveirqk
In the Beginning —
On the Plate
Chips&Salsa $5
Chicken Herb Pasta $12.50
Hummus with Pita Chips $5
Grilled,seasoned rotisserie chicken&herb butter sauce
over fettuccine sprinkled with parmesan cheese served
Pimiento Cheese and Veggies $5
Chicken Salad on Romaine with Pitas $6 w/steamed broccoli&garlic bread
Spinach Artichoke Dip with Pltas Quesadllia—Chicken,Beef or Veggie $11
$5
Grilled chicken,roast beef or sauteed veggies w/pepper
jack or cheddar cheese pressed in a flour tortilla w/salsa&
In The Green sour cream
Caesar Salad Flatbread of the Moment $12.50
$10
Romaine lettuce topped with grated parmesan,house made Ask Server for options
croutons and Caesar dressing.
Add Chicken
$2
Chef Salad In The Bowl
$11 Bowl of Soup
Ham,turkey,boiled egg,tomato,cucumber,shredded cheddar&croutons $6 of
on fresh salad green Cup Soup
Grilled Chicken Chef Salad
$12
Our chef salad w/seasoned,grilled rotisserie chicken instead of
ham&turkey In a Glass
Tasteful Trio All Beverages
$11 $2.50
A sampler of 3 of our house made spreads/sides served on fresh Coca Cola,Diet Coke,Sprite,Sundrop,Dr. Pe
salad greens w/pita chips. Choose from: pimiento cheese, Pepper Root
Beer,Ginger Ale,Sparkling Water,Tea(sweet or unsweet),
chicken salad, tuna salad, egg salad (when available), pasta Fresh Lemonade,Coffee, Hot Tea
salad,potato salad,hummus,spinach artichoke dip
House or Caesar Side Salad At the End
$5
Cookies
$2.50
Cake
$4.50
Parfait Pudding
$3.50
a\\1 �1
- — _ _
Off` i r 1
]F�a�llll M[emllu[ v ..41�
TASE
_ _
In Between
All Items from In Between Include chips substitute side salad,soup,potato salad,pasta salad,grilled veggies or steamed broccoli add$2
'gluten free options available'
Classic BLT:
$10
Grilled bacon with lettuce&tomato on toasted sourdough
Classic or Turkey Reuben: $11
Grilled corn beef or turkey,swiss&sauerkraut w/thousand island on toasted rye
Turkey Bacon Panini:
$11
Grilled turkey, bacon&swiss wired pepper aioli pressed in a ciabatta roll
Pesto Shredded Chicken Paninl: $11
Shredded&grilled rotisserie chicken,fresh mozzarella,pesto,spinach&tomato pressed in a ciabatta roll
Caprese Panini:
$10
Grilled tomato&fresh mozzarella w/pesto&balsamic reduction in a pressed ciabatta roll
Chicken Salad Wrap: $11
Grilled rotisserie chicken w/tomato,chopped romaine,parmesan&creamy Caesar dressing pressed
in a flour tortilla
Chicken Caesar Wrap: $11
House made chicken salad with provolone,lettuce&tomato wrapped in a flour tortilla
Buffalo Chicken Wrap: $11
Grilled chicken,cheddar cheese,tomato,chopped romaine&buffalo sauce pressed in a flour tortilla
Veggie Wrap: $11
Grilled squash/zucchini w/spinach,tomato,fresh mozzarella&hummus in a flour tortilla
Pimiento Cheese Melt: $11
House made pimiento cheese&tomato on toasted sourdough
Tuna Melt: $11
House made tuna salad w/provolone,lettuce&tomato on toasted sourdough
Classic or Bacon Cheddar Burger: $11
Grilled burger w/cheddar cheese,lettuce,tomato&side of mayo,ketchup,mustard Grilled bacon
•dded for bacon cheddar burger
`R ;ggie Burger: $10
ssic Hot Dog: $6
�'� ,1' ...tilled beef hot dog w/choice of the following toppings: ketchup, mustard.relish.onion,chili
• CATAWBA COUNTY
100A SOUTHWEST BLVD
NEWTON,NORTH CAROLINA 28658 RECEIPT
(,1 PHONE:828.465.8399
�J Monday,September 25,2023
1842 sM www.catawbacountync.gov
PAYOR:
Roberts,Laurie
PAYMENTS
TRANSACTION NUMBER: TRC-73979679-25-09-2023
_ PAYMENT DATE: 09/25/2023
PAYMENT TYPE: Credit Card
311164942
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
09-23-428514 I10-550200-663000 Food and Lodging Review Fee $75.00
TOTAL PAYMENTS: $75.00
EHPR-09-2023-45564
CASE TYPE: Environmental Health Plan Review WORK CLASS: Other FLI
SITE ADDRESS: 2220 HWY 70 SE,HICKORY NC 28602
Applicant OF GREAT TASTE,2220 HWY 70 SE,HICKORY NC 28602
B:8282444666 ROBERTS_LAURIE@OUTLOOK.COM
Paid By LAURIE ROBERTS,805 E 20TH ST,NEWTON NC 28658
C:8282444666
**NO PEOPLESOFT ACCOUNT ASSIGNED**
receipt 09/25/2023 13:55 Page I of I