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Home My WebLink AboutBack Yard Burgers Permit 011220 03 23 12LS.pdfTirneln: 1 2 '. 4 5, 1113M Time Out. 0 1 .' 3, 0 F-13M Total Time: 45minutes, [ETransitional �[Epm - _.�Ypni B A C K Y A R D B U R G E R S Name of EstabilshmenI 1 8 5 4 C A T' A W B A V A L L E Y B L V D Address: H I C K 0 R Y N C 2 8 6 0 2 City: State: ZIP� A N I L P A T E L Permillee B R A N D 0 N S L U D E R M anager or Person in charge [E Marlin Address Sarne A N I L P A T E L Mailing Name 1 8 5 4 C A T A W B A V A L L E Y B L V D M ailing Arldress H I C K 0 R Y N C a 8 6 0 Oily: -Grp; 3 a 5 Ph one, Fa Emergency Phone Number Catawba, Email Address: 5-5 - MunicipaVCommunrly 3-3 - MunicipaIiCommunkly 11 01 9 0 Water supply Waste -water, system Risk Orrlegoq Territory _a_oacltv .201801 1 80 1,066 3 I -Restaurant T Facilily ID [:] Existjnq, Facility? Old Facility ID: operate a, stalus Code [:1Atta0hMPnts Map # Parcel iD I 0 3 3 / .1 0 1 a Lal. Long, 1 ate; l!m*b_9AM_ox_mY_U_ []pushcart [:)MF(i Poshf;artlMobile Food Vnit operdfingin conjunylion with, Reslaurant or Commissarf ll)� Transitional Permit Conditions: PeTmitexpares 1 9 / ;2 0 1 ;2 [390days [Risodaps Pa rr Compfianl items torn pleled by GendifionslRemarks FIX DRAIN ON ICE MACHIJNE IIN REAR OF KITCHEN REPLACE BROKEN LIGHT SHIELDS IN KITCHEN REPLACE ANY MISSINGIBROKEN BASEBOARD TILE THROUGHOUT REPLACE ANY CRAKED/MISSING FLOOR TILE THROUGHOUT REPAINT AROUND WINDOW OF MANAGERS OFF]CE, EXIT DOOR, AND ALL TILE SUPPORTS ON CEILING AND VENT COVERS, REPAINT/REPLACE VENT COVER IN CEILING AT WALK IN COOLER REATTACH ANY LOOSE FRP WALL BOARD AS NEEDED. ESPECIALLY NEAR WALK IN COOLER CLEAN GRILL. GRATES, UNDERNEATH, AND AS NEEDED. FIX LEAK IN SODA MACHIINE AT DRIIVE THROUGH REPAIR ICE CREAM SLIDING DOOR REPAIR ALL BROKEN REACH IN COOLER DOORS Estab4shmenl Assigned TO: 1896-Sears, Luke -,e2wr IX Ignatuge, y -% M anageriPerson in charge 1896-Sears, Luke 0 3 1 ;2 3 / a 0 1 2 0 3 / a 3 / a 0 1 a EH81D Uat _e Title Bale: NC Department of Environmental & Natural Resources [:]New [ETransitionm Divlsjon of Environmental Health Date. 0373ir2012 NameofEstabfishmert BACKYARD BURGERS Permittee ANIL PATEL Location Address: 1854 CATAWBA VALLEY BLVD ManagerPerson in Charge, BRAND ON SLURER City: HICKORY State Zip28W2 uConty—L"8 _N_C BfllrngNarrlANILPATEL Status Code T BillingAddress, 18,54 CATAWBA VALLEY BLVD Establishment ID:— 2018011220 ------------ ------- CitV: HICKORY Statis NC Zip, 28602 Map #" Parcel 0, ---------------- -------- r ------ Email address- t-&-l- --L-----'-----. Loriq� ................. Pharr (828)325-,M68 Fax- Emergency Phone Number Permission is granted to operate a I - Restaurant as defined in G,S. 130A.247(l) and 13OA-,)48, Regulation of Food and Lodging Facilities, See permit requirements in Rules This permit is not transferable and may be revoked for failure to comply with all requirements. Wastewat@rsystemc *h1unicipalfCornmunily On-Sita System capattly, 90 Calegorf Water Supply M unrcirrali`CirmrnunaOn-Site System H El R1 PushcartIM a bile Food Unit operating in conlunchon with� Restaurant or Commissary Name and It) nurn4ef Condftn$IR errwark$: Eslalphshmenla,ssiqnedto:: 1896-Sears, Luke FIX IN ON ICE MACHINE IN REAR OF KITCHEN REPLACE BROKEN LIGHT SHIELDS IN KITCHEN REPLACE ANY WSSING6ROKEN BASEBOARD TILE THROUGHOUT REPLACE ANY CRAKEDIMISSING FLOOR TILE THROUGHOUT REPAINT AROUND WINIDOW OF MANAGERS OFFICE, EXIT DOOR, AND ALL TILE SUPPORTS ON CEILINGAND VENT COVERS. REPAINTIREPLACE VENT COVER IN COLING AT WALK IN COOLER REATTACH ANY LOOSE FRP WALL BOARD AS NEEDED, ESPECIALLY NEAR WALK IN COOLER CLEAN GRILL. GRATES, UNDERNEATH, AND AS NEEDED, FIX LEAK IN SODA MACHINE AT DRIVE THROUGH REPAIR ICE CREAM SLIDIJNG DOOR REPAIR ALL BROKEN REACH IN COOLER DOORS NEED TO HAVE A 6 INCH GAP BETWEEN ICE CREAM SCOOP DRAINAGE PIPE AND DRAIN. CLEAN INSIDE OF ALL COOLER TO REMOVE FOOD SPLATTER AND BUILD UP REPLACE ANY DIRTYfTORN COOLER GASKETS. []Aftachments Transition a] Permit Conditions This pennit shall expire on 09119t,2012 and is not renew@bW. All non-compfiant items listed heron and on allached pages (d applicable) must be tormArited wdhin 090 / R]I80 days days, This establishment must close if 0 nom:Dmpfiant Berns: are not corrected by the expiration date. Received By—A-6-1� V \, managefeerson in unarge TjOw Date, 0312312012' Signed, RS#: 1896-Sears, Luke Date: 03'23QO12 D Ptupose: Genwal Statute 130A -2248(b) states "Fla L-lablisbment, Atoll commence or crintinue op m.tion wftnt a penoit ortrarrsihonW pmmtis�med by the Deparu=t Tice penx:rit or transifi oral pertnit shall be issued to ffie ommer or operator of the establi Ammni,and shall nd be Lansfen ble If the establisfunent is teased, the pffmt or tm,tiaroil penrdt dW1 be issued to the lessee and sUl not lie hwisfemble. If the Iomtion of an establift, ient ges, a newpemnt shall be obtamed for the establishment, A Fernutshall be imued ordy TAen Uie ntablidiment saisfies all of the requirements of the nines The Conirnissurn "Il adoptrWes eAablishing the reqwernnits Unt must be met before a transitional la may be issued, and the period fbr %tiich a imnslitiotig penrarray Is e issued, The Dq)arinient rMy also inVose oonditions on the issuance of a "'mtt or Transinoxw pm-wt in acenniancevAth vales arlopted by the Con—='ssron ApeimtortranotTonal pea ra-media-wy revoked in accordancevaith G, S 130A-23(d) for Mtweof the est-ab1ishment to maintain a nanimum, grade of C. A pmrit cr transitional perriatrmay ally se be suspended or revoked in accordance with 0. S. 130A-23 -' PrepwafiarrLa1 envirunmental health q spedaliStS S11,31I jSgUe a p,,,iit eVery tj'njea change imperrriiit status is indihated. Fir epareare original and one copy for 1, Otional to be left vAlh theowner or operator 2. Copy for the to health depwitment. rhslpoktioraPlease refer to Records Retentim and Disposition Schedule 8,13.6, for Count-WDistnct Health, Departmentswi-ach is published bythe North Carolina Division ofArctuves &History. A,dditict,nalf0m,smybeordemd,frorn:Divl,.ionofEnvironn=WHteltb,,16321vlbilSm'icy 'Center„ pariCigb"NC2,7699-1632,(Coutiff52-01-00) DENR 1 d41 (reMsed 07,S08) Environmental Fleailh Servkes Section (revlaw 71081