HomeMy WebLinkAboutBandys Athletic Booster Concession 140194 08 23 12.pl.pdfTime En: 0
4
0
8,
1:13M
Time Out;
5
.'
0 0
Dam
Tolallrime.-
52minutors,
PM
19pni
,X%ew [:]Transitional
B A N
D
Y
S
A
T
H
L
E
T
I
C
B 0
0
S
T E
R
S
C 0 N C E S S
Name of Estabhshmenl
5 0 4
0
E
A S
T
B
A
N
D
Y S
C
R
0
S S
R
0
A D S
Address:
EA T
A
W
B
A
N
C
2
8 6 0 9
city
State:
Zip'
B A N
D
Y
S
A
T
H
L
E
T
I
C
B 0
0
S
T E
R
S
Permftlee
T 0 D
D
G
0 1
N
S
M anager or Person in charge
[N MallingAddress Same
B A N 0 Y S A T H L E T I C B 0 0 5 T E R 5
M Oing Name,
5 0 4, 0 E A S T 8 A N D Y S C R 0 S S R 0 A D S
M ailing Address
C A, T A W B A N C a 8 6 0 9
cijy; -zrw
6 1 - 0 5---
Phone Fax Emergency Phone Number
0 1 8 Catawba
EmaliAdare ss: FO--11ty#
5-5 - MunicipaMommunrly 3-3 - Municipal/Comirnunfty it 01
Water suoply Wastewater systern Risk Oate Territory V Capacity:
0 1 8 1 4 0 1 9 4 14 - Limited Food
Facility ID [:] EMtlng, F ac lity? 0 W F Wil IV Operate a Status Code
ElAttaeill's slits
Map # Parcel iD
0 8 3 0 1 a
Lal, Long.
EmOSAM-m-NIF-M []Pushcati [:3MFkl
Pushf;artlMobile, Food VmI opera fingin conjunctionwilhRestaurant or Comrmssarf ICE.:.
Transitional Perm it Conditions: Permit Expires: DdO days E31 80 day,$
Non-ComphantiternScompleted try'
GendilionsIlRemarks
Establishment Assigned To:
2031-Lewin, Paige
U EHS Signature,
20.31-1-evin, Paigge 0 8 1 0 3 0 1 2
EWSID -Crate
ManageriPerson in charge
0 8 / 3 3 0 1 d
Title Elate:
NC Department of Environmental & Natural Resources New []Transitional
Division of Environmental Health
Date. 08)23t2012
NaMeofEstablishment, BANDYS ATHLETIC BOOSTERS ON SS Permittee BAND'S ATHLETiC BOOSTERS
Location Address: 5040 EAST BANDYS CROSSROADS ManagerPerson in Charge: TODD GOIINS
City: CAT,WBA
State.'_�_G Zip. 28609 County-2-18
Bfllrngl\lamBANDYSATHLETIC BOOSTERS Status Code '
Bfl1jngAddr'e,,,,:,,,s' 5040 EAST BANDYS CROSSROADS Establishment ID:_ 201,8140194 ------------ -------
City : CATAWBA, State NC p, 28609 Map * Parcel ID ___—®_ -------------
Emait Address Lit Lonq�
- --------------- .................
Phone(828)461-,0592 Fax. Emergency Phone Number
Permission is granted to operate a 14 - Limited Food as defined in 130A.247(i) and 130A-248,
Regulation of Food and Lodging Facilities, See permit requirements in Rules This perrnit is not transferable and may be revoked for failure to
comply,mth ail requirements.
wastewater Systems: *MurucipallCoornmunily O-si nte System c]A apay: Category *.
WEl M IE
ater Suppi, M unicipauCorm num On-Sile System
H
PushcartIld o bile Food Unit operating In ccinianfhon with:
Pestaurant or Cornmwary Name arr IT&REW
Conctil*n$IR ernarkS.
Esla bhshrne nl assigned to: 2031-Levin, Paige
PERMIT GOOD THROUGH 2012
[]Aftachments
Transition at P erm it C onditions
This permit shall expire on and is not renewabile. All non -compliant Items hated herein and on attached pages (if
applica bW) must be completed within 90 / [:]180 days days. This establishment must close if 0 noncompflant items are not corrected by the
expiration dale
Received By: Title: Date: 0&2-V2'012
ManagefPprson in Charge
Srqned, RS*: 2031-Levhr, Paige
vn.=- I Date: 0&23'2012
1,n dEnAko—nmental Health
Pusli ose: G mftW Statute 130A 243(b) state, "No tylab bUbment shall co evict or continue operation w1hout a pest or trann,14 oral plemi t i ssued by, the Depwrtrioent,
The perrrit or transificinal pennit shall be issued to the owmer or operator of the establisturentavid shall not be transf lble_ If the establidment is leased, amp nt or
tratuotionall penrut dWl be iscued to the lessee and 4,all not be bwisforable. If the location of an establiftmni dainges, a newpesT4A shall be obtained for the
edabhshmeint. A perrnitsh-all be imed oTAywhen the establishment satisfies all of the reclixu=01ts of the rules The Conuisission dia11 adaptrWes establisliingthe
requi,remmils that must be met befire a transitional pamt may be issued, and the penod for w1rich a nansitional pe.Tnitrmy be issued, The Department nray also impose
conditions on the isscian-ce ofa pemit ortransaillomil lim—ut vi accorilawee voith mlesatiopttol by the Conmission
revoked in accordance nth G S. 130A-23(d) for failureof the rdablistirnexit to n-rdintain a n-ditimum grade of C A pm,=,t or Lransitional permtrmy of se be
su sp ffided or revoked in arcardanceasth G. S. 13 OA-2 3 ' Preparati on: Lacat en-uriminmental health specialists Mial I issue a pemait every time a change in pe immit, status is
indicated, prepare an origirial and one copy for 1, Oxional to be left vAth the OVorier or crlimtor, 1 Copy for the local health depwunent, DiqpocitiicuPlease refer to
Records Retention and Disposition Sch, edWe 8,,B 6, for County/Dnstnct Health Deirartments sdht,ch is published bythe Horth Carolt na Division, ofArclurre-s&History.
DEER 1 �41 (rovised 02108)
Environmental Health Services Section (review 7108)