HomeMy WebLinkAboutBaymont Inn Permit 200049 01 16 13.gk.pdfTime Im 0 9 * 5 IN81"n
, 8-EIPM
Time Out.
1 1 * 3 0
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Total Tine.
1 hr32 minutes
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Name of Establishment
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H i c k o r y
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State: Zip;
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Permittee
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M anager or Person in charge
EJ 1A ailing Address Same
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State, zip�
Phone
Fax
Emergency
Phone Number
1
8 C-atawb,a
Email Address:
County #
5-5 - Municipal/Community
3-3 - MunicipalICommunity
N/A
01 6 0
Water Supply
Wastewater System
Risk
Category
Territory Capacity.
a 0 1 8 2 0 0 0
4
9
20 - Lodging
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Facility lD E] Existing Facility?
0 to Facility ID:
Operate a:
Status Code
FlAttachments
Map #
Parcel ID #
0 1 / 1 6
0 1 3
Let
Long,
Date,
Push Cart or MFU [:]Pushcart
[:]MFU
PUShcartlhlobHe Food Unit operating in conjunction with;
Transitional Permit Conditions: Permit Expires:
CondifionsIR em arks
RE PAINT LAUNDRY ROOM
EH S Signature_
1655-gain, Greg 0 1 / 1 6 / a 0 1 3
EHSID Dats
Restaurant or Commissary ID,
090 days 0180 days
Non -Compliant items completed by:
Establishment Assigned To: L14O)npYoo,�,2
1655-rain, Greg
M anager/Person in charge
0 1 1 6 a 0 1 3
. . ..... . ....
TitLe gate:
ig
NG Deparlment oT Env irctrimentat &Natural Resources [j] New F_]Transitbnat
Division of Environmental I leafth
Date: 011162013
Name fEstablishment Bayrnontilrin Permftee-Chartrel Point Hospitality
Location Address- 1126 131h A,,n Or SF Manager/Persian in Charge. rhasity Fifinil
Gly, Hnckofy State, NO -1lp': 28602 Goulntto
.— y�
B thing Name, Channel Point Haspi°afity Status
Establishment ID: 20182OD0,49
city. Plants State:TX Zip: 75093 Map # - - - - - - - - - - - - - - - - Parcel ID: - - - - - - - - - - - - -
E 171 d ll Add te ss,. Lat. .._... ..W....._.. Lunn:. .._........Wm..._...
M
Emergency Phone Number
Pe�rmis;sion is grarit8d to operate a 20 - Lociging as defined in G S 130A,247(l):_wd I3GA-248,
Regulation of Food and Lodging Facilities See permit requirements in Rules. This permit is not transferaole, and may be, revoked for failure, to
comply with all requirements,
Wastemeter Systems: N1 urlcipivCrrnmunjty On -Site System cmpmcty� 60 Catogore ry
I VuricipalIC3mmunity On - Site System Watersuppill I H El
PUshearUldobile Food Unitope-afing in ComunC'jon with
Restaurant or Comm ssay Name anF15_iUrrt&e7
CcriditionniR ornarks,
Estatishment assigned to: 1655-1<ain, Greg
RE PAINT LAUNDRY ROOM
-his Permit shall expire oi
zorlizable) must to c3moletedwilhin 90 / []180 days
expiration da:e.
6'EM2139=
E]Atachments
and is not renewable, All nDn-ComClian'. items listed herBin and 4n allaChed aaqa$ _ (if
days. This astablishm,ent mist close if all noncornoli3rit reins are not corrected by the
n,t,, 0111612013
W�Sioned:_ I L� � — RE. #: 1Kin, Gect Date: 11,1111612013
Division of Environmental Health
'11tepertrutortransitionall permit all be isswil to flit iyxner or q3trafor of the establisttnentand shalt not be transfemble- Iffoie establislunent isl•xad' the perrit ar
transitonal permit shall be, isswd to the lessee and shall not be, tnnsfcTablt. If he locatim of ant stabli slunerlt dianges, a ntw perm i shall be, obtained for die,
establishtntnt- A perran: itrall be isaied only i,,Ien tie establishrrim-t satisfles all of the requi=entscT the rules - The, Comnission shill adopt rules est2blisbing the
requirunents that must be met be -'ore a transitional pemt miy lye. issued, acid the penad for wbidi a s.ttotialperntitmax, be issueJ. The Dtparaneru may also impase
suTerdtdpar rev,ok,t,di.n,acr-crdarcevithG-S- 130.4-232 Preparation- Lozal en),ironmerital health specialists shall issue pennit evtry, time a change in pe, M''t status is
indicated. Prepare anoripmal and one copy for Lcinginal to ire Left with !he'01aMer or oper<tor, L Cop-y for tkeloeal he-althdepartm,-ant.Disp,),Mtion: Please refer to
RecordsReterlton and 1hsposition Schedule SB .& for Counry,11istnct Health Depw=,mts,,NU:h is pub;.ished bythe -North Cirolina. aasim ofArclaves; & Fistony:
Additionalifornis ma-Ist ordredfrani: Division ofEnNtronrientil Health, 1632 Mail St.nice Ctmter,Ra1eigh_-.,,,C
DENR 13,41 (revised 02,108)
Ery iron m ent2l Health Sere cesSection (revievv7d08)