HS REVIEW /2 a 2 4754
N.C. Department of Environment and Natural Resources
Division of Environmental Health
Plan Review Unit
Food Establishment Plan Review Application
Type of Construction: NEW ❑ REMODEL
Name of Establishment: HogBitesBBO Commissary
Address: 1413 Cumberlin Street
City: Dunn Zip Code:NC County: 28334
Phone (if available): 410- 913 - 0832 Fax: _ _ -
Owner or Owner's Representative:Norman Lichtman Sr.
Address: 625 Old Hamiton Road
City & State: Dunn Zip Code: 28334
Telephone: 410- 913 - 0832 Fax: - -
E-mail Address: Norman@hogbitesbbq.com
Applicant: Same
Address:
City & State: Zip Code:
Telephone: _ - Fax: _ -
E -mail Address:
Title (owner, manager, architect, etc.):
I hereby certify that the information in this application is correct, nd I understand that any deviation
without prior approv; ',tom this e! r i Regulatgsy O_ay nullify plan approval.
_/,
Signature: % O
(Owner or Responsible Representative)
8/10/05 1
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Hours of Operation:
Sun 9 - 6 Mon 9 - 6 Tue 9 - 6 Wed 9 - 6 Thu 9 - 6 Fri 9 - 6 Sat 9 - 6
Projected number of meals to be served between product deliveries:
Breakfast: 0 Lunch: 0 Dinner: 0
Number of seats: 0 Facility total square feet: 450
Projected start date of construction: 8/1/10 Projected completion date: 8/15/10
TYPE OF FOOD SERVICE: CHECK ALL THAT APPLY
❑ Restaurant ❑ Sit -down meals
❑ Food Stand ❑ Take -out meals
❑ Drink Stand ❑ Catering
® Commissary Single- service (disposable): ® Plates ® Glassware ® Silverware
❑ Meat Market Multi -use (reusable): ❑ Plates ❑ Glassware ❑ Silverware
❑ Other (explain):
Check categories of Potentially Hazardous Food (PHF) to be prepared and served:
1. ❑ Meat
2. ❑ Seafood
3. ❑ Poultry
4. ❑ Other (explain): Hot Dogs
COLD STORAGE
Provide the method used to determine cold storage requirements:
Provide total cubic -feet of space dedicated to walk -in cold storage:
a) Walk -in Refrigeration storage 0
b) Walk -in freezer storage 0
Provide total cubic -feet of space dedicated to reach -in cold storage:
a) Reach -in refrigeration storage 14
b) Reach -in freezer storage 0
Number of refrigeration units: 1
Number of freezer units: 0
8/10/05 2
THAWING
Indicate by checking the appropriate box how potentially hazardous food (PHF) in each category will be
thawed. If "Other" is checked indicate type of food:
Thawing Process Meat Seafood Poultry Other
Refri. eration _ ❑
Running Water less than 70' F (21' C) Q
Cooked Frozen _
Microwave _ C
HOLDING
How will hot potentially hazardous food (PHF) be maintained at 140 F (60 C) or above during holding for
service? Indicate type and number of hot holding units.
NA
How will cold potentially hazardous food (PHF) be maintained at 45 F (7 C) or below during holding for
service? Indicate type and number of cold holding units.
NA
List any food that will be held between 45 ° F (7 ° C) and 140 ° F (60 ° C) for any of the following that apply, and
indicate how long the food will be held in each category.
STORAGE:
DISPLAY:
SERVICE:
COOLING
Indicate by checking the appropriate box how potentially hazardous food (PHF) will be cooled to 45 F
(7 C) within 6 hours. If "Other" is checked indicate type of food:
Cooling Process Meat Seafood Poultry Other
Shallow Pans
Ice Baths
Rapid Chill
How will ingredients for cold ready -to -eat foods such as tuna, mayonnaise and eggs for salads and
sandwiches be pre - chilled before being mixed and/or assembled?
8/10/05 3
FOOD PREPARATION PROCEDURES
The food preparation procedures should include:
• Types of food prepared or handled
• Time of day food is prepared or handled
• Equipment used for preparation or handling
If your company has developed food preparation procedures, they should be submitted.
1. PRODUCE PREPARATION PROCEDURE
a. Will produce be washed, rinsed or otherwise handled prior to use? Yes ❑ No n
b. Is there a location used for washing, rinsing or handling produce? Yes ❑ No ❑
c. Will it be used for other operations? Yes ❑ No ❑
Indicate location of produce washing or handling equipment and describe the procedure. Include time of day
and frequency of produce preparation, and menu items that contain produce.
NA
2. SEAFOOD PREPARATION PROCEDURE
a. Will seafood be washed, rinsed or otherwise handled prior to use? Yes ❑ No ❑
b. Is there a location used for washing, rinsing or handling seafood? Yes ❑ No ❑
c. Will it be used for other operations? Yes ❑ No ❑
Indicate location of seafood washing or handling (cutting, marinating, shelling, shucking, etc.) equipment and
describe the procedure. Include time of day and frequency of seafood preparation, and menu items that
contain seafood.
NA
3. POULTRY PREPARATION PROCEDURE
a. Will poultry be washed, rinsed or otherwise handled prior to use? Yes ❑ No ❑
b. Is there a location used for washing, rinsing or handling poultry? Yes ❑ No ❑
c. Will it be used for other operations? Yes ❑ No ❑
Indicate location of poultry washing or handling (cutting, marinating, etc.) equipment and describe the
procedure. Include time of day and frequency of poultry preparation, and menu items that contain poultry.
NA
8/10/05 4
4. PORK and /or RED MEAT PREPARATION PROCEDURE
a. Will meat be washed, rinsed or otherwise handled prior to use? Yes ❑ No n
b. Is there a location used for washing, rinsing or handling
pork and/or red meat? Yes ❑ No ❑
c. Will it be used for other operations? Yes ❑ No ❑
Indicate location of pork/red meat washing or handling (cutting, marinating, aging, etc.) equipment and
describe the procedure. Include time of day and frequency of pork and/or red meat preparation, and menu
items that contain pork/red meat.
NA
DRY STORAGE
Provide information on the frequency of deliveries and the expected gross volume that is to be delivered each
time: We will buy Hot Doas and Buns daily from local super markets. IPC's will be purchased once or twice
a month at Sam's Club or BJ's.
Provide total square feet of shelf space dedicated to dry storage: 16
Where will dry goods be stored? on racks
FINISH SCHEDULE
Indicate floor, wall and ceiling finishes (i.e., quarry tile, stainless steel, vinyl coated acoustic tile)
Area Floor Base Walls Ceiling
Kitchen tile FRP FRP PAINT
Bar
Food Storage TILE PAINT PAINT PAINT
Dry Storage TILE PAINT PAINT PAINT
Toilet Rooms TILE PAINT PAINT PAINT
Dressing Rooms
Garbage & Refuse TILE FRP FRP PAINT
Storage
Mop Service Basin TILE FRP FRP PAINT
Area
Other
Other
8/10/05 5
WATER SUPPLY- SEWAGE
1. Is water supply: Municipal ® Well ❑ Is sewer: Municipal ® Septic ❑
2. Will ice: be made on premises ❑ or purchased El
3. Water heater make and model: Mor -Flow American G51- 40T34 -3NV
4. Water heater storage capacity: 40 gallons.
5. Water heater recovery rate (gallons per hour at 100 °F temperature rise): _ gallons per hour.
(See Water Heater Calculation Worksheet — Page 9 to calculate recovery rate needed)
6. Check the appropriate box for indicating equipment drains:
Indirect Waste Direct Waste
Plumbing Fixtures Floor sink Hub Drain Floor Drain
Dishwasher ❑ ❑ ❑ ❑
Garbage Grinder ❑ ❑ ❑ ❑
Ice Machine 0 ❑ ❑ ❑
Ice Storage Bins ❑ ❑ ❑ ❑
Food Prep Sinks ❑ ❑ ❑ ❑
Utensil/Pot Wash Sinks ❑ ® ❑ LEI
Steam Tables ❑ ❑ ❑ ❑
Dipper Wells ❑ ❑ ❑ ❑
Refrigeration ❑ ❑ ❑ ❑
Potato Peeler ❑ ❑ ❑ ❑
Other ❑ ❑ ❑ ❑
Other ❑ ❑ ❑ ❑
Other ❑ ❑ ❑ ❑
8/10/05 6
DISHWASHING FACILITIES
a. Hand dishwashing
1. Number of sink compartments: 3
Size of sink compartments (inches): Length: 15 Width: 17 Depth: 10
Length of drainboards (inches): Right: 18 Left: 18
2. What type of sanitizer will be used?
Chlorine® Iodine[ Quaternary Ammonium❑ Hot Water® Other (specify):
b. Mechanical dishwashing
1. Will a Dishmachine be used? Yes ❑ No
Dishmachine manufacturer and model:
2. Type of sanitization: Hot water (180 °F) ❑ Chemical �f
c. General
1. Describe the procedure of how cooking equipment, cutting boards, counter tops and other food contact
surfaces that cannot be submerged in sinks or put through a dishwasher will be cleaned and sanitized?
Surfaces will be sanitized with chlorine solution of 50 PPM to 100 PPM and air dried
2. Describe location and type (drainboards, wall- mounted or overhead shelves, stationary or portable
racks) of air drying space
Drainboards
Provide total square feet of air drying space: 3
HANDWASHING/TOILET FACILITIES
Is there a hand washing sink (with soap and hand - drying device) in each food preparation and warewashing
area? Yes ® No ❑
EMPLOYEE AREA
Is space provided for employee's personal items? Yes ❑ No
If so, describe location:
8/10/05 7
GARBAGE AND REFUSE
1. Will refuse be stored inside? Yes ❑ No
If so, where:
2. Provision for garbage disposal: Dumpster ® Compactor ❑
3. Provision for cleaning dumpster /compactor: On -site ❑ Off -site ❑
If off -site cleaning, provide name of cleaning contractor: NA
4. Describe location for storage of recyclables: (cooking grease, cardboard, glass, etc.)
NA
CLEANING FACILITIES
1. Specify location and size of area for washing of garbage cans and storage of mops:
Mop sink 24x36 mops and brooms on wall brackets
2.9
2. Is a separate mop basin provided? Yes ❑ No
If so, describe type and location:
3. Indicate location of cleaning chemical system and chemical storage:
on racks
INSECT AND RODENT
1. Are all outside doors self - closing with rodent -proof flashing? Yes ® No n
2. How is fly protection provided on all outside doors?
Self - closing door Z Fly Fan ❑ Screen Door ❑
3. How is fly protection provided on windows?
Self - closing ❑ Fly Fan n Screening ❑
4. Indicate location of insecticide /rodenticide storage:
on rasks bottom shelf
5. Location of clean linen storage:
NA
6. Location of dirty linen storage:
NA
8/10/05 8
WATER HEATER SIZING
Water Heater Calculation Worksheet
Equipment Quantity Times Size GPH
One -Comp. Sink (See Note) X x x =
Two -Comp. Sink (See Note) X x x =
Three -Comp. Sink (See Note) 1 X 15 x 17 x 10 = 24.9
Four -Comp. Sink (See Note) X x x =
One -Comp. Prep Sink X 5 GPH =
Two -Comp. Prep Sink X 10 GPH =
Three -Comp. Prep Sink X 15 GPH =
Three Comp. Bar Sink (See Note) X x x =
Four Comp. Bar Sink (See Note) X x x =
Hand Sink 1 X 5 GPH = 5
Pre -Rinse X 45 GPH =
Can Wash X 10 GPH =
Mop Sink X 5 GPH = 5
GPH = 70% of "Final
Dishmachine X =
Rinse Usage"
Cloth Washer X 15 GPH =
Hose Reel X 5 GPH =
Other Equipment X =
Other Equipment X =
Gallons per hour (GPH) Recovery Rate needed (based on 100 temperature rise) Total 34..9
Note: GPH = (Sink size in cu. in.) x (7.5 gal. /cu. ft.) x (# compartments x .75 capacity)
GPH Calculation for Sinks 1,728 cu. in. /cu. ft.
Short version for above GPH = (Sink size in cu. in.) x (# compartments) x (.003255/cu. in.)
Example: (24" x 24" x 14 ") x (3 compartments) x (.003255) = 79 GPH
8 10/05 9