HS REVIEW 97579 zi242
HARNETT COUNTY PLAN REVIEW APPLICATION COVER LETTER
FOOD SERVICE ESTABLISHMENTS
Review for Compliance with NC Rules Governing the Sanitation of Food Service
Establishments (15A NCAC 18A .2600)
All items are to be submitted through the Central Permitting Office at 108 East Front St.,
Lillington, NC 27546 or by mail to PO Box 65, Lillington, NC 27546. You may contact the
Central Permitting Office at 910- 893 -7525, Ext. 2. However, please contact our office wit
questions regarding the contents of this application.
The North Carolina Rules Governing the Sanitation of Food Service Establishments require
that plans be submitted for approval prior to construction / renovation / modification / change
ofownership of such facilities by the local Health Department.
Plans are reviewed using North Carolina's "Rules Governing the Sanitation of Food Service
Establishments," 15A NCAC 18A .2600. You may view these rules at
www.deh .enr.state.nc.us /ehs /rules.htm or obtain a copy from our office at 307 Cornelius
Harnett Boulevard, Lillington, NC 27546. For additional information regarding facility design
and layout, you can access the "Guidelines for the design, installation and construction of food
establishments in North Carolina" by going to the web page:
http: / /www.deh.enr.state:nc.us /ehs /food /plan2.htm .
Plans for franchised, chain, and prototyped facilities are required to be submitted to the North
Carolina Department of Environment and Natural Resources, Division of Environmental
Health,
Facility and Plan Review Unit, Room 1A109, 2728 Capital Blvd., Raleigh, NC 27604. Checks
must be made payable to DENR/EHSS.
If you have questions, contact one of the following Food and Lodging staff listed below at 910-
893 -7547:
Gale Violette Greene, RS Jamie Turlington, RS
Food and Lodging Program Specialist Environmental Health Specialist
Cindy Pierce, RS
Environmental Health Specialist
Plans must be submitted with the following supporting documentation:
1) Complete set of plans drawn to scale showing the placement of each piece of food
service equipment, storage areas, trash can wash facilities, etc. along with general
plumbing, electrical, mechanical, and lighting drawings
D Plans must include a site plan locating exterior equipment such as dumpsters or
walk ins
C )) A complete equipment list and corresponding manufacturer specification sheets
c 0 A proposed menu
C q A completed Food Service Plan Review Application
$200 Plan Review Fee
•
8/09
Gg
Page 1 of 11
Food Service Plan Review Application
Type of plan: New NEW Remodel Change of Ownership
Name of Establishment: KINGTUT
Physical Address: 6242 HWY S 401
City: Buunlevel State: NC Zip: 28323
Phone (if available): (919)830 -4159 Fax: (919)805 -3978
Website: NA
Applicant: KASDY A DAWOUD
Address: 1924 Quail Ridge RD
City: RALEIGH State: NC Zip: 27609
Phone: (919)803 -4159 Fax: (919)805 -3978
Email: DavidKasdv(aaaol.com
Owner (if different from Applicant):
Address:
City: State: Zip:
Phone: Fax:
Email:
I certify that the information in this application is correct, and I understand that any
deviation
without prior approval from this Department may nullify plan approval.
Signatu : _ 1 Date: 2 / I / 20 11
(Appli ant or esponsible Representative)
Page 2 of 11
Hours of Operation:
Mon 6A:8P Tues 6A:8P Wed 6A:8P Thurs 6A:8P Fri 6A:8P Sat 6A:8P Sun Closed
Number of Seats 20
Facility total square feet: 3520 F
Projected start date of construction / change of ownership: After Costruction Permit
Food Safety Knowledge:
Do any members of management have current ServSafe or equivalent food service
certification? NO I have More than 20 Experience As F &B Director, Restaurant
Manager and Banquet and convention center Manager at Marriott Durham, Hilton Raleigh and
Washington Duke inn and golf Club -
Type of Food Service: Check all that apply
X Restaurant Sit down meals
Food Stand X Take -out meals
Drink Stand X Catering
Commissary
Meat Market
other (explain):
Utensils:
Multi - use (reusable): NO Single - use (disposable): YES
Food delivery schedule (per week): 2 Times & AS NEEDED
Indicate any specialized process that will take place:
Marinating Curing Acidification (sushi, etc.) Smoking
Reduced Oxygen Packaging (e.g. vacuum packaging, sous vide, cook - chill, etc.)
Explain checked processes:
Chicken & Beef , Adding only Lemon juice ,onion juice Salt and Pepper
Indicate any of the following highly susceptible populations that will be catered to or
served:
NO Nursing /Rest Home NO Child Care Center NO Health Care Facility
NO Assisted Living Center NO School with pre - school aged children or an Immuno
compromised Population
Page 3 of 11
Water Supply:
Type of water supply: (check one)
❑ Non - public
Community /Municipal
❑ Non - transient, non - community
DTransient, non - community
Is an annual water sample required of your establishment? (check one)
❑ Yes
1 No
Wastewater System:
• Type of wastewater system: (check one)
1 Public sewer
❑ On -site septic system
Number of current seats: 14
Number of seats applying for: 20
Water Heater:
Manufacturer and Model: NORITZ Model 199 Series
Storage Capacity: gallons
• Electric water heater: kilowatts (kW)
• Gas water heater: BTU's
Water heater recovery rate (gallons per hour at 100F rise): GPH
If thankless, 5.5 GPM ; Number of heaters: 2
*Water heater calculator on the Plan Review Unit web page at
www.deh.enr.state.nc.us/ehs/food/plan
Page 4of11
HOT HOLDING
Foods that will be held hot before serving: Rice —Supe Some time
COLD HOLDING
Foods that will be held cold before serving: Tomato, Green papers, Cucumber,plack
olive,oreen olive, lattice, pickles, Fresh fruit Chiken and Beef
DRY STORAGE
Frequency of deliveries per week: 2 Bas needed Square feet shelf space: 40.6 ft2
Is a separate room designated for dry storage? YES
FINISH SCHEDULE
Floor, wall and ceiling finishes (vinyl tile, acoustic tile, vinyl baseboards, FRP, etc.)
AREA FLOOR BASE WALLS CEILING
Quarry Tile look FRP Washable
Kitchen Quarry Tiles CovedTiles Panel Ceiling tiles
Bar NA NA NA NA
4" Rubber Washable
Food Storage VCT Base FRP Panel Tiles
4" Rubber Exposed Metal
Dry Storage VCT Base FRP Panel Structure
coved Tile look FRP
Toilet Rooms Quarry Tiles Ceramic Tiles Panel Ceiling Tiles
Garbage Can
Wash Area Out Side
coved Tile look FRP
Rest Room Quarry Tiles Ceramic Tiles Panel Ceiling Tiles
Serving Line in Exposed Metal
Store VCT Ruber Base FRP Panels Structure
Page 5 of 11
FOOD PREPARATION FACILITIES
Number of food prep sinks: 1 Are separate sinks provided for vegetables and meats? YES
Size of sink drain boards (inches):
How will sinks be sanitized after use or between meat species? Washed with hot water
then sanitized with sanitizer solution mixed as per manufacture
spasefication
DISHWASHING FACILITIES
Hand Dishwashing
Number of sink compartments: _3
Size of sink compartments (inches): Length 24 Width 18 Depth , 14
Length of drain boards (inches): Right 24 " Left 24"
Are the basins large enough to immerse your largest utensil? YES
What type of sanitizer will be used?
Chlorine X Chlorine Quaternary ammonium Hot water Other (specify) _
Mechanical Dishwashing
Will a dishmachine be used? Yes No NO
Dishmachine manufacturer and model:
Hot water sanitizing? or chemical sanitizing?
How will large utensils such as prep tables, dough mixing bowls, slicers, and other food
contact Surfaces that cannot be submerged in sinks or put through a dishwasher be cleaned
and sanitized?
How many air drying shelves will you have? 2
Calculate the square feet of total air drying space: 9 ft2
HANDWASHING
Indicate number and locations of hand sinks in the establishment: There Will Be 3 Hand
wash sinks, 2 Sinks at bathrooms 1 inside kitchen
Page 6 of 11
EMPLOYEE AREA
Indicate location for storing employees' personal items: _ Office
GARBAGE, REFUSE AND OTHER
Will trash be stored in the restaurant overnight? Yes _ No NO If so, how will it be
stored to prevent contamination? Out Side At dumpster
Location and size of can wash facility: Out at right side of the kitchen door
24X24X10
Are hot and cold water provided as well as a threaded nozzle? YES
Will a dumpster be provided? - YES Do you have a contract with the dumpster provider
For cleaning? After Construction Will have a contract
How will used grease be handled? We strive to do not have grease and if we have we will
control it, also we have grease trap
Is there a contract for grease trap cleaning? After Construction
Are doors self - closing? YES Fly fans provided? YES
Where will chemicals be stored? Inside the store there will be special area for it at the
storge room
Where will clean linen be stored? No linen will be used
Where will dirty linen be stored? No linen will be used
Page 7 of 11
FOOD HANDLING PROCEDURES
Explain the following with as much detail as possible. Complete descriptions including specific
Areas of the kitchen and corresponding items on the plan where food is handled will expedite
the plan review process.
Explain the entire food handling procedure for each food item on the proposed menu.
Including:
• How the food will arrive (frozen, fresh, packaged, etc.)
• Where the food will be stored
• Where and how the food will be thawed
• Where (prep tables, sink, counter, etc.) the food will be handled (washed, cut,
Marinated, breaded, cooked, etc.)
• When (time of day and frequency /day) food will be handled
• Whether or not the food or any part of the food will be used as leftovers or as any
Ingredient in a future dish
• How the food will be cooled if applicable
FOOD PRODUCT Breakfast 2 Eggs cooked the way you like
Eggs will arrive fresh, separated in container, will be stored in reaching cooler frequently
served in the morning, have no leftover.
Grab 2 Eggs from the reaching cooler in a small container Break each egg in a small
plate separate to make sure that each of the eggs is good, mix the two eggs together with a
clean fork, add one ounce of half and half Cream mix all together, spry Small Pan with
Pam, pour the mix , steer with clean spoon until it cooked, scoop with the spoon to a
disposable plate, pot 2 slice of toast in toaster until it get to golden color, serve to guest
with package fork and knife , all utensils used will go for wash as specified in hand washing
Part of the review
_ FOOD PRODUCT: Stake of Pancake _
Pancake mix delivered packaged or inside cans , stored at the dry storage, frequently
served in the morning,pancack mix will be mixed with milk or water as per manufacture
specification,and stored at reaching cooler to be used only at the same day and never to be
used the next day.
Have the flat grill hot (350F) spry part of it with pam pour 5 ounce of pancacke mix on it
wait for one minute and use a spatula to turn it over , wait one minute until it cooked, -
move the pancake to a disposable plat serve it with syrup ,
FOOD PRODUCT: fresh fruit bowl
_Fresh fruit arrive fresh will be stored at cooler, served all day. After mixing will be stored at
cooler, no left over will be served next day
Cantaloupe or water melon, orange, apple, and strawberry will be washed thoroughly , peeled
and cut mixed with yogurt , served in a disposable bowl
All utensils used to cut or mix will go for wash as specified in hand washing Part of the review
Breakfast Side order
All Muffin, Biscuit, will be delivered ready made, stored at dry storage.
•
All Dav Specials _
FOOD PRODUCT: Flafel with Lebanon salad &Homos
Falafel mix comes in packaged (Some time mixed and frozen) stored in dry food storage,
served all day after Mixing it will stored in cooler (40F) for next day use,
Peeled fava beans ,peeled chickpeas , finely chopped onion, finely chopped ,fresh parsley, finely
chopped ,salt ,ground red pepper , cumin, Spoon falafel into hot oil by the tablespoon. Fry for
about 2 minutes or until falfel is a golden brown color. _Served With Lebanon salad (fresh cut of
tomato, Romaine and onion All utensils used to cut or mix will go for wash as specified in
hand washing Part of the review
Page 8 of 11
_ FOOD PRODUCT: Fool medames
Fool medames ( Fava beans) Comes in Small 12 oz cans will be stored at dry storage , after
cans opens you can not store for next day it must be used at the same day, it is only 2 portion
per can, Just add lemon Juice olive oil and warm up in a small pan then serve left from cans
will be kept at cooler
_ FOOD PRODUCT:_Baba Ghanosh
Boiled and peeled Eggplant Fine Chopped and Mixed with Teheni, olive oil, cumin and lemon
juice , Eggplant delivered fresh stored at cooler,Teheni delivered in Glass Jars stored at dry
storage , Served all day, could be stored in cooler for next day in plastic or glass pan.
Heat water at deep ban until it boils throw one (as you need for the day) or two Eggplants in it
for fifteen minute, Strain the hot water out of the pan and add new cold water for washing the
Eggplant ( Eggplant will be steel hot) get the eggplant out and peel it in glass pawl take the
skin out add Teheni, lemon Juice , Cumin and little salt, Smash it with fork or use food
processor , Scoop with spoon add beta bread beside and serve , All utensils used to cut or
mix will go for wash as specified in hand washing Part of the review
_ FOOD PRODUCT Stuffed grape leaves
Grape leaves comes in gars or cans, will be kept in dry storage when it is not open after
opening will be kept in cooler served in disposable platter with lemon sauce
_ FOOD PRODUCT shish kabab (beef or chicken)
Pre cut Beef or chicken in a small to be ready for marinating in lemon onion salt and pepper
All meet and chicken comes pre cut in plastic bags will be kept in freezer and will be thawed
by leaving it in a flow of water (50F -60F) the same day to be used then marinating it in lemon
and onion sauce then grilled in the grill marinated left over from meet and chicken will be kept
in cooler to be used next plater. All utensils used to cut or mix will go for wash as specified
in hand washing Part of the review
_ FOOD PRODUCT Grilled Chicken & cheese Sandwich
Pre cut chicken Brest Ready to be grilled Just add salt and pepper add cheese and toasted
bread , tomato and romaine _ pre cut chicken in plastic bags will be kept in freezer and will be
thawed by leaving it in a flow of water (50F -60F) the same day to be used _ pre cut in plastic
bags will be kept in freezer and will be thawed by leaving it in a flow of water (50F -60F) the
same day to be used
Page 9 of 11
The following questions.will test how much you already know about food safety. Please
answer
to the best of your ability and as clearly as possible in order that the EHS understands what you are
trying to say.
1. What are the final cook temperatures ( °F) for the following foods?
a. Chicken 180 Whole chicken 170 Breast _
b. Hamburger 160
c. Ground Sausage 160
d. Pork 160 -170
e. Eggs _ 140
f. Steaks _ 170
2. In the following list, place in order from top to bottom, how the following will be
Stored in a cooler and /or freezer: raw chicken, raw eggs, vegetables, foods that are
Cooling, raw pork, raw hamburger, beef steak.
Top Cooling food after ice Bath
Eqg& Milk _
Vegetable
Beef Steak
Hamburger
Chicken
Bottom _ Raw Pork
3. Describe how you would cool hot foods for the next day's usage. Explain specific
Examples, stating temps, time of cooling process, and size of containers.
From 140° F to 40° For colder within four hours. Reduce the size of large pieces of hot food by cutting
Large items into smaller pieces (no more than 2 in. thick). Divide large batches into smaller portions. * Pour thick
foods into pre - chilled shallow pans to a depth of no more than two inches. Pour thinner liquids to No more than 3
inches deep. Thick foods include foods such as gravy, chili, stew, mashed potatoes, and most vegetables. Thin
foods would include most soups, excluding chowder.* Put a mixture of half ice and cold water in a large pan or
sink. Immerse the pan of hot food into the ice water bath.* When the food reaches a temperature of 70 °F, cover it,
and transfer it to a refrigerator to complete the cooling process * Stir food regularly* Check the temperature of
food in several places.* put it in the fridge on the highest shelf possible.
4. What minimum temperature ( °F) must leftovers be reheated to? 165F
5. Describe your sanitizing procedures for your pots, pans and other utensils. Be Specific.
a. Scrape food and solids from the containers and utensils.
b. Use the 1" sink of the 3 compartment sink filled with hot water mixed with detergent and use
• a brush to clean up the inside of pans and containers.
c. Rinse the containers and utensils in the 2n sink compartment filled with clean hot
water.
d. Sanitize the containers and utensils in the 3 sink compartment filled water at 75
degrees or higher mixed with Sanitizer Solution as per Manufacturer's instructions.
e. Place all items on the draining board to drain.
Page 10 of 11
6. Describe how you will sanitize the cutting boards, prep area tables, prep sinks, and
Knives,when switching from one food to another. Describe what products will be
Used to clean this area and the contact time for the sanitizing chemicals used.
a. Wash surface with detergent solutions
b. Rinse surface with hot clean water
c. Sanitize surface with sanitizing solution mixture at the concentration specific to
the manufacturer's label. Place wet items in a manner to allow air drying.
7. Please list the hot holding and cold holding temperatures of foods that are held on a
Buffet bar or held in the walk -in cooler.
Hot Holding 135 -140 ( °F)
Cold Holding 40 ( °F)
8. Describe when you and your employees are required to wash your hands.
a. Before every time food is handled
b. After Every time food is handled
9. Describe your sick employee policy.
Sick employee must not handle food or come in contact with the quests. It is
best to see doctor and take necessary time off to get healthy.
10. Explain how to use and calibrate a thermometer. Put the thermometer in ice it must
read 32F, put the thermometer in boiling water it must read 180F, Thermometer must be
inside every cooler in middle area to read average temperature
11. Explain the policy if there are cuts or burns on the hands of an employee. No emplvee
should handle food without food gloves but employee might be in pain because of
burns or injure, we might can use that employee in a different post like cashiering if we
could not do so the employee may take some time off to recover.
12. Explain the procedure for making up a sanitizing solution. Mixing sanitizing solution as
per manufacture specification written at the sanitizer.
13. Will staff be allowed to smoke? Where will they be allowed to smoke? No Smoking will
be permitted in our facility , there will be an ashtrays neer the out side door for quest to
destroy there cigarette before interring the facility
14. What distributors will be used to purchase the food being sold? US FOOD CO.
Or available suppliers on the same community
15. Where will personal drinks be stored and how will they be stored ?. Drinks will be
allowed only at break time not after , Before or During work time and only at set -
down table
These questions must be answered correctly to demonstrate whether the restaurant owner or
Operator is knowledgeable enough to receive a Permit/Transitional Permit from this office.
Page 11 of 11
King Tut Menu
All Dav
Breakfast Special
1- 2 Eggs cooked the way you like
(Scrambled, over medium, boiled or Sunnyside) Served with hot toast & hash brown
2- Stake of pancake
3 pancakes served with maple syrup
3- 3Hot pancakes with sausages& maple syrup
4- Egg Biscuit with beef Sausage
5- Muffin Sausage with Egg
6- Fresh fruit Bowl with yogurt
All Dav Spcial
1- Falafel with Lebanon salad & Homos
(3 falafel served with homos, beta bread and tomato cucumber salad)
2- Fool medames
Egyptian fava beans, served with beta bread, Teheni & green salad
3- Baba Ghanosh
(Cooked eggplant with Teheni, Served beta bread)
4- Stuffed Grape leaves (8 OZ with lemon sauce)
5- Shish Kebab plate (Chicken or Beef)
Served with white rice and Green Salad
Sandwich Special
1- Gyro with pita bread (Sandwich or platter)
2- Roll up Eggplant (grilled eggplant with garlic sauce in beta bread)
3- Grilled Chicken & Cheese sandwich
4- Falafel Sandwich with Lebanon salad & Homos
5 - Turkey and Cheese Sandwich
Salad Spcial
1- Greek Salad (platter)
Fresh romaine, onion, cucumber, tomato, feta Cheese mixed with olive oil and plsamic venerate
2- Caesar Salad with Grilled Chicken
Fresh romaine, cucumber Parmesan cheese mixed with Caesar dressing
3- Tabula
Lebanese Salad With Lemon sauces
4 -Fresh green salad
Lettuce. Cucumber, tomato Served with your choice of dressing
5 -Fresh Fruit Salad With Yogurt
Pizza pizza pizza
Pizza for one 10'
Tomato sauce, mixed cheese, Pepperoni, Black olive, Meet, green paper, and onion.
Pizza Midum 12'
Tomato sauce, mixed cheese, Pepperoni, Black olive, Meet, green paper, and onion.
Pizza Large 14'
Tomato sauce, mixed cheese, Pepperoni, Black olive, Meet, green paper, and onion.
Sweet Pzza
Pizza mad with pineapple, banana and glassed with Sugar syrup
Desserts
1 -Ice Cream of your choice 2- Chocolate Cake 3- Carrot Cake
Beverage
All Juices from the cooler
Sodas from the cooler
Coffee, Tea
Fountain sodas Small, Medium and large
Today Special
All specials will be determent the same day of service
1- Byrd Special 2- McNeill Hobbs Special 3- Bunnlevel Special
Healthy platter Build your own Muscles Energy Platter
For your Hart High protein High carbohydrates