food plan review application process · food plan review application process ... a copy of the...

Environmental Health Division 3020 Rucker Avenue, Suite 104 Everett, WA 98201-3900 fax: 425.339.5254 tel: 425.339.5250

Food Plan Review Application Process

The enclosed plan review application package and checklist are designed to help guide you through the

plan review process. The construction, conversion, change of menu, change of food preparation processes,

alteration and remodel of a food establishment require Snohomish Health District (SHD) review and

approval (WAC 246-215). Incomplete applications will be returned to the applicant.

Before submitting your application

Contact your local building, planning and zoning departments for additional requirements.

Have a Washington State business license www.bls.dor.wa.gov

Obtain water approval. If the facility is connected to a well, obtain approval for its use. Contact

Snohomish Health District Water and Wastewater Section at 425.339.5250.

Obtain septic/sewer approval. If the facility is connected to a septic system, obtain on-site sewage

approval. Contact Snohomish Health District Water and Wastewater Section at 425.339.5250.

Plan review application submittal

You must submit a complete application packet including plan review fees. Plan review fees are non-

refundable. Find applications at www.snohd.org/Shd_EH/Eh_FLE/FoodPermit.aspx

New construction includes facilities not previously permitted as a food establishment or those

closed for more than 30 days. This fee applies if you add a new permit type to a currently

permitted facility (i.e. adding a lounge, deli, or catering permit).

Remodel includes changes or alterations to a currently permitted facility such as a remodel or

change of menu, change of food preparation processes, equipment or commissary relocation.

Additional fees are required for multiple-permit facilities and resubmission of previously approved

plans.

Contact plan reviewer at 425.339. 5250 if you have questions.

Do NOT purchase any equipment or begin any construction until you have SHD written approval.

Consultations (highly recommended) are available in 30-minute increments by appointment.

Applications will be accepted in person Monday – Friday from 8 a.m. – 4 p.m., except legal holidays or

by mail/courier to Snohomish Health District, Attn: Food Section Plan Review, 3020 Rucker Ave, Suite

104, Everett, WA 98201-3900. Plan review applications submitted electronically are preferred. For

directions on how to submit plans electronically contact a plan reviewer at 425.339.5250 or at

[email protected]

Application review

Plan review staff from SHD will review your application to ensure that the proposal complies with state

and local codes.

SHD’s goal is to review and respond to complete applications within 30 days of the date of submittal.

Notification of approval or request for additional information will be sent to the Plan Review Contact

provided on the application.

Plan review approval

Once you receive application approval you will need to:

Verify accuracy of Operating Permit information.

http://www.bls.dor.wa.gov/

http://www.snohd.org/Shd_EH/Eh_FLE/FoodPermit.aspx

mailto:[email protected]

Food Plan Review Application Process


Pay for annual permit fees. Please note that operating permit applications are not accepted more than

30 days prior to the anticipated opening date of the establishment. See attached fee schedule for

annual permit fees. A facility may be required to obtain multiple permits. Operating permits expire

December 31 of each year. If you have questions about the permits you need, please contact a plan

reviewer at 425.339.5250 or at [email protected].

A copy of the approval letter you receive will be sent to the Building Department and Washington State

Liquor Control Board as needed.

Preoperational inspection

Review and verify completion of the Preopening Checklist.

Contact SHD at least 7 days in advance, to schedule your preopening inspection. As most

establishments require at least1 follow-up inspection, it is highly recommended that you schedule the

first preoperational inspection with sufficient time for any deficiencies to be corrected and still allow

time to schedule a reinspection prior to the proposed opening date of the establishment.

Your plan review fee includes one preopening inspection. Subsequent preopening inspections will be

subject to a reinspection fee.

If your facility operates without preopening approval, you will be subject to enforcement action and

additional fees.

No food storage or preparation is allowed in the establishment prior to the preoperational

inspection. No food storage or preparation is allowed in the establishment until after SHD

approval to open. A small amount of food product may be allowed if needed for proper temperature

verification on equipment such as soft serve ice cream and yogurt machines.

Submit all application and permit fees in person before SHD gives approval to open, and all

preinspections are completed. The application and fees will not be accepted more than 30 days

prior to the establishment opening date. You may NOT open for business until you have SHD

approval. The permit holder is required to post the permit in the food establishment where consumers

can see it easily.

For questions or additional information about this process, please contact a plan reviewer at 425.339.5250

or at [email protected].

FoodPlanReviewApplicationProces_EH_10_2014_kkc




Agency Resource List Snohomish Health District 3020 Rucker Ave, Suite 104, Everett WA 98201-3900 Water & Wastewater Section, on-site sewage review 425.339.5250 Water & Wastewater, water/well review 425.339.5250 Food Safety Section, reviews for food establishments and school kitchens 425.339.5250 Washington State Department of Health (DOH) Retail Food Code 877.485.7316 or 360.236.3385 Washington State Department of Agriculture (WSDA) Wholesale licensing, cottage industry 360.902.1876 United States Department of Agriculture (USDA) Wholesale licensing, meat/poultry 888.674.6854 Federal Food & Drug Administration (FDA) Wholesale licensing, processed food 888.463.6332 Tax and& License Contacts for tax and licensing requirements for general business licenses, liquor licenses, business taxes, property taxes, and occupational taxes:

Washington State Department of Revenue Unified Business Identifier (UBI) number, retail sales, business and occupation tax 19800 North Creek Parkway, Bothell 98011 425.984.6400 Department of Labor & Industries Industrial insurance and medical aid, safety inspections & compliance, mobile food unit approvals 525 E College Way, Mt Vernon 98273 Electrical permits 360.416.3000 Safety inspection 360.416.3000

Employment Security Department Unemployment insurance 1301 Tacoma Ave S, Tacoma 98402 253.593.7300

Internal Revenue Service Federal unemployment tax, social security, and federal excise tax Rucker Building 3020 Rucker Ave Suite 301, Everett WA 98201 Toll-free 800.829.1040

Washington State Liquor Control Board

State Office, 3000 Pacific Ave SE, Olympia 98504 Liquor licenses 360.753.6259 http://liq.wa.gov

1

http://www.doh.wa.gov/CommunityandEnvironment/Food.aspx

http://agr.wa.gov/Portals/Food

http://www.usda.gov/

http://www.fda.gov/

http://liq.wa.gov/

Agency Resource List


Office of Secretary of State, Corporation Division Registration of firm or corporate name Republic Building 801 Capitol Way S, Olympia 98501 360.725.0377

Washington State Department of Licensing Statewide business license information, trade name registration PO Box 9030, Olympia 98507 360.902.3900

Snohomish County Assessor Parcel number information 3000 Rockefeller Ave, M/S 510; Everett 98201 425.388.3433 Snohomish County Treasurer Personal tax information 3000 Rockefeller Ave, M/S 501; Everett 98201-4060 425.388.3366 Snohomish County Auditor Unincorporated Snohomish County business licenses 3000 Rockefeller Ave, Everett 98201 425.388.3388

Recycling & Garbage Service

Verify service for a particular city or area of Snohomish County with the specific service provider. Waste Management Snohomish County 1 800.592.9995 Arlington, Brier, Darrington, Everett (South of 112th St SE), Granite Falls, Lynnwood (East of Hwy 99), Marysville, Mill Creek, Mountlake Terrace, Mukilteo, Stanwood, Unincorporated Snohomish County Rubatino Refuse Removal Inc. 425.259.0044 Everett Republic Services of Lynnwood, Allied Waste Division 425.778.6508 Edmonds, Gold Bar, Lake Stevens, Lynnwood, Woodway, Sultan, Unincorporated Snohomish County

Waste Oil Companies This list is provided for informational purposes only and for the convenience of the user. This should not be taken as an endorsement by the Snohomish Health District. This is not a complete list of contractors available for services. Find more contractors in the Yellow Pages or similar references. This list may be amended at any time.

Baker Commodities 5795 South 130th Pl, Seattle 98178 206.243.7387, 800.562.5058 Darling International 2041 Marc Ave, Tacoma 98421 253.572.3922, 800.524.2410 2

http://wmnorthwest.com/ssnohomishcounty/index.html

http://www.rubatino.com/Default.aspx

http://www.republicservices.com/Corporate/Localservices/Location.aspx?SID=197

http://www.bakercommodities.com/division-detail.php?d=12

http://www.darpro.com/



General Biodiesel 6333 1st Ave S, Seattle 98108 206.932.1600 Standard Biofuels Multiple Puget Sound locations 888.872.9968 http://www.generalbiodiesel.com Additional waste oil company information may be found a the following Seattle Public Utilities website Seattle Public Utilities

Sewer & Water Districts Contact for sewer connections, grease traps/vaults/interceptors, and water connections.

Alderwood Water & Wastewater District 3626 156th SW, Lynnwood WA 98087 425.743.4605

City of Brier (Sewer District) 2901 228th St SW, Brier 98036 425.775.5440 City of Edmonds (Water and Sewer District) 7110 210th St SW, Edmonds 98026 425.771.0235 City of Everett (Water and Sewer District) 3200 Cedar, Everett 98201 360.257.8800 City of Granite Falls (Water and Sewer District) PO Box 1440 (206 Granite Ave) Granite Falls 98252 360.691.6441

City of Lynnwood (Water and Sewer District) PO Box 5008 (19100 44th Ave W 98036) Lynnwood 98046 425.775.1971 City of Marysville (Water and Sewer District) 80 Columbia St, Marysville 98270 360.363.8100 City of Monroe (Water and Sewer District) 806 West Main, Monroe 98272 360.794.7400 City of Mountlake Terrace (Water and Sewer District) PO Box 72 (23204 58th Ave W) Mountlake Terrace 98043 425.670.8264 City of Snohomish City Utilities 116 Union Ave, Snohomish 98290 360.568.3115 City of Stanwood Public Works 10220 Union Ave NW, Stanwood 98292 360.629.2181 City of Sultan (Water and Sewer District) PO Box 1199 (319 Main St) Sultan 98294 360.793.2231 3

http://www.generalbiodiesel.com/

http://standardbiofuelsusa.com/

http://www.generalbiodiesel.com/

http://www.seattle.gov/util/groups/public/@spu/@conservation/documents/webcontent/spu01_003872.pdf

http://www.alderwoodwater.com/

http://ci.brier.wa.us/publicworks/info.htm

http://www.edmondswa.gov/government/departments/public-works-home/utilities.html

http://www.ci.everett.wa.us/default.aspx?ID=55

http://ci.granite-falls.wa.us/pages/public-works.php

http://www.ci.lynnwood.wa.us/City-Services/Sewer-and-Water.htm

http://marysvillewa.gov/index.aspx?nid=397

http://www.monroewa.gov/index.aspx?NID=96

http://www.cityofmlt.com/cityServices/utilities/utilities.htm

http://www.ci.snohomish.wa.us/137/City-Utilities

http://www.ci.stanwood.wa.us/publicworks

http://ci.sultan.wa.us/departments/public-works



Cross Valley Water District 8802 180th SE, Snohomish WA 98296 360.668.6766

Lake Stevens Sewer District 1106 Vernon Rd. Ste A, Lake Stevens 98258 425.334.8588 Mukilteo Water and Wastewater District PO Box 260 (7824 Mukilteo Speedway) Mukilteo 98275 425.355.3355 Olympic View Water and Wastewater District 23725 Edmonds Way, Edmonds 98026 425.774.7769

Seven Lakes Water Association (Lake Goodwin area) 17507 W Lake Goodwin Rd, Stanwood 98292 360.652.8192

Silver Lake Water and Sewer District

PO Box 13888 (15205 41st Ave SE Bothell, 98012) Mill Creek 98082 360.793.1101

Cities/Snohomish County Contact for zoning, building/plumbing permits, fire codes, occupancy requirements, other building requirements and local business licenses.

Arlington 238 N Olympic, Arlington 98223 360.403.3421 Bothell 18305 101st Ave NE, Bothell 98011 425.486.3256 Brier 2901 228th St SW, Brier 98036 425.775.5440 Darrington PO Box 397 (1005 Cascade St) Darrington 98241 360.436.1131 Edmonds 121 5th Ave N, Edmonds 98020 425.775.2525 Everett 2930 Wetmore, Everett 98201 425.257.8700 Gold Bar 201 Center St W, Eatonville 98328 360.832.3361 Granite Falls 107 5th St, Gold Bar 98251 360.793.1101 4

http://www.crossvalleywater.net/faq.htm

http://www.lkstevenssewer.org/

http://www.mukilteowwd.org/

http://slwsd.com/

http://www.arlingtonwa.gov/

http://www.ci.bothell.wa.us/

http://www.ci.brier.wa.us/

http://town.darrington.wa.us/

http://www.mrsc.org/cityprofiles/cityprofile.aspx?id=63

http://www.ci.everett.wa.us/

http://www.cityofgoldbar.us/




Index PO Box 88 (511 Ave A) Index 98256 360.793.2488

Lake Stevens

Po Box 257 (1812 Main St) Lake Stevens 98258 425.334.1012

Lynnwood PO Box 5008 (19100 - 44th Ave W) Lynnwood 98046-5008 425.670.5000 Marysville 1049 State Ave, Marysville 98270 360.363.8000 Mill Creek 15728 Main St, Mill Creek 98012 425.745.1891 Monroe 806 W Main St, Monroe 98272 360.794.7400 Mountlake Terrace PO Box 72 (6100 219th St SW Suite 200)

Mountlake Terrace 98043 425.775.0420 Mukilteo 11930 Cyrus Way, Mukilteo 98275 425.263.8000 Snohomish 116 Union Ave, Snohomish 98290 360.568.3115 Snohomish County Planning and Development 3000 Rockefeller Ave, M/S 604, Everett 98201 425.388.3311 Stanwood 10220 270th St NW, Stanwood 98292 360.629.2181 Sultan PO Box 1199 (319 Main St, Suite 200) Sultan 98294 360.793.2231 Woodway 23920 - 113th Pl W, Woodway 98020 253.299.5530 5

AgencyResourceList_EH_08_2014_kkc

http://www.lakestevenswa.gov/

http://www.ci.lynnwood.wa.us/

http://marysvillewa.gov/

http://www.cityofmillcreek.com/


http://www.cityofmlt.com/

http://www.ci.mukilteo.wa.us/

http://www.ci.snohomish.wa.us/

http://www1.co.snohomish.wa.us/Departments/PDS

http://www.ci.stanwood.wa.us/


FoodEstablishmentPlanReviewCheckLIst_EH_08_2014_kkc


Food Establishment Plan Review Checklist Facility name ___________________________________________________________________________ This checklist will help you prepare a complete plan review application. Check off each item in the plan review application packet and provide items in the following order. Submit the completed plan review packet and checklist with the required application fee. Make a copy of this plan review packet for your file prior to submittal. Plan review fees are non-refundable .

ITEM

DESCRIPTION

Office Use Only

Intake

1 Water and sewer adequacy

Provide proof that the facility is connected to an approved water and sewer or septic system.

2 Application Provide complete application. Include a copy of your business license.

3 Plan review questions

Provide complete Plan Review Questions form.

4 Floor plan Provide a floor plan of the entire facility. Floor plan must show location of all equipment

(sinks, refrigeration, cooking, hoods, blenders, countertop appliances, etc.), restrooms, storage areas, etc. Floor plan must be no smaller than ¼ equals 1’.

5 Equipment list Provide make and model numbers of all equipment (including countertop appliances). Show location on floor plan. For remodels both new and existing equipment must be shown on the floor plan. Only commercial grade, National

Sanitation Foundation (NSF) or equivalent, equipment is acceptable.

6 Finish schedule Provide the materials used for all floors, walls, ceilings, counters, and cabinets.

7 Menus Provide a detailed menu of all the food and beverages you will be serving or a list of food and beverages you will be selling. Include condiments, iced beverages and baked

goods. Be sure to include specials and seasonal items. Only food and beverages listed may be served. All breakfast, dinner, lunch, bar/lounge, happy hour, kids, catering, and online menus must be submitted.

8 Food sources Provide a list of all food and beverage suppliers.

9 Food preparation steps

Provide a description of how each menu item will be prepared.

10 Waste disposal Provide complete Waste Disposal form.

11 Supplemental questions

Provide complete Supplemental Question form(s) if applicable.

(catering and food processing)

12 Fee Include application fee. Provide separate checks for water review and plan review.

I understand I cannot open this food establishment until I have received written approval from this program, obtained all annual operating permits and have been inspected and approved by all applicable city, county and state agencies.

Signature/Title _____________________________________________________________________________ Date _____________________

1


Plan Review Questions

Facility Name ___________________________________________________________________________

1. Provide a description (the scope) of your project.

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

2. Yes No Will facility remains open during the remodel? If yes, submit additional information as

noted in the Open During a Remodel questionnaire.

3. Yes No Will you offer catering? If yes, complete the catering questionnaire.

4. Yes No Will you offer off-site food delivery?

5. Yes No Will alcoholic beverages be served? (include on menu)

6. Yes No Is there customer seating inside the facility? (this includes all bar, lounge and banquet seating)

7. Yes No Is there customer seating outside the facility? How many seats are outside? _________

8. Yes No If you have seating, is your restroom accessible to customers without passing through food preparation, food storage and/or scullery areas?

9. Yes No Do you have to go outside to access any walk-in refrigeration/freezers, food storage, equipment, and cooking or preparation areas? All locations must be clearly marked on floor plans.

10. Where will chemicals such as cleaning products be stored?

__________________________________________________________________________________

__________________________________________________________________________________

11. Where will employee belongings be stored?

__________________________________________________________________________________

__________________________________________________________________________________


2


12. Yes No Is all lighting above food preparation, storage and service areas shatterproof or covered? (required)

13. Yes No Will any food be self-service? If yes, list foods and how you will prevent contamination:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

14. Yes No Are all food and single-service items protected from customer contamination by a sneeze guard? This includes self-service condiment bars, salad bars, buffet lines, espresso counters and all other food preparation areas.

15. Yes No Are handwash sinks located at all cook lines, food preparation and service areas, and dishwashing areas?

16. Yes No Is a 3-compartment sink with integral drainboards on both sides provided? (required)

17. Yes No Is each compartment of the 3-compartment sink large enough to submerge and wash all equipment?

18. Yes No Do all sinks, including 3-compartment sinks, and food preparation sinks have basins with rounded corners? (required)

19. Yes No Can you completely fill two compartments of the 3-compartment sink with hot water and provide hot water at all handwash sinks without the temperature dropping below 100°F?

20. Yes No Are indirect drains (i.e. air gap) provided for all food preparation sinks, 3-compartment sinks, dishwashers, ice machines, pop dispensers, steam tables, woks, dipper wells, walk-in refrigeration/freezers, and all equipment in which food or food contact equipment is placed?

21. Yes No Does your menu include fresh fruit and vegetable items, such as lemons, limes, onions, tomatoes, potatoes, lettuce or berries?

22. Yes No If your menu includes fresh fruit and vegetable items, is an indirectly drained food preparation sink with an integral drainboard provided? (required)

23. Yes No Will you prepare, rinse or thaw under running water, raw meat, poultry, and or seafood? If yes, list:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________


3


24. Yes No If raw meat, poultry, or seafood are prepared, rinsed or thawed under running water, is a second indirectly drained food preparation sink with an integral drainboard provided? (required)

25. Yes No Is at least 16” of separation or proper barriers provided between all food preparation sinks and any source of contamination?

26. Yes No Is at least 16” of separation or proper barriers provided between all produce preparation sinks and raw meat, poultry, and or seafood?

27. Yes No Are 16” high splash guards installed on both sides of all handwash sinks?

28. Yes No Are 16” high splash guards installed between all sinks that are less than 16” apart?

29. Yes No If handwash sinks have splash guards (partitions, walls and or equipment) on both sides

is there a minimum of 18” between the splash guards?

30. Yes No Are soap and paper towel dispensers installed inside the splash guard area at all handwash sink locations?

31. Yes No Are all handwash sink basins at least 10” long by 10” wide and 5” deep?

32. Yes No Do you have a mop sink? (required)

33. Yes No Is the mop sink located so food and equipment are not contaminated when used?

34. Yes No Does the mop sink have a vacuum breaker installed?

35. Yes No Will a chemical dispensing system be installed at the mop sink?

36. Yes No N/A Are all ice machines, ice bins, dishwashers, food preparation sinks, hot wells, drip trays, espresso machines, beer taps and dipper wells indirectly drained with an air gap? (buckets are not allowed.)

37. Yes No N/A If a soda fountain system is used, is a reduced pressure backflow assembly

(RPBA) installed and tested?

38. Yes No Will any food be stored or prepared at another location? If yes, list name and address where food will be stored or prepared: __________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

39. Yes No Will any food be cooked or hot held unattended (i.e. overnight or more than 2 hours of

unattended cooking)? If yes, the questionnaire for cooked or unattended food must be completed.


4


40. Yes No Will there be any cooking or food preparation outside the establishment? All locations must be clearly marked on floor plans.

41. Yes No Will any food of animal origin be undercooked at the customer’s request, such as steaks, eggs, or hamburger? If yes, list:

__________________________________________________________________________________

__________________________________________________________________________________

42. Yes No Will any fish or seafood be served raw or undercooked? If yes, list:

__________________________________________________________________________________

__________________________________________________________________________________

43. Yes No Is proper parasite destruction documentation submitted for all fish or seafood served raw or undercooked?

44. Yes No Will any menu items include wild mushrooms? If yes, the wild mushroom questionnaire must be completed.

45. Yes No Will any food be smoked as a method of food preservation rather than flavor

enhancement? (used to preserve or change a food so it no longer requires refrigeration) If yes, you must submit the food preparation steps for all the smoked foods along with laboratory documentation of shelf stability for each food item.

46. Yes No Will any food be cured? If yes, the food preparation steps for all the cured foods must be submitted.

47. Yes No Will any food additives be used to preserve or change a food so it no longer needs to be

refrigerated? If yes, the food preparation steps for all these foods along with laboratory documentation of shelf stability must be submitted for each food item.

48. Yes No Will a display tank be used for molluscan shellfish, such as oysters or clams? If yes, submit additional information as noted in the Molluscan Shellfish Tank questionnaire.

49. Yes No Will custom processing of animals be offered for a customer’s personal use as food (i.e. deer) and not for sale or service in a food establishment? If yes, submit the food preparation steps including how custom processed foods will be kept separated from all other foods during receiving, processing, storage and handling.

50. Yes No Will any food be grown specifically for sale or service in the food establishment such as sprouts? If yes, the growing and food preparation steps for all these food items must be submitted.


5


51. Yes No Will any food be vacuum packaged or reduced oxygen packaged? If yes, submit additional information as noted in the Vacuum Packaging-Reduced Oxygen Packaging questionnaire.

52. Yes No Will any food be cook-chill or sous vide ? If yes, submit additional information as noted in

the cook-chill or sous vide questionnaire.

If you answered yes to questions 44-51, include the proper food preparation process descriptions and variance request.

PlanReviewQuestions_EH_09_2014_kkc


Equipment List Facility name ___________________________________________________________________________

List all food service equipment, including make and model numbers. Examples include, but are not limited to,

refrigerators, sinks, stoves, ovens, steam tables, blenders, ice machines, ventilation hoods, and all countertop

appliances. If make and model number cannot be found, a picture of the equipment is required. The item

numbers on this list must be the same as the item numbers for the equipment on the floor plan.

All equipment ID numbers must correspond to location on floor plan. Equipment must be commercial grade

and meet American National Standards Institutes (ANSI) standard (NSF, ETL or UL Sanitation listed). Only

one item per line.

Sample Equipment List

ID # Kind of equipment Make Model #

1 Refrigerator 8’x8’ walk-in ACME R-789WI

2 Ice machine GAPP IM-987

3 Rice cooker ACME CR-543

4 3-compartment dish wash sink (with 2 drainboards) ACME S-3CWD

The equipment list is included on floor plan.

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Please add a second page if needed.

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EquipmentList_EH_09_2014_kkc


Finish Schedule for Plan Review

Facility name __________________________________________________________________________

Provide the materials used for all floors, walls, coving and ceilings.

All bare wood surfaces (doors, trim, counters, shelves, cabinets, etc.) must be smooth and cleanable. Food contact surfaces must be covered with food grade materials.

Floors must be constructed of light colored, smooth, easily cleanable, non-absorbent material. Expansion joints, seams, saw cuts and the like in concrete floors in all areas, including customer seating areas, must be filled and sealed so as to provide a smooth and cleanable surface.

Coving must be installed at all wall/floor junctions.

Walls must be constructed of light colored, smooth, easily cleanable, non-absorbent materials. Provide Fiber Reinforced Plastic (FRP), laminate plastic, tile, or similar waterproof material on wall surfaces behind sinks, dishwashers, food preparation areas, and areas exposed to moisture.

Ceilings above the kitchen, lounge, wait and service areas must be constructed of light colored, smooth, easily cleanable, non-absorbent materials. Unsealed and or perforated acoustical ceiling tiles are not allowed. Vinyl covered ceiling tiles such as vinyl rock or other washable surfaces are allowed.

Cabinet shelving must be nonabsorbent, smooth and easily cleanable. (Self-stick vinyl or other type surfaces are not acceptable)

All lighting over food preparation, handling and storage areas must have covers or shatterproof bulbs.

Sample finish schedule Floors Coving Walls Ceiling Counters Kitchen vinyl tile 6" rubber base FRP painted gypsum board laminate Wait Area vinyl tile 4" rubber base painted gypsum board vinyl rock laminate Lounge sealed concrete 4" rubber base varnished wood Armstrong VL tiles granite Dining Area carpet 4" rubber base painted gypsum board painted gypsum board n/a Bathrooms ceramic tile ceramic tile painted gypsum board painted gypsum board laminate Shelving Refrigerators: stainless steel wire shelves; Dry storage: stainless steel wire shelves; Liquor

storage: varnished wood. Lighting Bar lights are shatterproof bulbs. All kitchen lights have covers.


Finish schedule

Included on floor plans

Floors Coving Walls Ceiling Counters

Kitchen

Wait area

Lounge

Dining area

Bathrooms

Shelving ______________________________________________________________________

______________________________________________________________________

Lighting ______________________________________________________________________

______________________________________________________________________

FinishSchedulePlanReview_EH_09_2014_kkc


Menu Sample Facility name ___________________________________________________________________________ Provide copies of your menus. Include all food and beverages you will serve. If the facility is a grocery store serving only fruits, vegetables or commercially prepackaged food, a list of goods sold may be submitted in place of the menu. Be sure to include specials and seasonal items. Only food and beverages listed may be served. Submit copies of all breakfast, dinner, lunch, bar/lounge, happy hour, kids, catering, and online menus, fresh sheets, table tops or menu boards. If a menu board will be used, provide photographs of the menu showing all food and beverages listed. All menu items must be readable in photographs. Menu, food preparation steps, and the mode of operation may be restricted to protect public health (WAC 426-215). A consumer advisory is required for all food of animal origin that is offered raw, undercooked or cooked to the customer’s specification. Be sure all menu items requiring a consumer advisory are clearly identified and remind the patron that consuming these foods may result in foodborne illness. Consumer Advisory information may be found at Washington State Department of Health under Code Clarifications.

Sample menu

AAA #1 Drive In

Breakfast Pancakes ........................................... $2.00 Eggs*, hash browns, bacon, toast ...... $3.00 Oatmeal .............................................. $2.00 Lunch Ham sandwich .................................... $3.00 Pho soup* ........................................... $3.00 Rib eye steak* ...................................$10.00 Dinner Prime rib*...........................................$10.00 Shrimp pasta .....................................$10.00 Deluxe cheeseburger* .......................$10.00 Chicken salad ....................................$10.00

Salads Mixed greens....................................... $3.00 Romaine .............................................. $3.00 Caesar* ............................................... $3.00 Beverages Fountain beverages Large ................................................... $3.00 Medium ............................................... $2.00 Small ................................................... $1.00 Coffee ................................................. $1.00 Tea ...................................................... $1.00

*These menu items are served raw, undercooked or cooked to your specification. Consuming raw or undercooked food may increase your risk of foodborne illness.

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http://www.doh.wa.gov/CommunityandEnvironment/Food/FoodWorkerandIndustry/FoodSafetyRules.aspx


Food Preparation Steps

Facility name ___________________________________________________________________________ Provide the food preparation steps for 6 menu items including complicated processes such as cooling, grill marking, partial cooking, packing sandwiches/salads/etc, smoking, sous vide, unattended and overnight cooking, reduced oxygen packaging, and the like. Include how each menu item is obtained, stored, prepared, cooked and kept hot before serving. Menu items that are prepared in an identical way may be grouped together. Menu, food preparation steps, and the mode of operation may be restricted to protect public health (WAC 426-215).

Examples: BBQ beef/pork – beef and pork are delivered frozen and stored in the walk-in refrigerator to thaw. After the beef and pork are thawed, they are marinated in our special sauce in the walk-in refrigerator overnight. Meats are then cooked on the smoker. After smoking, the beef and pork are shredded and mixed with our BBQ sauce and cooled in hotel pans at 2” food depth in the walk-in refrigerator. After meats are cooled to 41°F, they are covered with plastic wrap. Meats are reheated in the steamer as needed and kept in the front area steam table until served. Leftover items are cooled uncovered in the walk-in refrigerator at 2” food depth. All hamburgers – patties are purchased frozen. Frozen patties are placed on grill once ordered. Hamburger patties are not cooked in advance. Pho soup – beef bones are delivered and stored in the walk-in refrigerator. The beef bones are placed into a large pot, and water is added. The bones and water are brought to a boil and vegetables and spices are added. After soup is cooked half of the broth is held hot on the range at above 135°F and the remainder is cooled to 41°F uncovered in the walk-in refrigerator at 2“food depth. The remaining pho soup is reheated to over 165°F the next day before use.

Chicken salad – raw chicken is purchased frozen and thawed in the walk-in refrigerator. Chicken is marinated overnight in the walk-in refrigerator. Chicken is cooked on char-broiler, cut into small pieces and placed on sheet pan at 2” food depth to cool in the walk-in refrigerator. After chicken has cooled to 41°F, the chicken is portioned and wrapped. Portioned chicken is kept in the preparation refrigerator until ordered. Chicken is mixed with greens and salad toppings per order. All salad greens are rinsed each morning in the food preparation sink and stored in the preparation refrigerator. Ham/turkey/roast beef sandwiches – ham, turkey and roast beef are purchased pre-cooked. Meat is sliced daily, portioned, and placed in the preparation refrigerator. All fruits and vegetables are rinsed each morning in the food preparation sink and stored in the preparation refrigerator. Sandwiches are made to order and served cold or heated on panini grill. Shrimp pasta – shrimp is purchased pre-cooked and frozen. Shrimp is thawed in the walk-in refrigerator. Pasta is par-cooked on stove and cooled at 2” food depth uncovered in the walk-in refrigerator. Once cooled to 41°F, the shrimp and pasta are portioned, bagged and stored in the preparation refrigerator. When ordered by customer, portioned pasta and shrimp are sautéed on stove-top.

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Food Sources Facility name ___________________________________________________________________________ List all food and beverage suppliers you use. Please check the boxes of the common suppliers you use and add the name and phone number of any of your suppliers that are not already listed. This list is provided for informational purposes only and for the convenience of the user. This should not be taken as an endorsement by the Snohomish Health District. This is not a complete list of available suppliers. Look in the Yellow Pages or similar references for additional suppliers.

Name of supplier Phone number

Boyd’s Coffee 800.545.4077

Cash N Carry (Everett) 425.339.2628

Charlie’s Produce 206.625.1412

Coke 800.647.2653

Costco (Everett) 425.379.7451

Costco Business Center (Lynnwood) 425.640.7700

Food Services of America 425.251.9100

Franz Bakery 206.682.2244

Pepsi 425.355.2212

Restaurant Depot (Woodinville) 425.483.5600

Sam’s Club 253.333.1026

Sunfood Trading 800.479.8823

Sysco 206.721.1777

_______________________________________ _______________________________

_______________________________________ _______________________________

_______________________________________ _______________________________

_______________________________________ _______________________________

_______________________________________ _______________________________

FoodSourcesPlanReview_EH_08_2014_kkc


Waste Disposal Facility name _________________________________________________________________________

Garbage

Name of the company ______________________________________________________________

Size and type of container ______________________________________________________________

Frequency of pick-up ______________________________________________________________

Location of container ______________________________________________________________

Distance from building ______________________________________________________________

Waste oil






Recycling






WasteDisposal_EH_09_2014_kkc


Water and Sewer Adequacy / Food & Community Safety Facility name Site address ____________________________________________________________

City ____________________________ State _________ ZIP _______________

Parcel number __________________________ Proposed number of seats ________

Contact name __________________________ Phone ________________________

Email _________________________________ Fax ___________________________

New construction Remodel/Alteration Expansion of existing restaurant

Yes No Is facility connected to a septic system?

Yes No Are public restrooms available?

Yes No Is a grease trap required by sewer district or building department?

Describe the proposed project:

________________________________________________________________________________________

________________________________________________________________________________________

Sewage system Sewer bill attached Below completed by official This section should be completed by a Public Sewer System Official, if a sewer bill or availability letter is not provided.

Name of system ____________________________________ Sewer utility ___________________________________

The above system will provide service to the facility listed at the above address.

System official _______________________________ Phone _____________________ Date ____________________

Water system This section should be completed by a Public Water System Official, if a water bill or availability letter is not provided.

Name of system ________________________________________________ State ID number __________________

The above facility is connected has applied

The above system will provide service to the facility listed at the above address.

System official _______________________________ Phone _____________________ Date ____________________

HEALTH DISTRICT USE ONLY

On-site Approved to submit (signature) ______________________________________________ Date ____________________ Final septic approved (signature) ____________________________________________ Date ____________________

Water Name of water system _______________________________________ State ID Number ________________________

Not adequate for use Adequate for use (signature) _____________________________________________ Date ____________________

Comments ________________________________________________________________________________________

WaterSewerAdequacyFoodCommunity Safety_EH-09_2014_kkc

HEALTH DISTRICT USE ONLY

Pre-approved water system

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Equipment List:

# Item Name Qty Make Model

1. Freezer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . Ice Line. . . . . . . . . . . . . . . F-158Z4

2. Refrigerator 8x8 walk-in . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . ACME. . . . . . . . . . . . . . . . R-789WI

3. Rice cooker. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . ACME. . . . . . . . . . . . . . . . CR-543

4. Deep fryer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . ACME. . . . . . . . . . . . . . . . DF-876

5. Char-Broiler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . ACME. . . . . . . . . . . . . . . . CB-123

6. Gas range. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . GAPP . . . . . . . . . . . . . . . . GR-332

7. Wok. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . ACME. . . . . . . . . . . . . . . . CW-3323

8. Work table. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . ACME. . . . . . . . . . . . . . . . EQ-4LOC

9. 3-compartment dish wash sink (with 2 drainboards). . . . . . 1 . . . . . . . . ACME. . . . . . . . . . . . . . . . S-3CWD

10. Dishwasher. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . GAPP . . . . . . . . . . . . . . . . DW-1234

11. Shelving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 . . . . . . . . ACME. . . . . . . . . . . . . . . . EQ-3S

12. Refrigerator sandwich prep. . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . GAPP . . . . . . . . . . . . . . . . R-SP1

13. 1-compartment produce food prep sink (with drainboard). .1 . . . . . . . . ACME. . . . . . . . . . . . . . . . S-FPWD

14. Mop sink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . ACME. . . . . . . . . . . . . . . . S-MOP

15. Hot water heater . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . GAPP . . . . . . . . . . . . . . . . HW-123G

16. Ice machine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . GAPP . . . . . . . . . . . . . . . . IM-987

17. Soda pop fountain dispenser. . . . . . . . . . . . . . . . . . . . . . . .1 . . . . . . . . ACME. . . . . . . . . . . . . . . . SP-5000

18. Handwash sink wall mount . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . PORCLEAN . . . . . . . . . . . S-HWM

19. Handwash sink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . PORCLEAN. . . . . . . . . . . S-POR100

20. Cash register. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . POS . . . . . . . . . . . . . . . . . CR-5582

21. Coffee maker. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . GAPP . . . . . . . . . . . . . . . . CM-37475

22. Hood ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . GAPP . . . . . . . . . . . . . . . . EQ-HV200

23. Food warmer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . ACME. . . . . . . . . . . . . . . . EQ-FW1000

24. Refrigerator 2 door beverage cooler. . . . . . . . . . . . . . . . . . 1 . . . . . . . . GAPP . . . . . . . . . . . . . . . . R-200BC

25. Splashguards 12” stainless steel . . . . . . . . . . . . . . . . . . . . 5 . . . . . . . . ACME. . . . . . . . . . . . . . . . SG-412

26. Employee storage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . ACME. . . . . . . . . . . . . . . . ES-6FTL

27. 1-compartment raw meat/seafood food prep sink . . . . . . . 1 . . . . . . . . ACME. . . . . . . . . . . . . . . . S-FPWD

(with drainboard)

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Example Floor Plan

1. One floor plan must be submitted with the name and address of establishment, contact person and phone number.

2. Each plan must be drawn to scale (no smaller than ¼" = 1') and show in detail the following:

a. Number, type and location of all sinks and drainboards.

b. Refrigeration and cooling equipment.

c. Food preparation and service areas.

d. Employee restrooms.

e. Customer restrooms (required if you have indoor or outdoor seating).

f. Dry goods storage area (show detail of shelving area and describe type of shelving).

g. Employee storage (required).

h. Service, bus or wait areas.

3. All equipment must be labeled on the floor plan and correspond to the equipment list.

Scale ¼” = 1'

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Facility Name: AAA #1 Drive In

Facility Address: 123 Main Street, Everett, WA 98201

Contact Person: J. D. Public

Contact Phone: (425) 339-5250


Inspection is based upon requirements of WAC 246-215. Rules & Regulations of the State Board of Health for Food Service Sanitation. Other agency approvals requisite to your operation may include County or City Planning, Building, Plumbing and Fire Departments, Water and Sewer Utilities.

Application must be completed in full and submitted with fee and the items listed for processing:

Menu (Including beverages

HACCP Menu Review

Plans & specifications Reviewed for completeness by _____________ EHS Initials

TYPE OF PLAN REVIEW (Check applicable box)

$630 (PLU 333) New food service establishment

$168 Base fee plus $168 per hour for each add’l hour (PLU 311)

Remodel of existing food service establishment or revision of approved plan

$168 (PLU 335) Reopen former food service establishment

$168 (PLU 334) New Limited Grocery

$168 plus lab fees (PLU 385) HACCP–when req’d by WAC for menu items

$630 Base fee plus $150 for each

add’l permit (PLU 366) New multiple permit food service establishment (large grocery store)

ESTABLISHMENT INFORMATION

Name:

Site Address:

City: ZIP:

OWNER INFORMATION

Name: Phone:

Address: E-mail Address:

City: State: Zip:

CONTACT INFORMATION (if different than owner)

Name: Phone:

Address: E-mail Address:

City: State: Zip:

OTHER INFORMATION

Type of Food Service Establishment:

Local Building Inspection Agency:

Water Supply (check one): Private Well Public

Water District:

Sewage Disposal (check one): Onsite Sewage System Sewer

Sewer District:

APPLICANT SIGNATURE DATE

General Food Plan Review Application

OFFICE USE ONLY

GeneralFoodPlanReview_EH_05_2014_kkc


Fee Schedule - Food Safety EFFECTIVE December 1, 2014

TITLE FEE DESCRIPTION

LATE CHARGE FOR RENEWAL OF ANNUAL PERMITS EXPIRING DECEMBER 31

$300.00 Annual permit fee and completed Health District invoice must be received in the Environmental Health Division office by 5 p.m. on the last business day of the following January.

FOOD SERVICE OPERATING WITHOUT A PERMIT Applies to Food Service Establishments and Temporary Food Services

Double prescribed permit fee.

LESS THAN FULL YEAR PERMIT / NEW ANNUAL PERMITS EXPIRING DECEMBER 31

Does NOT apply to Change of Ownership or Temporary Event fees.

Permits obtained on or after April 1 will be pro-rated at 75% of the annual fee.

Permits obtained on or after July 1 will be pro-rated at 50% of the annual fee.

Permits obtained on or after October 1 will be pro-rated at 25% of the annual fee.


CHANGE OF OWNERSHIP $132.00 Annual operating permit

FOOD SERVICE WITH ONSITE SEWAGE DISPOSAL REVIEW $168 .00 Fee charged annually with food service permit

FOOD SERVICE ESTABLISHMENT PERMIT FEES

GENERAL FOOD Includes but not limited to restaurant (with or without lounge), concession stand, mobile food vehicle, food stand concession, commissary, bakery, caterer, grocery with multiple permits, limited grocery with or without food prep, private club, retail meat dealer, retail fish dealer, tavern with or without food prep, year round campground/park food service.

0-12 seats Seat count includes lounge seats

a) Low Risk $326.00 Annual permit fee

b) Medium Risk $489.00 Annual permit fee

c) High Risk $651.00 Annual permit fee













Over 250 seats Seat count includes lounge seats




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TITLE FEE DESCRIPTION CATERING ENDORSEMENT (for licensed food establishments that also offer catering services)

$25.00 In addition to General Food fee

Annual permit fee

MOBILE FOOD VEHICLE (except frozen food vendors refer to General Food annual permit fee 0-12)

General Food fee plus $130.00 per vehicle

Annual permit fee

SCHOOL/YOUTH ACTIVITY CONCESSION



VENDING MACHINES

With potentially hazardous foods – risk level – Low $121.00 Annual permit fee

FOOD THERMOMETERS

a) Dial probe $9.00 Fee includes sales tax

b) Digital tip sensitive $24.00 Fee includes sales tax

FOOD WORKER CARDS

a) 2-year initial or 3-year renewal $10.00

b) Replacement for lost card $10.00

MANAGER COURSES

a) Manager Certification $175.00 Instructional and supplies fee

b) Manager Recertification $132.00 Instructional and supplies fee

c) Manager Recertification without purchasing book $79.00 Instructional fee

d) Serve Safe Certification and Test $175.00 Includes Serve Safe curriculum, book, materials, and test.

e) Manager Self-Inspection Program Establishment Fee Credit For qualified food establishments with certified managers, up to 25% of the prior year’s annual establishment permit fee will be credited to the establishment upon completion of the current year’s inspection program per SHD procedures.

PLAN REVIEWS

a) Limited Grocery $168.00 Plan review and pre-operational inspection fee

b) General Plan Review New Food Service Establishment including School and Satellite Kitchens

$630.00 Plan review and pre-operational inspection fee

c) Multiple Permit Facility $630.00 Base fee for plan review and pre-operational inspection PLUS $150.00 for each additional permitted facility plan review and pre-operational inspection

d) Food Stand Concession, Mobile Food Vehicle $420.00 Base fee for plan review and pre-operational inspection PLUS $168.00 for each additional hour over 2.5 hours.

e) Exempt from permit food establishments $40.00 As required by WAC246-215-08305. Plan review fee.

f) Site Inspection to re-open former food service establishment $168.00 Per inspection to reopen former Food Service Establishment

g) Hazard Analysis Critical Control Point Review (HACCP) $168.00 When required by WAC for menu items Plus lab fees

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Plan Review Continued

h) Plan Revision $168.00 Base fee for alteration to existing facility or revision of approved plan PLUS $168.00 per hour for each additional hour over 1 hour

i) Reactivate Plan Review $168.00 Applicable on projects idle for more than one year

REINSPECTION AND REINSTATEMENT FEES

a) Reinspection and office conference per III.B.3, Enforcement Procedures

$273.00 Reinspection and office conference fee

b) Reinspection after first preoccupancy inspection $168.00 Reinspection fee

c) Reinstatement following closure by Health Officer's Order $315.00 Reinstatement fee

d) Reinstatement fee following closure by Health Officer’s Order for an existing, immediate health hazard.

$541.00 Reinstatement fee

e) Reinspection due to uncorrected red item violation $168.00 Reinspection fee

CAMPGROUNDS / PARKS

a) Food service / all year General Food Fees

Annual permit fee

b) Food service / seasonal (3 consecutive months or less) $336.00 Annual permit fee

SCHOOLS

a) Central kitchen, no direct food service $525.00 Annual permit fee

b) Satellite kitchen with food service $336.00 Annual permit fee

c) School kitchen with food service $400.00 Annual permit fee

d) School/Youth sports food concession – Risk level low $126.00 Annual permit fee

e) School/Youth sports food concession – Risk level medium $210.00 Annual permit fee

TEMPORARY FOOD SERVICES

LATE FEE CHARGE Temporary Food Service & Mobile Food Vehicle Non-refundable fee charged if the application is not received in the

Environmental Health Division office seven (7) days before the event.

$48.00 Late charge fee

FOOD SERVICE OPERATING WITHOUT A PERMIT Applies to Food Service Establishments and Temporary Food Services

Double prescribed permit fee

a) Limited Risk Applicable to one event not to exceed 21 days

$55.00 Event permit fee

b) Low Risk Valid 1-21 consecutive days $79.00 Event permit fee

Annual / Restrictive No more than 3 days per week at same location (see WAC 246-215-011)

$200.00 Annual permit fee for first location PLUS $100.00 for each additional location

c) Farmers Market Coordinator Program Low Risk

For Farmers Markets that meet definition of RCW 66.24.170(4)(g) and coordinator partipating in monitoring program vendors will receive 25% off of the temporary services permit fee. Only applies to first location and low risk permits.

d) Medium/High Risk Valid 1 day $111.00 Event permit fee

Valid 2-3 consecutive days $163.00 Event permit fee



Annual / Restrictive No more than 3 days per week at same location (see WAC 246-215-011)

$475.00 Annual permit fee for first location PLUS $168.00 for each additional location

e) Farmers Market Coordinator Program Med/High Risk

For Farmers Markets that meet definition of RCW 66.24.170(4)(g) and coordinator partipating in monitoring program vendors will receive 25% off of the temporary services permit fee. Only applies to first location and medium/high risk permits.

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f) Food Demonstrator (Low Risk foods only)


Annual (Low Risk foods only)

No location restrictions apply $184.00 Annual permit fee

g) Judged Cook-off 1-20 entrants – not open to public $263.00 Event permit fee

1-20 entrants – open to public $578.00 Event permit fee

21-over entrants –not open to public $263.00 Event permit fee

21-over entrants – open to public $840.00 Event permit fee

h) Mobile Food Vehicle Operating with an annual permit $37.00 Event permit fee

i) Product Information Form Fee waived if submitted in conjunction with Temporary Food Services application

$40.00 Paperwork processing fee

ENVIRONMENTAL HEALTH DIVISION / Miscellaneous Fees APPEAL PROCEDURE:

a) Step One

NO FEE

b) Step Two $920.00 Fee refundable if appellant prevails in Step Two

MISCELLANEOUS PERMIT FEE:

a) The Health Officer is authorized to establish fees on an individual basis for any Environmental Health Division operations which do not precisely conform to any of the defined categories. Such fees to be determined by the Health Officer to be the closest related fee or $168.00 per hour.

b) Post emergency waiver of Clearance and Repair fees for qualified damaged structures.

RECORD RETRIEVAL

Duplicating $.15 Per page

SERVICE CHARGE $25.00 Returned check (bank service charge)

REFUND PROCESSING FEE $20.00 May be waived for a bona fide reason approved by the Director

Adopted by the Board of Health 12/09/2014 FeeScheduleFoodSafety_EH_2014_sm

food plan review application process · food plan review application process ... a copy of the...

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