GLYNN COUNTY FOOD SERVICE PERMIT APPLICATION
Contents
1. REFRIGERATOR CONDENSATE DRAIN LINES HOSE CONNECTION BEVERAGE DISPENSER W CARBONATOR OTHER TRAP A fitting or device which provides a liquid seal to prevent the emission of sewer gases without materially affecting the flow of sewage or waste water through it An integral trap is one that is built directly into the fixture e g a toilet fixture A P trap is a fixture trap that provides a liquid seal in the shape of the letter P Full S traps are prohibited Are floor drains provided amp easily cleanable if so indicate location Page 31 The undersigned hereby applies for a permit to operate a Food Service Establishment pursuant to the OCGA 26 2 371 373 and hereby certifies that he has received a copy of the Rules for Food Service or can obtain a copy online at http health state ga us pdfs environmental 290 5 14 pdf Chapter 290 5 14 Georgia Department of Human Resources I hereby certify that the above information is correct and I fully understand that any deviation from the above and submitted plans without prior permission from the Environmental Health office may nullify final approval Signed Signature s of Owner s or responsible representative s Date Date Date Date Title State Whether Business Owner or Authorized Agent NOTE ANY CHANGES IN THE EXISTING FOOD SERVICE ESTABLISHMENT FACILITY WILL REQUIRE THE OWNER OR AGENT2. 2 Does each refrigeration unit have a working thermometer 3 Is each refrigerator operating at 41F or colder 4 Do you have a procedure for date marking ES Air Gap i Air Break Indirect Waste Large adapters twice the diameter of smaller pipe ex 2 pipe needs 4 adapter In second illustration small pipe extends into adapter but is not sealed to it they do not physically connect PLAN CHECK GUIDE FOR RETAIL FOOD FACILITIES Glynn County Health Department Environmental Health Section 1725 Reynolds Street 105 Brunswick GA 31520 Phone 912 279 2940 fax 912 267 4879 The Plan Check Guide for Retail Food Facilities is an outline of requirements for plan preparation before submission to the Glynn County Health Department Environmental Health Section It is intended to give basic information for compliance with Georgia Food Service Rules and Regulations Chapter 290 5 14 Georgia Food Service Rules and Regulations apply throughout the state This guide only encompasses health aspects and should not be construed to encompass other agencies involved such as the local planning and zoning department local building authority or the local fire department Owners and agents should be advised to contact the appropriate local agencies involved to obtain any permits and or to clarify other local codes If you have any questions about the plan review process please contact this office at 912 279 2940 Construction Plan Appro
3. Is the hot water generator sufficient for the needs of the establishment Provide calculations for necessary hot water See Section 9 of the Food Service Manual for Design Installation and Construction for more information 84 Is there a water treatment device YES O NO oO 85 If yes how will the device be inspected amp serviced HOT WATER GENERATING EQUIPMENT For information on sizing water heating equipment see attachment A in the reference section of this application The portion of the application that is not to be returned to environmental health Page 19 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS THAWING FROZEN POTENTIALLY HAZARDOUS FOOD 86 Please indicate in the appropriate boxes how frozen potentially hazardous foods PHF s will be thawed More than one method may apply Also indicate where thawing will take place Thawing Method THICK FROZEN FOODS THIN FROZEN FOODS Refrigeration Type of food Thawing Location Type of food Thawing Location Running Water Less than 70 F 21 C Microwave as part of cooking process Cooked from Frozen state Other describe e Frozen foods approximately one inch or less thin and more than an inch thick Page 20 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS TH
4. 108 lux 10 foot candles of light Dry food and utensil storage rooms refrigeration storage toilet rooms and dressing rooms shall be provided with at least 108 lux 10 foot candles of light Light fixtures in areas where food is prepared open food is stored or utensils are cleaned shall be of shatterproof construction or protected with shatterproof shields and be readily cleanable V Ventillation 1 Provide adequate ventilation to remove gasses odors steam heat grease vapors or smoke from all rooms in the facility including food preparation toilet janitorial garbage and changing rooms consistent with the requirements of local building codes 2 Exhaust Hoods and Ducts Mechanical exhaust ventilation shall be required at or above all commercial type deep fat fryers broilers fry grills steam jacketed kettles ranges ovens barbeques rotisseries dishwashing machines and other similar equipments to effectively remove gasses odors steam heat grease vapors or smoke from the facility Usually chemical sanitizing or other under counter dishwashing machines do not require exhaust hoods Ventilation plans for each system shall include front and side elevations of the exhaust hood and duct details to the roof fans both exhaust and make up air Provide manufacturer specification sheets for exhaust fan make up air fan and hood filters Specify the number and location of make up air diffuser VI Equipment Requirement
5. TO CONTACT THE LOCAL HEALTH AUTHORITY IT IS ILLEGAL FOR FOOD SERVICE ESTABLISHMENTS TO BEGIN OPERATION WITHOUT FIRST OBTAINING A VALID FOOD SERVICE PERMIT FROM THE LOCAL HEALTH AUTHORITY Approval of these plans and specifications by the Environmental Health office does not indicate compliance with any other code law or regulation that may be required federal state or local It further does not constitute endorsement or acceptance of the completed establishment structure or equipment A pre opening inspection of the establishment with equipment in place and operational will be necessary to determine if it complies with the Food Service Rules Page 32 DO NOT RETURN WITH APPLICATION THE FOLLOWING PAGES ARE FOR PERSONAL USES AND REFERENCE Pre opening Checklist for Operators If you can Answer yes to each item you are ready for scheduling a pre opening inspection Hand washing facilities 1 Is hot and cold running water available at each handwashing sink 2 Are mixing valves combination faucets or metered faucet provided at each hand washing sink 3 Are metered faucets set for a minimum of 15 seconds 4 Are hand cleansers provided for all hand washing sinks 5 Are approved methods for drying hands provided at all hand washing sinks such as paper towels 6 Are covered waste receptacles available in unisex and women s restrooms 7 Are all toilet room doors self closing Dishwashing Facilities 1 Do all dish machines
6. have data plates with operating specifications 2 Do all dish machines have the required temperature and pressure gauges that are accurately working 3 Is your dish machine reaching 160 F at the tray level or dispensing 50ppm chlorine residual in the final rinse 4 Do you have a procedure for manual cleaning and sanitizing of fixed equipment 5 Does the three compartment sink have a drain board on each end of it Or alternatives 6 Do you have sanitizer test strips in proper range for all sanitizers used Miscellaneous 1 Are all containers of chemicals including spray bottles clearly labeled and stored away from food 2 Will dry product storage be stored 6 inches off the floor 3 Are all food containers made of food grade materials 4 Do you have a system for laundering linens or work clothes 5 Are all food preparation areas free of carpet Insect and Rodent Control 1 Are all outside doors self closing and rodent proof 2 Are screens provided for doors and windows that will be kept open to the outside 3 Are all pipes amp electrical conduit openings sealed Is the ventilation system exhaust and intake protected 4 Is the area around the building clear of unnecessary brush litter boxes and other unnecessary items 5 Do you have a location and a procedure in place for cleaning garbage cans and floor mats Is the drain plumbed to sewer Refrigeration Units 1 Are all refrigeration units operational
7. inspection Contact your Environmental Health Specialist at least 48 hours in advance to request a preliminary construction inspection prior to the installation of equipment Final Pre opening inspection Upon completion of construction including finishing work contact your Environmental Health Specialist at least 48 hours in advance to arrange for a final pre opening inspection Approved materials equipment and good workmanship are significant factors in the evaluation and final field approval of food facility construction and equipment installation Prior to opening for business or use of remodeled areas final construction must be approved IV Structural Requirements Floors Floors in food establishments shall be durable smooth and impervious to water grease and acid and of easily cleanable construction i e quarry tile of seamless epoxy pour Floor surfaces in all areas where food is prepared packaged dispensed or stored in open containers where any utensil is washed where refuse is stored where janitorial facilities are located in all toilet and hand washing areas and in employee changing and clothing storage areas shall be approved type that continues up walls at least four inches forming a 3 8 inch minimum radius cove as an integral unit Floor drains draining to an approved sewer system are required in floors that are water flushed for cleaning and or where pressure spray methods for cleaning equipment are used W
8. material curbed and sloped to a drain to be used exclusively for general cleaning purposes and for the disposal of mop bucket and other liquid waste The sink shall be located so as not to contaminate and food preparation areas food storage areas utensils or equipment The sink shall provide hot minimum 120 F and cold running water from a combination faucet or a mixing valve The mixing valve faucet shall be equipped with a backflow prevention device Dishwashing and Glass washing Machines An area should be provided for scraping utensils and equipment as circumstances require An overhead pre rinse sprayer with scupper tray sink or garbage disposal will satisfy this requirement Dishwashing machines may be connected directly to the sewer immediately downstream from a floor drain or they may be drained through an approved indirect connection Spray type dishwashing machines which are designed for a hot water bactericidal rinse shall be provided with an approved booster heater or be connected to an approved recirculating water system which is capable of maintaining the rinse water not less than 180 F These machines may require an approved type II exhaust hood Spray type dishwashing machines which are designed for a chemical bactericidal rinse shall be capable of maintaining the rinse water at a temperature in accordance with NSF listing Dishwashing machines including glass washing and under counter dishwashing machines m
9. of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS PERSON IN CHARGE 7 Who will be your Certified Food Safety Manager CFSM and what certification do they hold and when does it expire If you are any operation other than continental breakfast or serve only non potentially hazardous food 8 Are you aware of the rule that requires a knowledgeable person to be present at all times of operation Yes No Who will be your people in charge PIC PROPER USE OF RESTRICTION AND EXCLUSION 9 List symtoms and illnesses that would require you to exclude or restrict food workers LIST symptoms and illnesses 10 How are employees informed of this illness and symptom policy provide a copy of written policy Page 6 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS HANDWASHING AND HANDSINKS A handsink shall be located to allow convenient use in food preparation food dispensing and ware washing areas 11 Do you have reminder signs at all hand sinks explaining when and how to wash hands 12 List all 5 handwashing steps 1 2 3 4 oF 13 When are employees required to wash their hands list specific examples ex after going to restroom 14 How do you enforce hand washing and ill employee requirements 15 Is there a hand washing sink in each food preparation food dispensing and warew
10. 546 912 269 4373 Fire Inspector Fire Inspector u County Building Inspector City of Brunswick Building Inspector 912 554 7456 912 267 5519 912 506 1432 Building Inspection Official Building Inspection Official Environmental Health Department 912 279 2940 Environmental Health Specialist Brunswick Glynn County Joint Water amp Sewer Commission 912 261 7143 Compliance Coordinator F O G amp Backflow Inspector GLYNN COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH FOOD FACILITY PLAN REVIEW amp APPROVAL PROCEDURE Note Please ensure the zoning allows for the proposed use in the proposed location Georgia Food Service Rules and Regulations Chapter 290 5 14 requires a plan review prior to construction on all new or remodeled food facilities Plans will be reviewed within 10 working days of receipt by the Environmental Health office If plans are not approved a written notice will be sent to applicant detailing additional information needed All construction and operational aspects of your project must be completed and approved by this office prior to issuance of the health permit Below are the steps for receiving a heath permit e Obtain and review Georgia Rules and Regulations for Food Service Chapter 290 5 14 Available at http health state ga us programs envservices index asp e Submit a menu or list of foods to be prepared in the facility e Submit a list of all food sources and suppliers e Submit a set
11. ERMOMETERS 87 List the types of food probe thermometers 0 220 F range that food handlers will be using A facility is required to have thermometers for testing food temperatures This thermometer must be capable of testing thick and thin items 88 ow 90 9 92 93 94 95 List steps for how you calibrate your food probe thermometers and how often Ice point method or boiling point method Who is responsible for calibrating thermometers Where the thermometers will be kept How do you clean and sanitize your probe thermometer Do you have accurate thermometers placed in the warmest part of each cooling unit PERSONAL CLEANLINESS Are hair restraints provided for every employee working with food as required Total number of employees Have you shown the location for personal belonging storage on the plans Reminder Break area office area dressing room and personal storage areas cannot be located in areas of food and or utensil storage preparation food service or dish areas Page 21 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS SANITIZER BUCKETS AND CLOTHS 96 Will linens includes cloths used for cleaning be laundered on site YESO NOCO 97 If yes what will be laundered and where 98 If no how will linens includes cloths used for cleaning be cleaned 99 Is a laundry dryer available YES O
12. FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS 109 Are there drain boards on both ends of the pot sink required YES 0 NO O 110 If using Dish machine list Type of sanitization used Hot water temp provided Booster heater Chemical type 111 If using dish machine Is ventilation provided YES O NO O 112 Do all dish machines have templates with operating instructions YES O NO D 113 Do all dish machines have temperature pressure gauges as required that are accurately working YES O NO O 114 Do you have test kits or thermometers for testing sanitizing process in machines 115 Dishes and utensils must be air dried prior to stacking you must included adequate space for air drying Where will dishes be air dried 116 Describe how cutting boards counter tops equipment and other food contact surfaces that are too big to be submerged into sinks and too big for the dishwasher are cleaned and sanitized these surfaces are required to be washed rinsed and sanitized 117 When does cleaning and sanitizing need to occur Page 24 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS SEWAGE DISPOSAL 118 Is building connected to a municipal sewer YES ONO O 119 If no is private disposal system approved YES ONO O PENDING O Please attach copy of written approval and or permit 120 Are grease traps provided YES ONO O 121 Ifso whe
13. NO UH 100 What is the location of clean linen cleaning cloths storage 101 What is the location of dirty linen cleaning cloths storage VEGETABLE PRODUCE SINK 102 Do you have a sink for washing fresh produce as required 103 Is produce sink labeled for produce only Yes 104 Does your produce sink have an indirect drain as required Page 22 No Yes U No Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS WAREWASHING AND SANITIZING All food contact surfaces must be washed rinsed and sanitized this includes utensils equipment and preparation surfaces etc 105 How will any reusable utensils equipment or dishes be washed rinsed and sanitized as required Three compartment sink O Dishwasher O 106 Ifusing 3 compartment sink is each compartment large enough to hold the largest item required to be washed rinsed and sanitized as required YES ONO O 107 What type of sanitizer is used in three compartment sink and for sanitizer buckets OChlorine LIHot water LIIodine LIQuaternary ammonium LIOther 108 Are test papers and or kits available for checking each type of sanitizer concentration as required A At what concentration do you use this sanitizer B What type of test kit do you have C When do you use your test kit Page 23 Georgia Department of Community Health PERMIT APPLICATION
14. PPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS COLD STORAGE Refrigerated food must be maintained at 41 F or colder 49 Is adequate and approved freezer and refrigeration available to store frozen foods frozen and refrigerated foods at 41 F 5 C and below YES NO 50 Will raw meats poultry and seafood be stored in the same refrigerators and freezers with cooked ready to eat foods YES NO 51 If yes how will cross contamination be prevented 52 Does each refrigerator freezer have a thermometer YES NO 53 How will you ensure that each refrigerator has a working thermometer and that the temperature is maintained at 41 F or colder ie temperature logs etc 54 List size description manufacturer and what will be stored in each Refrigerator freezer Size capacity Manufacturer or Type of food stored Number Description inside Page 13 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS HOT HOLDING 55 Will you hot hold any food 56 What foods will be hot held soup grits gravy etc 57 What type of equipment will you use for holding food hot 58 What is the required temperature for hot holding food 59 How will you ensure that food is at the required temperature throughout the day temperature logs etc 60 Describe how food temperatures hot holding wi
15. RATIONS 3T 32 33 34 35 36 37 Georgia Department of Community Health SELF SERVICE Will you provide self service food to your customers O Yes O No N A How will you protect food in self service areas from customer contamination Are you installing a buffet or salad bar O Yes O No If yes is the buffet or salad bar mechanically refrigerated O Yes O No What will happen to food leftover from buffet N A U N A If you will be using ice for keeping food cold such as in a salad bar milk and juice at hotel breakfast buffet how should the food be stored in the ice Please describe If not using ice how will food be held cold at buffet such as salad milk and juice at hotel breakfast buffet Page 10 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS DRY FOOD STORAGE 38 Are containers constructed of safe material to store bulk food products Ie sugar flour spices etc Indicate Type of Containers Yes No UN A 39 Do containers have tight fitting lids Yes O No N A 40 Are they labeled Yes UNo UN A 41 Are they equipped with a scoop that has a handle Yes UNo UN A 42 Specify the type of shelving unit that will be provided in the following areas Dry storage Walk in freezers Walk in coolers Beer alcohol cooler Kitchen ute
16. Step Step Step Step Step GLYNN COUNTY FOOD SERVICE PERMIT APPLICATION 1 Beginning the Process Pick up an Environmental Health application and design a plan for your food facility by following the Plan Review Construction Guide Online construction guide at http health state ga us programs envservices FSPlanReviewManual asp Contact other agencies including your local Building inspection Joint Water and Sewer and the Fire Inspector for information concerning their requirements 2 Submittal of Application Plan and Fees Turn in your completed application and a copy of your plan and a full menu with consumer advisory to the Environmental Health for review Pay plan review fee Environmental Health has 10 days to review all applications and plans 3 Plan Review Process Your Plan will be reviewed by the EHS The proposed facility plan is checked according to the requirements of the Georgia Foodservice Rules and Regulations 290 5 14 New businesses and change of ownership on all facilities will be required to meet the current laws Inadequate plans may result in a delay of approval In this case a letter may be mailed to you outlining the deficiencies and or requesting additional information If any changes on the plans are desired by the facility revised plans must be submitted to Environmental Health for review and approval before construction begins 4 Construction and Pre opening Inspections Two or more in
17. all state the specific fish by species that have been frozen to meet the parasite destruction requirements 72 List your food suppliers for the following Chapter 3 Section 2 Category Suppliers Game meats e g emu ostrich elk Raw or partially cooked fish products e g lox ceviche raw oyster sushi Fresh or live shellfish Wild mushrooms 73 Will you conduct food processing within your facility smoking meats sous vide canning specialty processing If yes describe process Page 17 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS WATER SUPPLY 74 Is water supply public or private PUBLIC O PRIVATE O 75 If private has source been approved YES O NO O PENDING O Please attach copy of written approval and or permit ICE MACHINE 76 Is ice made on premises O or purchased commercially O 77 If ice is purchased who is your supplier 78 How will you provide ice needed for processes in this facility 79 If made on premise are specifications for the ice machine provided YES O NO O 80 Is an ice machine provided and indirectly drained YES O NOCO 81 Describe provision for ice scoop storage Page 18 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS HOT WATER 82 What is the capacity of the hot water generator 83
18. ar sink 25 20 Washing machine 9 12 lbs 45 45 Washing machine 16 lbs 60 60 Employee shower 20 20 Warewashing dish machine See specs See specs Other Total Peak Demand GRAND TOTAL WATER HEATER CALCULATIONS e From the manufacturer obtain the first hour output or the storage capacity of the water heater in gallons and the recovery rate in GPH at a 100 F temperature rise First hour output storage capacity X efficiency 0 7 gas 1 0 electric recovery rate 100 F e Determine the Total Available Hot Water TAHW TAHW First Hour Output Second Hour recovery 100 F rise 2 Example If you plan to use a gas water heater with a 60 gallon storage capacity and a 25 GPH recovery at 100 temperature rise the calculation would be as follows TAHW 60 gallons storage X 0 7 efficiency 25 gallons recovery 25 recovery 2 TAHW 92 gallons 2 46 gallons Note Total Available Hot Water must be equal to or greater than the Total Peak Demand indicated in the hot water usage chart above Authority Georgia Food Service Rules and Regulations DHR Chapter 290 5 14 06 1 h For office use Required Recovery Rate Total Peak Demand Storage Capacit 2 SAMPLE FLOOR PLAN unm Salad Bar En SC Too C x I g rc B Il 3 L ps4 x de a i Pet ER l PD SCALE X 1 NOTE this isnot intended as a model layout but ONLY to illustrate a procedure for submitting plans and Data
19. ashing area as required YES O NO O 16 Do all hand washing sinks including those in the restrooms have a mixing valve or combination faucet YES O NO O 17 Do self closing metering faucets provide a flow of water for at least 15 seconds without the need to reactivate the faucet YES O NO O 18 Is hand cleanser available at all hand washing sinks YES O NO O Page 7 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS HANDWASHING AND HANDSINKS 19 Are hand drying facilities paper towels air blowers etc available at all hand washing sinks YES O NO O 20 Is there a waste receptacle provided at each hand sink YES O NO O 21 Is hot at least 100 degrees and cold running water under pressure available at each hand washing sink YES O NO NO BARE HAND CONTACT 22 It is a violation to handle ready to eat food with bare hands this includes all raw produce and any foods that need no further cooking in order to be consumed Describe how you will minimize the handling of ready to eat food APPROVED SOURCES 23 Are all food supplies from inspected and approved sources YES NO List names of food source 24 What are the projected frequencies of deliveries for Frozen foods Refrigerated foods Dry goods 25 Provide information on the amount of space in cubic feet allocated for Dry storage Refrigerated Storage Frozen storage 26 How will dry go
20. ctor be used O O Number Size Frequency of pick up Contractor 132 Will garbage cans be stored outside O O 133 Describe surface and location where dumpster compactor garbage cans are to be stored 134 Describe surface and location of grease storage receptacle 135 Is there an area to store recycled containers O O Describe Indicate what materials are required to be recycled OGlass OMetal 0 Paper LICardboard OPlastic 136 Is there any area to store returnable damaged goods ie dented cans O O Page 26 PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS 137 138 Georgia Department of Community Health AND MOBILE FOOD SERVICE OPERATIONS LIGHTING Are all of your light fixtures over food preparation display service storage and utensil washing areas shielded or shatter resistant as required Yes O No Do I meet the following light intensity requirements Yes O No 1 At least 10 foot candles 108 lux at a distance of 75 cm 30 inches 30 inches 75 cm above the floor in walk in refrigeration units and dry food storage areas and in other areas and rooms during periods of cleaning 2 At least 20 foot candles 215 lux at a surface where food is provided for consumer self service such as buffets and salad bars or where fresh produce or packaged foods are sold or offered for consumption and inside equipment such as reach in and under counter refrigerators 4 At lea
21. d or prepared HACCP and Highly Susceptible Populations 65 Providing a HACCP plan is required for specialized processing methods such as vacuum packaged food items prepared on site or otherwise required by the regulatory authority Attach a copy of HACCP plan if applicable See Rule 290 5 14 02 5 page 24 and Rule 290 5 14 04 6 j page 70 and 71 of Chapter 66 Will the facility be serving food to a highly susceptible population YES NO If yes how will the temperature of foods be maintained while being transferred between the kitchen and service area CHEMICALS 67 Are chemicals cleaning products sanitizers stored separately from food and clean equipment YES O NOO 68 Indicate location 69 Are all toxics for use on the premise or for retail sale this includes personal medications stored away from food preparation and storage areas YESO NOU 70 Are all containers of toxics including sanitizing spray bottles clearly labeled YES O NOO Page 16 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS VARIANCE SPECIAL PROCESS 71 If serving raw fish sushi lox ceviche will parasite destruction be done on site or by the supplier A On site Provide your procedure on parasite destruction Explain process B Supplier Provide the name of your supplier and documentation to show parasite destruction Each invoice received from the supplier sh
22. dividual covers Refrigeration e All reach in and walk in refrigeration and freezer units shall be adequate in capacity and usage to meet the needs of the proposed operation and shall a Be specifically constructed for commercial use and shall meet of be equivalent to applicable NSF standards Domestic model refrigerators and freezers will not be accepted if they do not meet the needs of the operation b Have shelving that is nonabsorbent non corrodible easily cleanable and shall meet or be equivalent to applicable NSF standards Be provided with an accurate readily visible thermometer d Drain condensate and other liquid waste in a sanitary manner to a floor sink or other approved device by an indirect connection located outside the refrigeration and freezer units Condensate may be drained to a properly installed and functioning evaporator e e Walk in refrigeration and freezer units shall also a Be designed to be closed and sealed to the floor or be constructed integral with the floor Coved bases shall be provided at the intersection of interior floors and walls b Be Flashed or sealed to walls and or ceiling as needed to prevent rodent and vermin harborage of inaccessible areas c Have non corrodible shelving that is at least six inches above the floor and shall meet or be equivalent to applicable NSF standards Raw wood is not acceptable d Have floor drains and floor sinks located outside units 7 Sinks e Wh
23. egal Entity give names title address and phone number of persons involved including owners and officers Otherwise indicate N A Name Address City Phone Name Address City Phone Name Address City Phone Name Address City Phone USE ADDITIONAL PAPER IF NEEDED Page 1 This food service Unit will operate as part of Check Applicable Blocks L Extended Food Service Operation LI Mobile Food Service Operation Type Please check the appropriate unit location route and complete the information L Unit Locations 1 2 L Unit Routes 1 2 Attach to the permit application the following paper work from your Base of Operation s county of origin 1 Copy of Food Service Permit for the Restaurant of the Base of Operations 2 Copy of the most recent Food Service Inspection Report 3 Copy of the current county of origin approved menu I attest that the information provided above is true and accurate I agree to comply with the State of Georgia Rules and Regulations for Food Service Chapter 290 5 14 and I further understand that as specified under Rule 10 subsection 2 d 1 of this rule that the Health Authority is to be allowed access to the establishment and to the records specified under Rule 04 subsection 3 1 and Rule 06 subsection 2 q and subsection 5 d 7 of this Rule I understand that only the foods listed on the menu submitted with the establishment plans may be prepared and s
24. em if applicable Plan drawn to scale of food establishment showing location of equipment plumbing electrical services and mechanical ventilation Equipment schedule The undersigned hereby applies for a permit to operate a food service establishment pursuant to O C G A 26 2 371 373 et seq and hereby attests to the accuracy of the information provided in on the application and affirms to comply with the Rules and Regulations for Food Service Chapter 290 5 14 Georgia DHR Applicant s Name Phone Number Address Street Highway or RFD City County State Zip Code Applicants Signature Date Page 3 Type of Service Check the food service that best describes your operation Cook and Serve example hamburgers cooked on grill and served immediately Cook Hold Hot and Serve example includes hot held soup gravy etc Cook Chill Reheat Hold Hot and Serve example includes cooling and reheating of previous hot held foods Hold Cold and Serve example make cold sandwiches and salads only Commercially prepackaged food only except beverage example heat or fry comercially packaged chicken wings cheese sticks etc Continental Breakfast definition non potentially hazardous food which has been prepared commercially and is served to the customer out of the original container in which it was purchased Potentially hazardous foods such as milk cream butter and cheese only if it is served in single s
25. en a sink is installed next to a wall the integral metal backsplash shall be sealed to the wall Hot and cold water under pressure shall be provided through mixing valve to each compartment of the following sinks a Utensil sinks Where multi service kitchen utensils and eating and drinking utensils are washed a minimum three compartment stainless steel sink with dual integral stainless steel drain boards shall be provided The sink compartment shall be large enough to accommodate the largest utensil or piece of equipment to be washed and the drain boards shall be as large as the largest sink compartment b Vegetable preparation sinks Food facilities shall provide a separate sink for washing raw fruits and vegetables c Hand washing sinks Hand washing sinks shall be provided in each food preparation areas food dispensing areas and warewashing areas sufficient in number and conveniently located so as to be accessible at all times for use by food handlers Soap and single use towels or hand drying device shall be provided in permanently installed dispensers at the hand washing sinks Hand washing sinks shall be equipped to provide tempered water at a temperature of at least 100 F 38 C through a mixing valve or combination faucet d Janitorial sinks Food establishments shall be equipped with either a one compartment non porous janitorial mop sink or a slab basin or floor constructed of concrete or equivalent
26. en otherwise installed they shall be mounted or enclosed so as to facilitate cleaning i e at least two inches from wall and six inches above the floor Where conduits or pipelines enter a wall ceiling or floor the opening around the line shall be tightly sealed and made smooth Conduits or pipelines shall not be installed across any aisle traffic area or door opening Multiple runs or clusters of conduits or pipelines shall be installed within walls or encased in an approved sealed enclosure Exterior Doors and Windows All exterior doors shall be well fitted and self closing to effectively prevent the entrance of flies rodents and vermin If exterior door remains open for extended time periods then a screen door with no less than 16 mesh per square inch screening will be required All exterior which open to food preparation areas food storage areas and utensil washing areas shall be screened with no less than 16 mesh per square inch screening Pass through Windows When food is passed through a window to a customer on the outside of the building the size of the window should not exceed 432 square inches Food service pass through window openings should be equipped with a self closing screen or window or an automatic switch activated air curtain which will produce an air flow eight inches thick at the discharge opening and with an air velocity of not less than 600 FPM foot per minute across the entire opening measured at a p
27. erved in this facility Note It will be the responsibility of the permit holder to notify the Health Authority when ever there is a change in schedule or locations Name of Applicant Phone Signature of applicant Date DO NOT WRITE BELOW THIS LINE HEALTH DEPARTMENT USE ONLY DISPOSITION L Unit Permit Issued YES NO Date If Yes then permit Page 2 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS OPERATIONAL INFORMATION Hours of Operation Sun am pm Thurs am pm Mon am pm Fri am pm Tues am pm Sat am pm Wed am pm Number of Seats Number of Staff Maximum per shift Total Square Feet of Facility Number of Floors on which operations are conducted Maximum number of Meals to be served Breakfast approximate number Lunch Dinner Projected Date for Start of Project Projected Date for Completion of Project Type of Service Sit Down Meals must have public restroom check all that apply Take Out Caterer Mobile Vendor Other _ Please enclose the following documents Proposed Menu including seasonal off site and banquet menus Manufacturer Specification sheets for each piece of equipment shown on the plan Site plan showing location of business in building location of building on site including alleys streets and location of any outside equipment dumpsters well septic syst
28. erving comercially packaged original containers Likewise juices and condiments including jams jellies sugar salt and pepper may be served only in single serving commercially packaged original containers If you meet the exact definition of continental as shown here then you do not need a food service permit and will be subject to rules and regulations for Tourist Accommodations chapter 290 5 18 Please supply us with a menu of your continental breakfast to include drinks Other If your operation is anything other than continental breakfast as defined above you will need a food service permit and must complete the following application Will food be transported to another location as with a catering operation or satellite or mobile kitchen Yes No Page 4 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS FOOD PREPARATION REVIEW Check categories of Potentially Hazardous Foods PHF s to be handled prepared and served CATEGORY YES NO 1 Thin meats poultry fish eggs o O hamburger sliced meats fillets 2 Thick meats whole poultry El El roast beef whole turkey chickens hams 3 Cold processed foods p O salads sandwiches vegetables 4 Hot processed foods L1 a soups stews rice noodles gravy chowders casseroles 5 Bakery goods 0 0 pies custards cream fillings amp toppings 6 Other Page 5 Georgia Department
29. for approval
30. harge through an air gap into an open floor sink or other approved type of receptor that is properly connected to an approved sewer system The floor sink or other approved waste receptors should be located to provide adequate drainage of the equipment being served Equipment should be located within 15 feet of the waste receptor Floor sinks or other approved waste receptors shall be located so that they are readily accessible for inspection cleaning and repair Overflow from floor sinks shall be prevented from flowing into accessible areas i e storage cabinets display refrigerators etc 15 Sewage Disposal Grease Traps amp Interceptors All liquid waste including sewage generated by a food establishment shall be disposed of in an approved manner into either a public sewer system or to an approved on site sewage disposal system Note Check with local public works agencies i e Water amp Sewer Department for information or regulations regarding special sewerage grease trap and interceptor requirements 16 Lighting In every room and area in which food is prepared processed or packaged or in which utensils are cleaned sufficient natural or artificial light shall be provided to produce an intensity of not less than 215 lux 20 foot candles The work surfaces on which alcoholic beverages are prepared or where utensils used in the preparation or service of alcoholic beverages are cleaned shall be provided with at least
31. here floor drains are utilized the floor surface shall be sloped 1 5 1 4 inch per foot to floor drains Approved anti slip floor finishes or materials are acceptable in areas where necessary for safety reasons such as traffic areas Walls amp Ceilings Walls and ceilings shall be durable smooth nonabsorbent and washable i e gloss or semi gloss enamel paint epoxy paint FRP paneling stainless steel ceramic tile Walls and ceilings in food preparation and utensil washing areas and interior surfaces of walk in refrigeration units shall also be light colored must have light reflectance value of 70 or greater Exposed brick concrete block rough concrete rough plaster or textured gypsum board is not acceptable The wall behind sinks and dish tables should be covered with a durable water proof material i e FRP ceramic tile stainless steel etc extending from the top of the coved base to 12 inches above the backsplash Walls adjacent to floor mounted mop sinks should be covered with durable water proof material extending from the top of the sink to at least 48 inches above the floor Provide durable cleanable smooth non corrodible and non flammable material i e stainless steel ceramic tile etc behind the cook line and to any side walls that are adjacent or in close proximity Conduits All plumbing electrical and gas lines shall be concealed within the building structure to as great an extent as possible Wh
32. ll be maintained while in transport and at the catered site or satellite kitchen s Page 14 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS Cooling 61 Will you be cooling any foods If you do any cooking or hot holding you are likely to be doing cooling 62 In the appropriate box list food items that will be cooled Cooling Solid Food Soft Thick Food Liquid Food Method roast turkey solid refried beans rice thin broths cuts of meat potatoes stews soups sauces amp chili Shallow Pans Ice Baths Reduce Volume or Size Blast Chiller Other Describe Adequate and appropriate refrigeration is required Food preparation sink and ice machine are required PHF s must be cooled to 41 F 5 2 C within 6 hours 135 F to 70 F in 2 hours then 70 F to 41 F in 4 hours 63 How will the two stage cooling process be monitored If you are cooling the process must be monitored Page 15 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS DATE LABELING 64 Describe your procedure for date marking of ready to eat potentially hazardous food items All food prepared and potentially hazardous food removed from original packaging must have a date label Note Maximum 7 day hold after potentially hazardous items are opene
33. ls and ceilings shall have surfaces that are smooth nonabsorbent and easily cleanable Toilet tissue shall be provided in a permanently installed dispenser at each toilet Toilet rooms shall be separated from other portions of the food establishment by well fitted self closing doors that prevent passage of flies dust or odor Toilet rooms shall be vented to outside air by means of an operable screened window an air shaft or a light switch activated exhaust fan consistent with the requirements of the local building codes 12 Water An adequate protected pressurized potable supply of hot water at least 120 F and cold water shall be provided In sizing the water heater the peak hourly demands for all sinks dishwashing machines etc are added together to determine the minimum required recovery rate The water supply shall be from a water system approved by Glynn County Environmental Health 13 Backflow Protection An approved backflow prevention device shall be properly installed upstream of any potential hazard between the potable water system and a source of contamination i e all threaded water outlets mop sinks sprayers dishwashers etc 14 Indirect Waste Receptors All steam tables ice machines and bins food preparation sinks utensil washing sinks display cases and other similar equipment that discharge liquid waste shall be drained by a means of indirect waste pipes and all wastes drained by them shall disc
34. lude floor area where desks equipment ladders or other items may be placed Shelving shall meet NSF standards or the equivalent Shelving must be durable easily cleanable nonabsorbent and vermin tight The lowest shelf shall be at least six inches above the floor with clear unobstructed area below 8 Other Required Storage Facilities Adequate and suitable space shall be provided for the separate storage of clean and soiled linen A room area or cabinet separated from any food preparation or storage area or utensil washing or storage area shall be provided for the storage or all cleaning equipment supplies and poisonous substances i e mops buckets brooms cleaning compounds waxes commercial insecticides detergents bleaches or any other injurious or poisonous materials 9 Clothing Changing Rooms and Areas A room enclosure i e locker cabinet etc or designated area shall be provided where employees may change and store clothing and personal effects The room enclosure or designated area should be sized to accommodate the number of employees The room enclosure or designated area shall be separate from toilets food storage food preparation and utensil washing areas 10 Refuse Disposal Facilities Garbage and waste grease shall be disposed into adequate watertight nonabsorbent rodent proof containers with close fitting lids There shall be an area provided for the storage of these containers and facili
35. nsils Reminder All storage equipment must be 6 above the floor and all surfaces must be non absorbent smooth and easily cleanable COOKING 43 How will final cooking reheating temperatures of food products be measured 44 What type of temperature measuring device will be used 45 List types of cooking equipment Page 11 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS REHEATING 46 How will reheating cooked and cooled food to 165 F for at least 15 seconds for hot holding be done rapidly and within 2 hours CONSUMER ADVISORY 47 List food from animals that you will serve raw or partially cooked such as eggs steaks sushi steak tartar and oyster shooters 48 Explain how raw or partially cooked animal foods will be identified on menus and which consumer advisory will be used Advisory and asterisks are required if you serve items such as eggs over easy medium cooked steak etc A Consuming raw or undercooked meats poultry seafood shellfish or eggs may increase your risk of foodborne illness OR B Consuming raw or undercooked meats poultry seafood shellfish or eggs may increase your risk of foodborne illness especially if you have certain medical conditions A MENU WITH A CONSUMER ADVISORY AND ASTERISKS MUST BE PROVIDED WITH THIS APPLICATION Page 12 Georgia Department of Community Health PERMIT A
36. ods be stored off the floor Page 8 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS FOOD STORAGE 27 How will you store raw animal food to prevent contamination of ready to eat food REFRIGERATION 28 Are your walk in coolers and walk in freezers accessible from inside the establishment Yes UNo N A 29 Have you designated refrigerated space for e Cooling large quantities of food Yes O No e Marinating food product O Yes O No e Separating meat poultry fish and other food items Yes L No e Quick chilling of food O Yes No e Special events large volumes of food O Yes No 30 Refrigeration and freezer storage Note Coolers What food will be stored in Short term refrigeration reach in What food will be stored Long term refrigeration walk ins refrigerator and walk in freezer Which equipment will be have adequate space for cooling product blast chiller additional walk in cooler extra cooler space Is there a cold holding unit for the display of product Are there cold holding units for products for customer self service must maintain potentially hazardous food at 41 F of less and each must have a thermometer located so as to be visible and in the warmest part of the unit Page 9 PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPE
37. of detailed plans and list of equipment to be used If any alterations are made after review submit changes to EH for approval e The following need to be included in the plans and are requirements for equipment and physical facilities O O O Square footage and number of seats Floor plan drawn to scale 1 4 inch 1 foot showing location of all sinks coolers and other equipment Minimum 3 compartment sink hand sink vegetable sink and mop utility sink required A direct waste connection may not be used for equipment in which food or ice is placed or utensils washed Use air gap Equipment schedule Include manufacturers specification sheets and method of installation of equipment All food service equipment must meet applicable NSF standards Finish schedule specifying materials and finishes for floors bases walls ceilings shelving and cabinets All surfaces must be non absorbing and easily cleanable Identify food preparation sinks including location of indirect drains Show where raw and ready to eat food will be prepared Identify each designated hand sink This includes hand sinks in the restrooms food preparation food service and dishwashing areas Location of entrances exits loading unloading areas and docks Plumbing schedule including location of floor sinks overhead wastewater lines water heater BTU or KW and capacity grease trap or interceptor Source of water supply and method of sewage disposal indica
38. oint three feet below the air curtain Window openings must be closed when not in use Delivery and Cargo Doors All delivery doors leading to the outside shall open outward and be self closing Overhead air curtains must be provided when delivery doors must remain open for extended periods of time and when necessary to exclude insects dust dirt and fumes The air curtain when installed inside the building shall produce a downward and outward air flow not less than three inches thick at the nozzle with an air velocity of not less than 1600 FPM across the entire opening measured at a point three feet below air curtain When the air curtain is installed outside the building the same velocity of air needs to be directed straight down over the entire door opening The air curtain shall turn on automatically when the door is open An overhead air curtain is not a substitute device to permit a door to remain open Large cargo type doors shall not open directly into a food preparation area Cargo type doors that open into any food warehouse of a food facility may only be open during deliveries Dry Food and Beverage Storage Adequate and suitable space shall be provided and designated on plans for dry storage purposes This area shall be equipped with sufficient and approved shelving to accommodate anticipated needs It shall include only aisle space and floor area where shelving cabinets or other storage facilities are located It shall not inc
39. ors provided on all entrances left open to the outside as required O O 145 Do all openable windows have a minimum 16 mesh screening as required O O 146 Is the placement of electrocution devices identified on the plan O O 147 Will all pipes amp electrical conduit chases be sealed ventilation systems exhaust and intakes protected O O 148 Is area around building clear of unnecessary brush litter boxes and other harborage O O 149 Will air curtains be used If yes where O O Reminder All doors and windows must be weather rodent and insect proof and tight fitting Daylight is NOT to be observed around door Page 29 FINISH SCHEDULE Applicant must indicate which materials quarry tile stainless steel 4 plastic coved molding etc will be used in the following areas KITCHEN FLOOR COVING WALLS CEILING SHELVING QUARRY TILE QUARRY TILE PAINTED DRYWALL VINYL COATED TILES WIRE RACKS EXAMPLE Bar Food Storage Other Storage Toilet Rooms Dressing Rooms Garbage amp Refuse Storage Mop Service Basin Area Warewashing Area Walk in Refrigerators and Freezers Page 30 AIR P TRAP VACUUM CONDENSATE INTEGRAL GAP required BREAKER PUMP TRAP DISHWASHER GARBAGE GRINDER ICE MACHINES ICE STORAGE BINS MOP SINK HANDWASH 3 COMP SINK PRODUCE SINK STEAM TABLE DIPPER WELL
40. oved plans are desired revised plans shall be submitted for review and approval prior to construction All construction and equipment installation shall be subject to field inspection The food facility shall not open for business until final approval is obtained from the Glynn County Environmental Health Office and a valid food service permit is issued Call your Glynn County Environmental Health Specialist at least 48 hours in advance for inspection appointment s II Minimum Requirements for Food Facility Plans Plans shall be drawn to scale 1 4 inch 1 foot and shall include the following III l 2 m DR 10 Name and address of facility Name mailing address and telephone number of owner contractor and contact person Floor plan of entire facility Floor plan showing equipment layout including a Complete equipment list b Equipment specification sheets Plumbing layout Electrical layout Exhaust hood ventilation and make up air system design Site plan including proposed exterior waste storage receptacle location Room finish schedule for floors base coving walls and ceiling that indicates the type of material the color and surface finish for each room or area Give specific brand names and colors Samples of proposed finish material may be required Any changes to plans must be re submitted to the Glynn County Environmental Health Office Field Construction Inspections Preliminary construction
41. re If a grease trap is not required you will need a letter from Joint water and sewer stating no grease trap required Provide schedule for cleaning amp maintenance of grease trap 122 How is backflow prevention devices inspected amp serviced RESTROOMS Check with local Fire Department on handicap accessibility questions 123 Can the public access the restrooms without going through the kitchen storage area or utensil washing area Yes O No AII dine in facilities must have patron toilet facilities 124 Are the rooms mechanically vented to the outside Yes No 125 Have you provided garbage containers with lids for sanitary items and diapers As required O Yes O No 126 Are restroom doors equipped with self closers as required O Yes No Page 25 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS GARBAGE AND REFUSE DISPOSAL Reminder All containers must be easily cleanable with tight fitting lids doors covers and shall be kept covered when not in use If designed with drains plugs must be in place except during cleaning Inside YES NO 127 Do all containers have lids O O 128 Will refuse be stored inside O O If so where 129 Is there an area designated for garbage can or floor mat cleaning O O Outside 130 Will a dumpster be used O O Number Size Frequency of pickup Contractor 131 Will a compa
42. s All new and replacement food related and utensil related equipment shall meet or be equivalent to approved applicable sanitation standards All utensils display cases windows counters shelves tables refrigeration units dishwashing machines and other equipment used in the preparation sale service and display of food shall be made of nontoxic non corrodible materials and shall be constructed installed and maintained so as to be easily cleaned Equipment shall be installed so as to facilitate cleaning under and around the equipment and of all adjacent surfaces Equipment should be sealed to adjacent walls and equipment or should be spaced away from the adjacent walls and equipment at least six inches All floor mounted equipment shall be placed on NSF approved casters minimum six inch high cleanable legs or be completely sealed in position on at least four inch high continuous coved base or concrete curb Food Protection Equipment e Displays of unpackaged foods or utensils shall be shielded so as to intercept direct line between the customers mouths and the food or utensils being displayed or shall be dispensed from approved self service containers e Cafeteria buffet salad bar self service food preparation and storage areas shall be protected by approved sneeze guards Please see your Environmental Health Specialist for approved specifications e Approved self service containers shall have tight fitting in
43. s and or to clarify other local codes If you have any questions about the plan review process please contact this office at 912 279 2940 THIS PORTION OF THE APPLICATION SHOULD BE SUBMITTED WITH FLOOR PLAN AND THE PLAN REVIEW FEE YOU MUST ALSO SUBMIT A COPY OF THE MENU WITH CONSUMER ADVISORY Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS Complete in duplicate and forward the original to the County Health Department in which the facility is located Name of Facility Check Appropriate Block s Q Mobile food Service Food Service Establishment Catering Operation New Change of Owner Renovation of Existing Establishment Plans Attached Equipment List Attached Menu Attached Supporting Documentation Plan Review Checklist Food Preparation Review Construction Review Food Service Risk Categorization Risk TypeI Risk Type II Risk Type III HAACP Plan Address of Facility Ga Street Highway or RFD City County Zip Code Billing Address Phone Physical Location of Mobile Unit s if Applicable Counties in which mobile units will operate Business Owner s Name Phone Number Business Owner s Address Street Highway or RED City County State Zip Code Business Ownership Phone Individual Association Partnership Corporation or legal Entity If Association Partnership Corporation or L
44. spections may be necessary One construction inspection to ensure that installation is completed to specifications Second inspection after construction and before opening for business is required The Permit Application fee is due at the time of your final inspection before we issue your Foodservice Permit All construction should be finished equipment should be installed and functional and your pre opening checklist should be complete 5 Routine Facility Inspections After you are open for business your EHS will be making periodic unannounced inspections of your facility An operating food service facility is required to maintain a clean organized environment in good repair Employees are required to practice safe and sanitary methods of handling food at all times As a Food Service Operator you are required to know the Georgia Foodservice Rules and Regulations Glynn County Environmental Health 1725 Reynolds Street 105 Brunswick GA 31520 Phone 912 279 2940 Fax 912 267 4879 Certificate of Occupancy Signature Form All of the following departments must sign this form for the issuance of a Certificate of Occupancy Once completed please take it to In Glynn County 1725 Reynolds St Suite 3 floor Brunswick GA In the City City Hall 601 Gloucester Street 1 floor Brunswick GA Business Applicant Name Address Date Glynn County Fire Department City of Brunswick Fire Department 912 554 7533 912 554 7779 912 267 5
45. st 20 foot candles 215 lux at a distance of 30 inches 75 cm above the floor in areas used for handwashing warewashing and equipment and utensil storage and in toilet rooms 5 The light intensity shall be at least 50 foot candles 540 lux at a surface where a food service employee is working with food or working with utensils or equipment such as knives slicers grinders or saws where employee safety is a factor MOP SINK JANITORIAL SINK 139 What type of sink do you have a mop sink is required Pre fabricated floor basin Laundry Tub O Wall mounted sink 140 Have you specified a heavy duty mop rack capable of holding wet mops above the mop basin as required Yes No Page 27 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS HOOD SYSTEM YOU MUST CONTACT THE FIRE DEPARTMENT FOR APPROVAL OF HOOD SYSTEM 141 Indicate all areas where exhaust hoods are installed LOCATION SQUARE FEET FIRE PROTECTION 142 How is each listed ventilation hood system cleaned Page 28 Georgia Department of Community Health PERMIT APPLICATION FOOD SERVICE ESTABLISHMENTS AND MOBILE FOOD SERVICE OPERATIONS INSECT AND RODENT CONTROL APPLICANT Please check appropriate boxes YES NO 143 Will all outside doors be self closing and rodent proof as required O O 144 Are screen do
46. te if other than a municipal system Systems must meet state regulations Mop sink or curbed cleaning facility with facilities for hanging wet mops Location for storing chemicals Location for the storage of personal items such as dressing rooms locker areas and employee rest areas o Dish warewashing machine or 3 compartment sink including indirect drain Largest piece of equipment must be able to fit into sink or dish machine Indicate if dish machine is chemical or high temperature sanitizing o Indicate surface materials and the location of where the dumpster compactor garbage cans waste oil and recycling containers are stored e Complete the application fee schedule determination worksheet and plan review forms Return plans and completed paperwork to EH for review with applicable fees plan review and first year s permit e Contact EH office to schedule an initial construction walk through e When facility is complete schedule a final inspection All equipment hot water dishwashers stoves coolers freezers etc must be on and operational for final opening inspection Note This packet only encompasses Environmental Health requirements and should not be construed to encompass other agencies involved such as the local planning and zoning department local building authority or the local fire department Owners and agents should be advised to contact the appropriate all local agencies involved to obtain any permit
47. ties for their washing A mop sink or floor mounted janitorial sink may be sufficient to clean the food waste containers of a small food facility Structural requirements for interior refuse disposal rooms and areas a Floors shall be smooth durable grease resistant nonabsorbent coved and easily cleanable b Walls and ceilings shall be durable easily cleanable impervious to grease and moisture and capable of withstanding the expected impacts The room or enclosure shall be well ventilated d Hot and cold running water through a mixing valve protected with a backflow protection device and located so that the room or enclosure can be cleaned Structural requirements for exterior refuse disposal facilities a An outdoor storage ground surface for refuse recyclables and returnables shall be constructed of nonabsorbent material such as concrete or asphalt and shall be smooth durable and cleanable b Ifused an outdoor enclosure shall be constructed of durable and cleanable materials c Wash down facilities shall be provided with hot and cold water and a sanitary drain for liquid waste disposal The slope to the drain shall be on a 1 5 gradient slope e 11 Toilet Facilities In each food facility there shall be employee toilet facilities Toilet facilities that are provided for use by patrons shall be so situated that patrons do not pass through food preparation food storage or utensil washing areas The floors wal
48. ust have two integral stainless steel drain boards one for soiled utensils and one for clean utensils The drain boards shall be sloped and drained to an approved waste receptor Drain boards shall be large enough to adequately store all utensils above the floor at all times or additional approved shelving or racks shall be provided in the dishwashing area for this purpose A minimum of a three compartment stainless steel sink with dual integral metal drain boards is required in addition to any dishwashing machine When a dish table is installed next to a wall the integral metal backsplash shall be sealed to the wall Dipper Wells A cold running water dipper well shall be provided if scoops or reusable serving utensils are stored in water The dipper well shall be drained by means of an indirect connection Attachment A HOT WATER REQUIREMENTS AND TANK SIZING HOT WATER USAGE Specify the water heater storage capacity in gallons e Manufacturer Model Specify the water heater recovery rate in GPH __ Temp Rise in F The high gallon demand should be used when multi use eating utensils are used and low gallon demand is to be used in carry out facilities where single service items are used EQUIPMENT QUANTITY GPH GPH TOTALS HIGH LOW 4 compartment sink 80 65 3 compartment sink 60 45 Vegetable sink 15 10 Mop curb sink 20 20 Lavatory handwashing sink 5 5 Pre flush unit 45 45 B
49. val Procedures for Food Facilities A plan approval must be obtained from the Glynn County Environmental Health Office before constructing or remodeling any building for use as a food facility Remodeling of a food facility means construction building enlarging altering converting or repairing that requires a permit from the local building authority The following procedures are required to process and approve food facility plans as well as to obtain final approval to open for business l The plans must include sufficient information to demonstrate compliance with the minimum requirements of the Georgia Food Service Rules and Regulations Chapter 290 5 14 Plans must be prepared by an architect draftsman designer contractor or owner All plans must be drawn in a concise detailed and professional manner Inadequate plans will be rejected Items to be submitted to begin the plan review process a Set of detailed plans b Completed application and fee schedule c Payment of plan review fee Upon plan approval one set of approved plans must remain at the construction site until the final inspection has been made A second set of approved plans will be kept on file by the Environmental Health Office until construction has been completed Before commencing construction approvals must be obtained from the Environmental Health Office local building authority and other appropriate agencies If any changes on the appr
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