Plan Review Information

Average number of meals to be served daily

Number of deliveries per week

Amount of space (in cubic feet) allocated for dry storage shelving

Amount of space (in cubic feet) allocated for refrigerated storage shelving

Amount of space (in cubic feet) allocated for frozen storage shelving

Location of hot water heater

Capacity

Is the hot water heater shared with another establishment?
Yes
No

Mechanical Dishwashing Type

Mechanical Dishwashing Make

Mechanical Dishwashing Model

Type of sanitizers to be used

Three/Four compartment sink (Enter Length, Width & Depth)

Will largest utensil fit into each compartment of the sink?
Yes
No

Type of sanitizers to be used

Is storage facility available for employees' personal belongings?
Yes
No

Will linens be laundered on site?
Yes
No

If NO, how and where will the linens be cleaned?

Name of refuse company

Frequency of pickup

Is proposed menu (including seasonal, off-site and banquet menus) available to submit?

Is a diagram of the establishment drawn to scale showing equipment, plumbing, electrical, and mechanical services (architectural plans or hand sketches are acceptable)?

Is the equipment schedule (list of equipment including model and specifications) available?

Is the Site Plan showing location of food establishment, outside equipment, dumpsters, and grease receptacles available?

Does it indicate which finish materials will be used in each area for floors, walls, and ceilings?

Provide HACCP plan for the following specialized processing methods (select all that apply):

Reduced Oxygent Packaging/Vacuum Packaging

Use additives to render a food non-potentially hazardous

Curing and smoking for preservation

Molluscan shellfish tanks

Other specialized processing

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Proposed Menu
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Diagram of Establishment
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Equipment Schedule
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Site Plan
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Materials Used in Each Area
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Reduced Oxygent Packaging/Vacuum Packaging
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Molluscan shellfish tanks
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