Form Center

By signing in or creating an account, some fields will auto-populate with your information.

Food Service Establishment Plan Review and Permit Application

  1. ccseal00
  2. Food Service Establishment Plan Review and Permit Application

    The intent of this application is to provide information in addition to the plans regarding the operational procedures of the facility. 

    The North Carolina Rules Governing the Sanitation of Food Service Establishments (15A NCAC 18A .2600) requires that plans be submitted to the local Health Department for approval prior to the construction, renovation or modification of a food service facility located in Craven County. The application must contain all supporting documents or it will not be accepted. All applicable fees must be paid at that time and fees may be paid over the phone or a check may accompany the submittal. 

    Please be aware that plans for franchised, chain, and prototypical facilities are also required to be submitted to the State of North Carolina Department of Health and Human Services, Division of Environmental Health, Plan Review Unit (phone number: 1-919-707-5684, website:

  3. Submittal Checklist:

    1. Plan Review Fee (see Fees schedule on website or call 252-636-4936) 

    2. Employee Health and Personal Hygiene Plan describing process to exclude or restrict food workers who are sick, diagnosed, been exposed to food-borne illness, or have infected cuts and lesions. 

    3. A completed Food Establishment Plan Review Application (below) 

    4. A copy of the proposed menu. Indicate which food items will be produced by specialized food processes on site and indicate any food items which will be served raw, undercooked, or not otherwise processed to eliminate pathogens AND how that will be disclosed on the sample menu 

    5. A complete set of plans, drawn to scale (no smaller than 1/4”-1’), showing the location of equipment, plumbing, and lighting/electrical services. The plans and specifications should include at least the following, but not limited to: 

    • Site plan including; dumpster location, grease storage container location, entrances and exits, loading and unloading areas. 
    • A floor plan with the location of all food service equipment with each unit clearly identified 
    • Refrigeration and hot-holding equipment 
    • Utensil wash sink, dishwasher equipment with designated soiled dishes area, designated air-drying location, and designated storage of clean dishes and utensils 
    • Food preparation sinks, labeled for usage 
    • Handwashing sinks 
    • Storage rooms, garbage rooms, toilet rooms 
    • Finish schedule for each room including floors, walls and ceilings, floor and wall joint coving 
    • Electrical layout that meets lighting requirements: 50 foot-candles at food contact surfaces, food preparation area, and food cooking area; 20 foot-candles at consumer 
    • self-service, handwashing and ware washing areas; and 10 foot-candles at walk ins and dry food storage.
    • Food and dry goods storage area; Note all items shall be stored at least 6 inches above the floor 
    • Plumbing schedule, including floor drains, floor sinks, waste water lines, hot water generating equipment (manufacturer, model and recovery rate specifications shall be submitted), grease traps and/or grease interceptor location, handwashing sinks, ware washing sinks, dump sinks for bars, prep sinks and facilities for the washing of garbage cans and mops 
    • Cabinets/shelves for storing toxic chemicals 

    6. Manufacturer specification or cut sheets for each piece of equipment shown on the plans; all food service/kitchen equipment must be commercial and meet ANSI sanitation standards 

    7. Standard procedures that ensure compliance with the NC Food Code (or state which ones are being developed). Designated clearly on the plan equipment for adequate rapid cooling, including ice baths and refrigeration, and equipment for hot-holding potentially hazardous foods 

     

    Additional planning Information can be found at: 

    NC DHHS Plan Review Guidelines 

    Food Establishment Plan Review Manual 

    https://ehs.dph.ncdhhs.gov/faf/food/planreview/docs/plan-review-for-food-establishments-guide-2016-final.pdf

  4. Type of Construction*
  5. *Revisions to Approved Plans. Provide a list of all changes to the previously approved plans. Revise application as related

  6. Name of Establishment

  7. Owner or Owner's Representative

  8. Title (owner, manager, architect, etc)

  9.  

    I certify that the information in this application is correct, and I understand that any deviation without prior approval from this Health Regulatory Office may nullify plan approval.

  10. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  11. NOTE: If food service facility is served by a septic system or a well, an inspection must be conducted by the Health Department prior to submitting this application. Please contact the Onsite Water Protection section at: 252-636-4936

  12. Sunday

  13. Monday

  14. Tuesday

  15. Wednesday

  16. Thursday

  17. Friday

  18. Saturday

  19. Breakfast

  20. Lunch

  21. Dinner

  22. Number of food deliveries per week:

  23. Number of seats:

  24. Facility total square feet

  25. Project start date of construction

  26. Projected completion date

  27. Type of food service: (Select all that apply)*
  28. Type of utensils used: *
  29. Will specialized processes be used as specified in Section 3-502.11 of the North Carolina Food Code?*
  30. If YES, indicate which processes will be used:
  31. Indicate any of the following highly susceptible populations that will be catered to or served:*
  32. Will any virtual brans be provided?*
  33. How was the volume of cold storage indicate below determined to be adequate?

  34. Reach-in cold storage (in cubic feet):

  35. Walk-in cold storage (in cubic feet):

  36. Reach-in refrigerator storage: Ft3

  37. Walk-in refrigerator storage: Ft3

  38. Reach-in freezer storage: Ft3

  39. Walk-in Freezer Storage: Ft3

  40. Number of reach-in refrigerators

  41. Number of reach-in freezers

  42. List foods that will be held cold: (Include equipment used)

  43. List foods that will be hot: (include equipment used)

  44. Cooling:

    Indicate by checking the appropriate boxes how cooked food will be cooled to 41°F (7°C) within 6 hours. 

  45. Cooling Process*

    (** Check only if rapid chill equipment such as blast chillers are provided.)

  46. if "Other" is checked indicate the type of food

  47. Thawing

    Indicate by checking the appropriate boxes how food in each category will be thawed.

  48. Thawing Process*
  49. If “Other” is checked indicate the type of food:

  50. Food Handling Procedures: (Should be provided by owner/owner’s representative)

    Explain the following with as much detail as possible. Provide descriptions of the specific areas of the kitchen and corresponding items on the plan where food will be handled.

     

    Explain the handling procedures for the following categories of food. Describe the process from receiving to service including:

    • How the food will arrive (frozen, fresh, packaged, etc.)

    • Where the food will be stored

    • Where (specific pieces of equipment with their corresponding equipment schedule numbers) and how the food will be handled (washed, cut, marinated, breaded, cooked, hot held, etc.)

    • When (time of day and frequency/day) food will be handled

  51. Provide information on the frequency of deliveries and the expected gross volume that is to be delivered each time:

  52. Where will dry good be stored?

  53. Square feet of dry storage shelf space: ft2 

  54. Finish Schedule:

    Indicate floor, wall and ceiling finishes (e.g. quarry tile, stainless steel, vinyl coated acoustic tile)

  55. Water Supply and Sewage:
  56. Water Supply*
  57. Sewer*
  58. Ice*
  59. Water Heater(s):
  60. Manufacturer and model

  61. gallons

  62. Kilowatts (kW)

  63. BTU's

  64. GPM

  65. e.g.: Three-comp sink, one comp sink, two comp sink, dish machine, can wash, hand sink, pre rinse, mop sink, prep sink.

  66. Equipment Drains:
  67. Warewashing Equipment
  68. Size of each sink compartment (inches)                   Length                       Width                      Depth

  69. What type of sanitizer will be used?*
  70. Mechanical Warewashing:*

    Will a Warewashing machine be used?

  71. Type of sanitization:
  72. Describe how cooking equipment, cutting boards, slicers, counter tops, other food contact surfaces and clean in place equipment that cannot be submerged in sinks or put through a dishwasher will be cleaned and sanitized:

  73. Describe location and type (drainboards, wall-mounted or overhead shelves, stationary or portable racks) of air-drying space:

  74. Indicate number and location of handwashing sinks:

  75. Indicate location for storing employees’ personal items (ex. coats, purses, medication, etc.):

  76. Refuse and Recycalables:*

    Will refuse be stored inside?

    Provisions for refuse disposal

    Will a contract for off-site cleaning of the dumpster/ compactor be obtained?

    Will the dumpster/compactor be cleaned at the establishment?

  77. Location and size of service(mop) sink/can wash

  78. Insect and Rodent Control*

    How is protection provided on all outside doors?

    How is protection provided on windows (including drive-thru windows) or other openings to the outer air?

  79. Indicate location of clean and dirty linen storage:                      N/A (no linen storage on site)

  80. Indicate location of poisonous and/or toxic materials (chemical, sanitizers, etc.) storage:

  81. Leave This Blank:

  82. This field is not part of the form submission.