HomeMy WebLinkAboutMiscellaneous - 585 CHICKERING ROAD 4/30/2018 585 CRICKMOG RD
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Copy
North Andover Health Department
Community Development Division
September 25, 2014
Shadi's Restaurant
Michel Asmar, Owner
585 Chickering Road
North Andover, MA 01845
Re: Approval of application for a food prep area
Dear Mr. Asmar,
This correspondence is in response to your application for the addition of a food preparation
room,to be constructed in a current storage area, within the existing food establishment known
as Shadi's Restaurant. The application has been approved at this time. Please call the Health
Department if you have any questions on the procedure described on our expectations going
forward. We would be happy to assist you with any issues that come up during construction.
Thank you in advance for your cooperation in this matter.
Looking forward towards pre-opening of the kitchen prep area; prior to receiving your approval
to operate in this area, you will likely have two Health Department inspections; a construction
inspection and a final food inspection.
When all equipment and structural elements are in lace a construction inspection should be
place, P
requested. Please call, a few days ahead to avoid delays. At that time a complete punch list will
be provided. Once completed,please call the Health Department again for re-inspection. The
Health Inspector will instruct you on the next step in the process and you will discuss together
when you may begin bringing in food and when food preparation may begin.
To avoid common pitfalls review the following;
All lighting over food prep, service and wash areas must be non- breakable.No unprotected glass
can be over food areas. Also, any ceiling areas over food or food prep areas must be washable,
exposed pipes free of dust and dirt and all high wash floor areas should have a curved base
coving along the walls.
Page 1 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
i
cl7,edi's Restaurant September 25, 2014
r I
As this is construction in an open food operation, please take care to conceal any dust or dirt in
the area of construction and avoid having it enter the operating area.
I
Sinw.ely,
Z/r'r
`� Susan , •"HS/RS
Public ealth Director
Cc: file
Page 2 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
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RECEIVED
Food Establishment SEP 25 2014
TOWN OF NORI"H ANDOVER
Plan Review Guide HEALTH DEPARTMENT
FOOD ESTABLISHMENT PLAN REVIEW APPLICATION IS TO BE COMPLETED BY
THE OPERATOR AND SUBMITTED TO THE REGULATORY AUTHORITY—at least 60
days in advance before commencement of any food establishment planned openings.
TOWN OF NORTH ANDOVER, MA
Regulatory Authority
1600 Osgood Street, Suite 2035,North Andover, MA 01845
Dater � 2Q�LF
9 4�
NEW -New construction,not yet built 9
REMODEL -partial or major renovation of existing establishment e,3 F
CONVERSION—exist a tab .lishment that you are purchasing '
Name of Establishm�t: A ; a f 14 Q LA4} `�'
Corporate Name:_ flo 1�� �--
Category: Restaurant, Institution ,Daycare , Retail Market , Other
Establishment Address: <S z��f'
Phone: (at location if available) A 76 — 6g�-- c,75519
E-mail Contacts:
Name of Owner:
Mailing Address: 59) .S C�k e_k l g mk.7- a4ifjo
Telephone: q �} •- � q 0
Applicant's Name (if different than owner): /UtS-�S Ao4 j f 0#J
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 1 of 19
Title (owner, manager, architect, etc.):
Mailing Address:
Telephone:
Date Received: BOH office use only
Date Review completed: BOH office use only: Approved/Denied
Date Revised application Received: BOH office use only
Date Review completed: BOH office use only: Appr/eceived
Technical Assistance with the Permitting Process
The Town Planning Department offers the option of attical Review Committee (TRC)meeting
to all applicants. As the applicant, I acknowledge that I an explanation and understand that the
purpose of the TRC meeting is it to assist me in the varesses needed to open my establishment.
If declined I understand that I have forfeited this opporore about the North Andover permitting
process.
I wish to attend or decline(circle one)participation in the TRC process. Date of TRC (BOH only)
General Information
Hours of Operation: Sun Thurs
Mon Fri
Tues Sat
Wed
➢ Number of Seats for customers:
➢ Number of Staff:
(Maximum per shift)
➢ Total Square Feet of Facility:
➢ Number of Floors on which
operations are conducted
➢ Maximum Daily Meals to be Served: ➢ Breakfast
(approximate number) ➢ Lunch
➢ Dinner
Town of North Andover,Health Department, 1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 2 of 19
Type of Service: Sit Down Meals
(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 system - if applicable)
Plan drawn to scale of food establishment showing location of equipment,plumbing, electrical services
and mechanical ventilation
Equipment schedule
CONTENTS AND FORMAT OF PLANS AND SPECIFIATIONS
1. Provide plans that are a minimum of 11 x 14 inches in si including the layout of the floor plan accurately
drawn to a minimum scale of 1/4 inch= 1 foot. This is to low for ease in reading plans.
2. Include: proposed menu, seating capacity, and project d daily meal volume for food service operations.
3. Show the location of each piece of equipment. Each must be clearly labeled on the plan with its common
name. Each unit must be sequentially numbered and the numbers must correspond to the equipment
specification sheets and an equipment schedule. All self-service hot and cold holding units must have sneeze
guards.
5. Label and locate separate food preparation sinks when the menu dictates to preclude contamination and
cross-contamination of raw and ready-to-eat foods.
6. Clearly designate adequate hand washing lavatories for each toilet fixture and in the immediate area of food
preparation, cooking and ware washing. (a hand sink should be located within 10 feet of each area for easy
access for all food handlers)
7. Provide the room size, aisle space, space between and behind equipment and the placement of the equipment
on the floor plan.
8. On the plan, represent auxiliary areas such as storage rooms, garbage rooms, toilets,basements and/or cellars
used for storage or food preparation. Show all features of these rooms.
9. Include and provide specifications for:
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 3 of 19
a. Entrances, exits, loading/unloading areas and docks;
b. Complete finish schedules for each room including floors,walls, ceilings and coved juncture bases;
c. Plumbing schedule including location of floor drains, floor sinks,water supply lines, overhead waste-water
lines, hot water generating equipment with capacity and recovery rate, backflow prevention, and wastewater
line connections;
d. Lighting schedule with protectors;
(1)At least 110 lux(10 foot candles) at a distance of 75 cm (30 inches) 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 220 lux (20 foot candles):
(a)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;
(b)Inside equipment such as reach-in and under-counter refrigerators;
(c)At a distance of 75 cm (30 inches) above the floor in areas used for hand washing, ware washing, and
equipment and utensil storage, and in toilet rooms; and
(3)At least 540 lux (50 foot candles) at a surface where a food employee is working with food or working with
utensils or equipment such as knives, slicers, grinders, or saws where employee safety is a factor.
e. Food Equipment schedule to include make and model numbers and/listing of equipment that is certified or
classified for sanitation by an ANSI accredited certification program (when applicable).
7
f. Source of water supply and method of sewage disposal. Provide,/the location of these facilities and submit
evidence that state and local regulations are complied with;
g. A mop sink or curbed cleaning facility with facilities for hanging wet mops;
h. Garbage can washing area/facility;
i. Cabinets for storing toxic chemicals;
j. Dressing rooms, locker areas, employee rest areas, and/or coat rack as required;
k. Site plan(plot plan for new construction)
PLEASE CIRCLE/ANSWER THE FOLLOWING QUESTIONS
FOOD PREPARATION REVIEW
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 4 of 19
Check categories of Potentially Hazardous Foods (PHF's)to be handled,prepared and served.
CATEGORY* (YES) (NO)
1. Thin meats,poultry, fish, eggs (hamburger; sliced meats; fillets) ( ) ( )
2. Thick meats, whole poultry(roast beef, whole turkey, chickens,hams) ( ) ( )
3. Cold processed foods (salads, sandwiches, vegetables) ( ) ( )
4. Hot processed foods (soups, stews, rice/noodles, gravy, chowders, casseroles) ( ) ( )
5. Bakery goods (pies, custards, cream fillings &toppings) ( ) ( )
6. Other
FOOD SUPPLIES:
1. Are all food supplies from inspected and approved sources? YES/Fzen
2. What are the projected frequencies (daily, weekly, etc) of deliveries fofoods ,
Refrigerated foods , and Dry goods
3. Provide information on the amount of space (in cubic feet) allocate, for:
Dry storage ,
Refrigerated Storage , and
Frozen storage
4. How will dry goods be stored off the floor?
COLD STORAGE:
1. 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 /
2. Will raw meats,poultry and seafood be stored in the same refrigerators and freezers with cooked/ready-to-
eat foods?YES/NO
If yes,how will cross-contamination be prevented?
3. Does each refrigerator/freezer have a thermometer? YES/NO
Number of refrigeration units:
Number of freezer units:
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 5 of 19
4. Is there a bulk ice machine available? YES /NO Is ice packaged and sold for retail? YES/NO
THAWING FROZEN POTENTIALLY HAZARDOUS FOOD:
Please indicate by checking the appropriate boxes how frozen potentially hazardous foods (PHF's) in each
Hca—tegoorry—will be thawed. More than one method may apply. Also, indicate where thawing will take place.
[Food Thawing Method *Thick or Bulk Frozen XThin/Portioned Frozen
Refrigeration
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Running Water Less than
70°F(2I-C)
Microwave (as part of cooking
process)
Cooked from Frozen state
^Other(describe) 1 i
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*Frozen foods: approximately one inch or less =thin, and more than an inch=thick.
PREPARATION:
1. Please list categories of foods prepared more than 12 hours in advance of service.
2. Will food employees be trained in good food sanitation practices? YES/NO
Method of training:
Number(s) of employees:
Dates of completion:
3. Will disposable gloves and/or utensils and/or food grade paper be used to prevent handling of ready-to-eat
foods? YES/NO
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 6 of 19
4. Is there a written policy to exclude or restrict food workers who are sick or have infected cuts and lesions?
YES-/NO Please describe briefly:
Will employees have paid sick leave? YES/NO
5. How will cooking equipment, cutting boards, counter tops and other food contact surfaces which cannot be
submerged in sinks or put through a dishwasher be sanitized?
Chemical Type:
Concentration:
Test Kit: YES/NO
6. Will ingredients for cold ready-to-eat foods such as tuna,maonnaise and eggs for salads and sandwiches be
pre-chilled before being mixed and/or assembled?YES/NO
If not,how will ready-to-eat foods be cooled to 41'F?
7. Will all produce be washed on-site prior to use? YES/NO
Is there a planned location used for washing produce? YES /NO
Describe
If not, describe the procedure for cleaning and sanitizing multiple use sinks between uses.
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 7 of 19
8. Describe the procedure used for minimizing the length of time PHF's will be kept in the temperature danger
zone (41 T - 140T) during preparation.
9. Where raw meats,poultry and seafood are prepared in the same work area or using the same equipment as
cooled/ready to eat foods, how will cross contamination be prevented?
10. Please list all PHF's you plan to serve which will/may not be cooked to the previously listed minimum
temperatures. A proper"consumer advisory"warning notation must be printed on menu or menu boards.
11. Provide a HACCP plan for specialized processing me/opulation?
ch as vacuum packaged food items prepared
on-site or otherwise required by the regulatory authority.
12. Will the facility be serving food to a highly susceptiblYES /NO
If yes, List measures taken to comply with code requirem
COOKING:
1. Will food product thermometers be used to mea ure final cooking/reheating temperatures of PHF's?
YES /NO What type of temperature measuring evice:
Minimum cooking time and temperatures of product utilizing convection and conduction heating equipment:
➢ beef roasts
➢ 130°F(121
min)
➢ solid seafood pieces ➢ 145°F(15 sec)
➢ other PHF's ➢ 145°F(15 sec)
➢ eggs:
■ Immediate service 145°F(15 sec) pooled* 155°F(15 sec)
(*pasteurized eggs must be served to a highly susceptible population)
➢ pork ➢ 145°F(15 sec)
➢ comminuted meats/fish ➢ 155°F(15 sec)
➢ poultry ➢ 165°F(15 sec)
➢ reheated PHF's ➢ 165°F(15 sec)
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 8 of 19
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2. List types of cooking equipment.
HOT/COLD HOLDING:
1. How will hot PHF's be maintained at 1407 (60°C) or above during holding for service? Indicate type and
number of hot holding units.
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2. How will cold PHF's be maintained at 417 (5°C) or below during hdlding for service?Indicate type and
number of cold holding units.
COOLING:
Please indicate by checking the appropriate boxes how PHF's will be cooled to 41°F (5°C)within 6 hours
(140°F to 70°F in 2 hours and 70°F to 417 in 4 hours).I
Iso, indicate where the cooling will take place.
COOLING THICK THIN MEAT THIN SOUPS/ THICK RICE/
METHOD MEATS GRAVY SOUPS/ NOODLES
j GRAVY
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Shallow Pans
f
j Ice Baths
Reduce
Volume or Size
Rapid Chill i
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Other(describe)
i
Town of North Andover,Health Department, 1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 9 of 19
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REHEATING:
1. How will PHF's that are cooked, cooled, and reheated for hot holding be reheated so that all parts of the food
reach a temperature of at least 1657 for 15 seconds. Indicate type and number of units used for reheating foods.
2. How will reheating food to 165°F for hot holding be done rapidly and within 2 hours?
A. FI ISH SCHEDULE
erials selected must be durable and appropriate to the area and its intended use. High moisture and food
splash areas must be non-absorbent, smooth and easily cleanable.All openings must be tight fitting,properly
sealed and without voids. Applicant must indicate which materials (i.e. quarry tile, stainless steel, 4"plastic
coved molding, etc.)will be used in the following areas. (please be specific)
Kitchen FLOOR COVING WALLS CEILING
FI —
Bar
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Food Storage �"� ,-` - � x / �,
,b . 1/�p V
V I N E
Oth Storage
Toilet Roo s
Dressing Qoms
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9S40--Fax:978.688.8476 Page 10 of 19
Kitchen
T
I
Garbage & `
Refuse Stor e
Mop Service
Basin Area
Ware washing
AA
Area %
Walk-in
Refrigerate s d
Freezers
B. INSECT &RODENT CONTROL
APPLICANT-PLEASE CHECKAPPROPRIATE BOXES.
YES NO N/A
1. Will all outside doors be self-closing and rodent proof?
2. Are screen doors pro.Vided on all entrances left open to the outside?
3. Do all operable indows have a minimum#16 mesh screening?
4. Is the place ent of electrocution devices identified on the plan?
5. Will all ipes & electrical conduit chases be sealed; ventilation systems
exha t anal intakes protected?
6. Is Orea around building clear of unnecessary brush, litter, boxes and other
harborage?
7. Will air curtains be used? If yes,where?
8. Do you have a plan to have a contract pest control company? If yes, list
company name, describe frequency of inspection and type of service.
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 11 of 19
C. GARBAGE AND REFUSE
INSIDE YES NO N/A
9. Do all containers have lids?
10. Will refuse be stored inside? If so,where?
11. Is there an area designated for a garbage can or floor mat cleaning?
OUTSIDE
12. Will a dumpster be used? Number: Size of:
a. Number:
b. Size of:
c. Frequency of Pick-Up?Indicate days and how often
13. Will a compactor be used?
Number:
Size:
Frequency of Pick-Up
14. Will garbage cans be stored outside?
15. Describe surface and location where dumpster/compactor/garbage cans are to
be stored.
16. Describe location of grease storage receptacle
17. Is there an area to store recycled containers?
18. Is there any area to store returnable, damaged goods?
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 12 of 19
D. PLUMBING CONNECTIONS
The FDA Food code and plumbing requirements do not replace or supersede the MA State Plumbing Code,
which also must be fully met; instead, it highlights potential hazardous circumstances and particular types of
equipment common to food service operations that, if through improper design or installation, could result in
contamination of food or water supply. Please indicate proposed properly installed equipment.
Equipment Code Confirmed Describe/Comments
Requirements by
Operator
please
initial
Dish Machine Backflow prevention
device
Indirect Waste
Steam Jacketed Backflow prevention
Kettle device
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Indirect Waste
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Steamer Backflow prevention
device
Indirect Waste
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Garbage Disposals Backflow prevention
or dish table device
troughs;
jSubmerged inlets
At all hose Backflow prevention
connections device
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Garbage can Backflow prevention
washer device
Carbonated Carbonated Backflow
beverage prevention device
dispenser
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 13 of 19
Refrigerator Indirect Waste ` s
condensate/drain
lines
Ice storage bins Indirect Waste
All inks Air Gap ��
Ice Cream dipper Air Gap
wells
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p
Other
19. Are floor drains provided&easily cleanable, if so, indicate location:
E. WATER SUPPLY
20. Is water supply public( ) or private ( )?
21. If private, has source been approved? YES ( )NO ( )PENDING( )
Please attach copy of written approval and/or permit.
22. Is ice made on premises ( )or purchased commercially( )?
If made on premise, are specifications for the ice machine provided?YES ( )NO ( )
Describe provision for ice scoop storage:
Provide location of ice maker or bagging operation
23. What is the capacity of the hot water generator?
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 14 of 19
24. Is the hot water generator sufficient for the needs of the establishment?Provide calculations for necessary
hot water
25. Is there a water treatment device? YES ( )NO ( )
If yes,how will the device be inspected & serviced?
26. How is backflow prevention devices inspected& serviced?
F. SEWAGE DISPOSAL
27. Is building connected to a municipal sewer? YES ( )NO ( )
28. If no, is private disposal system approved? YES ( )NO ( )PENDING( )
Please attach copy of written approval and/or permit.
29. Are grease traps provided? YES ( )NO ( )
If so -where?
Note: Grease Traps must have the following sign. The language in bold is specific; please do not change it in any
way. If you have one or more interior grease traps please note the plumbing code 248 CMR 10.09(m):
1. A laminated sign shall be stenciled on or in the immediate area of the grease trap or interceptor in letters
one-inch high.The sign shall state the following in exact language:
IMPORTANT The grease trap/interceptor shall be inspected and thoroughly cleaned on a regular and frequent
basis. Failure to do so could result in damage to the piping system,and the municipal or private drainage
system(s).
G.DRESSING ROOMS
30. Are dressing rooms provided? YES ( )NO ( )
31. Describe storage facilities for employees'personal belongings (i.e.,purse, coats,boots, umbrellas, etc.)
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 15 of 19
H. GENERAL
32. Are insecticides/rodenticides stored separately from cleaning& sanitizing agents? YES ( )NO ( )
Indicate location:
33.Are all toxics for use on the premise or for retail sale(this includes personal medications), stored away from
food preparation and storage areas? YES ( )NO ( )
34. Are all containers of toxics including sanitizing spray bottles clearly labeled? YES ( )NO ( )
Note: Material Safety Data Sheets (MSDS) are required to be kept for all chemicals on the premises. Where
will the MSDS information be kept on display for easy access in an emergency?
35. Will linens be laundered on site? YES ( )NO ( )
If yes,what will be laundered and where?
If no, how will linens be cleaned?
36. Is a laundry dryer available? YES ( )NO ( )
37. Location of clean linen storage:
38. Location of dirty linen storage:
39.Are containers constructed of safe materials to store bulk food products?YES ( )NO ( )
Indicate type:
40. Indicate all areas where exhaust hoods are installed:
LOCATION FILTERS WOR SQUARE FEET FIRE AIR CAPACITY AIR MAKEUP
EXTRACTION PROTECTION CFM CFM
DEVICES
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Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 16 of 19
41. How is each ventilation hood system that is listed cleaned?
I. SINKS
42. Is a mop sink present? YES ( )NO ( )
If no,please describe facility for cleaning of mops and other equipment:
43. If the menu dictates, is a food preparation sink present? YES ( )NO ( ) detail answer
J. DISHWASHING FACILITIES
44. Will sinks or a dishwasher be used for ware washing?
Dishwasher( )
Two compartment sink( )
Three compartment sink( )
45. Dishwasher
Type of sanitization used:
Hot water(temp.provided)
Booster heater
Chemical type
Is ventilation provided?YES ( )NO ( )
46. Do all dish machines have templates with operating instructions? YES ( )NO ( )
47. Do dish machines have temperature/pressure gauges as required that are accurate? YES ( )NO ( )
48. Does the largest pot and pan fit into each compartment of the pot sink?YES ( )NO ( )
If no,what is the procedure for manual cleaning and sanitizing?
49.Are there drain boards on both ends of the pot sink?
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 17 of 19
1
YES ( )NO ( )
50. What type of sanitizer is used?
❑Chlorine
❑Iodine
❑Quaternary
ammonium
❑Hot Water
❑Other
51. Are test papers and/or kits available for checking sanitizer concentration?YES ( )NO ( )
K. HANDWASHING/TOILET FACILITIES
52. Is there a hand washing sink in each food preparation, cooking and ware washing area? YES ( )NO ( )
53.Do all hand washing sinks, including those in the restrooms,have a mixing valve or combination faucet?
YES ( )NO ( )
54. Do self-closing metering faucets provide a flow of water for at least 15 seconds without the need to
reactivate the faucet? YES ( )NO ( )
55. Is hand cleanser available at all hand washing sinks? YES ( )NO ( )
56. Are hand drying facilities (paper towels, air blowers, etc.)at all hand washing sinks? YES ( )NO ( )
57. Are covered waste receptacles available in each restroom? YES ( )NO ( )
58. Is hot and cold running water under pressure available at each hand washing sink? YES ( )NO ( )
59.Are all toilet room doors self-closing? YES ( )NO ( )
60.Are all toilet rooms equipped with adequate ventilation? YES ( )NO ( )
61.Are hand washing signs and instructions posted in each employee restroom?YES ( )NO ( )
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 18 of 19
L. SMALL EQUIPMENT REQUIREMENTS
62. Please specify the number, location, and types of each of the following proposed for on site use:
Slicers
Cutting boards
Can openers
Mixers
Floor mats
Other
X%XX�FXX�ClfX�7F
STATEMENT: I hereby certify that the above information is correct,and I fully understand that any
deviation from the above without prior permission from this Health Regulatory Office may nullify final
approval.
Signature (s)
Print:
Owner(s) or responsible representative (s)
Date:
X�C X�CXX�CX�CXX)C
Approval of these plans and specifications by this Regulatory Authority 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).
f the establishment
A reconstruction inspection with equipment in lace and a preopening inspection0
P PP
will be necessary to determine if it complies with the local and state laws governing food service
establishments.
Page Last Updated: 1/29/2013
Town of North Andover,Health Department,1600 Osgood Street,Suite 2035,
North Andover,MA 01845--Phone:978.688.9540--Fax:978.688.8476 Page 19 of 19
HAND SINKS
WALL MOUNT HAND SINKS
MODEL: PROJECT: ITEM#: QTY:
PRODUCT IMAGES STANDARD FEATURES
° Fabrication
HS-9 HS-2 HS-4 20 gauge stainless steel.All seams tig welded and polished
° Bowl
F- _ ►�_ Deep drawn with stamped rim to prevent spillage
° Wall Mounting Bracket
Offset design for added strength
7�14F
° Faucet
4"on center wall mount faucet included on most models
° Drain
11 Stainless Steel
° Drain with Overflow
Stainless Steel with plastic overflow tube and inlet
13 Plumbing
HS-5 HS-6 HS-7
�/2"IPS hot and cold water.1 '/2"IPS drain outlet.Install at 36"
working height.'/z"faucet supply 12"from floor.1 '/z"drain line
i 23'/4"from floor.(3 1/2"IPS drain on Model HS-20)
Low Lead Compliance
-' Low Lead Compliant faucet options are available to meet
California AB-1953 and Vermont S152 standards
(jJ r
OPTIONAL ACCESSORIES
HS-8 HS-10 HS-20 ° H-100 Chrome Plated 1 1/2"IPS P-Trap
-, __----------- ° H-101 Deck Mount Soap Dispenser
° H-102 Upgrade:Low Lead Wrist Handle Faucet
-- _ ° H-103 Wrist Handle Kit
H-104 Wall Mount Soap Dispenser
° H-105 Wall Mount Towel Dispenser
Al ° H-106 One Side Splash(Specify Side)
H-107 Two Side Splashes
' ° H-108 Stainless Steel Skirt
° H-109 Upgrade:Low Lead Royal Series Faucet
° H-110 Side Support Brackets
° H-111 Soap&Towel Dispenser
° H-200 Upgrade: Low Lead Commercial Series Faucet
APPROVED BY:
CERTIFICATIONS: Due to our commitment to continued product improvement,specifications are subject to change without notice.
Printed in the USA Krowne Metal Corporation Rev.1/2013
100 Haul Rd.Wayne,NJ 07470 • Toll Free:(800)631-0442 • Fax:(973)872-1129 No.2.1
sales@krowne.com 9 www.krowne.com • www.facebook.com/KrowneMetal • www.twifter.com/KrowneMetal
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HAND SINKS
!MALL MOUNT HAND SINKS
MODEL: PROJECT: ITEM#: QTY:
WALL MOUNT HAND S K- S
HS-9 —y HS-2 HS-4
�72•. I ,Z lbs.
1 i--1a'1 14 lbs. i—14--.� 14 lbs.
z•'
16114"� ��_ - 2- �-�.4 - 1'..
17" 1113!4' *D 15" 10.
I-9-94"_I
�A_� �
1 g•' T' 1
1.. `p 10 $" 18•�(2"
i
0
14 1 2.. 14- •• 2..
5 I �•• c �-
&510•• �,-vz i?s -6-Sf8" 8-5!8'- ~,arz iP, &518..
HS-5 HS-6 HS-7
ts" 15 lbs. —16^
—14''" 11 lbs.E3-4 I
�16 --+
2•• 2.. 15,
75" 1 .
4" 6518" � 9
" 8" 16112 �O.0 17,
23'
-6516'• 12'
6518" �&516"
HS-8 HS-10 HS-20
16"
I--14••� 35 lbs. 19 lbs.
,4'
2" _7_ �-
15" t0.. l 5. 8.5'
1 L 15' :
4-114"
1
�1111-
�8.5' 8.5'
24 �—
�!1 g
14" 10 �'• 18.5�2 fVJ/i i�
1 11
6.: 20' 6' 1 6- T
12' ti ::: i
8-518•• IJ
65!6"
.;. aw •�•E�s,y„s��e APPROVED BY:
CERTIFICATIONS: Due to our commitment to continued product improvement,specifications are subject to change without notice.
Printed in the USA Krowne Metal Corporation Rev.1/2013
100 Haul Rd.Wayne,NJ 07470 • Toll Free:(800)631-0442 • Fax:(973)872-1129 No.2.1
sales@krowne.com • www.krowne.com • www.facebook.com/KrowneMetal • www.twifter.com/KrowneMetal
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Item#:
SINKS
fliniE (;OMiPAR MEN t ONE DFRAINBOARD Qty#:
0 0
Model#:
Project#:
SINK FE(iTURES: SINK OPTIONS:
Full,/fabrirnfe.f h—d fnr the fidl mefal fhirknnec th—n hn t fho hrn•d_ DA06RAn1 InIT CCDIGC
_. .. - . ... - _... -- -:..`-:zl.._-....- .-
and greater durability than a dray n sink • 14 Gauge type 30A 4tainless steel
• 12"bowl depth
9"high backsplash,with 2"return to wall at 45 dcgrc,,....;t`c cy;n •Stairl!cz;3 s cci!cg':;_C.-3331m.:13
stailation tile edging •NSF listed
2 ii2 iilg;I. iiiv ubgi&8 sa1'liiaqi01;ej+iili ai ,I;flee edges STANDARD SERIES
• 16 gauge type 304 stainless steel
Leg assemblies located directly under the sink bowls for greater load • 12"bowl depth
suppoi, •GG1 c d
•NSF listed
Legs are 1 5/8"diameter tubing with adjustable bullet feet
ECONOMY SERiES
All corners are coved at 5/8"radius,welded and polished to form a • 18 gauge 304 tubs
one-piece sanitary unit - 12"bowl depth
•Galvanized legs(stainless steel available)
!! '^'- ^` ^~ drains and 1"faucet holes NSF listed
punched in backsplash on 8"centers as required
Sulks((ilill dfai ^rte'.` 3C nx.,u aaucitl.^.na!:Cy ....=.
each drain board fad" sir :;y:;,
UIIVICIVJIVIVS HAHAMOUNT S I'ANDARD ECONOMY
7187
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43
385/8
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!; DIMENSIONS ARE TYPICAL(TOL.+!-1/2")
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RJ-1-1818-24 L or R 16 16 45 '112 Z4 I 24+ 1 b lie ivies 0,5 le i i!+ ivies
{ RJ-1-1818-30 L or R 18 18 51 1/2 24 30 8 1/9 N/A. 39 12 1/4 NIA
R 24 RQ 1/2 qO 1 R R 1/2 KI/A 27 15 1/4 N/A
J-I-162'-L4 L or R 18 24 45 1!2 30
r124 81/2 N/A 33 151/4 N/A
RJ-1-1824-30 L or R 18 24 51 1/2 30 30 81/2 N/A 39 151/4 N/A
RJ-1-2020-20 L or R 20 20 43 ?/2 26 20 .91/2 N/Q 1/a
RJ-1-2020-24 L UI k ZVLV 4/ It/ Zb Z4 `J 1/Z IV/N 34 13 1/'+ N/M I
RJ-1-2020-30 L or R 20 20 53 1/2 26 30 9 1/2 N/A 40 13 1/4 N/A
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i R,i-i-2028-24 L or R 20 28 47 V2 34 24 91/2 N/A 34 171/4 N/A
E RJ-1-2028-30 L or R20 28 531/2 34 30 9 1/2 N/A 40 171/4 N/A
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RJ-1-2424-36 L or R 24 24 631/2 30 36 11 1/2 N/A 48 151/4 N/A
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'.j-i G'+✓v3V L Or 24 3u 57 i i2 so 3u i i i i2 NIA 42 181/4 N/A
RJ-1-2430-36 L or R 24 30 631/2 36 36 11 1/2 N/A 48 181/4 N/A 1
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RJ Fabricators reserves the right to progressively alter our
product specifications to iair;lai,, ;:r ."iu-q;.a;i .
1121 Railroad St. Corona, CA 92882 800-993-4835 Toll Free wv.—,.r;fab.com
