HomeMy WebLinkAboutM_King County Health Department Permit_180219_v1FoodEstablishmentInspectionReport>FormCPublicHealth[Seattle&KingCountyTEMPERATUREOBSERVATIONSItemNumberViolationscitedinthisareamustbecorrectedwiththetimeframespecified.PREOPERATIONALINSPECTIONApprovedbyPublicIIealthSeattle&KingCounty-InspectionreportsentviaemailtoOo(AL’.Notes:1.WeonlyapproveyourapplicationforapermanentfoodserviceestablishmentfromheDepartmentofPublicHealthSeattle&KingCounty.Otherpermitsandinspectionsiiayberequiredbyotheragencies.Operatingthisestablishmentwithoutthesepermitsaninspectiomayresuitinicgwuionuyuippropriatcagcncics.02032.Aninvoicemaybesenttoyouifthetotalplanreviewactivitytimesandpreoperatioal3.Aninspectionmayoccurwithin30days.Fnnrcthntnflrmnlnvrc”hnvcnvnlitffnnHwnrkrrrnrdwithin14dvcofhire.httn:IIw’.t.iwkinmrniintv.gov/heafthservjces/health/ehs/fr---Pleasepaythereturnpreoperationalinspectionf:InpersonattheBellevueEastgateOfficewhichislocatedComments98007.OfficehoursareMondaythroughFridayfromg:0(BusinessName:Operator:PageofLAddressCityZIPEmailPhone:-C‘-ASiZt.J1()GeneralHealthRecordIDP/EDateTimeInOfficeTimeActivityTimeTravelTimePR_____6i$m:m:mmPointsService128EScheduled129EReturn126EFIdP1Rvw130EComplaint133EIllnessIlnj.134EPermitlnv.136EFieldEduc.127Pre-0perat10LHACCPL_____.14-..inspectionwentbeyondthebasetime(2,3,or4hours).Pleasepaythisbillwithin34-kkI4-,,.f1,Tk-..,l,ESatisfactEUnsatisfact,Complete04DlncompleteE_____Adaysto04ESuspend07ElApproved1oEDisapprv’d26EFol/upRqd00EN/ALOApprovedwithconditions(refertothe________TIApprovalispendingatthistime(refertotheinspectionTIFollow-upreturninspectionrequired(refertotheins________Notes:Areturninspectionfeeof$430÷S215/hourafter2emailedandthereturninspectionfeemustbepaidpriortcSR7405829.Basedonaninspectionthisday,theaboveitemsareviolations,whichmustbecorrectedinthetimespecifiedbythehealthofficer.Afoodestablishmentpermitmaybesuspendedwithoutwarning,noticeorhearingiftherequirementsofthefoodcodeand/ordirectivesofthehealthofficerarenotmetorifviolationsarenotcorrectedinthetimestatedinthisreport.Thepermitwillbesuspendedifanimminenthazardexistsorthereare90ormoreredcriticalpointsorifthereare120ormoretotalpoints.Thehealthofficerwillprovideanopportunityforanappealonthevalidityofasuspensionorthefindingsofaninspectionreportifawrittenrequestisfiledwiththehealthofficerwithinten(10)daysofthesuspensionorinspection.Thefilingofanappealdoesnotstaytheeffectivenessofasuspension.ThecompletedinspectionformisapublicdocumentthatmustbemadeavailabletoanypersonwhorequestsitundertheprovisionofthePublicDisclosureAct(42.17.260RCW)._______________PersoninCharge-—.(Signature)(PrintedName)1—t\-’i’•k0RegulatoryAuthority(Signature)-(PrintedName)TotalPointsPH-0078-3(Rev.7/14)