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43. 'es El No Will any fish or seafood be served raw or undercooked? If yes, list: <br /> 44. VYes ❑ No ❑ N/A If fish or seafood will be served raw or undercooked, is proper parasite <br /> destruction documentation submitted? <br /> 45. ❑ Yes 'No Will any menu items include wild mushrooms? If yes, the wild mushroom questionnaire <br /> must be completed. <br /> 46. ❑ Yes 12/No Will any food be smoked as a method of food preservation rather than flavor <br /> enhancement? (Used to preserve or change a food so it no longer requires refrigeration) If yes,you <br /> must submit the food preparation steps for all the smoked foods along with laboratory documentation of <br /> shelf stability for each food item. <br /> 47. ❑ Yes GVICIo Will any food be cured? If yes, the food preparation steps for all the cured foods must be <br /> submitted. <br /> 48. ❑ Yes 2/No Will any food additives be used to preserve or change a food so it no longer needs to be <br /> refrigerated? If yes, the food preparation steps for all these foods along with laboratory documentation of <br /> shelf stability must be submitted for each food item. <br /> 49. ❑ Yes "No Will a display tank be used for molluscan shellfish, such as oysters or clams? If yes, <br /> submit additional information as noted in the Molluscan Shellfish Tank questionnaire. <br /> 50. ❑ Yes 'iNo Will custom processing of animals be offered for a customer's personal use as food (i.e. <br /> deer) and not for sale or service in a food establishment? If yes, submit the food preparation steps <br /> including how custom processed foods will be kept separated from all other foods during receiving, <br /> processing, storage and handling. <br /> 51. ❑ Yes Et/No Will any food be grown specifically for sale or service in the food establishment such as <br /> sprouts? If yes, the growing and food preparation steps for all these food items must be submitted. <br /> 52.° Yes ❑ No Will any food be vacuum packaged or reduced oxygen packaged? If yes, submit <br /> additional information as noted in the Vacuum Packaging-Reduced Oxygen Packaging questionnaire. <br /> 53. ❑ Yes Colo Will any food be cook-chill or sous vide ? If yes, submit additional information as noted in <br /> the cook-chill or sous vide questionnaire. <br /> If you answered yes to questions 44-51, include the proper food preparation process descriptions and <br /> variance request. <br /> Environmental Health Division /1 <br /> 3020 Rucker Avenue,Suite 104 ■ Everett, WA 98201-3900 ■ fax:425.339.5254 ■ tel: 425.339.5250 <br />