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<br /> 40 •
<br /> SNOHOMISH
<br /> HEALTH DISTRICT
<br /> QuestionnaireWWW.SNOHD.ORG & Operating Procedures
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<br /> Facility name:
<br /> Acknowledgements
<br /> 1. Have you read the Mobile Unit Requirements document?
<br /> IIYes CI No ,,,,,,,.,,,,..,,,,,,,,,,,,,,,,,„
<br /> 2. I understand all refrigerators, sinks, and food equipment must be commercial grade (National
<br /> Sanitation Foundation (NSF) standards or equivalent)?
<br /> II Yes 0 No
<br /> 3. I understand the mobile food unit must return to its approved commissary kitchen daily.
<br /> II Yes CI No
<br /> 4. Have you submitted all items from the application checklist?
<br /> Wes 0 No
<br /> 5. Have you submitted a Sales Site Agreement for each sales site where you will operate for at least 1
<br /> hour'?
<br /> N Yes 0 No
<br /> 6. Do your Food Preparation Steps include which foods you prepare in the mobile unit and which
<br /> foods you prepare in the commissary kitchen?
<br /> II Yes CI No
<br /> 7. Have you submitted interior and exterior pictures of the mobile unit?(Recommended)
<br /> *Yes 0 No
<br /> Operations
<br /> 8. Will your mobile food unit operate at a fixed sales site for 1 hour or longer? If yes, please complete
<br /> the Sales Site Agreement form for each proposed sales site.
<br /> II Yes 0 No
<br /> 9. During transport, all mechanical hot-and cold-holding equipment must run to maintain food
<br /> temperature. How are hot-and cold-holding equipment powered during transit?Please note:Some
<br /> options may require approval from Washington State Labor and Industries(L&l).
<br /> II Truck engine or battery lii Propane 0 Generator GI Other ,
<br /> 10. Where will you store the mobile unit overnight?
<br /> 6502 Evergreen Way, Suite A
<br /> Everett, WA 98203
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<br /> n '--Environmental Health Division
<br /> ;i1, .,,• Date: 08/12i2021
<br /> 3920 Rucker Avenue,Suite 104•Everett, WA 982013900• .10(423I 5254•tel 425.339.5250 Page 1
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