2814 RUCKER AVE 2025-04-07 - Laserfiche WebLink

Environmental Health Division 3020 Rucker Avenue, Suite 104 ■ Everett, WA 98201-3900 ■ fax: 425.339.5254 ■ tel: 425.339.5250 SNOHOMISH COUNTY400 HEALTH DEPARTMENT Tap Room / Tasting Room Questionnaire This facility is a food service establishment that does not handle any open food or conduct any food preparation including garnishes. (initials) What are the general beverages you plan to serve? ❑ Beer ❑ Wine ❑ Cider ❑ Other: Option to attach a copy of your written menu. What method will you serve the above beverages? D ❑ Glassware ❑ Disposable cups only ❑ Other: Select from the options below all proposed beverage sources: D ❑ Brewed in-house ❑ Other local breweries ❑ Purchased commercially Where will chemicals be stored? Where will employee belongings be stored? Is all equipment commercial grade, NSF certified or equivalent? ❑ yes ❑ no Is there a handwash sink(s) by your dishwashing and beverage service area that is conveniently located, HDsLO\ DFFHssLEOH directly visible and not blocked by any walls or doorways? ❑ yes ❑ no Is your handwash sink(s) at least 8"x8" and large enough to fit both hands at the same time? ❑ yes ❑ no Is there a mop/service sink conveniently located for the disposal of mop water? ❑ yes ❑ no Does your 3-compartment sink have attached, sloped drainboards and rounded edges? ❑ yes ❑ no Will any of your beverages be served from a tap system? ❑ yes ❑ no D If you answered yes, will the drip tray be removable for cleaning or plumbed indirectly? Do you intend to refill customer-owned growlers? ❑ yes ❑ no D If you answered yes, please describe the contamination-free process for doing so: Is there a permanently plumbed restroom on-site that is available to customers without needing to walk through dishwashing, storage, service, or brewing areas? ❑ yes ❑ no How will you prevent pest entry? Please list the company or service provider you will utilize for garbage removal a. Name: Phone: 17. Have you contacted the Washington State Liquor & Cannabis Board to obtain all necessary permits and licensing for this establishment? ❑ yes ❑ no ❑ not applicable (no alcohol served) 18. Have you already reached out to your local building department to apply for a plumbing permit for this establishment (Required)? ❑ Yes ❑ No 19. Is your facility currently connected to a public water supply? ❑ Yes ❑ No 20. Please indicate which type of wastewater connection is available at your facility: ❑ Public hewer 6ystem ❑ Approved 2Q sLWH Septic System