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SNOHOMISH <br />HEALTH <br />DISTRICT <br />October 19, 2010 <br />ENVIRONMENTAL HEALTH DIVISION <br />3020 Rucker Avenue. Suite 104 <br />Everett, WA 98201-3900 <br />425.339.5250 FAX:425.339.5254 <br />Deaf/Hard of Hearing: 425.339.5252 (TTY) <br />OCT i 2010 <br />Patrick Me Evoy CITY OF EVERETT <br />PO Box 28400 Erig: n=cringlPa', : SLivirer. <br />Bellingham, WA 98228 <br />Subject: Proposed, Remodel and opening of Forest Park Chevron, 4101 Rucker Ave., Everett <br />Dear Mr. Me Evoy: <br />Your plans received October 13, 2010 have been reviewed with the Rules and Regulations of the State Board <br />of Health, and with the policies of the Snohomish Health District. Willi the addition of the following <br />conditions, the plans are approved. <br />1. The I lealth District operating permit application process must be completed prior to opening for business. <br />'['his facility will be a low risk grocery and a medium risk deli with no scats. A change of ownership fee is <br />required to obtain these permits. <br />2. A reduced pressure backflow prevention device is required at the end of the copper water pipe serving the <br />pop dispensing system prior to the carbonation device. No copper pipe or other potentially corrosive <br />material is allowed after the reduced pressure back0ow prevention device. <br />A Preoperational inspection is required prior to operating permit issuance and approval to open for <br />business. At the time of inspection the construction of the food service establishment must be complete and all <br />cquipntcnl must be in place and in proper operating condition. Incomplete construction or equipment operation <br />will result in a SI60.00 rcinspcction fec. Requests for a preoperational inspection must be received at [east <br />one week in advance of the date being requested fur the inspection. Contact the Food Program office a <br />minimum of one week in advance to schedule :in appointment for the preoperational inspection. [lie <br />preoperational inspection will ensure compli;u cc +ith the Rules and Rct ulations of the State Board of Health <br />for Food Scrvicc Sanitation. <br />Changes or additions to the approved plans or equipment require prc-approval from the Snohomish Health <br />District prior to implementation of the changes. Change or additions to the approved plans without Health <br />District approval will void this conditional approval. <br />Please note that failure to schedule a preoperational inspection prior to opening for business or rcopcmng for <br />business following a remodel may result in enforcement action. <br />)'lease contact me if you have any questions. My office number is 425.339.5250 and my email address is <br />igILkens[alshd.snohom ish.wa.eov. <br />Sincerely, <br />Jlhin Sipkcns, R.S., REHS. REHP <br />Environmental Health Specialist 11 <br />Food Service Plan Review <br />JS/snt <br />Enclosure: Permit application and current fee schedule <br />cc: City of Everett Building Department <br />