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Home My WebLink Aboutplan-check-questionnaireALAMEDA COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH PLAN REVIEW QUESTIONNAIRE FOR FOOD ESTABLISHMENTS 1.What type of food establishment will this be? _______________________________________ Describe: ___________________________________________________________________ 2.Name of Business: ____________________________________________________________ 3.Address of Business: ___________________________________________________________ 4.Will there be a Cannabis Manufacturing facility? ____________________________________ 5.Will there be a Hood System (additional fees required per system)? ______________________ a.How many Hood Systems? _______________________________________________ 6.Will there be any handling of unpackaged foods or drinks? ____________________________ a.Portioning, cutting, dispensing, etc.? ________________________________________ b.Cooking? ______________________________________________________________ c.Deep fat frying? ________________________________________________________ d.Charbroiling or barbecue? _________________________________________________ 7.Will there be a Salad Bar or other self-service foods? _________________________________ 8.Will there be any Catering? _____________________________ If so, submit a Catering SOP 9.Does any of the food items prepared require a HACCP or ROP? ________________________ 10.Will there be a Shellfish Tank (oysters, clams, etc.)? _________________________________ 11.Will there be a tank for Finfish or Crustaceans? _____________________________________ 12.On-site eating or drinking? ________________Exclusively Take-out? ___________________ 13.Will multi-use eating & drinking utensils be used? ________Single Service Utensils? _______ 14.Will you have a Dishwashing Machine? ___________________________________________ a.If so, will it be high temperature or chemical (low temperature)? __________________ 15.Will sinks be used for washing produce, thawing of foods, or other food preparation? _______ 16.Is there a Pick-up Area for third party delivery services or to go customers? _______________ 17.Number of employees on site? ___________________________________________________ 18.What is the total square footage of floor space? _____________________________________ 19.What is the seating capacity? ____________________________________________________ 20.Will alcoholic beverages be served on the premises? _________________________________ 21.Is the proposed location zoned for the proposed use? _________________________________ 22.Is the facility on a Septic System? __________Is the facility using Well Water? ____________ 23.Is this a new construction or a remodel? ____________________________________________ 24.If a remodel: a.Will this be a change in type of operation? ____________________________________ b.Name and type of previous business _________________________________________ c.What changes will be made? (size, equipment, facilities, etc.) ____________________ Describe: ______________________________________________________________ 25.If new construction: a.New building? __________________________________________________________ b.Name and type of business there now? _______________________________________ c.The building is how many stories high? ______________________________________ d.Is there a basement? _____________________________________________________ If yes, how will it be used? ________________________________________________ 26.Is the building part of a shopping mall or center? ____________________________________ 27.Are there any common or shared facilities? If so, specify (restrooms, storerooms, garbage area, others) ____________________________________________________________________________ 28.Business owner’s name: ________________________________________________________ Business owner’s phone number: __________________email: _________________________ Business owner’s address: ______________________________________________________ 29.Property owner’s name: ________________________________________________________ Property owner’s phone number: __________________email: __________________________ Property owner’s address: _______________________________________________________ 30.Architect’s name: _____________________________________________________________ Architect’s phone number: _______________________email: __________________________ 31.Contractor’s name: ____________________________________________________________ Contractor’s phone number: ______________________email: _________________________ 32.Provide a copy of the proposed menu. 33.Provide a copy of menu of the existing food establishment.