EmailMe Form - Environmental Health

State Requirements
Title 15A NCAC (North Carolina Administrative Code) 18A .2600 "Rules Governing The Sanitation of Food Service Establishments" specifies in Section .2670 "General Requirements For Pushcarts and Mobile Food Units" that: "(f) [Pushcarts and mobile food units] shall operate in conjunction with a permitted restaurant and shall report at least daily to the restaurant for supplies, cleaning, and servicing." Title 15A NCAC 18A .2672 "Specific Requirements For Mobile Food Units" further states "(g) A servicing operation area must be established at a restaurant for the mobile food unit. Potable water servicing equipment shall be installed, stored, and handled in a way that protects the water and equipment from contamination. The mobile food unit's sewage storage tank shall be thoroughly flushed and drained during servicing operation. All sewage shall be discharged to an approved sewage disposal system."
Name of Establishment Making Request
Individual Making Request
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Title of Individual Making Request
Primary Address of Establishment

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I have read the regulations listed above and hereby authorize:
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Doing Business As:
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To operate a pushcart/mobile food unit in conjunction with my facility. I understand the applicable regulations require the unit report daily to my restaurant for supplies, cleaning, and servicing, including replenishing of any on-board water supply and disposal of all solid and liquid wastes. I agree to allow all supplies for the unit to be stored on my premises and understand that the Rowan County Health Department does not permit supplies for such facilities to be stored in any private residence. I understand that any sanitation deficiencies resulting at my restaurant, even if directly or indirectly related to the operation of the pushcart/mobile food unit, will be reflected in the sanitation grade of my restaurant. This agreement shall remain in effect as long as I am the restaurant owner/operator, unless rescinded by notifying the pushcart/mobile food unit owner and the Environmental Health Division of the Rowan County Health Department in writing. I agree to notify both parties in writing should this approval be rescinded.
Signature of Owner & Date
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Restaurant Owner Operator's Phone Number
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Signature of Push Cart/Mobile Food Unit Operator & Date
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Push Cart/Mobile Unit Operator Phone Number
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