20120306160651356.pdfIra Surjadiputra
5822 200" St SW #A
Lynnwood, WA 98036 ,.
'oo a 17
Subject: Proposed Waroeng Jajanan, 1° Hwy 99 Suite I, Edmonds
Dear Ira Surjadiputra:
Environmental Health Division
RECEIVED
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Your revised plans received January 30, 2012 have been reviewed with the Rules and Regulations of
the State Board of Health, and with the policies of the Snohomish Health District. With the addition of
the following conditions, the plans are approved.
1. The conditional approval of the plans for Waroeng Jajanan was based upon the plans
submitted January 19, 2012 and the menu and HACCP submitted January 12, 2012. Any
changes to the plans submitted January 19; 2012 and the menu and HACCP submitted
January 12, 2012 will void this approval.
2. The menu for this establishment consists of prepackaged food items only. No food
preparation and or repackaging of food items are allowed.
3. The Health District operating permit application process must be completed prior to opening for
business. This facility will be classified as a low risk food establishment with 0-12 seats.
4. No mop sink is indicated on the floor plan. A mop sink is required. The location must be approved
prior to installation.
5. Hot water must be available to all handwash sinks within 15 seconds. The hot water for the facility
must not be used, at any plumbing fixture, for a minimum of 6 hours prior to the preoperational
inspection. This is required so that proper testing of the, 1 5-second time requirement for hot water
availability can be completed.
6. All food service equipment, both new and used, must be listed by the National Sanitation Foundation
(NSF) or equivalent for its intended use. Used and new refrigeration must be capable of holding food
at temperature of 41 °F or below.
7. All food service equipment must be listed by the National Sanitation Foundation (NSF) or equivalent
for its intended use. The Avanti freezer model CF211 G was not found in the current NSF or
equivalent listings. This equipment must be replaced with NSF or equivalent listed equipment or
documentation must be submitted which demonstrates NSF equivalency. Manufacturer names and
model numbers for replacement equipment or equipment documentation must be submitted prior to
the request for a preoperational inspection. Originally submitted manufacturer names and model
numbers should be rechecked to assure the information submitted is accurate.
8. Extra wall protection is required on walls behind all sinks, including restroorn handwash sinks. A 16-
inch high backspiash of plastic laminate, fiberglass -reinforced plastic or equal is acceptable. A
backsplash higher than 16 inches is required on the wall behind counter top equipment taller than 16
3020 Rucker Avenue, Suite 104 0 Everett, WA 98201-3900 M tel: 425.339.5250 M fax: 425.339.5254
Subject: Proposed Waroeng Jajanan, Z3-34'5" Hwy 99 Suite I, Edmonds
February 3, 2012
Page 2
inches. Wall protection behind mop sinks must cover the entire splash zone. Plastic coated
hardboard is not acceptable.
9. All floors in the establishment must be surfaced with a durable, nonabsorbent, easily cleanable
material. Expansion joints, seams, saw cuts and the like in concrete floors in all areas, including
customer seating areas, must be filled and sealed so as to provide a smooth and cleanable surface.
10. The ceilings must be non -perforated, nonabsorbent, smooth and easily cleanable.
11. Cabinet shelving must be nonabsorbent, smooth and easily cleanable. (Self stick vinyl or other type
surfaces are not acceptable)
12. All light fixtures in the storage areas must be provided with covers and shatterproof bulbs.
13. The ventilation system shall be installed and operated to meet applicable building, mechanical, and
fire codes.
14. Plumbing must meet state and local codes.
A preoperational inspection is required prior to operating permit issuance and approval to open
for business. At the time of inspection the construction of the food service establishment must be
complete and all equipment must be in place and in proper operating condition. Incomplete construction
or equipment operation will result in a $168.00 re -inspection fee. Requests for a preoperational
inspection must be received at least one week in advance of the date being requested for the
inspection. Contact the Food Program office a minimum of one week in advance to schedule an
appointment for the preoperational inspection. The preoperational inspection will ensure
compliance with the Rules and Regulations of the State Board of Health for Food Service Sanitation.
Changesor • to the approved plans or equipment pre -approval
Snohomish Health District prior to implementation of the changes.
Please contact me if you have any questions. My office number is 425.339,5250 and my email address
is rhoppa ,shd.snohomish.wa.gov.
Sincerely,_-,
R'obert-Hopp`a, RS'
Environmental HeO Specialist
Food EstablishmeOt Plan Review
f7NI
Enclosure: Food Establishment Operating Permit Application and Fee Schedule
cc City of Edmonds Building Department,
Brent French, RS, Environmental Health Specialist