Wake County Department of Environmental Services Reduced Oxygen Packaging of Raw MEAT, Raw POULTRY, Cheeses, Raw & Frozen FISH, and/or Raw Vegetables/Cook Vide Application Packet Name of Establishment: ____________________________Soup & Salad Restaurant___________ Plan Date: ____________________MM/DD/YYYY___________________________ Street Name Raleigh, NC 12345_______________________ Address of Establishment: __123 Name of Primary Contact: ____John Smith____________________________________________ Email of Primary Contact: ________________________________ Phone Number of Primary Contact: _____________919-555-5555_______________________ John Smith, Executive Chef____________________ Signature of Primary Contact: __________ HACCP Team Owner Executive Chef HACCP Manager All Managers on Duty
Wake County Department of Environmental Services Reduced Oxygen Packaging of Raw MEAT, Raw POULTRY, Cheeses, Raw & Frozen FISH, and/or Raw Vegetables/Cook Application Packet Name of Establishment: ____________________________Soup & Salad Restaurant___________ Plan Date: ____________________MM/DD/YYYY___________________________ Address of Establishment: __123 Street Name Raleigh, NC 12345_______________________ Name of Primary Contact: ____John Smith____________________________________________ Email of Primary Contact: ________________________________ Phone Number of Primary Contact: _____________919-555-5555_______________________ Signature of Primary Contact: __________ John Smith, Executive Chef____________________ HACCP Team Owner Executive Chef HACCP Manager All Managers on Duty Vide