HomeMy WebLinkAbout20260519_PJA26-0257_Commissary Agreement SNOHOMISH
COUNTY444'
HEALTH DEPARTMENT Commissary Agreement
❑ 1 own both the business requiring and the business providing commissary services.
® This agreement between the commissary owner and the vendor signifies that both parties agree to the vendor's
access to and use of the services identified below The Snohomish County Health Department will not recognize any
transfer of this agreement to food service facilities or persons not specifically identified in this agreement
Food Service Establishment requiring commissary support to qualify for a permit to operate
Name of Establishment: Gutsy Lantz Enterprises, LLC DBA: She's Got Bowls
owner of
Establishment; Susan Jensen
Mailing address: 2522 Rucker Ave. Apt. 403, Everett,WA 98201
Phone number(s): 425.232,9538
Email address: shesgotbowls@gmaii.com
Business days&hours: Service Times Vary
The following services will be provided by the commissary:
Approved water supply(if yes,attacks ®Yes ❑ No Handwashing sink 91 Yes ❑No
water/sewer form to application)
Approved wastewater disposal(if yes, ®Yes ❑ No Food preparation sink for vegetables I ® Yes ❑No
attach water/sewer form to application
Garbage disposal El Yes ❑ No Food preparation sink for raw meats ®Yes ❑No
Dry Storage for food and single service ❑Yes ❑ No Approved 3-compartment sink ® Yes ❑No
Refrigeration space 6 cubic feet ®Yes ❑ No Approved restroom V Yes ( ❑No
Freezer space 6 cubic feet ®Yes ❑ No Entrance key for after hours access 91 Yes ❑ No
Ice in pounds per day lbs. ❑Yes ® No Power Supply ,Q Yes ❑No
Fryer Oil Disposal ❑Yes ® No Walk-in Refrigerator/Blast Chiller El Yes ❑ No
Commissary sewage system $]water/sewer form attached
Commissary water system ]water/sewer form attached
Is this commissary connected to a ❑Yes ®No
septic system?
Is a grease trap required by sewer W Ves ❑No
district or building department?
Environmental Health Division 7.30.24rt
3020 Rucker Avenue,Suite 104 ■ Everett,WA 98201-3900 0 fox:425.339.5254 ■ tel;425.339.5250
f SNOHOMISH
COUNTY
tt& HEALTH DEPARTMENT
Commissary Agreement
I verify the it nnation provided in this agreement is accurate and w
Food e are responsible to comply with the Washington
State Code(WAC246-215)and will allow access for inspection during business hours for either business,
Commissary name:
5 Rights Brewing Company
Commissary address:
1514 3rd Street, Marysville, WA 98270
Business hours:
Tues 4-9PM, Wed-_Friday 2=9 PM, Saturday Noon-9PM, Sunday Noon-BPM Commissary owner's name: Robert Whitlow — — — —
Commissary phone: - — —
425.334,1026
Robert Whitlow
Printed Name of commissary Owner 12/11/2025
Signatur of commissary owner Daft
Susan Jensen
�i 111 ei Nar»e olFood Service Estabrishment owner 1211 1 f 2025
Signature of moo ervice Establishment Owner
Daft
FOR MOBILE FOOT]UNITS
Washington State Retail Food Code Requirement(WAC 246-215-09126.4): The PERSON IN CHARGE shall
document presence at the COMMISSARY on a log, maintain records for one year, and shall make the records available
for inspection by the REGULATORY AUTHORITY upon request.
Please read through the following statements and Initial to indicate your agreement:
f, the mobile food unit operator, acknowledge that I will be required to maintain logs detailing when l
visit my commissary, how often, and for how long.
1, the mobile food unit operator, acknowledge that I will main
tain the logs for a minimum of 1 year.
AN(K I h_ , the mobile food unit operator, acknowledge that the commissary logs may only be filled out and
stored ON-BOARD the mobile food unit.
Environmental Health Division
3020 RuckerAvenue, Suite 104■ Everett, WA 98201-3900 ■fax:425.339,5254 0 tel:425,339,5250