Agenda Packet_2025-10-21 - Laserfiche WebLink

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Floor Sinks With Cooking Equipment Type Location Qty / Qty Missing Screens Floor Sinks With Wok(s) Cooking Area ______/_____ Floor Sinks With Kettle(s) Cooking Area ______/_____ Floor Sinks With Other Cooking Area ______/_____ Cooking Equipment Floor Drains and Other Floor Sinks Type Location Qty / Qty Missing Screens Common Drains Food Prep/Rinse/Dish-wash Area ______/_____ Common Drains Cooking Area ______/_____ Floor Sinks without Equip Food Prep/Rinse/Dish-wash Area ______/_____ Floor Sinks without Equip Cooking Area ______/_____ Floor Sinks without Equip Other Areas ______/_____ X. Grease Removal Devices Grease Interceptor Yes No If not, is there space available? Yes No Interceptor Shared with (FSEs):__________________________________________________ Distance from kitchen area _______________________________________________ Location______________________________________________________________ Manufacturer __________________________________________________________ Model ________________________________________________________________ Size (Gallons) _________________________________ Estimated Documented Dimensions (Inches): Length _____ Width _____ Fluid Depth _____ Access Depth (grade to interceptor base) _____ Date Installed __________Number of Lids (Excluding Sample Box Lid) 1 2 3 4 Sample Box Yes No Baffle Tees Checked Yes No Pumper Name _____________________________________________ Pumping Frequency Monthly Quarterly Semi-Annually Annually Other_______ Grease Trap Yes No If not, is there space available? Yes No Passive Automatic Fixtures Connected _________________________________________ Location_______________________________________________________________ Manufacturer _____________________Model ________________________________________ Size (Gallons) ________________________________________________________ Dimensions (Inches): Length___________ Width ____________ Fluid Depth___________ Date Installed __________________________________________________________ Baffle Tees Checked Yes No Baffle Tees Screened Yes No Pumping Frequency Weekly Semi- month Monthly Quarterly Semi-Annually Other___________ Serviced by Employee Yes No If Yes, how is grease disposed? Brown Grease Barrel Yellow Grease Barrel Trash Other___________________ XII. Closing Requests Request a copy of the facility menu, inspection logs, training logs, and manifests. Request a copy of the water bill if available, ideally from the months of January or February, to determine water usage. Interviewee Information Primary Language English Spanish Chinese Japanese Vietnamese Other ______ Perceived Language Comprehension Fluent Partial Unsure How successful was the communication with the Interviewee? (1-10) ____________________ Page 4 of 4 City Council43910/21/2025