REV 1/2019

Michigan
Department
Pages 9-23 ask structural and equipment questions that the operator may wish to
have the contractor or architect assist in completing.

of Agriculture
Refer to the Fixed Food Establishment Plan Review Manual for technical assistance in
completing this worksheet. This manual is available from your reviewing agency or by
visiting; http://www.michigan.gov/mdard/0,4610,7-125-50772_50775_51203---,00.html

and Rural
It is important to complete this document in its entirety. Sections that are left blank may
cause delays in the plan review of your food establishment. If a section is not pertinent to
your operations, writing in NA for not applicable in that section would suffice.

Development

Food Manager Knowledge

Under the Food Law of 2000, as amended, food establishments are REQUIRED to have a
person in charge (PIC) during all hours of operation and at least one active managerial employee that
has completed and obtained a Certified Food Manager (CFM) certificate under a program accredited
by American National Standards Institute (ANSI). A list of ANSI accredited programs can be found at:
https://www.ansi.org/Accreditation/credentialing/personnel-certification/food-protection-manager/
ALLdirectoryListing?menuID=8&prgID=8&statusID=4

A designated person in charge shall demonstrate knowledge of foodborne disease prevention,

application of food safety, (HACCP) principles, and the requirements of the Food Code.
Please check all that apply:
Certified Food Manager's (CFM) Certificate submitted: YES NO

Employee currently in or signed up for CFM class: YES NO

If yes, submit invoice for class.

Menu
It is REQUIRED to provide a full menu including all beverages or minimally a list of foods offered.
The menu does not have to be the final print version; this will be requested later. It is suggested that
a “proof” copy of the menu be submitted for approval prior to final printing. Additionally, it should be
noted if the establishment will host guest chefs or “popup” restaurants that may serve food items not
listed on the menu.

The customer must be informed by means of a consumer advisory that a menu item contains raw or
undercooked foods of animal origin. A guidance document on providing a consumer advisory can be
found at: http://www.michigan.gov/documents/mda/MDA_FCConsAdvisMay08_245934_7.pdf

Menu submitted: YES NO

Establishment will host guest chefs or “popup” restaurants: YES NO
Menu items contain raw or undercooked animal-based foods: YES NO
If YES, the menu contains a consumer advisory: YES NO

SOP’s and HACCP

It is REQUIRED to provide a full set of Standard Operating Procedures (SOP’s). A SOP manual can
be accessed at: http://www.michigan.gov/mdard/0,4610,7-125-50772_50775_51203---,00.html . SOPs should
be specific to your menu, food processes, and equipment.

Standard Operating Procedures (SOP’s) submitted: YES NO

Hazard Analysis and Critical Control Points (HACCP) plan is a written document that outlines the
formal procedure for specialized food processes such as smoking food for preservation, curing,
reduced oxygen packaging, fermentation, and/or packaging raw unpasteurized juice (FDA Food Code
3-404.11, 3-502.11, 3-502.12, 3-801.11). Products produced for wholesale under the Code of
Federal Regulations, may also require specific HACCP plans under these regulations. Please
consult your regulatory agency if you plan to wholesale products (i.e. sell to another retail or food
service operation).

Facility performing a specialized food process:

Reduced Oxygen Packaging (ROP) ☐ YES ☐ NO

(e.g. vacuum packaging, cook-chill, sous vide, canning, bottling)
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 TCS to non-TCS with additives ☐ YES ☐ NO
(e.g. pickling, fermentation, acidification)
Custom processing animals ☐ YES ☐ NO
Sprouting seeds ☐ YES ☐ NO
(e.g. mung beans, alfalfa, lentils)
Smoking for preservation ☐ YES ☐ NO
(e.g. beef jerky)
Packaging juice ☐ YES ☐ NO
Curing ☐ YES ☐ NO
(e.g. nitrates/nitrites- DQ 10, prague powder, curing salt)
Live molluscan shellfish tank ☐ YES ☐ NO

If YES, variance application submitted: ☐ YES ☐ NO

https://michiganfoodsafety.com/variance.html

If YES, HACCP plan submitted: ☐ YES ☐ NO

Facility making products to wholesale: ☐ YES ☐ NO

**Submission of a variance application and/or HACCP plan, during the plan review process,
does not mean the submitted variance application and/or HACCP plan is automatically
approved. Further review of your submitted variance application and/or HACCP plan by the
regulatory authority will be conducted and communicated with you.

**If you wish to conduct any of these specialized food processes in the future, approval must
be granted by the Detroit Health Department prior to beginning any special food process.

Food Preparation Review

(See Fixed Food Establishment Plan Review Manual Parts 1 and 3)

1. How will time/temperature control for safety (TCS) food be thawed? List food items that apply.

Thawing Method Food less than 1” thick Food more than 1” thick

Refrigeration

Running water (less than 70ºF)

Microwave as part of cooking

process

Cook from frozen

Other (please describe):

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2. Cooking and reheating TCS foods: List all cooking or reheating equipment and mark all
applicable boxes for the listed equipment.

Equipment Name Cooking Reheating New Used NSF Certified or

Equivalent
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐

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3. Hot and cold holding of TCS food: List all hot or cold holding equipment and mark all applicable
boxes for listed equipment.

Equipment Name Hot Hold Cold Hold New Used NSF Certified or
Equivalent
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐
4. Will ice be used as a refrigerant for TCS food? YES NO

If YES, list the types of foods involved. Ensure this process is described within your standard
operating procedures.

Click or tap here to enter text.

5. Will time as a public health control be used instead of hot or cold holding? YES NO

If YES, list the types of foods involved. As a reminder, a standard operating procedure must
be submitted for this process.

Click or tap here to enter text.

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6
 6. Cooling TCS food: List foods that will be cooled using each of the following methods. Hot TCS
foods must be cooled from 135ºF to 70ºF in 2 hours or less and within a total of 6 hours from
135ºF to 41ºF or less. If prepared from room temperature or pre-chilled ingredients (i.e. tuna
salad) then the foods must be cooled from 70ºF to 41ºF within 4 hours.

Cooling Method Food Items

Shallow pans Click or tap here to enter text.
under refrigeration

Ice bath Click or tap here to enter text.

Volume Reduction Click or tap here to enter text.

(e.g. quartering a large roast)

Rapid chill equipment Click or tap here to enter text.

(e.g., blast chillers)

Ice paddles Click or tap here to enter text.

Other (describe method as well Click or tap here to enter text.

as listing foods)

7. Bare hand contact: How will employees avoid bare hand contact with ready-to-eat foods?
Check all that apply.

Disposable Gloves Deli Tissue

Suitable Utensils Other (Describe):

8. Will produce be cleaned on-site? YES NO

If YES, describe which sink(s) will be used for food preparation:

Click or tap here to enter text.

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9. Date marking: When TCS food is ready-to-eat and will be kept under refrigeration for more than
24 hours after preparation/opening, a date marking system must be utilized. Note: The day of
preparation counts as Day 1.

Will the establishment have food items that must be date marked? YES NO

If YES, list the foods or types of foods involved. Ensure a standard operating procedure is
submitted for this process.

Click or tap here to enter text.

10. Catering/off-Site/satellite: This section is intended for food that will be served by establishment
employees off-site from the planned establishment. This section does not pertain to the
delivery of pre-ordered food to a customer (e.g. delivering a pizza).

Complete section A through F, if establishment employees will be serving food off-site at

other locations.
A. List of menu items to be served off-site:

Click or tap here to enter text.

B. Maximum number of meals per day taken to or prepared at off-site location:

Click or tap here to enter text.

C. How will hot food be held at proper temperature during transportation and at the off-site
location?

Click or tap here to enter text.

D. How will cold food be held at proper temperature during transportation and at the off-site
location?

Click or tap here to enter text.

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 E. What type of vehicle(s) will be used to transport food?

Click or tap here to enter text.

F. What types of food shields or food protection devices will be used at the off-site location?
(See plan review manual Part 4)

Click or tap here to enter text.

***Food that is prepared off-site from the planned establishment, would not be covered under the
planned establishment’s food license and additional food licensure may be needed for this off-site
food preparation. Consult with your regulatory agency regarding possible additional food licensing.

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Sinks & Warewashing Facilities
(See Fixed Food Establishment Plan Review Manual Part 8)

11. Dishwashing methods, mark all that apply. Dishmachine 3-Compartment Sink(s)

Dishwashing Sinks Length (inches) Width (inches) Depth (inches)

1st 3-compartment sink, size of
compartments (basins)
2nd 3-compartment sink, size of
compartments (basins)
3rd 3-compartment sink, size of
compartments (basins)

A. The 3-compartment sink must accommodate immersion of the largest item needing
cleaning. What is the largest item that will have to be washed in a sink and its size?
Please list all dimensions (length, width, and depth or height and diameter for a round
item).

Click or tap here to enter text.

B. List the location of all garbage disposals (Disposals cannot be in a food preparation sink
or the basin of a warewashing sink.)

Click or tap here to enter text.

C. If a dishmachine/glasswasher will be utilized, list the make and model number of unit and
how the unit will sanitize (e.g. chemical or high temperature).

Dishmachine/Glasswasher Make Model # Sanitizing Method

1st Unit

2nd Unit

3rd Unit

12. What type of mop (service) sink will be provided (e.g. curbed floor drain, mop sink on legs,
etc.)? Ensure location of this sink is indicated on the equipment plan.

Click or tap here to enter text.

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11
General
(See Fixed Food Establishment Plan Review Manual Part 16)

13. Will employee dressing rooms be provided? YES NO

If NO, describe how and where personal belonging will be stored.

Click or tap here to enter text.

14. Will laundry be done on-site? YES NO

If YES, mark which of the following will be used on-site. Washer Dryer

Describe what will be laundered on-site.

Click or tap here to enter text.

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 Room Finish Schedule
(See Fixed Food Establishment Plan Review Manual Part 10)

Describe the floor, coving, wall, and ceiling materials that will be used in each of the listed areas. See
plan review manual Part 10 for a list of possible materials.

Area Floor Coving* Wall Ceiling

15. Preparation

16. Cooking

17. Dishwashing

18. Dry Storage

19. Bar

20. Dining

21. Public and/or

Employee
Restrooms
22. Dressing
Room

23. Walk-in Cooler

24. Walk-in
Freezer

25. Garbage
Room

26. Janitor
Closet/Mop Sink
Room
27.

28.

*List the material that will be used to provide a smooth, rounded and cleanable surface where the
floor and wall joins. Note: Please explain abbreviations.

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Water Supply
(See Fixed Food Establishment Plan Review Manual Part 5)

29. Mark the water supply type: Municipal Existing Well New Well

30. If using a well, is the local health department in the process of approving? YES NO*

Sewage Disposal
(See Fixed Food Establishment Plan Review Manual Part 5)

31. Mark the sewage disposal type: Municipal Existing Septic New Septic
Field Field

32. If using an on-site septic system, is the local health department or Michigan
Department of Environmental Quality in the process of approving? YES NO*

*It is required that you contact your local health department to begin the approval process.

Insect and Rodent Control

(See Fixed Food Establishment Plan Review Manual Part 13)

33. Will outside doors be self-closing? YES NO

34. Will the facility have a drive-thru or walk-up window? YES NO

If YES, describe the method of pest entrance prevention (e.g. self-closing unit, air curtains,
other effective means, etc.)

Click or tap here to enter text.

35. Will openings around pipes, electrical conduits,

chases, and other wall perforations be sealed? YES NO

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Solid Waste/Refuse Storage
(See Fixed Food Establishment Plan Review Manual Part 17)

36. Outside Solid Waste/Refuse Storage

A. What type of storage will be used? Compactor* Dumpster* Cans

B. Describe the type of surface that will be under the container.

Click or tap here to enter text.

C. What is the anticipated minimum pick-up frequency?

Click or tap here to enter text.

D. Describe how solid waste/refuse will be transported from the interior of the establishment
to the outside waste/refuse storage area.

Click or tap here to enter text.

*Remember to show details on site plan, including unit location and slope of surface under the unit.

37. Inside Storage

A. Describe any inside solid waste storage (garbage, boxes, etc.) or solid waste container
cleaning area (e.g. garbage can cleaning area).

Click or tap here to enter text.

B. Will any compactors, garbage rooms, garbage

transport carts, or dumpsters be located inside? YES NO

If YES, make sure to show location on site plan

C. Describe the location where damaged merchandise or unacceptable products to be

returned will be stored.

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Click or tap here to enter text.

D. Describe how and where waste grease from equipment such as fryers will be handled
and stored.

Click or tap here to enter text.

E. Describe how and where redeemables/returnables/recyclables will be stored.

Click or tap here to enter text.

F. Mark the types of materials that will be recycled.

Glass Metal Paper Cardboard Plastic

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 Plumbing Cross-Connections
(See Fixed Food Establishment Plan Review Manual Part 12)

The following technical information is needed on the proposed plumbing. This section is best completed by a
qualified plumber, architect or engineer. Be sure to include all devices, equipment and fixtures that have cross-
connection protection. Remember to complete both the water supply and sewage disposal sections (e.g., a
dishwasher may have an AVB on the water supply and an air-gapped drain). Mark appropriate boxes.
Backflow Prevention Device Abbreviations
AVB=atmospheric vacuum breaker PVB=pressure vacuum breaker
RPZ=reduced pressure principle backflow preventer DC w/AV= Double check valve with an atmospheric vent

Sewage Disposal Water Supply

Fixture Air Air Direct AVB PVB RPZ Hose DC Air
Gap Break Connect Bibb w/AV Gap
38. Dishwasher ☒ ☐ ☐ ☐ ☐ ☐ ☐ ☐
39. Glasswasher ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
40. Garbage grinder ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
41. Ice machine ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
42. Ice storage bin ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
43. Mop sink ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
44. 3-compartment sink ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
45. Culinary (food preparation)
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Sink
46. Other sinks, except
handsinks, (1 or 2 ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
compartments)
47. Steam tables/Bain-marie ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
48. Dipper wells ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
49. Hose connections ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
50. Refrigeration condensate
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
drain lines
51. Beverage dispenser with
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
carbonator
52. Water softener drain ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
53. Walk-in floor drain ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
54. Wok range ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
55. Chemical dispenser ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
56. Outside sprinkler or
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
irrigation system
57. Power washer ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
58. Retractable hose reel ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
59. Toilet ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
60. Urinal ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
61. Boiler ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
62. Espresso machine ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
63. Combi-style oven ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
64. Kettle ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
65. Rethermalizer ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
66. Steamer ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
67. Overhead spray rinse ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
68. Hot water dispenser ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
69. Coffee machines, juice
dispensers or other non-
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
carbonated beverage
dispensers
70. Other (describe): ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐

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Formula Information
Several calculations are utilized to determine if there will be adequate hot water, dry storage space
and refrigerated storage space. This information requested on the following two pages provides the
necessary data for performing calculations. See the plan review manual for formulas and directions.
While the following information will be used to provide a good calculated baseline of how
much hot water, refrigerated storage, and dry storage space may be needed, your regulatory
agency does have the authority to adjust these calculated amounts based upon the specific
operations of your facility.

71. Hot Water

(See Fixed Food Establishment Plan Review Manual Part 12)

List each plumbing fixture that has a hot water supply line. Each fixture Fixture Count
should only be listed once.
Handsinks (not including restroom sinks)
Restroom Sinks
Single Compartment Sink
Double Compartment Sink
Triple (three) Compartment Sink
Food Preparation Sink
Overhead Spray Rinse
Bar Sink-three compartment
Bar Sink-four compartment
Cook Sink
Hot Water Filling Faucet
Steam Table/Bain-Marie
Coffee Urn
Kettle Stand
Garbage Can Washer
9 & 12 lb. Clothes Washer
16 lb. Clothes Washer
Shower Heads
Mop Sink
Dump Sink
Dishmachine/Glasswasher
Other (describe):
Other (describe):

72. Water Heater

Manufacturer: Click or tap here to enter text. Model #: Click or tap here to enter text.

A. Water heater proposed size:

KW: Click or tap here to enter text. Or BTUs: Click or tap here to enter text.

B. Water heater storage capacity in gallons: Click or tap here to enter text.

C. Water heater recovery rate @100ºF: Click or tap here to enter text.

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 D. Tankless units: Click or tap here to enter text.

Gallons per minute @ 70°F rise: Click or tap here to enter text.

and

Gallons per minute @ 100°F rise: Click or tap here to enter text.

Attach information for any additional water heaters. Specify what area each water
heater services and whether units will be installed in series or parallel.

73. Dishmachine Booster Heater:

Manufacturer: Click or tap here to enter text. Model #: Click or tap here to enter text.

Booster heater proposed size:

KW: Click or tap here to enter text. Or BTUs: Click or tap here to enter text.

Refrigerated and Dry Food Storage

(See Fixed Food Establishment Plan Review Manual Parts 3 & 7)

It is essential that a reliable estimate be made of the number of meals/customers that are served
between deliveries to calculate dry and refrigerated storage capacities.

A. # meals/customers estimated to be served per day: Click or tap here to enter text.

B. # days between deliveries: Dry food: Enter text Refrigerated food: Enter text

C. # meal/customers between Dry food: Enter text Refrigerated food: Enter text
deliveries (A x B = ):

Please describe any assumption made in determining the meal quantity estimate.

Click or tap here to enter text.

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 74. Refrigerated/Freezer Storage
(See Fixed Food Establishment Plan Review Manual Part 3)

Working, preparation or line refrigerators/freezers should not be included in this section. While these
types of units may be needed in the operation of your facility, these are not intended for long term
cold storage.
Walk-in Item # **Interior Usable Height (ft) Interior Length (ft) Interior Width (ft)

**The usable height within a walk-in is the space available for storage. Food is to be stored
6” from the floor and generally 12” to 18” from the ceiling of the unit.

Reach in Item # Interior Depth (in) Interior Width (in) Interior Height (in)

Will the reported cold storage space be utilized for storage of bulky food items (e.g. boxes of whole
produce, kegs, large meat boxes, bottled beverage), storage of any non-food items or for any food
preparation processes (e.g. cutting of meat, drying/aging/fermentation of food)? YES NO

If YES, what units, or what percentage of the reported cold storage space, will be used for these
purposes?

Click or tap here to enter text.

75. Dry Storage

(See Fixed Food Establishment Plan Review Manual Part 7)
*Storage Rooms
**Usable room height (ft) Interior Length (ft) Interior Width (ft) ***% Usable Floor
Space

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*Please note the location of any auxiliary storage (e.g. outside storage) on site plans.
**To determine usable height, determine height from floor to ceiling, then subtract height of food off
floor (usually 6”) and height of food from ceiling (usually 12-18”). Average usable height is 4 to 7 feet.
***% Usable Floor Space is the actual percentage of floor space available for storage, this is typically
0.3 to 0.8 (30% to 80%).
Or, if there is no dry storage room proposed, report all dry storage shelf dimensions:

Storage Shelving
Length of Shelf (ft) Depth of Shelf (ft) Clearance/Height # of Shelves per # of Units Proposed
between Shelves Unit
(ft)

Will the reported dry storage space be utilized for storage of non-food items such as
equipment/utensils, cleaning supplies, maintenance supplies, empty bottles/cans, linens, promotional
items, etc.? YES
NO

If YES, what shelving units, or what percentage of the reported dry storage space, will be used for
this purpose?

Click or tap here to enter text.

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Ventilation
(See Fixed Food Establishment Plan Review Manual Part 15)

Sufficient ventilation is needed to keep rooms free of excessive heat, steam, condensation, vapors,
obnoxious odors, smoke and fumes.

76. List the equipment that will be underneath a ventilation hood or will utilize a ventless system
and mark the type of ventilation proposed for that equipment.

Equipment Type I Hood Type II Hood Ventless

☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐
☐ ☐ ☐

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Open Dining, Exposed Food Preparation Areas & Outdoor Cooking
Operations
(See Fixed Food Establishment Plan Review Manual Part 18)

77. Will your facility have a dining area that will be exposed to the outdoors by being located
directly outdoors OR by having walls, windows, or doors that can be opened, exposing the
dining area to the outdoor environment? YES NO

If YES, explain how you intend to protect your kitchen and any food, utensils, and food
equipment located in the dining area from outdoor contamination and pest entry (e.g. using
air curtains, screens, tight fitting doors, etc.).

Click or tap here to enter text.

78. Will there be an outdoor food preparation or cooking area at the facility? YES NO

If YES, answer the following questions:

A. What food items are you intending to prepare/cook outdoors?

Click or tap here to enter text.

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B. What food equipment will be used for outdoor preparation/cooking and will this equipment
be portable or permanently fixed outdoors? Complete following chart and mark
appropriate boxes.

Outdoor Equipment Portable Permanent

☐ ☐
☐ ☐
☐ ☐
☐ ☐
☐ ☐
☐ ☐
☐ ☐
☐ ☐
☐ ☐

C. How do you intend to transport food between the outdoor preparation/cooking area and
the interior of the kitchen?

Click or tap here to enter text.

D. How will handwashing be addressed at the outdoor preparation/cooking area?

Click or tap here to enter text.

E. Where will the outdoor preparation/cooking area be located on the premises? Ensure this
is indicated on your site plan.

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Click or tap here to enter text.

F. How will the outdoor preparation/cooking area be protected from unauthorized access?

Click or tap here to enter text.

G. What overhead protection will be provided? What materials will be used?

Click or tap here to enter text.

H. Will walls be provided? If so, what materials will be used and what coving material will be
provided?

Click or tap here to enter text.

I. What type of floor/ground will be present in the outdoor preparation/cooking area?

Click or tap here to enter text.

J. What type of cooking fuel will be used and how will refuse and waste ash be collected in
the outdoor preparation/cooking area?

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 Click or tap here to enter text.

K. What lighting will be provided in the outdoor preparation/cooking area and how will it be
shielded?

Click or tap here to enter text.

Suggestion Sheet
Food Establishment Plan Review Worksheet

Suggestions for changes to this plan review worksheet are welcomed from all users (e.g., food
service operators, architects, engineers and regulators, etc.). Revisions to documents are made
periodically as needed. Thank you for taking the time to submit your ideas.

Name: Click or tap here to enter text. Phone: XXX-XXX-XXXX Fax: XXXXX

Address: Click or tap here to enter text.

City, State, Zip: Click or tap here to enter text.

E-Mail: Click or tap here to enter text.

Submit to:
Plan Review Specialist
Food Service Sanitation Section
Food & Dairy Division
Michigan Department of Agriculture
PO Box 30017
Lansing, MI. 48909

E-mail: [email protected]

For suggested changes, please indicate the specific location(s) in document. You may list your
suggestions below or attach separate sheets. Please be specific and clear.

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