Kitchen Use
This section contains information we require to meet our county health inspector permit for groups cooking for themselves. If you are not planning on cooking or are only doing "pot-luck" style meals / individual family cooking not in the main kitchen you do not need to fill this section out. Small planning retreats only have access to the kitchen in the Small Retreat Lodge and are not required to fill this out.

All Guest Groups using the kitchen must pay $66 for a Kitchen Permit issued by Lewis County Health Department. This permit places the responsibility for food safety and proper food handling procedures in your hands as the Guest Group.

You must also obtain a Food Handler's card for at least one person serving in your kitchen who will function as the "head cook" during your stay. Please note that it is very likely that the Health Department will conduct an inspection at least once during your stay. You can obtain a food handler's card online at: https://www.foodworkercard.wa.gov/language.html

We must have this information at least 2 weeks out from your event - information received after that will require a $75 late fee added to your final invoice to cover the late fees we will have to pay the county.

Email address *
What is the name of your group, church, or organization *
Your answer
We are... *
Required
At least one person must have a food handler's card
At least one person must have a valid food handler's card for Washington State. Please print and/or bring your card to camp so that it can be presented to the Health Inspector if need be. One person, with a valid food handler's card, must act as the "head cook" and will be the point person listed on the paper work. There is a strong possibilty that the Health Department will conduct an inspection during your stay - and while PVCC staff will be present for all of it your head cook will ultimately be responsible for your own food safety / cooking procedures.
What is the first and last name of the person acting as "head cook" for you? *
Your answer
Does this person have a valid food handler's card? *
You are required to pay a $66.00 kitchen permit fee.
Please select below how you will be paying that fee. Ideally checks should be made out to Lewis County Health Department but mailed to Pleasant Valley at PO Box 175 Mineral WA 98355
We...
Your Menu
In order for us to allow Guest Groups to use our kitchen we are required to obtain a separate food permit for each group. This permit must include information about what is being cooked and served.

Please list the meals you are planning on serving - you don't have to include everything just the main parts

Example:
Breakfast 1: Scrambled eggs and bacon
Lunch 1: Ham Sandwiches and Potato Salad
Dinner 1: Spaghetti, Garlic Bread, Salad.

Full menu *
Your answer
Descriptions of ingredients
In order for us to allow Guest Groups to use our kitchen we are required to obtain a separate food permit for each group. This permit must include information about what is being cooked and served.

For each item below please list the Main Ingredients for your meals. If none put "none" or "n/a"

Example:
Pre-cooked: Sandwich meat, pre-made soup, corndogs, hotdogs, chicken tenders, sausage patties
Raw: Ground beef, bacon, ground sausage
Dairy: Milk, cheese, yogurt, cottage cheese
Fresh Fruit/Veg: carrots, onions, salad mix, apples, oranges
Breads: Garlic bread, sandwich bread, pasta

Please give a detailed list of all meat products purchased that are pre-cooked or pasteurized eggs *
Your answer
Please give a detailed list of all raw meat products that will be cooked *
Your answer
Please give a detailed list of all dairy products *
Your answer
Please give a detailed list of all raw vegetables or fruit *
Your answer
Please give a detailed list of all breads *
Your answer
Other *
Your answer
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