1. No category

City & County of Denver
Public Health Inspections Division
Plan Review
201 W Colfax Ave. Dept. 205
Denver, CO 80202
Phone: 720.865.2832 (Kerwin Nance)
Fax: 720.865.2880
www.DenverGov.org
www.facebook.com/DenverPHI
Application Date: _____________________
Plan Review Form
Name of Establishment:
Phone:
Street Address:
Cell:
City:
Fax:
State/Zip:
Email:
Business/Ownership Information:
Phone:
Individual or Corporate Name:
Phone:
Street Address:
Cell:
City:
Fax:
State/Zip:
Email:
Name of Local Contact (Chef, GM, or Manager of Operations):
Phone:
Street Address:
Cell:
City:
Fax:
State/Zip:
Email:
Name of Architect:
Phone:
Street Address:
Cell:
City:
Fax:
State/Zip:
Email:
Name of Contractor:
Phone:
Street Address:
Cell:
City:
Fax:
State/Zip:
Email:
Check box for all individuals to receive copies of Health Department plan review letters
and other correspondence.
Date construction is to start: _________________
New Establishment:
YES
Date of planned opening: _____________________
NO
Remodel:
YES
NO
If yes, describe the scope of the project
Type of Establishment (Check all that apply)
Full Service
Bar
Fast Food
Coffee Shop
Market (Grocery)
School
Deli
Caterer
Fish Market
Concession
Meat Market
Specialty Shop
Convenience Store
Manufacture with Retail Sales
Marijuana Dispensary/Retailer
Marijuana Infused product
Animal Concept Facility
Other (specify):
Seating Capacity:
Indoor
Outdoor
Number of Staff (anticipated maximum per shift):
Projected daily maximum number of meals to be served:
Breakfast
Lunch
Dinner
Days and Hours of Operation
Days
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Hours
For Seasonal Operations, List the Months of Operation (Please circle all that apply)
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sept
Oct
Nov
Dec
Square Feet (ft2)
Please indicate square footage in each area
Total Square Feet of the Establishment
Total Square Feet of the Kitchen Area
Square Feet of the Food Preparation and Dishwashing Area
Square Feet of Retail Sales Area (Markets)
If the establishment is to operate in a multi-story structure, please indicate any satellite areas where food,
beverage, dispensing utensils, or ice will be handled by employees. Also, include any food or beverage storage
areas.
PLEASE INCLUDE ALL NECESSARY INFORMATION/DOCUMENTATION LISTED BELOW.
LACK OF COMPLETE INFORMATION MAY DELAY REVIEW AND PLAN APPROVAL.
Menu
Plumbing Specifications
Food Handling Procedures
Storage of Chemical and Personal Belongings
Specialized Food Process Procedures
Equipment Specification Sheets
Facility Floor Plan
Equipment Layout
MENU AND FOOD HANDLING PROCEDURES – TO BE FILLED OUT BY PERSON THAT WILL
BE INVOLVED IN THE DAILY OPERATIONS OF THIS FACILITY (CHEF, GM, OPERATIONS
MANAGER, ETC.)
NAME OF PERSON COMPLETING: ________________________________
A. Please submit menu. Include appetizers, entrees, lunches, dinners, sides, salads and beverages.
B. Will the operation involve any specialized processes (meat curing, fermentation, acidification, vacuum
packaging, juice packaging, cook chill, sous vide, pickling)?
1. If yes, please provide specifications sheets for the equipment that will be used (a preapproved HACCP
plan may be required prior to production)
C. List the foods that will be prepared in large quantities. Include foods that are made from scratch such as
soups, sauces, potato salad, pasta salads, chili, pasta noodles, roasts, casseroles, sausages, yogurts, etc.
D. What pieces of equipment will you use to rapidly cool potentially hazardous foods?
E. Will potentially hazardous foods be reheated and then held hot before being served?
1. Please list the equipment that will be used for reheating:
YES
F. Please describe how frozen foods will be thawed:
G. Are you going to be washing produce used in the operation?
Where?
YES
NO
H. Will a salad bar, buffet line, omelet station, sauté station, beverage bar or customer self service areas be
operated?
YES
NO
I. Will food be transported or delivered to another location?
YES
NO
If yes, please list the equipment that will be provided to maintain food at proper temperatures
during transport:
NO
J. Will the establishment prepare foods that will be sold online or wholesale?
YES
NO
If yes, please list the foods.
K.
Where will bulk supplies of cleansers, detergents, sanitizers, and other chemicals be stored?
L.
Where will employees' coats, hand bags, and other personal belongings be stored?
FACILITY FLOOR PLAN:
A. Plans must include the location and identification of all equipment and areas including:
Bar Service Area(s)
Hand Sink(s)
Chemical Dispensing Unit(s)
Ice Bin(s) or Ice Machine(s)
Chemical Storage Area(s)
Indoor/Outdoor Seating
Dipper Well(s)
Laundry Facility
Dish Machine(s)
Outdoor Cooking/Bar/Patio
Dishwashing Sink(s)
Recycle/Damaged/Return Goods Location
Dry Storage Area(s)
Toilet Facilities
Dump Sink(s)
Utility Mop Sink(s)
Floor Sinks/Floor Drains
Wait Station(s)
Food Preparation Sinks
Water Heater Location(s)
Grease Interceptor/Trap
B. Use the finish schedule to indicate interior finishes for each room within the establishment. If a complete finish schedule is included in the plans
indicate on which page the schedule is located.
ROOM FINISH SCHEDULE
Floors
Room Name
Or Number
Example:
Kitchen
Wall Finishes
Finish Material
Type of Base
North
East
South
Quarry Tile
Quarry Tile
FRP
FRP
FRP
Ceiling
West
Material
Finish
Stainless
Vinyl Acoustical Tile
Smooth
EQUIPMENT SPECIFICATIONS
A.
Please, submit equipment specification sheets, including make and model numbers of the equipment.
If the specification sheet lists more than one piece of equipment, identify the specific equipment to be
used. If there is no specification sheet available, the equipment will only be accepted upon a field
inspection to determine if it meets commercial and ANSI sanitation design criteria.
B.
Please submit specification sheets of all custom fabricated equipment and cabinetry, drawn to scale.
C.
Refrigeration/Freezer Capacities – Please complete the following table:
TYPE OF UNIT
# OF UNITS PROVIDED
TOTAL CUBIC FEET
Walk-in Refrigeration
Walk-in Freezer
Reach-in Cooler
Open Top Sandwich Cooler
Reach-in Freezer
Blast Chiller
Retail Display
Other
D.
Hot Food Holding Capacities – Please complete the following table:
TYPE OF UNIT
Steam Tables
Hot Box
Cook & Hold Units
Other
# OF UNITS PROVIDED
TOTAL CUBIC FEET
E.
Indicate the locations of drink dump sink(s) and/or knock boxes(s) installed in bars, coffee bars, wait
and bus stations where soiled drink glasses, cups and coffee grounds baskets will be dumped and prescraped prior to dishwashing. The first compartment of a 4-compartment bar sink may be utilized as a
dump sink.
F.
Is a food preparation sink provided?
YES
NO
If yes, please attach a specification sheet for the sink(s) and provide the following information.
1. ID or code(s) on plans:
2. Dimension of sink’s compartment(s):
×
(Length)
×
(Width)
(Depth)
3. Length of drain board(s):
G.
Is a garbage disposal provided?
YES
NO
If yes, please indicate number to be provided and their location(s)
H.
Will alternate equipment or methods be used in place of traditional drain boards where required for
3-compartment sinks, ware washing machines, and food handling sinks:
If yes, indicate the method that will be used and provide specification sheets:
I.
Please submit the following dishwashing information:
1. Manual - Include the size of each compartment (length x width x depth) for each 3compartment dishwashing sink that will be provided in the establishment. Also, indicate the
length of the drain boards attached to the 3-compartment sink. Please, indicate if a pre-rinse
spray hose will be installed at each sink.
Dimensions of
3-compartment Sink (L×W×D)
Length of
Left
Drain
board
Left Basin
Center Basin
Right Basin
PreRinse
Sprayer
(Yes/No)
Length of
Right
Drain
board
*Dish washing equipment must be large enough to accommodate the largest piece of equipment or
utensils used.
2. Mechanical - Include the make, model number, and attach a specification sheet of each
dishwashing machine that will be provided in the establishment. Please indicate if the
machine(s) is heat or chemical sanitizing.
Indicate the length of the drain board(s) attached to the dishwashing machines, and if a pre-rinse
sprayer is provided at the machine. Also, if a utensil soak (or slop) sink is provided, please give the
dimensions.
Make
Model #
Dish Machine
Information
Heat
or
Drain board
Chemical
Length
Sanitizing
PreRinse
Sprayer
(Yes/No)
a. If the machine is heat sanitizing, is a booster heater provided?
Utensil Soak
Sink
Dimensions
(L×W×D)
YES
If yes, please complete the table below:
Booster Heater Information
Make
Model #
KW/BTU
Distance from
Machine (ft)
NO
J.
Please provide installation information for all equipment that will be provided in the establishment.
Complete the following table to indicate format of equipment installation.
Installation Method
Equipment Installation List
Floor
Mounted
Sealed In Place
Legs 4”
Portable
Masonry Island
Legs: 6”
Casters
Make / Model
Plumbing Req. Yes / No
New (N) / Used (U)
ID # on Plan
Equipment
Counter/Table
Mounted
PLUMBING AND ELECTRICAL PLANS AND SCHEDULES:
The plumbing plan shall indicate:
1. Location of all floor sinks and floor drains.
2. Location of all hose bibs and hose reels if provided.
3. Location of restrooms, toilets, urinals and hand washing sinks.
4. Location of grease trap or grease interceptor and solids interceptor if required by the
waste water authority.
5. Location of the mop/utility sink. A dedicated hot and cold water supply shall be provided
for chemical dispensing towers.
6. Location of all chemical dispensing units to be installed. Provide the make, model number
and specification sheets for each dispensing unit.
7. Location of clothes washers and dryer, if provided.
8. Location of showers and the number of shower heads, if provided.
A.
Please, complete the table below for all plumbing fixtures and equipment that will be drained to the
sewer. Indicate if fixtures or pieces of equipment will be indirectly drained (i.e. to a floor sink) or
directly connected to sewer. If a plumbing fixture connection schedule is included in the plans,
indicate on which page the schedule is located:
Plumbing/Drainage Information
ID #
Fixture/Equipment
Indirect/Direct
Drainage
Method of Backflow
protection
B.
Approved backflow protection must be supplied on all fixtures and equipment with submerged inlets.
Vacuum breakers must be installed on water inlet lines for dishwashing machines, garbage disposals,
and hose bibs. Continuous pressure backflow devices must be installed on water lines where a valve
or shut off is located between the backflow preventer and the inlet to fixture/equipment, such as hose
reels, iced tea machines, smoothie machines, etc.
C.
Provide the following water heater information: (Please attach specification sheets)
1. Number of water heaters or water heating systems to be installed: _____. If more than one
water heater is to be installed, please indicate what fixtures each heater or system will service.
2. What is the distance between the water heating system(s) and the fixture that is farthest from the
heating system?
Standard Tank Type Heater
Make
Model #
KW/BTU Rating
Recovery Rate (GPH at
100ºF rise at sea level)
Heat Reclaim Systems
Make
Make
Model #
KW/BTU Rating
Recovery Rate (GPH at
100ºF rise at sea level)
Instantaneous/Tank less Systems
Flow Rate (GPM at
Model #
BTU Rating
100ºF rise at sea level)
Storage Tank
Capacity (gallons)
Electrical:
A. Provide plans and schedules that indicate the location and specifications of all lights
All lights in kitchen areas, dry storage areas, dishwashing areas, inside equipment, and
above areas where open foods are held or displayed must be equipped with shatter proof
bulbs or shields that will protect open food, utensils and single use items from broken
glass if a bulb is broken.
MECHANICAL PLANS AND SCHEDULES:
A. Provide plans and schedules that indicate the location and specifications of ventilation hoods and
restroom exhaust fans. The ventilation schedule shall include exhaust capacities (CFMs) for all
hoods and exhaust fans, including ventilation systems in restrooms. Indicate the volume of outside
air each roof top and make up air unit will supply into the building.
B. Provide make and model numbers or shop drawings for each exhaust hood and fan. Provide the size
(length x width) of each hood. Include manufacturer’s recommended exhaust listings in CFMs.
Type I Hood Air Balance Report
Fan ID #
Exhaust CFMs
Total Supply Air CFMs
*Outside Air CFM
*Volume of make-up air supplied into building must be greater than exhaust from building.
PREMISES:
The site plan must include the following:
1. Refuse enclosures and trash compactors.
2. Outside walk-in cooler(s) / freezer(s).
3. Grease interceptors.
4. Outside storage areas.
Worksheets for Calculating Minimum Hot Water Requirements:
The following worksheet is provided to assist operators in calculating hot water usage and sizing of the water heater
system required for the operation.
Standard Tank Type Systems:
I. Calculate Total Water Required By All Fixtures:
A. Three compartment sink calculation of water usage:
1. Measure dimensions, in inches, of each compartment, if compartments are not the same
dimensions see note below.
Length = __________ Width = __________ Depth = __________
2. Insert measurements into equation:
(________ x ________ x ________ x 3 x 0.375 ) ÷ 231 = ___________ GPH
length
width
depth
water usage
Note: If the compartment sizes of the sink are not the same, then 3 is taken out of the equation,
and the above calculation is done for each compartment. The volumes are added to obtain the
total gallons per hour of hot water used in the sink.
B. Utensil soak sink:
1. Measure dimensions, in inches, of the sink
Length = __________ Width = __________ Depth = __________ GPH
2. Insert measurements into equation:
( __________ x __________ x __________ x 0.375 ) ÷ 231 = __________GPH
Length
width
depth
water usage
Enter number into the attached “Table to Calculate Total Water Required by All Fixtures,”
C. Dish machine and conveyor pre-rinse water usage:
1. Use manufacturer’s rating in gallons per hour. Enter number into attached “Table to
Calculate Total Water Required by All Fixtures,”
2. Clothes washer water usage:
• Use manufacturer’s rating: _________, or
• 32 GPH for 9-12 pound washer, or
• 42 GPH for 16 pound washer.
Enter number into the attached “Table to Calculate Total Water Required by All Fixtures,”
D. “Calculate Total Water Required by All Fixtures” and the number of fixtures in the operation to
determine maximum hourly usage for each type of fixture in the operation.
Total water (GPH) required by all fixtures: _________ GPH.
II. Calculate Maximum Hourly Hot Water Usage:
If gas water heater is used go to Step A; if electric, Step B.
A. Gas Water Heater: If a gas water heater is to be used, calculate the maximum hourly hot water
usage for the facility by adjusting the total water required by all fixtures for altitude. The altitude
adjustment factor for Denver is 1.2.
Use the following equations to determine the maximum hourly hot water usage when a gas powered
water heater is to be used:
_______________ x _______________ = _______________ GPH
adjustment factor
total water required
maximum hourly
by all fixtures
hot water usage
Example, if the total gallon per hour usage for an establishment at an elevation of 5000 feet is
100 GPH, the adjustment factor is 1.2. Therefore, a water heater with 120 GPH recovery rate would be
required.
B. Electric Water Heater: If an electric water heater is to be used, the maximum hourly usage for the
operation is the same as the total water required by all fixtures. Use this value in the equation to
calculate the minimum Kilowatt (KW) rating of the water heater.
The value calculated in Step A or B is the minimum recovery rate of the water heater.
C. Heat re-claim systems:
Brand of water heater: _____________________; Model number:__________________
BTU Rating: _____________________
Recovery rate: _____________ gallons per hour at 100°F rise at sea level
Table to Calculate Total Water required For All Fixtures:
Plumbing
Fixtures
Water Usage
(gallons per hour)
Maximum Hourly
Water Usage Per
Type Of Fixtures
(Gallon per Hour)
Number of
Fixtures
Example: Dish Machine
50
1
50
Example: Hand Sink
5
4
(5 x 4 =) 20
3- Compartment sink
3-Compartment sink-Bar
Utensil soak sink
Dish machine
Dish machine pre-rinse
Laundry machine
All hand sinks
Mop sink
Hose Bib used for
cleaning
Total Water (GPH)
Required
by all fixtures:
Dishwashing Machine
Manufacturer: ____________________________
Model Number: ___________________________
Gallons per Hour Water Consumption: GPH_________
Tank-less or Instantaneous Systems:
I. Heater Specifications:
Manufacturer: ______________________
Model Number: _____________________
Flow Rate in Gallons per Minute (GPM) at 100ºF rise: ______________ GPM_______________
BTU Rating: ________________________ BTU**_____________________________________
*Units must be designed for commercial use.
**Electric units will only be approved as a dedicated hot water supply to a single hand washing sink.
II. Calculate the total hot water demand flow rate in Gallons Per Minute (GPM) using this table.
Example: Dish machine
8.0
1
Maximum Hourly
Water Usage Per
Type Of Fixtures
(Gallon per Hour)
(8.0 x 1) =8.0
Example : Hand sink (s)
0.5
4
(0.5 x 4) = 2.0
3-Compartment sink
Dish Machine
2.0 for each faucet
Laundry machine
2.0
Food Prep Sink
1.0
All hand sinks
Mop Sinks
Total water (GPM)
required
by all fixtures:
0.5
2.0
Plumbing
Fixtures
Water Usage
(gallons per hour)
Number of
Fixtures
*A flow rate reduction can be used for low flow water faucets installed on 3-compartment sinks; hand
operated pre-rinse sprayers, food preparation sinks, hand washing sinks and showers by entering the
manufacturer’s flow rate listed for the faucet or faucet’s aerator.
**Use manufacturer’s flow rate in GPM for specific make and model of dishwashing machine.
III. Storage Tank Sizing:
If a dishwashing machine(s) is to be installed the instantaneous water heating system must include a
storage tank. The storage tank must be at least 25 gallons or at least 25% of the gallons per hour
(GPH) demand of the dishwashing machine(s). The larger value of the two is the required storage tank
size.
Dishwashing Machine*
Manufacturer: ________________________________ Model Number: ______________________
Gallons per Hour Water Consumption: ____________________ x 0.25 = _______________
Storage tank capacity
(gallons)
Calculated Storage Tank Capacity: ____________ vs. 25 Gallons Storage Tank
Enter the larger of the two: _______________ Required Storage Tank Capacity**
*High temperature, heat sanitizing dishwashing machines must be provided with a separate booster heater.
Use of an instantaneous unit is not allowed for use as a booster heater.
**The storage tank must be installed in the hot water supply line located between the heater unit(s) and the hot
water distribution line. A recirculation line and aqua stat (water thermostat) must be installed at the storage
tank to assure the water in the tank remains at the appropriate temperature (120-140°F). The recirculation line
must be connected between the storage tank and the cold water supply line at the heater unit(s).
Number of Plumbing Fixtures Requiring Hot Water:
Name of fixture requiring Hot Water:
Number of Fixtures:
1. 3-compartment sinks
_________________
2. Dish machines
_________________
3. Pre Rinse Sprayers
_________________
4. Utensil Soak Sink
_________________
5. Hand sinks include restrooms
_________________
6. Mop Sink/Utility Sink
_________________
Additional Notes for Your Reviewer:
Additional Resources

Employee Health and Personal Hygiene Handbook:
http://www.fda.gov/food/guidanceregulations/retailfoodprotection/induststyandregulatoryassitancea
ndtraingresources/ucm113827.htm

Communicable Disease Manual:
http://www.colorado.gov/pacific/cdphe/communicable-disease-manual