Public Health & Social Services Department
Food & Environmental Services Section
3000 Pacific Avenue SE
Olympia WA 98501-8809
360-867-2667
foodapplication@co.thurston.wa.us
COMMISSARY USE LOG
THURSTON COUNTY WASHINGTON SINCE 1852
USER BUSINESS NAME: USER ________________________
COMMISSARY NAME: ________________________________
BUSINESS PERMIT #: ____________________________
COMMISSARY ADDRESS: _____________________________
DATE
TIME IN
TIME OUT
PROCESS CONDUCTED
PRINTED NAME OF BUSINESS REPRESENTATIVE
PRINTED NAME COMMISSARY REPRESENTATIVE
EXAMPLE
8 AM
10 AM
Prepared veg, cooked beans, loaded truck
Truck Employee
Commissary Employee
9 PM
11 PM
Emptied waste tank, washed pans and utensils, cleaned truck
Notes: To be completed at the time of each visit.
Form Version – Nov 2022
One copy to be maintained at commissary site and available upon request. One copy to be maintained on Mobile Food Unit and available upon request.
Notes:
Your name
Your email
Subject
Your message (optional)
