The Secretary Military Hlahla

Liqour Licensing Board T/a Mimosa Sports Bar

P. Bag 7704 Stand 8250 Chitoro Street
HARARE Kuwadzana 2
HARARE

LIQUOR ACT (CHAPTER 14:12 OF 1996)

HEALTH REPORT IN RESPECT OF APPLICATION TO BOARD

(If requested by the Secretary, seven copies to be submitted if requested by the applicant, in triplicate)

1. Subject of report: - Bottle Store

(Specify application reported upon)

2. If the application relates to the issue, renewal or removal of a licence state:-

(a) Whether, generally, the premises or proposed premises are or will be suitable for
the proposed carrying on of the type of business which in conducted or is
proposed to be conducted on the premises.
SUITABLE
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(b) Whether or not the following items are or will be satisfactory in relation to the
purpose to which the premises are or will be put:-

(i) Ventilation Satisfactory

(ii) Lighting Satisfactory
(iii) Sewage disposal and drainage Satisfactory
(iv) Sanitary facilities Satisfactory
(v) Water Supply Satisfactory
(vi) Refuse disposal Satisfactory
(vii) Standard of food Satisfactory
(viii)Food storage arrangements Satisfactory
(ix) Staff uniforms and changing rooms Satisfactory
(x) Equipment and furniture Satisfactory

3. In the case of this application, the following matters considered to be relevant to the
application are drawn attention to:
(Not Applicable)

Note: In the event of an adverse report being made under any of the items in 2 or 3 details
of the matter relied upon must be given.

Date_ __________________ DIRECTOR OF HEALTH SERVICES