TOWN OF BROOKLINE
Office of the Inspector of Milk, Room 14, Town Hall
NGOPR
APPLICATION FOR A LICENSE TO SELL MILK
The undersigned hereby applies for
the Laws of the Commonwealth and the Rules and Regulations of the Board of Health of the Town of
License to sell milk in the Town of Brookline, in accordance with
Brookline.
No, of License
19
Date of application.
Business name.
Place of business.
Name of owner or manager
Residence
Residence.
Names of partners or officers of company
Is your supply derived from dairies, contractors or your own cows?
Cream supplied by
Cans
Wholesale
Milk
Average amount of milk and cream
Cans
Retail
Quarts
Wholesale
sold daily in Brookline
Cream
Quarts
Retail
Elsewhere
Number of vehicles used in Brookline.
Elsewhere
Number of drivers in Brookline.
ROOM
MILK
Location
Are walls and ceiling sheathed or of rough boards?
Is floor trapped?
Is floor drained ?
If you have no separate milk room, where do you handle the milk?
What equipment have you for washing and sterilizing milk utensils?.
Where are the milk utensils washed?
Are the ice chests and sinks trapped?
Is there a water closet or urinal in the building in which your milk is handled, and where ?
Describe the manner in which waste water is disposed of
