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Home My WebLink About04 MLA17-00019 COTTAGE INDUSTRY APPLICATION ruocuSign Envelope ID:1A0031D8-2B06-4687-B710-8839FFA3978A {t( Washington State License Number 412943 �% Liquor and Cannabis Board UBf Number 6040283380010001 OLYMPUS GARDENS Trade Name Operating Plan Required Elements— Producer/Processor Submission of an operating plan that demonstrates the applicant is qualified to hold the marijuana license applied for is required as part of the application process listed in Washington Administrative Code (WAG) 314-55-020. This operating plan must include a floor plan and/or site plan which illustrates the entire operation being proposed.(WAC 314.55.020(11)) Please describe how your operating plan complies with the requirements listed in the WACs indicated below. Additional sheets may be attached if nece$; ary. 1. SECURITY (WAC 314-55-083) a. Will all employees wear an identification badge? 'Cooiv (-E:j YES b. Does your location have a security alarm system on all perimeter doors and windows? rip YES c. Does your video surveillance system and recording device meet the following requirements? YES �{!s Minimum camera resolution of 640 x 470 c[1] Internet protocol (IP) compatible r Recorded images clearly and accurately display the time and date Surveillance system storage device is secured on-site in a locked box ',c] Camera recordings must be continuously recorded twenty-four hours a day l_. Surveillance recordings must be kept for a minimum of forty-five days System includes image acquisition, video recording, management and monitoring � w hardware and support systems `D Camera placement allows for the clear and certain identification of any individual or activity on the licensed premises including all areas where marijuana is grown, cured or manufactured PO Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098,(360)664-1600,Icb.wa.gov LIQ1227 06/2016 Page 1 of 7 LOG ITEM # L(. Pageor j,_ 4 DocuSign Envelope ID:1A0D31D8.2886-46B7-8710-8839frA3978A UBI Number 6040283380010001 2. TRACEABILITY (WAC 314-55-083(4)) a. Will you use a third party vendor for your traceability software? 0 YES xQ NO If you selected YES, please list the name of the vendor/software: If you selected NO, please describe how you will comply with traceability requirements: USING LCB MJ TRACEABILITY SYSTEM b. Is the system listed above compatible with the LCB's traceability system? c1 YES 3. TRANSPORTATION OF PRODUCT (WAC 314.55.085) a. Quarantine: 1. Will all product be placed in quarantine 24 hours prior to transport? [c] YES 2. Will all product be entered into the traceability system? 7 YES b. Manifest: 1. Will the manifest be printed and attached to the product during transport? is. YES c. Will the product be transported in a locked safe and secure storage compartment that is secured to the inside body/compartment of the vehicle? s] YES 4. DESTRUCTION OF WASTE PRODUCT (WAC 314-55-097) a. Will waste be secured on site 72 hours prior to rendering it unuseable? YES b. Will all waste be disposed of in compliance with local and state laws, rules and regulations? in YES c. Will you grind or chip non-dangerous waste and mix it with 50% non-marijuana waste? ,D YES Po Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098,(360)664-1600,Icb.wa.gov LIQ1227 06/2016 Page 2 of 7 LOG ITEM I o__, Z of OocuSi'gn Envelope ID:1A0D31D8-2886-4687-B710.8839FFA3978A UBI Number 6040283380010001 5. DESCRIPTION OF OPERATION AND PREMISES a. Standardized Scale Will your scale meet the requirements listed below: YES 0 Licensees are required to have at least one scale on the licensed premises for the traceability and inventory of products. rr The scale(s) used must have a National Type Evaluation Program (NTEP) Certificate of Conformance (COC). If a scale meets this requirement it should have an ID name plate on it with the COC number. (!s I Licensees must register their scale(s) on a business license application with Business Licensing Services through the Department. b. Marijuana Production YES NO ❑ Q Indoor Grow [] ❑ Outdoor Grow c. Sizecategory (plant canopy): (l Tier 1 ❑ Tier 2 C Tier 3 d. List the total square feet you will dedicate to plant canopy for each: Recreational: 10,000 OUTDOOR GREENHOUSES Medical: NA e. Describe the type of eight foot fencing and material used to encompass your outdoor grow or to connect exterior buildings on the licensed premises: CHAIN LINK WITH SCREEN MESH TO BLOCK VISION f. I acknowledge that all soil amendments, fertilizers, pesticides and other crop aids used will be compliant with LCB standards listed in WAC 314-55-084: CE] YES PO Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098,(360)664-1800,Icb.wa.gov LIQ1227 06/2016 Page 3 of 7 LOG ITEM ='age 3 of s DocuSign Envelope ID:1 A0031 D8-2B86-46B7-8710-8839FFA3978A UBI Number 6040283380010001 6. PROCESSING OPERATION a. List the types of finished products that will be created on your licensed premises (such as useable marijuana, infused products and edibles): USEABLE MARIJUANA AND DRY SIFTED HASH b. Describe the processing methods and equipment you will use to create the items listed above (WAC 314-55-104): AFTER THE PLANTS HAVE DRIED, THEY WILL BE TRIMMED WITH A SATILLITE SL DRY TRIMMING MACHINE. PROTECTIVE GLOVES AND EYE WEAR IF NECESSARY WORN AT ALL TIMES. THE PRODUCT WILL THAN BE SORTED- USEABLE AND NON-USEABLE MATTER.NON-USEABLE MATERIALS WILL BE COMPOSTED. USUABLE MARIJUANA WILL BE CUT, TRIMMED AND SIFTED WITH SIFT BUCKETS FOR HASH AND PROPERLY WEIGHED AND PACKAGED FOR FLOWER. c. Describe the packaging for all finished products (usable and infused) to include how they will be sealed: HEAT SEALED PLASTIC BAGS AND OR GLASS JARS WITH HEAT SHRINK. d. Describe what information will be listed on labels affixed to your finished products (please indicate any differences between usable marijuana and marijuana-infused products): THE FOLLOWING INFORMATION WILL BE ON EACH PACKAGED ITEM- WARNING, THIS PRODUCT HAS INTOXICATING EFFECTS AND MAY BE HABIT FORMING. SMOKING IS HAZARDOUS TO YOUR HEALTH- THERE MAY BE HEALTH RISKS FOR BREAST FEEDING OR PREGNANT WOMEN- FOR USE BY ADULTS 21 YEARS AND OLDER ONLY- KEEP OUT OF REACH OF CHILDREN-MARIJUANA CAN IMPAIR, CONCENTRATION, COORDINATION AND JUDGMENT- DO NOT OPERATE VEHICLE OR MACHINERY UNDER THE INFLUENCE OF THIS DRUG- ALSO STATEMENTS FOR ALL PESTICIDES APPLIED AND GROWING MEDIUMS DURING PRODUCTION AND PROCESSING. PO Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098,(360)664-1600,Icb.wa.gov LIQ1227 06/2016 Page 4 of 7 LOG ITEM Page 4 of $ • DocuSign Envelope ID:IA0D31D8-2688-4697-6710.8839FFA3978A UBI Number 6040283380010001 e. Will all soil amendments,fertilizers, pesticides and other crop aids used be compliant with LCB standards listed in WAC 314-55-084: i"❑ YES 7. QUALITY ASSURANCE PROTOCOLS (WAC 314-55-102) a. Will all quality assurance testing be done by an accredited third party lab approved by the LCB: °E YES 8. EMPLOYEES COMPENSATION AND BENEFITS DATA (WAC 314-55.020) a. Will you provide a living wage (at least one hundred fifty percent of the state minimum wage) to eighty-five percent or more of your employees? ❑ YES Q NO b. Will you provide health insurance to at least eighty-five percent of your hourly employees? ❑ YES C NO c. Will you provide a defined benefit pension plan to at least eighty-five percent of your hourly employees? ❑ YES E NO d. Will you provide five or more paid sick days annually to at least eighty-five percent of your hourly employees? (l YES Q NO e. Is there a signed labor peace agreement or collective bargaining agreement with a labor organization in place? ❑ YES x❑ NO PO Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098,(360)664-1600,Icb.wa.gov L1Q1227 06/2016 Page S of 7 LOG ITEM 4 Page 5 of __. DocuSlgn Envelope ID: 1A0D31D8-28B6-46B7-B710-8839FFA3978A 6040283380010001 UBI Number 9. ATTACH FLOOR PLAN /SITE PLAN (architectural plans are accepted but not required). Plans must be drawn to scale. Please ensure your Floor Plan/Site Plan includes a key referencing the specific areas listed below. For your convenience, an example key is attached. a. Physical barrier/perimeter fencing enclosing the licensed premises including all gates b. Grow area(s) dedicated to medical marijuana c. Grow area(s) dedicated to recreational marijuana d. Processing area(s) e. Quarantine area(s) f. Label all rooms g. Points of ingress/egress to the licensed premises h. Location of all doors and windows Location of secured Surveillance System Storage Device j. Location of all cameras and alarms k. Designated Waste area(s) riDotuSgnoel ny. t4Stik Swtl[U 11/28/2016 -r+4042tEPWFC`4O£) Signature Date Click `yes' to attach floor plan n YES PO Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098,(360)664-1600,Icb,wa.gov LIQ1227 06/2016 Page 6 of 7 LOG ITEM Page (12 of Docu9ign Envelope ID:1A003108-28B6-4887-B710-8838FFA3878A UBI Number kEY FOR ALL MARIJUANA FLOOR PLANS O Surveillance Camera:You must have 100%camera coverage.If you do not have 360° cameras,you will need a minimum of two cameras in each room.Draw arrows to indicate all directions the camera is capturing. R Retail Display Case POS Retail Point of Sale XX Sight Obscured Fencing ime Fencing A Security Alarm:Sensorthat is required on all exterior doors and windows 1XXSurveillance System Storage:Room,Closet,Lockbox or other secured location Door or entry into a Retail and Non-Retail Premise W Window:All exterior windows require an alarm II Gate through fenced area:All gates require an alarm IDENTIFY ALL ROOMS AND AREAS ON THE FLOOR PLAN TO INCLUDE THE FOLLOWING: • Grow Area—Area where marijuana Is grown • ProcessingArea—Area where processing of any kind will occur • Quarantine Area—Area that marijuana or marijuana Infused products are kept before being removed ortransported • Security Room/Controlled Access Area—All areas restricted to the general public. • Waste Area—Area waste will be held prior to destruction Note:If architectural plans or any otherform of floor plan is submitted,you must provide a key, PO Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098, (360)664-1600,Icb.wa.gov LIQ1227 06/2016 Page 7 of 7 LOG !TEM 4 Pace `1 of .3` �. �br I -s . ..„;.. ,, ,:: ,;,. , ,:,.,...n,..:,,t.1.1.,,m,,,,t:,...f...„,,,44.!iiii4:44.14,../.,: t. iY , , . „„ . . _ , .....1,-..,,,,,,,,,,1"..,07,erf„.„;41.,,.,,?..,„,,,;;;,!...„..1,4,:„,,I, t It '4. ---- ,,,,,,,„v„:„. „,,,,„9,,,,,,,„:„. , , AF j �' sr,;dot ,;.° c . P 9,ti 4-, , ,1,1;04sil...4.,:„. f,:.t i h p f, = - 1 , ': t ;,,, a .-� ,,...e..:-.,--„, ,14-4,i'.----F,,,,'„:.ey �,� t f. ;:i e W t 0 1 i it' , , i I 1 { i r /*'-' , ..,,.„ , E` pi M . -, .f: Z..+Mt Zr:'x .=i..-',46.4-044‘4 h..a '''''''',''''''t. 'F 'F4:J < .4°'N. Irv'w ',t' +ys1=fir+'"• /17'i'+ .. io£mJ flYSi• 1:# 'age g of ruocuSign Envelope ID:1A0031D8-2B06-4687-B710-8839FFA3978A {t( Washington State License Number 412943 �% Liquor and Cannabis Board UBf Number 6040283380010001 OLYMPUS GARDENS Trade Name Operating Plan Required Elements— Producer/Processor Submission of an operating plan that demonstrates the applicant is qualified to hold the marijuana license applied for is required as part of the application process listed in Washington Administrative Code (WAG) 314-55-020. This operating plan must include a floor plan and/or site plan which illustrates the entire operation being proposed.(WAC 314.55.020(11)) Please describe how your operating plan complies with the requirements listed in the WACs indicated below. Additional sheets may be attached if nece$; ary. 1. SECURITY (WAC 314-55-083) a. Will all employees wear an identification badge? 'Cooiv (-E:j YES b. Does your location have a security alarm system on all perimeter doors and windows? rip YES c. Does your video surveillance system and recording device meet the following requirements? YES �{!s Minimum camera resolution of 640 x 470 c[1] Internet protocol (IP) compatible r Recorded images clearly and accurately display the time and date Surveillance system storage device is secured on-site in a locked box ',c] Camera recordings must be continuously recorded twenty-four hours a day l_. Surveillance recordings must be kept for a minimum of forty-five days System includes image acquisition, video recording, management and monitoring � w hardware and support systems `D Camera placement allows for the clear and certain identification of any individual or activity on the licensed premises including all areas where marijuana is grown, cured or manufactured PO Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098,(360)664-1600,Icb.wa.gov LIQ1227 06/2016 Page 1 of 7 LOG ITEM # L(. Pageor j,_ 4 DocuSign Envelope ID:1A0D31D8.2886-46B7-8710-8839frA3978A UBI Number 6040283380010001 2. TRACEABILITY (WAC 314-55-083(4)) a. Will you use a third party vendor for your traceability software? 0 YES xQ NO If you selected YES, please list the name of the vendor/software: If you selected NO, please describe how you will comply with traceability requirements: USING LCB MJ TRACEABILITY SYSTEM b. Is the system listed above compatible with the LCB's traceability system? c1 YES 3. TRANSPORTATION OF PRODUCT (WAC 314.55.085) a. Quarantine: 1. Will all product be placed in quarantine 24 hours prior to transport? [c] YES 2. Will all product be entered into the traceability system? 7 YES b. Manifest: 1. Will the manifest be printed and attached to the product during transport? is. YES c. Will the product be transported in a locked safe and secure storage compartment that is secured to the inside body/compartment of the vehicle? s] YES 4. DESTRUCTION OF WASTE PRODUCT (WAC 314-55-097) a. Will waste be secured on site 72 hours prior to rendering it unuseable? YES b. Will all waste be disposed of in compliance with local and state laws, rules and regulations? in YES c. Will you grind or chip non-dangerous waste and mix it with 50% non-marijuana waste? ,D YES Po Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098,(360)664-1600,Icb.wa.gov LIQ1227 06/2016 Page 2 of 7 LOG ITEM I o__, Z of OocuSi'gn Envelope ID:1A0D31D8-2886-4687-B710.8839FFA3978A UBI Number 6040283380010001 5. DESCRIPTION OF OPERATION AND PREMISES a. Standardized Scale Will your scale meet the requirements listed below: YES 0 Licensees are required to have at least one scale on the licensed premises for the traceability and inventory of products. rr The scale(s) used must have a National Type Evaluation Program (NTEP) Certificate of Conformance (COC). If a scale meets this requirement it should have an ID name plate on it with the COC number. (!s I Licensees must register their scale(s) on a business license application with Business Licensing Services through the Department. b. Marijuana Production YES NO ❑ Q Indoor Grow [] ❑ Outdoor Grow c. Sizecategory (plant canopy): (l Tier 1 ❑ Tier 2 C Tier 3 d. List the total square feet you will dedicate to plant canopy for each: Recreational: 10,000 OUTDOOR GREENHOUSES Medical: NA e. Describe the type of eight foot fencing and material used to encompass your outdoor grow or to connect exterior buildings on the licensed premises: CHAIN LINK WITH SCREEN MESH TO BLOCK VISION f. I acknowledge that all soil amendments, fertilizers, pesticides and other crop aids used will be compliant with LCB standards listed in WAC 314-55-084: CE] YES PO Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098,(360)664-1800,Icb.wa.gov LIQ1227 06/2016 Page 3 of 7 LOG ITEM ='age 3 of s DocuSign Envelope ID:1 A0031 D8-2B86-46B7-8710-8839FFA3978A UBI Number 6040283380010001 6. PROCESSING OPERATION a. List the types of finished products that will be created on your licensed premises (such as useable marijuana, infused products and edibles): USEABLE MARIJUANA AND DRY SIFTED HASH b. Describe the processing methods and equipment you will use to create the items listed above (WAC 314-55-104): AFTER THE PLANTS HAVE DRIED, THEY WILL BE TRIMMED WITH A SATILLITE SL DRY TRIMMING MACHINE. PROTECTIVE GLOVES AND EYE WEAR IF NECESSARY WORN AT ALL TIMES. THE PRODUCT WILL THAN BE SORTED- USEABLE AND NON-USEABLE MATTER.NON-USEABLE MATERIALS WILL BE COMPOSTED. USUABLE MARIJUANA WILL BE CUT, TRIMMED AND SIFTED WITH SIFT BUCKETS FOR HASH AND PROPERLY WEIGHED AND PACKAGED FOR FLOWER. c. Describe the packaging for all finished products (usable and infused) to include how they will be sealed: HEAT SEALED PLASTIC BAGS AND OR GLASS JARS WITH HEAT SHRINK. d. Describe what information will be listed on labels affixed to your finished products (please indicate any differences between usable marijuana and marijuana-infused products): THE FOLLOWING INFORMATION WILL BE ON EACH PACKAGED ITEM- WARNING, THIS PRODUCT HAS INTOXICATING EFFECTS AND MAY BE HABIT FORMING. SMOKING IS HAZARDOUS TO YOUR HEALTH- THERE MAY BE HEALTH RISKS FOR BREAST FEEDING OR PREGNANT WOMEN- FOR USE BY ADULTS 21 YEARS AND OLDER ONLY- KEEP OUT OF REACH OF CHILDREN-MARIJUANA CAN IMPAIR, CONCENTRATION, COORDINATION AND JUDGMENT- DO NOT OPERATE VEHICLE OR MACHINERY UNDER THE INFLUENCE OF THIS DRUG- ALSO STATEMENTS FOR ALL PESTICIDES APPLIED AND GROWING MEDIUMS DURING PRODUCTION AND PROCESSING. PO Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098,(360)664-1600,Icb.wa.gov LIQ1227 06/2016 Page 4 of 7 LOG ITEM Page 4 of $ • DocuSign Envelope ID:IA0D31D8-2688-4697-6710.8839FFA3978A UBI Number 6040283380010001 e. Will all soil amendments,fertilizers, pesticides and other crop aids used be compliant with LCB standards listed in WAC 314-55-084: i"❑ YES 7. QUALITY ASSURANCE PROTOCOLS (WAC 314-55-102) a. Will all quality assurance testing be done by an accredited third party lab approved by the LCB: °E YES 8. EMPLOYEES COMPENSATION AND BENEFITS DATA (WAC 314-55.020) a. Will you provide a living wage (at least one hundred fifty percent of the state minimum wage) to eighty-five percent or more of your employees? ❑ YES Q NO b. Will you provide health insurance to at least eighty-five percent of your hourly employees? ❑ YES C NO c. Will you provide a defined benefit pension plan to at least eighty-five percent of your hourly employees? ❑ YES E NO d. Will you provide five or more paid sick days annually to at least eighty-five percent of your hourly employees? (l YES Q NO e. Is there a signed labor peace agreement or collective bargaining agreement with a labor organization in place? ❑ YES x❑ NO PO Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098,(360)664-1600,Icb.wa.gov L1Q1227 06/2016 Page S of 7 LOG ITEM 4 Page 5 of __. DocuSlgn Envelope ID: 1A0D31D8-28B6-46B7-B710-8839FFA3978A 6040283380010001 UBI Number 9. ATTACH FLOOR PLAN /SITE PLAN (architectural plans are accepted but not required). Plans must be drawn to scale. Please ensure your Floor Plan/Site Plan includes a key referencing the specific areas listed below. For your convenience, an example key is attached. a. Physical barrier/perimeter fencing enclosing the licensed premises including all gates b. Grow area(s) dedicated to medical marijuana c. Grow area(s) dedicated to recreational marijuana d. Processing area(s) e. Quarantine area(s) f. Label all rooms g. Points of ingress/egress to the licensed premises h. Location of all doors and windows Location of secured Surveillance System Storage Device j. Location of all cameras and alarms k. Designated Waste area(s) riDotuSgnoel ny. t4Stik Swtl[U 11/28/2016 -r+4042tEPWFC`4O£) Signature Date Click `yes' to attach floor plan n YES PO Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098,(360)664-1600,Icb,wa.gov LIQ1227 06/2016 Page 6 of 7 LOG ITEM Page (12 of Docu9ign Envelope ID:1A003108-28B6-4887-B710-8838FFA3878A UBI Number kEY FOR ALL MARIJUANA FLOOR PLANS O Surveillance Camera:You must have 100%camera coverage.If you do not have 360° cameras,you will need a minimum of two cameras in each room.Draw arrows to indicate all directions the camera is capturing. R Retail Display Case POS Retail Point of Sale XX Sight Obscured Fencing ime Fencing A Security Alarm:Sensorthat is required on all exterior doors and windows 1XXSurveillance System Storage:Room,Closet,Lockbox or other secured location Door or entry into a Retail and Non-Retail Premise W Window:All exterior windows require an alarm II Gate through fenced area:All gates require an alarm IDENTIFY ALL ROOMS AND AREAS ON THE FLOOR PLAN TO INCLUDE THE FOLLOWING: • Grow Area—Area where marijuana Is grown • ProcessingArea—Area where processing of any kind will occur • Quarantine Area—Area that marijuana or marijuana Infused products are kept before being removed ortransported • Security Room/Controlled Access Area—All areas restricted to the general public. • Waste Area—Area waste will be held prior to destruction Note:If architectural plans or any otherform of floor plan is submitted,you must provide a key, PO Box 43098,3000 Pacific Ave.SE,Olympia WA 98504-3098, (360)664-1600,Icb.wa.gov LIQ1227 06/2016 Page 7 of 7 LOG !TEM 4 Pace `1 of .3` �. �br I -s . ..„;.. ,, ,:: ,;,. , ,:,.,...n,..:,,t.1.1.,,m,,,,t:,...f...„,,,44.!iiii4:44.14,../.,: t. iY , , . „„ . . _ , .....1,-..,,,,,,,,,,1"..,07,erf„.„;41.,,.,,?..,„,,,;;;,!...„..1,4,:„,,I, t It '4. ---- ,,,,,,,„v„:„. „,,,,„9,,,,,,,„:„. , , AF j �' sr,;dot ,;.° c . P 9,ti 4-, , ,1,1;04sil...4.,:„. f,:.t i h p f, = - 1 , ': t ;,,, a .-� ,,...e..:-.,--„, ,14-4,i'.----F,,,,'„:.ey �,� t f. ;:i e W t 0 1 i it' , , i I 1 { i r /*'-' , ..,,.„ , E` pi M . -, .f: Z..+Mt Zr:'x .=i..-',46.4-044‘4 h..a '''''''',''''''t. 'F 'F4:J < .4°'N. Irv'w ',t' +ys1=fir+'"• /17'i'+ .. io£mJ flYSi• 1:# 'age g of