Fillable APPLICATION fOr regIsTrATION uNder fOOd ACT 2014 (Masterton District Council New Zealand)

Fill Online, Printable, Fillable, Blank APPLICATION fOr regIsTrATION uNder fOOd ACT 2014 (Masterton District Council New Zealand) Form

Use Fill to complete blank online MASTERTON DISTRICT COUNCIL NEW ZEALAND pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

APPLICATION fOr regIsTrATION uNder fOOd ACT 2014 (Masterton District Council New Zealand)

On average this form takes 14 minutes to complete

The APPLICATION fOr regIsTrATION uNder fOOd ACT 2014 (Masterton District Council New Zealand) form is 5 pages long and contains:

  • 0 signatures
  • 27 check-boxes
  • 43 other fields

Country of origin: NEW-ZEALAND
File type: PDF

Use our library of forms to quickly fill and sign your Masterton District Council New Zealand forms online.

BROWSE MASTERTON DISTRICT COUNCIL NEW ZEALAND FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Masterton District Council
PO Box 444
Masterton 5840
Phone: 06 370 6300
mstn.govt.nz
health@mstn.
govt.nz
APPLICATION fOr regIsTrATION
uNder fOOd ACT 2014
We are LocaL Government
WWW.
mStn.Govt.nZ
sINgLe sITe
IN MAsTerTON
During the planning stage of any new food premises please contact Masterton District Council to ensure
the proposed premises meets all relevant requirements. Speak to:
Environmental Health Officer for suitability of the Food Act requirements
Resource Consents Planner about compatibility with the District Plan Building
Development Facilitators for Building Act requirements
Trade Waste Officer (regarding requirements for grease traps and consent)
appLicationS take 20 WorkinG dayS to proceSS
(provided all required information is supplied)
Before you Start, Let’S check that you have everythinG you WiLL need:
Complete the application form
Attach completed scope of operations document. Available from Masterton District Council or www.mpi.govt.nz
Attach site plan and/or colour photos If a scale oor plan (e.g. 1:50) of the proposed premises showing the layout,
ttings and xtures, detailing all oor, wall and ceiling surfaces, essential features and, if any, outdoor seating. If
colour photos – show the layout of the premises, including ttings and xtures in the food preparation area.
Attach a letter from your verier if that isn’t Council (National Programmes only) If you are applying for a
National Programme (NP) registration, you can choose your verier. You will need a conrming letter from
your verier to attach to this application. A list of recognised verication (or audit) agencies can be on the
MPI website, www.mpi.govt.nz, under ‘registers and lists’. The law requires Councils to verify businesses
registered under the template food control plan.
Attach copies of company registration certicates if you have a registered limited liability company If
your business is a registered limited liability company, a copy of the company registration certicate. See
www.companies.govt.nz
$134 - Registration fee must be paid when this application is submitted.
• If there are any changes to the details provided in this application after it has been sent, tells us in
writing immediately.
• The fee includes up to 2 hours to process the registration. Additional processing will be charged at
$67 per hour.
• Masterton District Council verification fee is $235 (up to 3.5 hours). Additional work will be charged
at $67 per hour. This will be invoiced separately.
• Fees are set in the in the Masterton District Council Annual Plan, and are reviewed annually.
Oce Use: GL 1520715
food act requirementS
The operator must ensure that the design, construction and location of the place of the food business enables
food to be safe and suitable, including by:
• Identifying and managing any risks posed to the safety or suitability of food
• Ensuring that the place has adequate space for producing, handling and processing of food as well as
xtures, ttings and equipment
• Ensuring that the design of the place enables the movement of staff, visitors and food to ow in a way that
prevents and manages risk
• Ensuring the design of the place provides easy access for cleaning and maintenance
• Ensuring the place is designed, constructed and located as to exclude dirt, dust, fumes, smoke and other
contaminates as well as prevents pests from entering and remaining
• Ensure materials used in the construction of the premises are not capable of contaminating food
The operator must also ensure that the facilities, equipment and essential services are designed, constructed,
and located in a way that enables food to be safe and suitable, this includes:
• Ensuring facilities, equipment, and essential services are not operated beyond their capacity or capability
• Water used for producing, processing, handling of food and for personal hygiene and cleaning is suitable
for purpose, does not adversely affect the safety and suitability of food
• The capacity of the water supply is adequate for the food business
traininG requirementS
It is good operating practice for at least one person, preferably the manager, to have completed a basic food
safety course. Under the Food Act 2014 managers are responsible for training their staff. For example if you are
operating under a template Food Control Plan the day-to-day manager must be familiar with and understand all
procedures before training staff. The manager would then need to complete and sign a staff training record for
each staff person who works in their business.
We are LocaL Government
WWW.
mStn.Govt.nZ
Masterton District Council
PO Box 444
Masterton 5840
Phone: 06 370 6300
mstn.govt.nz
health@mstn.govt.nz
Type of registration
Template food control plan: Food Service, Care Safe and Specialist Retail
NP3 NP2 NP1
Type of business
New Existing
BuSineSS information
Legal name(s) of operator (e.g. registered company, partnership or individual)
Copy of the company name registration from the New Zealand Companies oce attached (www.companies.govt.nz)
NZ Business number (NZBN)
For more information about NZBNs, including how to get one, visit www.business.govt.nz/companies)
Trading Name, if any (ie ‘Trading as’)
Same as legal name above
operator addreSS
You must provide this information to be registered. However, if the address is a dwellinghouse, you may ask that
the address is withheld from the public register by ticking the box below.
Postal address
This address is a private dwellinghouse and I wish it to be withheld from the public register.
Physical address
(if different to postal)
This address is a private dwellinghouse and I wish it to be withheld from the public register.
contact perSon detaiLS
The contact person details entered below will be used for communications about your registration, such as
sending approval documents and renewal reminders. Contact MPI if the details change.
Mobile
Business Phone
Email
Operator day to day manager name Position
APPLICATION fOr regIsTrATION
uNder fOOd ACT 2014
sINgLe sITe
IN MAsTerTON
verification aGency
Masterton District Council Other Name
I have attached a conrming letter from my verication agency.
premiSeS detaiLS
Proposed opening date
/ /
Number of staff
Grease Trap
Yes No
Shared grease trap
Yes No
Max occupancy
Type of grease trap
Capacity
Toilet numbers:
Urinal Stalls
Female
Unisex
Accessible
Number of Wash Hand basins
Male
Staff Only
Outdoor seating
Yes No
Building Consent No. (if applicable)
Resource Consent No. (if applicable)
moBiLe food premiSeS detaiLS
Vehicle make Vehicle registration number
Location where vehicle will be used
Address where vehicle will be when not in use
appLication Statement
I conrm that;
1) The information supplied in this application is truthful and accurate to the best of my knowledge and belief; and
2) The operator of the food business is able to comply with the requirements of the Food Act 2014.
Name
Job title
Signature Date
/ /
coLLection of information
Collection of Personal Information
• Some of the information collected will be displayed on a public register; and
• Under Principles 6 and 7 of the Privacy Act 1993, you have the right of access to, and correction of, any
personal information that you have provided.
Collection of Ocial Information
• All information provided to the Masterton District Council is ocial information and may be subject to a
request made under the Ocial Information Act 1982.
Written propoSaL
The written proposal should resemble a business proposal covering the following topics:
• The types of food to be provided and/or example menus
• The operating times of the business
• Whether any food will be transported or labelled
• The training/qualications/experience of any staff
• The number of staff to be employed
• If operating a home kitchen, how will goods be separated between domestic and commercial use, and how
much food is to be produced weekly/monthly.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

APPLICATION fOr regIsTrATION uNder fOOd ACT 2014 (Masterton District Council New Zealand)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 31 January 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document