Fillable Application To Operate Temporary Food Service (Island Health)

Fill Online, Printable, Fillable, Blank Application To Operate Temporary Food Service (Island Health) Form

Use Fill to complete blank online ISLAND HEALTH pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Application To Operate Temporary Food Service (Island Health)

On average this form takes 28 minutes to complete

The Application To Operate Temporary Food Service (Island Health) form is 4 pages long and contains:

  • 0 signatures
  • 45 check-boxes
  • 91 other fields

Country of origin: CANADA
File type: PDF

Use our library of forms to quickly fill and sign your Island Health forms online.

BROWSE ISLAND HEALTH 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
 
TEMPORARY FOOD SERVICE INFORMATION
Please refer to this sheet when completing your application and retain it for future reference.
For temporary food service, your primary concerns are to:
• Obtain all food from an approved source, such as a grocery store.
• Keep perishable food cold (≤ 4°C), frozen (≤ -18°C), or hot (≥ 60°C) until use.
• Ensure all utensils, containers, and work surfaces are regularly cleaned and sanitized.
• Ensure that sanitizer solution and appropriate test strips are readily available and in use.
• Wash your hands often with warm water, liquid soap, and paper towels. Never handle food when ill.
• Keep raw foods, especially eggs, meat and fish, separate from cooked foods.
• Cook and reheat foods to ≥ 74°C.
• Where food samples are offered, use single service dispensing or limit sample distribution to food handlers.
• Ensure food handling duties are performed separately from cash handling duties.
FOOD SAFETY AND SANITATION PLANS:
For single day events with simple preparation and lower risk foods, your Operational Plan on the attached application may
also serve as your Food Safety and Sanitation Plan. For multiday events and those with more complicated menus and/or
higher risk foods, separate Food Safety and Sanitation Plans are required in addition to the application. Plan templates and
instructions are available-refer to www.viha.ca
and use the search tool.
HAND WASHING:
• Wash hands before starting work, after using the toilet and whenever contamination may have occurred.
• Provide liquid soap and paper towel, and ensure an adequate amount of potable water is available at all times.
• Dispose of wastewater into a sewer connection (via toilet or laundry sink) or appropriate sewerage system.
TEMPORARY HAND WASH STATION EXAMPLE:
SCALE DRAWING OF LAYOUT:
The application requires a detailed scale drawing of how you will set up your temporary food service.
Be sure to include:
• All equipment for food storage &
preparation (counters, fridges, freezers, hot
holding, BBQs etc.)
• Storage of utensils and single service items.
• Location of hand washing stations(s)
• Location of dish washing station(s)
• Wastewater and garbage collection
• Flooring & overhead cover (e.g. tent)
SCALE DRAWING EXAMPLE:
Large or multiday
events and those with
higher risk foods
generally require
portable hand wash
sinks with supply and
wastewater tanks or
connections.
Temporary hand wash
stations are suitable
for shorter, lower risk
events only.
Contact
an EHO if you are
unsure whether more
is required for your
event.
PORTABLE HAND SINK EXAMPLE
APPLICATION TO OPERATE
A TEMPORARY FOOD PREMISES (for SPECIAL EVENT FOOD SERVICE)
• Submit completed application to the local Health Protection Office AT LEAST 14 DAYS PRIOR TO EVENT.
• Refer to TEMPORARY FOOD SERVICE INFORMATION sheet, and retain for reference with a copy of your application.
• Incomplete or late applications may not be processed. Any questions- contact your local EHO.
• No food service is to occur without a permit or written approval from an Environmental Health Officer.
DATE(S) OF FOOD SERVICE: TIME OF FOOD SERVICE:
EVENT INFORMATION
NAME OF EVENT: LOCATION OF EVENT (e.g. NAME OF PARK):
EVENT PHYSICAL ADDRESS (STREET / CITY):
NAME OF EVENT COORDINATOR: N/A PHONE NUMBER/ E-MAIL:
APPLICANT INFORMATION
APPLICANT NAME (INDIVIDUAL and ORGANIZATION, where applicable): PHONE NUMBER: EMAIL:
MAILING ADDRESS:
STREET CITY POSTAL CODE
FOOD PREMISES SET UP (check/complete all that apply)
INDOORS or OUTDOORS
ONSITE KITCHEN
ONSITE KIOSK
CONTACT FOR KITCHEN/KIOSK:
PHONE NUMBER:
SELF-CONTAINED MOBILE UNIT No Permit/Approval
Permit/Approval from a BC Health Authority ** Attach copy of current permit/approval**
FOOD PREPARATION AND SERVICE
List Foods & Beverages List Supplier / Producer Where is the item Prepared? Item is served:
At event In permitted Kitchen
Hot Cold
At event In permitted Kitchen Hot Cold
At event In permitted Kitchen Hot Cold
At event In permitted Kitchen Hot Cold
At event In permitted Kitchen Hot Cold
At event In permitted Kitchen Hot Cold
(Cont’d) Temporary Food Service Application, Page 2 of 3
VENDOR NAME:
DATE OF EVENT:
OPERATIONAL PLAN (*Also serves as Food Safety Plan for 1 day events with a limited menu and minimal preparation*)
REQUIREMENT SPECIFY HOW THIS WILL BE ACCOMPLISHED, LIST EQUIPMENT
USED
General Food
Protection
Protected from contamination (off
ground, covered)
Temperature
Monitoring
Record temp before/after
transport and every 2 hours (use
accurate probe thermometer)
Cooking and
Reheating
To required internal temperature
(e.g., Chicken and all reheated
foods to 74°C)
Hot-holding
Hold hot food at 60°C or hotter
Cold-holding
4°C or colder-Mechanical
refrigeration generally required
Food Contact
Surfaces
Smooth, non-porous and easily
cleanable (e.g., stainless steel)
Hand Washing
Warm water dispensed from non-
self-closing valve. Soap in a
dispenser and paper towels
Sanitizer
Approved sanitizer (e.g. 1 teaspoon
bleach/ litre water), use test strips
Water Supply
From an approved water supply
system via potable water hoses
Ware Washing 3 sinks for onsite food prep
Wastewater
Disposal
Into sanitary sewer (not ground
surface/storm drain)
FOODSAFE CERTIFIED FOOD HANDLERS: **1 certified person required at all times- attach copies of certificates**
NAME: PHONE NUMBER:
NAME: PHONE NUMBER:
NAME: PHONE NUMBER:
NAME: PHONE NUMBER:
IF APPROVED, HOW WOULD YOU LIKE TO RECEIVE YOUR PERMIT?
Pick up in HPES office Fax to: _________________ Mail Email:___________________________
(Cont’d) Temporary Food Service Application, Page 3 of 3
VENDOR NAME:
DATE OF EVENT:
SCALE DRAWING OF LAYOUT:
• Refer to the example in the information sheet.
• A separate page can be used if necessary.
#
List of
Facilities/Equipment
The information enclosed is true and accurate to the best of my knowledge. I understand that providing safe food is my
responsibility and I will follow all requirements. I will not provide food service without written EHO Approval.
Applicant Signature: _______________________________ Date: __________________________
---INTERNAL USE ONLY---
Application Approved and Permit Issued
Application Rejected Applicant Informed by EHO: By Phone By Email In Person
Submissions were incomplete
Submissions did not demonstrate an adequate understanding of required safe food handling practices.
Submission date did not allow sufficient time for EHO review in advance of event (min 14 days required).
The applicant (individual or organization has already operated for 14 days this calendar year so is not eligible
for further temporary permits.
Other: _________________________________________________________________________
EHO Signature: Date:
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 To Operate Temporary Food Service (Island Health)

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 15 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document