Fillable Food Business Establishment (Renfrewshire Council)

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Food Business Establishment (Renfrewshire Council)

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Application for Approval of
Food Business Establishment
Subject to Approval under Regulation (EC) No. 853/2004
Complete Parts 1 to 8 inclusive, and the specific sections of Part 9 that relate to the products of
animal origin in respect of which you are applying for the approval of your establishment, then
complete, sign and date Part 10.
PART 1: TYPE OF PRODUCT(S) OF ANIMAL ORIGIN FOR WHICH APPROVAL IS SOUGHT
Indicate the product(s) of animal origin in relation to which you are applying for approval to use the
establishment (tick all that apply).
Minced meat
Meat preparations
Mechanically separated meat
Meat products
Live bivalve molluscs (shellfish)
Fishery products
Dairy products
Frogs’ legs/snails
Rendered animal fats and greaves
Treated stomachs, bladders and intestines
Gelatine
Collagen
Raw material for the production of gelatine or collagen intended for human consumption (collection centre or tannery)
Stand-alone cold store
PART 2: ESTABLISHMENT FOR WHICH APPROVAL IS SOUGHT (THE ESTABLISHMENT)
Trading Name
Address
Post code
PART 3: FOOD BUSINESS OPERATOR AND MANAGEMENT OF THE ESTABLISHMENT
Name
Address of food
business operator
Postcode
Telephone number
Fax number
e-mail address
Names of managers of
the Premises
1 2 3
Job Titles
1
2 3
Names of Others in
control of the business
1 2 3
Job Titles
1
2 3
PART 4: USE OF THE ESTABLISHMENT
Which of the following activities will be conducted in/from the establishment? (tick all that apply)
Wholesale market
Manufacture
Other processing (please specify)
Packing
Storage
Cash and Carry/Wholesale
Catering (preparation of food for consumption in the establishment)
Retail (direct sale to consumers or other customers)
Market stall or mobile vendor
Stand-alone cold store
Distribution
Other (please specify)
PART 5: TRANSPORT OF PRODUCTS FROM THE ESTABLISHMENT
How will products be transported from the establishment? (tick all that apply)
Your own vehicle(s)
Contract/Private Haulier
Purchaser's own vehicle(s)
Other (please specify)
PART 6: SUPPLY OF PRODUCTS FROM THE ESTABLISHMENT TO OTHER ESTABLISHMENTS
Which of the following will be supplied with products from the establishment? (tick all that apply)
Other businesses that manufacture or process food
Wholesale packers
Cold stores that are not part of the establishment to which this application relates
Warehouses that are not part of the establishment to which this application relates
Restaurants, hotels, canteens or similar catering businesses
Take-away business
Retail shops, supermarkets, stalls or mobile vendors that you own
Retail shops, supermarkets, stalls or mobile vendors that you do not own
Members of the public direct from the establishment to which this application relates
Other (please specify)
PART 7: OTHER ACTIVITIES ON THE SAME SITE
Will any of the following activities be conducted on the same site as, or within, the establishment to
which this application approval relates?
YES
NO
APPROVAL CODE
Slaughter, including pigs, sheep,
cattle poultry, game etc
Cutting fresh (including chilled and
frozen) meat, poultry meat or game
Storage of fresh (including chilled and
frozen ) meat, poultry or game
PART 8: INFORMATION AND DOCUMENTATION
The following information is required in order to process your application and should be sent with this
application form if possible. Please indicate which information you are sending now. (N.B. information
that is not sent now will still be required before your application can be determined).
A detailed scale plan of the (proposed) establishment and the layout of facilities and equipment.
A description of the (proposed) food safety management system based on HACCP principles.
A description of the (proposed) establishment and equipment maintenance arrangements.
A description of the (proposed) waste collection and disposal arrangements.
A description of the (proposed) water supply
A description of the (proposed) water supply quality testing arrangements.
A description of the (proposed) arrangements for product testing.
A description of the (proposed) pest control arrangements
A description of the (proposed) monitoring arrangements for staff health.
A description of the (proposed) staff hygiene training arrangements.
A description of the (proposed) arrangements for record keeping.
A description of the (proposed) arrangements for applying the identification mark to product packaging or wrapping.
PART 9: ACTIVITIES/PRODUCTS TO BE HANDLED IN THE ESTABLISHMENT
Which of the following activities will be conducted in the establishment? Indicate by giving the
approximate quantities to be handled in kilograms or litres per week (tick all that apply).
PART 9(1) - Minced Meat and Meat Preparations
Handling minced meat
Handling meat preparations
Full details of activities and specific products
handled:
How many tonnes of minced meat in total will be
handled in the establishment per week on average:
How many tonnes of meat preparations in total will
be handled in the establishment per week on
average:
PART 9(2) - Mechanically Separated Meat
Mechanically Separated Meat
Full details of Activities and specific products
handled:
How many tonnes of mechanically separated meat
in total will be handled in the establishment per
week on average:
PART 9(3) - Meat Products
Meat Products
Full details of Activities and specific products
handled:
How many tonnes of meat products will be handled
in the establishment per week on average:
PART 9(4) - Live Bivalve Molluscs (Shellfish)/Fishery Products
Live Bivalve Molluscs (Shellfish)/Fishery Products
Full details of activities and specific products
handled:
How many tonnes of Live Bivalve molluscs
(Shellfish)/Fishery Products will be handled in the
establishment per week on average:
PART 9(5) - Raw Milk/Dairy Products
Raw Milk/Dairy Products
Full details of activities and specific products
handled:
How many tonnes of Raw Milk/Dairy Products will
be handled in the establishment per week on
average:
PART 9(6) - Eggs (not Primary Production)/Egg Products
Eggs (not Primary Production)/Egg Products
Full details of activities and specific products
handled:
How many tonnes of Eggs will be packed in the
establishment per week on average:
How many litres of Egg products will be handled in
the establishment per week on average:
PART 9(7) - Frogs’ Legs and Snails
Frogs’ Legs
Snails
Full details of activities and specific products
handled:
How many tonnes of frogs’ legs in total will be
handled in the establishment per week on average:
How many tonnes of snails in total will be handled
in the establishment per week on average:
PART 9(8) - Rendered Animal Fats and Greaves
Rendered Animal Fats and Greaves
Full details of activities and specific products
handled:
How many tonnes of Rendered Animal Fats and
Greaves will be packed in the establishment per
week on average:
PART 9(9) - Treated Stomachs, Bladders and Intestines
Stomachs, Bladders and Intestines
Full details of activities and specific products
handled:
How many tonnes of stomachs, bladders and
intestines in total will be handled in the
establishment per week on average:
Part 9(6) - Eggs (not Primary Production)/Egg Products
PART 9(10) - Gelatine
Stomachs, Bladders and Intestines
Full details of activities:
How many tonnes of gelatine in total will be
handled in the establishment per week on average:
PART 9(11) - COLLAGEN
Collagen
Full details of activities:
How many tonnes of collagen in total will be
handled in the establishment per week on average:
PART 9(12) - Stand-alone cold store
Stand-alone cold store
Full details of activities and specific products
handled:
How many tonnes of product will be handled in the
establishment per week on average:
PART 10: APPLICATION
Name of applicant
Position in business
Name of contact
Position in business
Tel (incl: Dialling Code)
Fax (incl. Dialling Code)
E-mail
Gelatine
I hereby apply, as food business operator of the
establishment described in Part 2, for approval to use
that establishment for the purpose of handling
products of animal origin for which Regulation (EC)
No. 853/2004 lays down requirements, as set out in
the relevant Parts of this document.
Signature:
Date:
If you need any help or advice about how to complete this form, or
about the products to which the Regulations relate, or the
circumstances in which approval under the Regulations is
required, please contact us on 0300 300 0380
Please submit the completed form:
e-mail: b-serv.es@renfrewshire.gov.uk
Post: Renfrewshire House
Environmental Services
Health Promotion Unit
Cotton Street
Paisley
PA1 1BR
IMPORTANT
Please notify of any changes of details you have given
on this form by writing or email to the above address(es)
Submit form by email
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Food Business Establishment (Renfrewshire Council)

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Completed 10 February 2021

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