primary business activities include the operation of a vehicle / mobile unit traveling from place to place to offer sale of products?
If yes, attach a copy of a valid WA State Drivers License for each person operating vehicle / mobile unit within the exterior boundaries of the Tulalip Reservation,
and a separate sheet providing description of all vehicles / mobile units used for this purpose. Description shall include at minimum the make, model, year, license
number, color, and affixed signage, advertisement, and/or other identifying marker for each vehicle / mobile unit.
Please check box that best describes this business:
On-site Preparation – Permanent establishment
On-site Preparation – Temporary establishment
Catering – Attach description of prep location and methods
Delivery only of food items prepared at an off-reservation establishment
On and Off-site Preparation – Attach description of prep location and
ease check box that best describes this business:
Child or Adult Care Facility Community Kitchen
Public School Government or Nonprofit Facility
Grocery/Convenience Store Seasonal Produce
Temporary Vendor - Provide dates below
Start: ______________________________ End: ______________________________
Hours of Operation:
M _____:_____ to _____:_____ F _____:_____ to _____:_____
T _____:_____ to _____:_____ S _____:_____ to _____:_____
W _____:_____ to _____:_____
Su _____:_____ to _____:_____
Th _____:_____ to _____:_____
Total # of Employees: ________
Food Handlers: ________ Deliverers: ________
Min. staff per shift:
________ Max. staff per shift: ________
HANDLING, COOKING & TEMPERATURE CONTROL METHODS
(i.e. Stove Top, Wok, Deep Fryer, Steamer, Oven, Smoker, BBQ, Gas Grill, Microwave, Hot Case, Steam Table, Refrigerat
or, Ice, Ice Bath, Freezer)
How Will Potentially Hazardous Food be Thawed?
Thawing Method Food less than 1” thick Food more than 1” thick
Refrigeration ___________________ ___________________
Running water (<70ºF) ___________________ ___________________
Microwave ___________________ ___________________
Cook from frozen ___________________ ___________________
Other: ___________________ ___________________
Explain how food will be handled during transport: __________________________
Method for cooling food (45°): Ice Bath Refrigerator at 2” to 4” Depth
Cooking & Reheating Potentially Hazardous Food
List all cooking & reheating equipment and check all applicable boxes:
Equipment Name: Cooking Reheating Frying Other
Hot and Cold Holding of Potentially Hazardous Food
List all hot & cold holding equipment and check all applicable boxes.
Equipment Name: Hot Cold
Eliminating contact with food with bare hands:
Disposable Gloves Utensils Bakery Tissue Other (list) ____________________________________
Will ice be used as a refrigerant for potentially hazardous foods? Yes No If yes, describe food types, duration, where this will occur, and the source of the ice.
TERO COMPLIANCE PLAN TERO (360) 716-4747
Tulalip TERO Title 9 #9.05:
TERO is the Equal Employment Opportunity Commission Representative (EEOC) on the Tulalip reservation. Tulalip TERO laws
and ordinances enforce specific requirements upon businesses, contractors, and subcontractors doing business within the exterior boundaries of the Tulalip
Reservation including regulating their employment practices and obligating them to provide preference in recruiting, hiring, training and promotions to certified
QUIL CEDA VILLAGE / TRIBAL GAMING AGENCY
QCV: Businesses and vendors operating within the boundaries of the Consolidated Borough of Quil Ceda Village (QCV) are required to enter into a lease agreement
and/or obtain a special operators license. For more information, contact the QCV Business Park at 360.716.5000.
TGA: Vendors providing services at or for any of the Tulalip Casino or Bingo entities are required to obtain a vendors license issued by the Tribal Gaming Agency
(TGA). For more information, contact the Tulalip TGO Office at 360.716.2000.
CIGARETTE, LIQUOR, FIREWORKS, BUSINESS, AND TRANSIENT ACCOMMODATIONS LICENSE REQUIREMENTS
Tulalip Tribes Cigarette Title 12 #12.10: LICENSE REQUIRED
Tulalip Tribes Liquor License Title 10 #10.35 and Tulalip Liquor Regulations: LIQUOR LICENSE(S) REQUIRED
Tulalip Fireworks Code Title 10 #10.25:
WHOLESALE AND RETAIL LICENSE(S) REQUIRED- Sale of retail fireworks in Tulalip is restricted to enrolled
members of the Tulalip Tribes of WA; sale of wholesale fireworks is unrestricted.
Tulalip Tribes Business License Title 10 #10.10: BUSINESS LICENSES ARE REQUIRED FOR ALL BUSINESSES OPERATING OR PROVIDING
SERVICES WITHIN THE EXTERIOR BOUNDARIES OF THE TULALIP RESERVATION.
Tulalip Tribes Transient Accommodation Ordinance Title 10 #10.40: LICENSE REQUIRED
Food Permit App Revised 03/2014
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