City Clerk Business Licensing
1800 W. Old Shakopee Road
Bloomington MN 55431-3027
PH 952-563-8728
Temporary Food
License Application
Please submit all applications 10 working days before the event.
Continued on page 2
Complete the chart below for all food and beverages to be served. Add additional pages if needed. Food must be from a
commercial source. Home-prepared foods are not allowed. Slowcookers/crock-pots are not allowed. Mechanical refrigeration
and hot holding equipment are required for events lasting longer than four hours.
Applicant name Business name
Applicant phone Email
Applicant address City Zip
Event Organizer Phone Email
Name of event
Date(s) Food service time: (Start-
Location and address of event
Will the event be open to the public?
Yes No
On-site person in charge of food service at event
Email Phone
Hot food: Purchased from: Preparation location: Equipment used to
cook/heat food:
Equipment used to
keep food hot
(above 135° F):
Cold food: Purchased from: Preparation location: Equipment used to
prepare food:
Equipment used to
keep food cold
(below 41° F):
Shelf-stable food and
Purchased from: Preparation location: Equipment used to prepare food:
57_040 (11/19) pg 1 of 2
Number of people expected
Employees must be able to wash their hands with warm running water and liquid hand soap. Paper towels must be provided
to dry hands. Hand sanitizer is not a substitute for hand-washing.
What hand-washing facilities will be provided in the stand?
Hand-washing sink Container with spigot lled with warm water
How will you eliminate direct hand contact with ready to eat foods? (gloves, utensils, etc.) ______________________________
What sanitizer will be provided to wipe down food contact surfaces and sanitize utensils?
Chlorine (bleach) 50-200 ppm Quaternary ammonium 200-400 ppm Not applicable (no food handling or only
prepackaged food)
Provide test strips for the chemical you choose. Test strips can be purchased online.
What facilities will be provided for dishwashing? (if applicable) __________________________________________________
What single-service utensils will be used? __________________________________________________________________
What toilet facilities will be provided for food handlers? _________________________________________________________
Provide the following unless foods are prepackaged:
A food thermometer to test food temperatures (0-220° F).
• Hats or hairnets for all people involved in food preparation or dishwashing.
An overhead covering for all food preparation or service areas outdoors, except over grills and fryers.
A oor for all food stands outdoors such as concrete, asphalt, plywood or mats.
A Class K re extinguisher if cooking with grease.
Will there be a tent greater than 200 square feet or a canopy greater than 400 square feet? Yes No
If yes, a separate permit is required from the Fire Prevention Division, 952-563-8933.
If the event is at a public school, attach a copy of the school permit.
Will alcohol be served at the event?
No Yes, Liquor Caterer _______________________________________________
Liquor Caterers must notify the Licensing Examiner at least 7 days prior to the event, 952-563-4923.
Based on the information provided herein, I understand that a temporary food license is required for this event. I further under-
stand that my application will be considered only for the food and beverage specied. The Environmental Health Specialist must
be advised of any deviations or changes to the menu.
Applicant’s signature Date
For office use only
This application is approved only for the operation as specied above.
Additional approval is required for any deviations.
n Multiple vendor: $928
Please select license type:
n 1 - 3 Days complex: $173
n 4 - 21 Days complex: $288
n 1 - 3 Days simple: $49
n 4 - 21 Days simple: $115
Environmental Health Specialist Date
57_040 (11/19) pg 2 of 2
Retain page 3 and 4 for reference.
Where will food be stored prior to the event? ________________________________________________________________
When will food be prepared? ____________________________________________________________________________
What time will food arrive at the event? ____________________________________________________________________
Please print out and sign here in ink.
Clear Form and Start Over
Temporary Food
License Requirements
Information Sheet
The Environmental Health Division must be notified of all
events that involve food service and sampling of food.
Contact our office at least 10 business days prior to an
event to determine if a Temporary Food License is
necessary. If a license is necessary, an application and a
short interview process will follow. The Bloomington City
Code adopts the Minnesota Food Code. Final approval
must be obtained before the event can take place.
Sanitary Facilities
1) Areas of food preparation, service or storage must provide
protection against adverse weather, wind or dust. Provide
a floor such as plywood or mats if set up on grass, gravel
or dirt.
2) Water must be obtained from a public supply and must
be stored in a sanitary manner.
3) Wastewater must be discharged directly to an approved
system or holding tank.
4) Garbage/refuse must be stored in a covered, leakproof
ntainer away from food
5) Handwashing facilities must be
provided with running water
(a container with a spigot is
permitted), nailbrush, pump
soap and paper towels.
Discharge water into a
holding vessel or waste
Food/food protection
1) Food/ice must be obtained from an approved commercial
source. Home prepared food is not
2) Food/ice must be covered and stored in a sanitary
manner at least six inches above the floor/ground.
3) TCS food must be held at 41° F or colder or at 135° F
or hotter. Mechanical refrigeration must be used for
events over four hours.
4) TCS food previously heated must be reheated to 165° F
and held at 135° F or hotter.
5) Ice used for storing canned/bottled beverages must be
self-draining and not be consumed.
6) S
elf-service food condiments must be individually
packaged or dispensed from an enclosed dispenser.
7) No bare hand contact with ready to eat foods. Use
utensils or gloves to handle food that will not be cooked.
8) Mark time when using time alone as the public health
9) A food thermometer must be provided to test food
temperatures (0-220° F).
1) Employees must wash their hands before handling
food, after handling raw meat and after eating, drinking,
smoking or using the toilet.
2) Employees must not have vomiting, diarrhea or sore
throat with fever. Employees’ hands must be free of
cuts, bandages or jewelry.
3) No eating, drinking, smoking or chewing gum in the
food prep/service area.
4) Employees must wear caps, hairnets or other effective
hair restraints during food activities and warewashing.
Employees must wear clean clothes and aprons over
outer g
Food equipment/utensils
1) Equipment/utensils must be commercial-grade. Crock
pots/slow cookers are not
2) Food contact surfaces must be clean and sanitized
before each use.
3) Sanitizing solution (50-200 ppm chlorine or
200-400 ppm quaternary ammonium) must be used for
sanitizing surfaces and dishes. Wet wiping cloths must
be stored in a sanitizing solution. Provide appropriate test
4) Equipment/utensils must be stored in a sanitar y
manner at least six inches above the floor/ground.
5) Dishes/pots/pans/utensils must be washed, rinsed with
clear w
ater, sanitized and air-dried. Towel drying is not
permitted. Provide three labeled buckets big enough to
accommodate the largest utensil.
TCS-Time/temperature control for safety: food that
supports the growth of bacteria. Examples include cooked or
raw animal foods (beef, pork, chicken, hotdogs, etc.). Heat
treated food from plants (cooked rice, potatoes, noodles,
vegetables). Cut melons such as watermelon, cantaloupe
and honeydew. Garlic and oil mixtures. Cut tomatoes and
leafy greens.These foods must be kept at proper
temperatures or you must use time as a public health control.
Community Development
Environmental Health
1800 W. Old Shakopee Road
Bloomington MN 55431-3027
PH 952-563-8934
FAX 952-563-8949
web_57rrfoodlic pg 1 of 1 (11/19)
1. Wash:
warm water
2. Rinse:
3. Sanitize:
Bleach 50-200 ppm
or quaternary
200-400 ppm.
4. Air dry
Community Development Environmental Health
1800 W. Old Shakopee Road
Bloomington MN 55431-3027
PH 952-563-8934
FAX 952-563-8949
Food Vendor
Bring this page to the event and complete checklist during set-up
1. Hand Washing Station (Required in the stand for open food or beverages)
Permanently plumbed hand sink in stand or
Container with hands-free/continuous ow spigot and
Warm water
Waste water container
Pump soap and paper towels (Required for open food or beverages)
2. Employee Hygiene
Food workers must wash hands prior to service and frequently during service
Food workers must not work if ill with vomiting, diarrhea or sore throat with fever in the last 24 hours
No touching ready-to-eat foods with bare hands. Use gloves or utensils
No eating or smoking in the food stand. All beverages are covered to prevent spills
No pets in the food service area
3. Food Source/Menu (Immediate closure if out of compliance)
No foods are prepared or stored at home
All foods are prepared at a licensed commercial kitchen or on-site at the event
4. Cooking
Raw chicken or poultry cooked to at least 165°F
Raw ground beef or ground pork cooked to at least 155°F
Raw steak, whole cuts of pork, sh or eggs cooked to at least 145°F
Food previously cooked & cooled at a licensed kitchen reheated to at least 165°F for hot holding
Commercially made precooked products heated to at least 135°F for hot holding (i.e. hot dogs)
5. Dish Washing
Wash, rinse and sanitize equipment and utensils used for time/temperature control for safety foods at least once every
4 hours or bring enough extra equipment and utensils to switch out every 4 hours. See page 3 for details on requirements.
6. Food Temperature Control
Hot foods held at 135°F or above
Cold foods held at 41°F or below. Must use mechanical refrigeration if event lasts more than four hours. May use ice
and insulated coolers if event lasts for four hours or less.
A thermometer to measure food temperatures is utilized
7. Sanitizer (If needed for wiping cloths or dishwashing)
Unscented chlorine bleach or Quaternary (Quat) sanitizer available
Sanitizer test strips available
Bleach concentration 50-200 ppm or Quat concentration 200-400 ppm
Wiping cloths stored in bucket with sanitizer solution
8. Storage
Food, beverages, plates, cups, utensils and equipment are stored at least 6” above the oor
Ice used to chill beverages is in a self-draining container/cooler
Ice is from an approved, commercial source
9. Floor and Ceiling (Required for open food or beverages)
Smooth, cleanable oors on dirt, gravel or grass surfaces
Overhead protection if outdoors such as a canopy