Guideline for the Sale of Foods at Temporary Food Markets
March 2016 14
Appendix IV - Application for Sale of Higher Risk Food at Temporary
Food Markets
Application Date: Applicant:
Mailing Address: City/Postal Code
Phone (Day): Phone (Cell):
Fax #: E-mail:
Applicant’s Signature:
Name of Market / Event: Date(s) of Event:
Location of Market / Event: Business Hours: to
NOTE: If selling at multiple markets - list all locations on separate page.
Market Manager: Phone #:
Provide a complete list of your food products. List additional foods on separate page if more space needed
Describe your packaging method by checking the applicable boxes as noted below.
Plastic Wrap Bottle Pouch Vacu-packed Other
Have you previously received a Letter of Acceptance or Confirmation for the foods intended to be sold:
No Yes If yes, please provide a copy of the letter(s) with your application.
For EACH food product intended to be sold at the temporary market, please include the following documents
with your application form:
a list of ingredients
a brief description of the preparation and
preservation method
a sample of your product label
for each food item, indicate location of
processing/packaging (e.g. commercial
establishment including address)
If you have done quality assurance testing of your
products, please provide a copy of your most recent
lab reports where applied:
Bacteriology or pH or A
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APPLICATION FORM IS DUE AT LEAST 30 DAYS PRIOR TO THE EVENT
AND SENT TO YOUR LOCAL HEALTH AUTHORITY
NOTE – Applicants should plan for a 14-day processing turnaround time.
To be completed by EHO
Received by:
Date:
Objection: Yes No
If yes, attach reason(s).
Sign or mark with Health Authority stamp and
return a copy of the reviewed application to the
applicant.
click to sign
signature
click to edit
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