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Tooele County Health Department 151 N. Main Street, Suite 140 - Tooele, UT 84074 Phone (435) 277-2440 Fax (435)277-2444
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Application For - Temporary Food Establishment Permit
Please
put N/A for any fields that are not applicable
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Establishment Name |
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Owner |
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Phone |
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Mailing Address |
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City/State/Zip |
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Email Address |
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Please Select one |
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Single Event Permit |
Event Name |
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Event Location |
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Event Coordinator |
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Event Coordinator Phone |
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Booth Contact Person |
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Booth Contact Phone |
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Requested Permit Date (Begin) |
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Requested Permit Date (End) |
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Hours of operation |
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Number of Booths |
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Annual Permit |
- An annual food establishment permit will only be issued to vendor with a satisfactory history of food code compliance in Tooele County
- A scheduled listing the dates and times of event must be submitted to the Department at the time of application. Any additions to the schedule must be submitted to the Department at least 72 hour prior to the event. Failure to do so may result in the exclusion of the establishment from the event. Schedule can be emailed to eh@tooeleco.gov.
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Application and Permit Fee Schedule Level of Hazardous Food |
Choose only one - Tier 1, Tier 2, Annual
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Tier 1 - Three or less foods that require time/temperature control for safety.
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*Permit Fee Quantity - Per Booth/Per Day
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Permit Fee - 72 hours prior to event: |
$20.00 | Quantity: |
| Item Subtotal: |
$0.00 |
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*Permit Fee Quantity - Per Booth/Per Day |
Late Permit Fee-Less than 72 hours prior to event: |
$35.00 | Quantity: |
| Item Subtotal: |
$0.00 |
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Tier 2- More than three foods that require time/temperature control for safety.
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*Permit Fee Quantity - Per Booth/Per Day |
Permit Fee - 72 hours prior to event: |
$40.00 | Quantity: |
| Item Subtotal: |
$0.00 |
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*Permit Fee Quantity - Per Booth/Per Day |
Late Permit Fee-Less than 72 hours prior to event: |
$55.00 | Quantity: |
| Item Subtotal: |
$0.00 |
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Annual Permit
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*Permit Fee Quantity - Per Booth/Per Year
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Annual Permit: |
$200.00 | Quantity: |
| Item Subtotal: |
$0.00 |
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Total: |
$0.00 |
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Menu Items |
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A site
plan must be included with this worksheet.
Plan should show locations of all cooking, cold and hot holding
equipment, hand washing stations, scullery, and garbage receptacles.
Indicate how compliance with regulation will be achieved:
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List all food items that will be prepared prior to the event |
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If food is prepared prior to the event, where will it be prepared? |
Commissary Name |
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Address/City |
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Phone |
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Of the items to be served hot, which will be cooked prior to the event? |
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*Accurate food thermometers must be used to determine appropriate final cook temperatures have been met.
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Once cooked, how will each cooked product be cooled? |
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Once cooled, how and where will each food product be stored? |
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How and where will products be reheated? |
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If transported to the event site, what equipment will be used to maintain hot food items? |
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*Must be kept at 135 degrees or greater.
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How will hot food items be stored above 135 Degrees at the event site? |
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List types of holding units and heat sources |
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If your booth requires electrical power, how will it be provided? |
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Of the menu items to be served cold, which will need to be cooked ahead of time and the cooled? |
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How will each product be cooled? |
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How and where will each cold food product be stored prior to the event? |
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What equipment will be used to transport cold food at 41 F or below to the event site? |
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How will cold food items be stored below 41 Degrees F at the event site? |
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List types of holding unit, types of coolants to be used |
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*Mechanical refrigeration or coolant material (dry ice, ice, gel packs, flue ice, etc.) must be provided.
List types of holding units, types of coolants to be used. |
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What final assembly of food products will take place at the event? |
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As foods are sold, how will product be re-supplied to the booth? |
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(Replenishing new product into old product is prohibited.)
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How and where will utensils be washed, rinsed and sanitized? |
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Sanitizer to be used |
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Concentration of sanitizer - ppm |
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(Note change every 2 hours)
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Are test strips used? |
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Source of water Hot |
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Source of water Cold |
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Source of water Tempered |
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What will be used to wash hands? Describe set up |
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How will wastewater, be collected? |
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wiping cloth water, hand wash water, or water from cooking processes
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Where will wastewater be disposed? |
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How will garbage/trash be disposed? |
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