Temporary Food Event - Food Vendor Notification Form

TEMPORARY FOOD EVENT

FOOD VENDOR NOTIFICATION FORM

Under the Food Act 2003 the proprietor of a food business, including a temporary food stall, must not conduct the food business unless the proprietor has given written notice, on the approved form that is to be notified to the appropriate enforcement agency before the business is conducted. The event organiser must submit completed forms to the City of Canada Bay at least fourteen (14) days prior to the event.

For further information or questions regarding this form, please contact Council via 9911 6555.

Details

Event Name *

Event Date *

Type of Application *

Public (ie Council land)Private

Approval Number *

Address where event will be held *

Postcode *

Type of vendor *

Temporary stallMobile vanPermanent PremisesNot for profit organisation

Vendor trading name *

ABN *

Proprietors name *

Company Name *Must not be a trustee.

Proprietors contact number *

Email *

Business Address *

Business Postcode *

Is the mailing address the same as business address? *

YesNo

Mailing address *

Mailing postcode *

Proposed hours of operation *

Food Vendor Details

Please indicate the type of foods sold at the stall *

Is food pre prepared prior to day of markets? *

YesNo

Where is food prepared? *This site must be registered with Council.

Please upload a copy of your most recent inspection report for this site. *

Browse

Please upload a copy of the most recent Food Authority or Council inspection report *

Browse

Please upload a copy of the Food Safety Supervisor Certificate *

Browse

A copy of this certificate must be kept onsite at all times.

Please upload a copy of your $20million Public Liability Insurance *

Browse

Checklist

Your temporary food stall must comply with the Food Safety Standards. Please complete the following checklist indicating if your stall complies or N/A if the item is not applicable to ensure your stall meets therequirements for a temporary food stall under the Food Act and Regulations.

Administration

Food Safety Supervisor is appointed and certificate kept in vehicle at all times *

YesN/A

Construction

Stall is fitted with a roof and three sides *

YesN/A

A smooth and impervious floor cover has been supplied as flooring and is able to be cleaned *

YesN/A

A physical barrier i.e. sneeze guards are installed in front of all cooking and preparation areas *

YesN/A

Hand wash basin is provided and located within the stall *

YesN/A

Hand wash basin is supplied with warm running water, liquid soap and paper towels *

YesN/A

Utensil/equipment washing facilities are provided and located within the stall *

YesN/A

Utensil/equipment washing facilities are provided with warm water, and detergent *

YesN/A

Food Handling

Potentially hazardous food (PHF) is under temperature control: food receipt, storage, display and transport; cold food at or less than 5°C, Hot food at or above 60°C. *

YesN/A

Digital Probe Thermometer provided to stall, readily accessible – accurate to +/- 1°C *

YesN/A

Food is stored a minimum of 150mm off the floor *

YesN/A

Food is stored in food grade containers *

YesN/A

Disposable eating utensils, straws etc. are stored in dispensers and protected from contamination *

YesN/A

Food handlers wash and dry hands thoroughly using hand wash facilities regularly *

YesN/A

Food handlers avoid unnecessary contact with ready to eat food or food contact surfaces by use of utensils, a gloved hand, food wraps etc *

YesN/A

Procedures in place for staff when handling food and money etc. *

YesN/A

Food safe sanitiser available for food preparation surfaces and equipment *

YesN/A

Other

Premises, equipment and food contact surfaces are kept in a clean and sanitary condition *

YesN/A

Equipment in a good state of repair and working order *

YesN/A

Suitable garbage and recycling receptacles are provided and arrangements made for frequent removal of garbage and recyclable materials *

YesN/A

Food labelling complies with Food Standards Code *

YesN/A

Applicant Declaration

I declare that the information provided by me in this document is accurate and to the best of my knowledge true.

Proprietor Name *

Date *

Proprietor Signature *

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