Temporary Food Event - Food Vendor Notification Form

TEMPORARY FOOD EVENT

FOOD VENDOR NOTIFICATION FORM

This form must be completed by the Food Vendor and submitted to the City of Canada Bay at least fourteen (14) days prior to the event.

Under the Food Act 2003, the proprietor of a food business—including a temporary food stall or food truck—must not operate the business unless they have submitted written notice, using the approved form, to Council before commencing operations.

For further information or questions regarding this form, please contact Council on 9911 6555 or council@canadabay.nsw.gov.au.

Details

Event Name *

Event Date *

Is the event being held on public or private land? *

Public (ie Council land)Private

Event Reference Number *For timely processing, the event reference number must be correct. Please ask the event organiser for the event reference number.

Address where the event will be held *

Postcode *

Type of vendor *

Temporary stallMobile vanNot for profit organisation

Vehicle Registration

If applicable, please provide your Plug and Play Pilot Mobile Food Vendor Permit Application Number

Vendor Trading Name *

Proprietors name *

Company Name *Must not be a trustee.

ABN *

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 Proprietor Details

Please indicate the type of foods sold from the food stall/vehicle *

Is food pre-prepared prior to the event? *

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 $20 million Public Liability Insurance *

Browse

Checklist for Food Safety Standards

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

Administration

Food Safety Supervisor is appointed and certificate held at the stall/vehicle at all times *

YesN/A

Construction

Stall/vehicle 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/vehicle *

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/vehicle *

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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