Nov 22
North Shore / Central Coast Tel 604-983-6700, Email: healthprotectionns@vch.ca
Powell River Tel 604-485-3310, Fax 604-485-3305
Richmond Tel 604-233-3147, Email: healthprotectionRH@vch.ca
Sechelt Tel 604-885-5164, Fax 604-885-9725
Squamish Tel 604-892-2293, Fax 604-892-2327
Vancouver Tel 604-675-3800, Email: temporaryevents@vch.ca
Whistler Tel 604-932-3202, Fax 604-932-6953

HH#________________TEMPORARY FOOD SERVICES APPLICATION
Applications must be received by VCH at least 14 days in advance of the event. Home-prepared foods are not allowed.
A $50.00 administration fee is charged for late applications. No guarantee late applications will be reviewed,processed or approved.
For Office Use Only: Administration fee required to review late application  Not approved  Reviewed
 Permit emailed  Permit printed for delivery  Approved, no Permit required

Event Information:
Name of Event: _________________________________Date(s) of Event: _________________________Time:_________Name and Address of the place where Event is held: ________________________________________________________
Event Coordinator Name: ______________________________ On-site contact, if different: _______________________
Coordinator phone number: ____________________________ Email: _________________________________________
Applicant Information:
Applicant (Operator) Name: ____________________________ Phone number: ________________________________
Legal (Company) Name: _______________________________ Trade/Business/Individual Name: ___________________
Mailing Address: ______________________________________ Email: _________________________________________
Dates/Times of operation, if different from above: _________________________________________ Booth #__________Name and Address of approved food premises or base of operation, if other e.g. a co-packer, please explain:___________________________________________________________________________________________________
General Description of food services, check all that apply: Handling of raw meat, poultry, fish or shellfish on site  Perishable foods on site  Food cooked on site
 Food reheated on site  All menu items prepared on site  Service of food prepared off site
 Food samples provided  Portioning food for sampling on site  Pre-packaged non-perishable foods only
List all menu items below e.g. lasagna, cookies and pop. A Food Safety plan may be requested for approval.

List food items to be sampled and how each is given out in a sanitary manner e.g. in single service cups:

There must be a food handler at the booth with a valid (within 5 years) FOODSAFE certificate (or equivalent as listed onBCCDC website). List name(s), certification date and number. Certificates and personal identification are required on site.
Name:
Name:

Cert. Date:
Cert. Date:

Cert. Number:
Cert. Number:

Note: Food preparation and service to the public on site shall not start until your temporary food premises is approved. You may berequired to set up earlier before the event time.
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REQUIREMENTS FOR TEMPORARY FOOD SERVICES

Complete ALL relevant sections in full. Approval is based on accurate information provided and the discretion of the Environmental
Health Officer. See Guide at: Planning Guide for Temporary Events and Markets
Requirements
How you will meet the requirements.
Check () one or more that applies
Construction of outdoor booth• An overhead cover over all food contact surfaces, equipment, food storage and displayareas.
• Cooking equipment located away from public to protect food from contamination and toprevent injury.
• Flooring is a hard, level surface.
• Food is not stored on the ground.

Hand Washing Station*Must be at the booth and operational prior to start of food handling.
**Public or staff washroom sink not acceptable.
• Liquid soap in pump dispensers and single-use paper towels.
• Potable hot and cold running water under pressure and hands free washing.
• Temporary hand wash station (only for low risk and minimal food handling type).
Acceptance is subject to Health review (See diagram on page. 3).
Additional Sinks – Warewashing, Dishwashing and Sanitizing Equipment• A 2-compartment sink with potable hot and cold running water is required forcomplex food preparation; large volume of food handled, processing of raw
meat/poultry/seafood/fish and warewashing.
• A commercial dishwasher to wash and sanitize reusable containers andutensils used by the public.
Sanitizing Solution• Provide approved sanitizing solution for food contact surfaces in labelled container:o 100 ppm chlorine (2 to 3 ml of unscented bleach to 1L of water).
o 200 ppm quaternary ammonium (follow label instructions).
Wastewater Collection/Disposal• Collected and disposed of in the sanitary sewer.
Not to be drained on the ground or into storm drains.
Garbage Collection• Adequately sized bins, leak-proof and disposed of in a sanitary manner.
Food Protection• Food shall be protected from contamination.
• Food contact surfaces used to prepare, store and serve food be smooth, nonabsorbent and easily cleanable e.g., stainless steel, rigid food grade plastic.
Cold-holding during Transport and On-site• Mechanical refrigeration preferred and may be required OR equivalent method toconsistently maintain potentially hazardous foods at 4°C (40°F) or below at all times.
• Maintain internal food temperature at 4°C (40°F) or below at all times.
Cooking / Reheating• Food to be cooked or reheated to an internal food temperature of 74°C
(165°F) or above.
Hot-holding during Transport and On-site• Maintain internal food temperature at 60°C (140°F) or above at all times.

Monitoring Food Temperatures• Provide accurate thermometers to check internal food temperature on site.
• Check and record temperatures before and after transport.
• Monitor and record temperatures every 2 hours thereafter.

 Booth is indoor Organizer or coordinator will provide cover for outdoor booth Will bring our own tent /umbrella / canopy
 Will locate cooking equipment away from the public Booth is located on concrete or asphalt
 Site will provide hard, level surface over grass or dirt
 Will bring our own hard, level surface over grass or dirt Food will be stored off ground Plumbed in hand sink available at the booth Portable sink in booth with pressurized hot and cold running water Portable sink shared between booths, easily accessible
 Temporary hand wash station in booth (acceptance is subject to Healthreview) Will bring our own soap and paper towels, if not supplied by venue Hand washing sink or station not needed, food is prepackaged, noportioning or handling on site (acceptance is subject to Health review)
 2-comp sink accessible at the venue Sink in the booth, hook up to a potable supply with a food grade hose
 Will bring our own detergent and sanitizer, if not supplied by venue Not needed, will bring a sufficient number of utensils
 On site dishwasher or a dishwashing service is available No reusable containers for public, use single service utensils only Will use 100 ppm bleach solution in bottles on site
 Will use 200 ppm Quats solution in bottles on site
 Will have test strips on site to verify concentration
 Will provide details of approved sanitizer (if not bleach or Quats)
 Will use sanitizer wipes (acceptance subject to Health review) Have direct connection to sanitary sewer Have an adequately sized holding tank with a disposal service
 Container / bucket used, will dispose into a toilet or mop sink
 Organizer / coordinator to provide containers and collect Will provide containers at booth and dispose at venue
 Will provide containers at booth and dispose off site
 Will use covers, food wrap, sneeze guards, single use disposable
utensils, individual sampling containers etc.
 Will use food grade storage containers Cutting boards, cooking utensils, tongs, bowls, table top etc., allcleanable and non-absorbent
 Transport in cooler(s) with ice or ice packs
 Transport in refrigeration/freezer unit(s) Mechanical refrigeration/freezer unit(s) provided by venue
 Mechanical refrigeration/freezer unit(s) at the booth Cooler(s) with ice or ice packs at booth Food will not require cold-holding Use a stove or oven at the booth with appropriate power supply Use a barbeque at the booth Other equipment, specify_______________________________
 No need to cook or reheat Transport in insulated container(s) for hot foods
 Transport in warming unit(s) Use a stove or oven at the booth Use chafing dishes with adequate fuel supply Use insulated containers Other, specify_______________________________
 Food will not require hot-holding Have probe thermometer to use at the booth Have additional thermometers to use at the booth e.g. infrared Staff will check and record cooler and food temperatures every 2 hours

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Should I fail to meet these requirements, in accordance to the Food Premises Regulation B.C. Reg. 210/99, Section 6,I understand that I will not receive approval to operate this temporary food premises.

Signature of Applicant

Date of Application

Event coordinators and Market managers are responsible to ensure all application forms are submitted 14 days in advanceof the event/market. Please return this application to your event coordinator or market manager. If there is nocoordinator/manager, please send the application directly to the health office on time.
An administration fee of $50 will be charged for late applications.
Incomplete applications will not be approved.
Credit Card Type____________ Card #___________________________________ Expiry Date MM/YY____________Name on Card _____________________________________________________ Fee Amount $__________________ADDITIONAL INFORMATION:A LAYOUT OF YOUR TEMPORARY FOOD PREMISES MAY BE REQUIRED, SEE EXAMPLE:

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