City of Park Ridge 505 Butler Place Park Ridge, Illinois 60068 (847) 318-5200 www.parkridge.us Temporary Food Permit Application Health Officer must approve menu and booth layout before a permit can be issued. All applications must be turned in 10 days prior to the event. * Event Name * Location * Set Up Date Format: MM/DD/YYYY * Set Up Time * Event Starting Date Format: MM/DD/YYYY * Event Ending Date Format: MM/DD/YYYY * Event Times * How long will food service occur at this location? If not consecutive days, please list dates. This permit is only good for one location, for a maximum of the fourteen (14) days listed above. Vendor Information: * Organization / Business Name * Address * City * State Zip * Phone Email * Onsite Contact Person * Phone Food to be Prepare, Supplier Information, Process of Transportation and Preparation Example: Menu Item, Source, Preparation / Transportation Hamburgers, Grocery Store (name), purchased frozen, cooked to order Fried Rice, Restaurant (name), made a restaurant, transported in hot box, held at steam table *No preparation will be allowed onsite until a temporary permit is issued. Vendor Booth Layout Indicate all food service equipment, including mechanical cold and hot holding units, cooking equipment, hand washing facilities, dishwashing facilities, potable water supply and insect fans. Upload Booth Layout Check all the following about what equipment will be provided at your booth: Approved transportation equipment for hot and cold foods Mechanical hot holding equipment (i.e., no heat lamps or crockpots) Mechanical cold holding commercial refrigeration or freezers (i.e., no household refrigerators) Probe and equipment thermometers for checking food and equipment temperatures Flooring and overhead cover, if not provided by the organizer Dunnage racks or pallets to store all food and paper goods off the ground Dispensers for condiments (i.e., pre-packaged, squeeze bottles or hinged lid containers) Hand washing facilities with paper towels and liquid hand soap (i.e., a camp sink or a container with a hands free tap and a bucket to catch the waste water) Clean clothes and hair covering (i.e., cap, visor or bandana) for employees Wash, rinse and sanitize containers that are large enough to hold soiled utensils Cleaning supplies (i.e., dish soap, sanitizer, sanitizer test strips, brooms, trash bags and garbage cans with lids) Wiping cloths and extra buckets, fans, containers for used cooking oil and charcoal, extension cords, fire extinguishers and first aid kits All food is obtained from approved commercial sources (i.e., local stores, distributors, or restaurants). Home-prepared food is prohibited Vendor bringing prepared food from outside Park Ridge– A current health inspection report for the facility where food was prepared is required * * * Office Use Only * * * Risk 1 $75 Risk 2 $50 Risk 3 $25 Approved by Date Format: MM/DD/YYYY Submit Show Translate a beginning of page