Requirements For Your Temporary Food Premise Food Safety Plan

Public Health Protection
4th floor - 1600 Third Avenue, Prince George, BC V2L 3G6

Telephone: (250) 565-2150, Fax: (250) 565-2144, www.northernhealth.ca
REQUIREMENTS FOR YOUR TEMPORARY FOOD PREMISE
Food Safety Plan*

Each application must be accompanied with a written set of procedures, which ensure that a
health hazard does not occur. *For more information talk to a Public Health Inspector.
Food Safe Certificate

The on-site supervisor must have a Food Safe Certificate or equivalent. There must be one
person in charge with Food Safe present at all times.
Application
Submit the application at least two weeks prior to the date of the function, to Public Health
Protection, Northern Health Authority, 4th Floor, 1600-3rd Ave, Prince George, BC
Permit to Operate
Display the Permit to Operate in a prominent location at the food booth. The Permit may be
mailed to the applicant or it may be picked up at Northern Health, prior to the function.
Food Preparation
• All foods must be prepared in an approved facility or on-site, NOT at home.
• If prepared off-site, give the location and the dates of preparation.
Temperature Controls for Potentially Hazardous Foods

 During transportation, storage, & display, foods must kept:
Below 4°C (40°F), or
Above 60°C (140°F)
 Provide thermometers to check temperatures of cold and hot holding. Probe
thermometers are needed to check internal temperatures of foods for thorough
cooking and hot holding.
Food Protection
 Display foods in a manner, which prevents contamination.
Sanitation
 Provide hot (& cold) water in a 5-gallon insulated container with a tap. Add 1 tsp
bleach per gallon of hot water. Provide a basin below the tap for washing to function
as a sink.
 Provide soap in a dispenser and paper towels.
 Provide a 5-gallon bucket to collect wastewater, for disposal in the city sanitary
sewer.
Garbage
• Provide sufficient number of garbage containers.
PLEASE PRINT and SUBMIT AT LEAST 2 WEEKS PRIOR TO THE DATE OF THE EVENT/FUNCTION/SPECIAL OCCASION
APPLICATION FOR TEMPORARY FOOD PERMIT

Date of Application
Special Event Information
Event Name:
What is the common name of the Event ?
Event Location
Where will the event be held? Ie: Name of Park or Community Centre
Address of Event:
If held over several streets in the central business area, state ‘Downtown’
Event Coordinator:
Person or Society responsible for the whole Event
Contact Info
Include Address & Phone #
Where can we reach the Organizer
Event Details
Start Date End Date
Dates of Event
Times of Event
No of People
Expected to Attend
▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪
Applicant Information
Name of Temporary
Food Establishment
Day Phone:
Name of Owner
Cell Phone:
Contact Person
Contact Address:
Who will be the contact person during the event?

Page 2
Facility Details
Type of Facility □ Food Trailer □ Tent / Canopy
□ Building on Site □ Open Air
□ Mobile Cart □ Other
Chain or Franchise? □ Yes □ No
If Yes, please state Name
Running Hot Water Present? □ Yes
Waste Water Disposal Method:

□ Piped Connection □ Holding Tank
□ Other
Waste Disposal Description
Type of Food Storage □ Cold □ Hot

(tick all applicable categories)
□ Frozen □ Dry
Food Served
Perishable Food Prepared / Services? □ Yes □ No
Commercially Prepackaged Food? □ Yes □ No
Preparation / Packaging before Event? □ Yes □ No
Location of Preparation
Menu (include all beverages and extra ingredients served with each item)
Food Preparation
How will foods be protected from contamination?
(eg sneeze guard, plastic wrap)
How will potentially hazardous foods(s) be stored at proper temperatures
(eg meat, fish, dairy products) (4º C/40ºF or below or 60ºC/140ºF or above)
If applicable, how will food(s) be cooked?
All Food preparation will be done on-site □ Yes □ No

If NO, provide detailed information as to where and when the food is being prepared, how it will be transported to the site,
and by whom

Page 3
Thermometer provided □ Yes

Attach Your Food Safety Plan □ Yes
Hand / Ware & Surface Washing Faciities

Do you have the following available? (please tick all applicable boxes)
Warm Water under gravity or pressure □ Yes
Paper Towels □ Yes
Liquid Soap □ Yes
Basin to act as a sink □ Yes
Large 5 Gallon plastic Waste Container to hold Waste Water
(must not be disposed of on ground or in gutter) □ Yes
Describe Method of Cleaning and Disinfecting Surfaces / Equipment / Dishes:
Single Service Utensils will be used: □ Yes □ No
Staff
Number of Certified Supervisors
Number of Certified Food Handlers
Total Number of Food Handlers (certified and non-certified)
Food Safe Certificates attached □ Yes
Signature
I am familiar with good public health practices that pertain to the operation of a food premise, and declare that to the best of
my knowledge, the information submitted here is accurate
SIGNATURE OF APPLICANT PRINT NAME
PHONE NUMBER:
Approval
APPROVED BY DATE
Environmental Health Officer


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Public Health Protection

4th floor - 1600 Third Avenue, Prince George, BC V2L 3G6