Temporary Food Establishment Checklist
These conditions must be met to obtain a foodhandling permit.
Food from approved sources and identified.
Clean location and equipment.
Food covered and protected (barrier to shield food from public).
PHF’s (i.e., cream-filled pastries and pies and salads such as potato, chicken, ham, crab, etc.) cannot be
served.
Utensils and equipment protected (clean and covered)
Effective measures taken for fly control (i.e. fans, screens).
Portable running water under pressure.
Ability to heat water.
Utensil sink with drain boards or counter space large enough to accommodate largest utensil (i.e. pots,
skewers, racks, spoons, etc.).
Approved employee hand washing facilities with antibacterial soap and paper towels.
Refrigerator 45 degrees or less with accurate air thermometer available.
Approved sanitizer (100 ppm CL or 200 ppm QA) in a labeled spray bottle for use on all clean food
contact surfaces.
Metal stem type food thermometer accurate to +/-2 degrees F (0-220F) available for food temperatures.
Approved garbage, grease, and gray water (dish water) disposal method at each TFE.
Single service items (cups, forks, etc.) properly stored and handled.
Single service cup dispensers or original packaging (plastic sleeves).
Approved food grade hose for approved drinking connections.
No person with a communicable disease shall with TFE.
Bandages and gloves should be available for injuries.
Be prepared to discuss the following during permitting
What is your or potable water? Will other food prep locations on or off the premises of the TFE be used (i.e. restaurants, caterers)? How and where will food be thawed? What methods will be used to maintain proper food temperature for holding hot and/or cold foods? What are the cooking temps for PHFs?
Martin-Tyrrell-Washington District Health Department
Application for Environmental Health Services
(A site plan is NOT required with this application)
Owner/Authorized Agent: ______
County of Property: ______Phone: ______
Current Mailing Address: ______
Site Location: ______
______
Services Requested:
Food and Lodging Fee
Restaurant Plan and Review - $150.00 (additional restaurant plan application is required)
Temporary Food Stand (for profit) - $75.00 (additional TFE application is required)
Migrant Housing Inspection
No charge
Tattoo Parlor Permit Fee
$200.00 (additional tattoo application is required)
Public Swimming Pool/Spa Fee: (additional state pool application is required)
One pool/spa - $150.00
Two pools - $165.00
Complaint: ______
______
______
I hereby grant county and state officials permission to enter the property to conduct the services requested. The information I submitted is true, correct, and complete.
Owner/Agent Signature: ______Date: ______
Amount Paid: ______Check #: ______Cash: ______Receipt #: ______
Clerk Signature: ______Date: ______
Martin County Health Department210 West Liberty Street
Williamston, NC 27892
252.793.1626
52.793.1644 - Fax / Tyrrell County Health Department
408 Bridge Street
Columbia, NC 27925
252.793.1760
252.766-3376 - Fax / Washington County Health Department
198 NC Hwy. 45 N
Plymouth, NC 27962
252.791.3107
252.791.3108
Temporary Food Service Vendor Application
This application shall be completed by all food vendors who intend to sell food to the public at an
event where a permit is required. This application must be submitted with the requested information and Application for Environmental Health Services Application at least 10 days prior to the event. The Division of Environmental Health does reserve the right to deny any permit request and to limit the menu specified on the vendor application.
**Effective July 1, 2009, there is a $75 vendor permit fee that must be paid in advance of the event. Non-Profit Organizations are exempt, but must fill out application and provide tax ID number. If you do not provide a valid tax ID number then you are not exempt and must pay $75 fee and be permitted.
Event information
Name of the Event: ______
Event Coordinator: ______Phone Number: ______
Location of Event: ______
Date and estimated time of set up: ______
Date that food sales will begin: ______
Length of Event: ______
Vendor Information
Business Name: (For Profit):______
Organization Name: (Non Profit):______Tax. Number ______
Contact Person: ______Contact Number: ______Alt#: ______
Address: ______City: ______State: ______
Mailing Address if Different: ______
M-T-W Environmental Health does reserve the right to limit menu items of potentially hazardous foods at temporary food service events.
Signature: ______Date: ______
Temporary Food Service Vendor Application
Please list the equipment that will be used: (i.e.; deep fryers, woks, stove, and flat grill).
______
Please list how food will be held at 45° F or below and or 140° F and above (i.e.; coolers, refrigerators, hot holding equipment).
______
______
______
If you are permitted Mobile Food Unit:
Names on Permit: ______
Name of business: ______
County who issued permit: ______
Please attach a menu with the foods listed below. Please provide all sources of any shellfish or seafood that will be served. If food is to be catered from a permitted facility, Please provide method of transport and documentation from facility about what will be served.
If you have any questions you may call the following numbers:
Martin County / 252.793.1627 Robert Martin252.793.1628 Gene Raynor
252.793.1644 Fax
Tyrrell County / 252.793.1760 Sam Brickhouse
252.766.3376 Fax
888.388.9208
Washington County / 252.791.3107 Mitchell Patrick
252.791.3108 Fax
888.388.9208
Martin County Health Department
210 West Liberty Street
Williamston, NC 27892 / Tyrrell County Health Department
408 Bridge Street
Columbia, NC 27925 / Washington County Health Department
198 NC Hwy. 45 N
Plymouth, NC 27962
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