Mobile Trucks and Trailers Guidelines for Plan Review

Transcription

Mobile Trucks and Trailers Guidelines for Plan Review
Mobile Trucks and Trailers Guidelines for Plan Review
Mark’s
Mobile
Health District – All mobile trucks and trailers selling or giving away open foods or any item that require refrigeration or
hot holding must have a valid Snohomish Health District (SHD) food establishment operating permit to operate in
Snohomish County. To obtain a permit, all mobile units must be reviewed and approved by SHD. The plan review
process usually takes 7 to 30 days, sometimes longer. Until reviewed, approved and permitted, the mobile unit may not
operate in Snohomish County.
Department of Motor Vehicles (DMV) – The mobile truck or trailer must be currently licensed as a truck or trailer by
the Washington State Department of Motor Vehicles. If a trailer is used, proof of ownership of a tow vehicle to move the
trailer is also required.
Labor & Industries (L&I) – The mobile truck or trailer must pass inspection and be approved by the Washington State
Department of Labor and Industries (L&I) for electrical, structural and mechanical correctness. Call 360.902.5221 to
receive all necessary paperwork required for L&I approval.
Sample L&I Approval Stamp
Have you contacted these agencies?
 Washington State Department of Motor Vehicles (DMV)
 Washington State Department of Labor & Industries (L&I)
A mobile unit that has a route, such as a lunch truck, must provide the route or itinerary each month or when the itinerary
changes.
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Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
A mobile unit that is set up at one location must have approved restroom access, within 200 feet of the vehicle, without
crossing any major streets or intersections. Portable toilets are not allowed. A Restroom Agreement letter is required. All
mobile units must be returned to the commissary or other approved storage location at the end of each operating day.
Once approved, the mobile unit must be totally self-contained, have attached and fully functional wheels, and be able to
move immediately by being towed or driven without the removal of blocks or other structural devices. A mobile unit with a
structure built around or attached to it is not considered a mobile unit and must be connected directly to sewer or
approved septic and water and meet all current food service establishment requirements and all other applicable
agencies’ requirements.
A mobile unit that prepares food on the unit should have the following (minimum) improvements:

A fresh water tank that provides sufficient water to wash, rinse and sanitize reused utensils and provide a
minimum of 5 gallons of water for washing of hands.

A wastewater tank with a capacity of at least 115 percent of the fresh water tank. (For a 35-gallon tank, the
wastewater tank capacity must be 42 gallons.)

An adequately sized hot water tank that provides enough hot water to fill two compartments of the 3-compartment
sink to the top and still be able to provide a minimum of 100°F hot water at all hand sinks.

A pressurized water system for both hot and cold water, using a mechanical pump
providing at least 15 lbs. of water pressure. Gravity systems are prohibited.

A fully functional accessible hand washing sink that is at least 10 inches wide by 10
inches long and 5 inches deep. The sink must drain and have a mixing faucet, hot and
cold running water, soap, and paper towels. If necessary, the sides must have splash
barriers a minimum of 12 inches high to prevent water splashing into food preparation
equipment, counters, and sinks. Sinks can not be under counters or equipment and must
be easily visible and accessible.

A commercial National Sanitation Foundation (NSF) approved 3-compartment
sink is required with drain boards on both ends. Hot and cold running water
must be supplied. The 3-compartment sink must be constructed so that each
compartment is the same size. Each drain board must have a surface area at
least as large as the surface area of one compartment of the 3-compartment
sink. All utensils or pots and pans must fully submerge in each compartment of
the 3-compartment sink.

If fruits or vegetables (example: a single head of lettuce, apple, tomato or onion) are
washed in the mobile unit, a commercial National Sanitation Foundation (NSF)
approved food preparation sink is required. The sink must be stainless steel and
have a drain board space equal to the size of the sink. The drain board must be
located immediately to the left or right of the sink. Food prep sinks must be indirectly
plumbed. Indirectly plumbed means at least a one inch air gap in the waste line to
prevent sewage from backing up into the food prep sink. All raw meat must be
prepared at the commissary or have a separate food prep sink on the mobile unit. If
food prep sinks are installed on the mobile unit, additional potable water supply and
wastewater tank capacity may be required.
Other required equipment:

Commercial NSF or equivalent refrigeration must be installed in the mobile unit. It is recommended that at least 2
steel-door refrigerators capable of holding foods at 41°F be installed in the mobile unit. Refrigerator space of 48
cubic feet or more is recommended. A low risk mobile unit should have commercial NSF or equivalent
refrigeration units with at least 12 cubic feet capacity. Cooling in any mobile unit is prohibited. Leftovers from
a mobile may not be retained or cooled.
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Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250

A Reduced Pressure Backflow Assembly (RPBA) must be installed if using a post-mix soda fountain. The drain
line from the ice bin must be indirectly plumbed.

All cooking equipment such as stoves, ovens, BBQs, grills, fryers, toasters, soup cookers, microwaves,
refrigerators, freezers, blenders, espresso machines, grinders, etc. must be commercial grade and bear the
certified stamp of the NSF or equivalent.


A hood is required if cooking equipment such as fryers, griddles, ovens, hot plates, etc are installed. Approval
must be obtained from L&I and inspected by the Fire Marshall in the county or city where the mobile unit will
operate.
Menu and source of foods:

A detailed menu must be provided, including all foods and beverages to be sold or given away. A Food Flow Plan
is required for each menu item. See the Food Flow Example.
Food flows:
A food flow for all similar menu items may be submitted as one food flow item.
When creating the flood flow for the menu items mention the following if applicable:

Will multiple ingredients be assembled or mixed?

Are the ingredients potentially hazardous foods?

Will the food(s) be prepared or held for several hours prior to service?

Will any of the foods require cooling and or reheating? All cooling must be done at the commissary.

Do any food items pass through the critical temperature zone, 140°F to 41°F, more than once?

What is the style of food service to be provided; cook-to-order (cook-serve), service of pre-packaged foods,
service of large volumes of food, or food preparation requiring multiple steps and handling?
The names and phone numbers of all vendors where food/beverages are purchased must be provided. All suppliers must
be approved.
Commissary:
Hours of operation of the commissary must be the same as the mobile unit’s hours of operation, or the mobile unit’s
operator and his/her employees must have keyed access to the commissary. If found operating without access to the
commissary, the mobile unit will be required to close.
3
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
All commissaries must be approved food service establishments with a current SHD operating permit.
Commissaries located outside of Snohomish County may be approved on a case by case basis with concurrence of the
Health Department in that county.
If the mobile unit is found to be connected directly to a fresh water source by hose or line, or to sewer or septic, the unit
will be required to close.
Wastewater must be dumped at an approved dumpsite. Provide the name of the facility where the wastewater tanks will
be dumped. A written agreement between the mobile unit owner and the wastewater dump station may be required. Logs
and receipts must be kept, showing when the tanks are dumped. If the commissary is used to dump the wastewater and
if the commissary is on a septic system, approval must be obtained from the SHD Water and Wastewater Program. This
will be done as a part of the plan review process and commissary approval.
Commissaries must have back up refrigeration, mop sinks, and additional sinks such as food prep sinks, ware washing
facilities. Some commissaries will be required to have cooking facilities. An agreement listing all services provided by the
commissary must be obtained and signed by the commissary owner/manager and the mobile unit’s owner and provided to
SHD. Use of private residences or homes as commissaries is prohibited.
Floor plan and equipment list:
A floor plan and equipment list for the mobile unit is required.
Business Name. [WAC 246-215-121(16)]
The PERMIT HOLDER must provide the REGULATORY AUTHORITY
a designated business name and ensure that name is posted on the
MOBILE FOOD UNIT in a manner easily visible to customers during operation.
Inspections and operating permit:
A preoperational inspection is required prior to approval to open for business and operating permit issuance. The
preoperational inspection must be scheduled at least one week in advance. It is recommended that sufficient time
between the preoperational inspection and proposed opening date be provided to allow for preoperational reinspections
if needed.
Ready for inspection means -- All construction is completed. All equipment is in place. All refrigeration, freezers,
cooking, hot holding, reheating equipment, and dish washing equipment is in place, turned on, and properly working. All
handwash sinks are provided with hot water within 15 seconds. All plumbing is completed. All shelving is in place. All
cleaning is completed.
Note that no food or food preparation of any kind is allowed in the mobile unit or commissary without SHD approval and
operating permit issuance. Food prepared without approval and permit will be considered as being from a non-approved
source and will be discarded.
Submittal of the application for food establishment operating permit and permit fee(s) is required prior to approval to
open. The application and fee(s) must be at SHD office prior to opening for business. Note that operating permit
applications and fee(s) are not accepted more than 30 days prior to the projected opening date.
You may open for business after obtaining final approval from SHD, submittal of the operating permit application and
permit fee(s) and after obtaining final approvals from all other applicable agencies.
For additional information, contact SHD Food & Living Environment Program
Phone: 425-339-5250
Website:www.snohd.org
Email: [email protected]
MobileTrucksTrailersGuidlinesPlanReview_EH_07_2014_kkc
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Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
L&I Approval
You must provide documentation that the Washington State
Department of Labor and Industries (L&I) has approved and
inspected your mobile unit before Snohomish Health District (SHD)
can give final approval. If you are buying a used unit without L&I
approval, please take photos of the proposed mobile unit and show
them to the SHD Plan Reviewer. Many times, older units do not meet
the standards of L&I or SHD.
Think of L&I as Washington's "Building Department" for concession
trailers/trucks. Portable structures are regulated by L&I for such
things as electrical wiring, water supply and waste water systems,
and any mechanical systems such as gas piping or heating and cooling equipment. It is not L&I's jurisdiction to regulate
what elements you need to satisfy SHD requirements. For example, SHD can require a hand washing sink; however, it
is L&I's responsibility to be sure it is plumbed correctly. To obtain approval from L&I and SHD, follow these steps:
1. Obtain a copy of the Washington Administrative Code (WAC) and relevant applications from L&I through
one of the following methods:

Phone:
1.360.902.5218

Internet:
www.lni.wa.gov/TradesLicensing/FAS/default.asp

Mail: Washington State Department of Labor and Industries
PO Box 44000
Olympia, WA 98504-4000
2. Complete the application and return to L&I with all applicable fees for approval.
3. After L&I approval and final inspection, you will receive a sticker (similar to the sticker below) and approval
letter. L&I will apply the L&I sticker on the mobile unit.
4. Submit a copy of the L&I approval letter to SHD. The L&I sticker must be on the mobile unit at the preopening inspection to obtain SHD approval.
L&IApproval_EH_07_20143_kkc
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
Food Stand /Mobile Food Vehicle Plan Review
Application must be completed in full and submitted with fee and the items listed for processing:
Menu (Including beverages)
HACCP Menu Review
Plans & specifications
Reviewed for completeness by _____________ EHS Initials
TYPE OF PLAN REVIEW (Check applicable box)
$420 Base fee (2.5 hours) plus
$168 per hour for each add’l hour
(PLU 390)
Food Stand Concession (New)
Mobile Food Vehicle (New)
$168 Base fee plus $168 per hour
for each add’l hour (PLU 311)
Remodel of existing Food Stand Concession or Mobile Food Vehicle or revision of
approved plan
$168 (PLU 335)
Reopen former Food Stand Concession or Mobile Food Vehicle
ESTABLISHMENT INFORMATION
Name:
Site Address:
City:
ZIP:
OWNER INFORMATION
Name:
Phone:
Address:
E-mail Address:
City:
State:
Zip:
CONTACT INFORMATION (if different than owner)
Name:
Phone:
Address:
E-mail Address:
City:
State:
Zip:
COMMISSARY INFORMATION
Commissary Name:
Local Building Inspection Agency:
Commissary Water Supply (check one):
Commissary Sewage Disposal (check
one):
Private Well
Public
Onsite Sewage System
Sewer
Water District:
Sewer District:
FoodStandMobileFoodVehiclePlanReviewAppl_EH_05_2014_kkc
OFFICE USE ONLY
Inspection is based upon requirements of WAC 246-215. Rules &
Regulations of the State Board of Health for Food Service Sanitation.
Other agency approvals requisite to your operation may include County
or City Planning, Building, Plumbing and Fire Departments, Water and
Sewer Utilities.
APPLICANT SIGNATURE
DATE
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
Mobile Truck/Trailer Check Off List/Questionnaire
Name of Mobile:
DMV License Plate Number of mobile:
Contact Person:
Phone number:
(
) -
General & Equipment Information
Do you have L&I approval?
Yes
No
Is a picture of the mobile unit included? Yes
No
Is an equipment list provided?
No
Yes
How many sets of utensils will be kept on hand?
Is a to-scale floor plan included showing the location of all sinks and equipment? Yes
No
Are all refrigerators and equipment NSF and commercial approved?
Yes
No
I understand the mobile unit must be driven to the commissary nightly.
Yes
No
How will the mobile unit operate?
Sales Site Name:
Route
Single Location
Sales Site Address:
Provide the make and model number of all required refrigerators on the mobile unit:
Make:
Model:
Cubic Foot Capacity:
Make:
Model:
Cubic Foot Capacity:
Make:
Model:
Cubic Foot Capacity:
Plumbing
Is a floor plan showing the plumbing diagram submitted? Yes
No
What is the size of the mobile’s wastewater tank?
Gallons
What is the size of the mobile’s fresh water tank?
Gallons
Does the mobile’s hot water tank have adequate hot water capacity to fill 2 of the 3 compartments
in the 3-compartment sink & still provide hot water above 100º F at all hand sinks?
Hot Water Heater:
Size:
Make:
Yes
Model Number:
Make:
Mechanical Water Pump:
Model Number:
Is the mechanical pump capable of pressurizing both the hot and cold water systems to 15 psi? Yes
Hand Wash Sink size is:
inches wide,
No
inches long,
No
deep.
Is a mixing faucet installed on the hand sink?
Yes
No
Yes
No
Does the 3-compartment sink have drain boards on each side?
Yes
No
Is the 3-compartment sink big enough to wash and submerge the largest pot, pan, or utensil?
Yes
No
Does the faucet reach all 3-compartments of the 3-compartment sink?
Yes
No
3-Compartment Sink: Is a 3-compartment sink installed?
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
Menu
Is a menu submitted?
Yes
No
Is a list of suppliers provided?
Yes
No
Are you aware no cooling is allowed on a mobile?
Yes
No
Will any items be served raw or undercooked?
Yes
No
Where will food items be prepared? Select C (Commissary) or M (Mobile)below
Produce
C
M
Meats
C
M
Cooling
C
M
Other:
C
M
Other:
C
M
Other:
C
M
Other:
C
M
Other:
C
M
Other:
C
M
Other:
C
M
Beverages
List all beverages:
Where will beverages be cold held?
Where will refrigerated items be stored at the end of each night?
Commissary:
Name of Commissary
Address of Commissary
Are commissary restroom agreement(s) submitted with plans?
Yes
No
Is the commissary accessible without crossing a street?
Yes
No
Is the restroom within 200 feet of the mobile sales site?
Yes
No
Is a key available to allow after hour access to the commissary?
Yes
No
Are sales site hours of operation within the regular hours of operation of the restroom?
Yes
No
How and where will fresh water be obtained?
(Be specific as to location and how water is
transported)
Refuse Disposal/Waste Water
How and where will trash be disposed at sales site?
How and where will food waste be disposed?
How and where will wastewater be disposed?
(Be specific as to location and how wastewater is
transported.)
(Name)
(Date)
MobileTruck/TrailerCheckOffList/Questionnaire_EH_07_2014_kkc
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
Description of Food Preparation Process (HACC)
Menu Review
Referring to your proposed menu (attach a copy), complete the information on the
following page. List three of your anticipated most popular foods and explain how the
product is prepared. Attach additional sheets as necessary. Please refer to the
examples below of how to complete this information.
EXAMPLES:
Teriyaki chicken with salad
30 pounds of raw chicken delivered frozen 3 times a week  Chicken thawed in
refrigerator on bottom shelf  Once thawed, chicken is trimmed (process takes
approximately 30 minutes) and rinsed in food prep sink  Marinated in bucket in
refrigerator Cooked on grill to 165°F (temperature is taken using a stem thermometer)
 Hot held in steam table at 140°F or higher  Chicken order is grilled quickly prior to
serving  Leftover chicken is transferred to a shallow two-inch depth metal pan, level of
food not exceeding two inches, uncovered and immediately refrigerated to 41°F or
below  Per order, leftover chicken is taken from the refrigerator and reheated on the
grill to 165°F and served until fresh product is needed.
4 boxes of lettuce delivered 3 times a week  The lettuce is stored in the refrigerator on
top shelf  Food prep sink is cleaned and sanitized  Lettuce is rinsed in food prep
sink (gloves worn)  Lettuce is then cut on sanitized cutting board (gloves worn) 
Stored in plastic bins in refrigerator on top shelf  Per order, lettuce is dispensed with
tongs to serving plate  Served with packaged dressing.
Cheeseburger
40 pounds of beef patties are delivered twice a week. Product is transferred and stored
in the walk-in cooler on the bottom shelf at 41°F or below. Small quantities of
hamburger patties are transferred to refrigerated drawer located under grill. Per order,
hamburger patty is retrieved from drawer with metal tongs and placed on grill. While
hamburger is cooking, hamburger buns are toasted (gloves worn). Once the patty has
reached a cooking temperature of 155°F or higher (checked with thermometer), cheese
is added and melted. Beef patty is then placed on the bun and condiments are added
(ketchup, mustard, shredded lettuce, tomatoes and onions). Product is wrapped and
served.
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
List below three of your anticipated most popular foods and explain how each product is
prepared.
Product #1:
Product #2:
Product #3:
DescriptionFoodPreparationProcessHACCP_EH_06_2014_kkc
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
Commissary Agreement
I own both the business requiring and the business providing commissary services and as such no commissary
agreement is necessary.
This agreement between the commissary owner and the vendor signifies that both parties agree to the vendor’s access
to and use of the services identified below. Snohomish Health District (SHD) will not recognize any transfer of this
agreement to food service facilities or persons not specifically identified in this agreement
Food Service Establishment (FSE) requiring commissary support to qualify for a Permit to Operate
Name of FSE
Vendor (FSE owner)
Mailing address
Phone number(s)
Business days & hours
The following services will be provided by the commissary:
Approved water supply
Approved waste water disposal
Garbage disposal
Dry storage for food and single service
Refrigeration space _____cubic feet
Freezer space _____cubic feet
Ice in pounds per day ______lbs.
 Yes
 Yes
 Yes
 Yes
 Yes
 Yes
 Yes
 No
 No
 No
 No
 No
 No
 No
Handwashing sink
Food preparation sink for vegetables
Food preparation sink for raw meats
Approved 3-compartment sink
Approved restroom
Entrance key for after-hours access
 Yes
 Yes
 Yes
 Yes
 Yes
 Yes
 No
 No
 No
 No
 No
 No
I verify the information provided in this agreement is accurate and we are responsible to comply with the Washington
State Food Code (WAC246-215) and will allow access for inspection during business hours for either business.
Commissary name
Commissary address
Business hours
Commissary owner’s name
Commissary phone
Printed name of Commissary Owner
Signature of Commissary Owner
Date
Printed name of Food Service Establishment Owner
Signature of Food Service Establishment Owner
Date
CommissaryAgreement_EH_06_2014_kkc
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
EXAMPLE
Commissary Agreement (for Caterer, Food Stand concessions and Mobile Food Vehicles)
A commissary agreement is a signed letter from the owner of a Snohomish Health District approved and
permitted facility giving you permission to use that facility to store your product, wash and sanitize utensils,
obtain fresh water supply, dispose of wastewater and use restrooms on a daily basis. A separate agreement
granting permission to use the restrooms is required if the restrooms are at a different location than the
commissary.
A commissary agreement must be submitted with the permit application for a new Caterer, Food Stand
Concession and Mobile Food Vehicle, or in the event of a change of ownership. In addition, owners of
Mobile Food Vehicles must also submit an itinerary for their vehicle. If your commissary agreement has expired
or changes, then a new commissary agreement is required.
EXAMPLE
Itinerary (for Mobile Food Vehicles only)
Date:
Mobile Food Operation Itinerary for:
Name of Mobile Food Vehicle:
License #:
Permit #:
Commissary:
Include all stops, listing the time, place, name and address:
Time
Name
4:00am – 5:00am
Commissary
5:15am – 6:30am
Alice’s Gym
7:45am – 8:15am
Fish Market
8:30am – 10:00am
Phil’s Tires
10:30am- Return to Commissary
4:30pm – 6:00pm
Batting Cage
Address
3020 Rucker Avenue, Everett
3389 Hansen Avenue, Edmonds
14432 Poplar Street, Mountlake Terrace
836 Stevens Way, Mountlake Terrace
343 Oscar Rd, Edmonds
Submit a new itinerary each time there are changes to any of the information.
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
Restroom Agreement Letter
Date:
Food Safety Program
Snohomish Health District
3020 Rucker Ave., Suite 104
Everett, WA 98201-3900
Restroom letter for:
(Name of Food Stand Concession or Mobile Food Vehicle)
I,
have an agreement with
(Owner name of Restroom facility)
(Owner name of Food Stand/Mobile)
giving
and his/her employees the right to use the restrooms
(Name of Food Stand/Mobile)
at
(Name and address of Restroom facility)
The hours that I allow the restroom to be used are:
These hours are during my normal operating hours.
These hours are outside my normal operating hours. I have provided afterhours access.
This agreement begins
. I am not responsible for any actions of
(Date)
(Name of Food Stand/Mobile)
outside of my establishment and may terminate my agreement with
(Name of Food Stand/Mobile)
for
( Reason for termination of agreement)
I understand that Snohomish Health District has the right to inspect the restroom while
the restroom is in operation.
I will notify Snohomish Health District at such time as the agreement is terminated.
Signed:
Date:
(Restroom Owner)
(Consult your attorney before signing any legal document)
RestroomAgreementLetter_EH_07_2014_kkc
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
Annual Food Establishment Permit Application
Application must be completed in full and submitted with fee and the REQUIRED items listed for processing:
Menu (Including beverages)
Food Flow Sheet (HACCP)
Commissary Letter Food Stand Concessions &
Restroom Letter
Mobile Food Vehicles only
Submittal Complete ____________ EHS Initials
Establishment Name:
Site Phone:
Establishment Address:
City / Zip:
Owner Name:
Owner Phone:
Mailing Address (if different):
City/ St/ Zip:
Email Address:
Signature of the owner or an officer of the legal ownership affirms the accuracy of the information provided in this
application and that the permitted facility will be operated in compliance with the rules of the Washington State Food Code.
Signature:
Date:
Print Name:
New establishment
Change of ownership (PLU 301) – Must complete reverse side of application.
GENERAL FOOD
MULTIPLE PERMITS
RISK CATEGORY
0 – 12 Seats (PLU 374)
Grocery
A (Low)
13 – 50 Seats (PLU 375)
Bakery
B (Medium)
51 – 150 Seats (PLU 376)
Deli
C (High)
151 – 250 Seats (PLU 377)
Meat / Fish
Over 250 Seats (PLU 378)
Specialty Fish
Other
OFFICE USE ONLY
PERMIT #__________________________
OTHER
Catering Only (PLU 374)
Mailed / Delivered / PU_______________
Date / Initials
Mobile Food Vehicle (except frozen foods) (PLU 303)
Permits are valid through December 31 and are NOT transferable.
New permits issued on or after the following dates are pro-rated:
April 1 – 75% of annual fee
July 1 – 50% of annual fee
October 1 – 25% of annual fee
(Does not apply to fee for change of ownership.)
AnnualFoodEstablishmentPermitAppl_EH_2014_kc
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
Change of Ownership Statement
Date of Ownership Change:
Former Establishment Name (if changing):
Previous Owner Name:
Is facility currently open?
YES
NO
Will facility remain open?
YES
NO
Copy of menu submitted. (REQUIRED)
If no, what is your reopening date?
YES
NO
Will there be changes to kitchen and/or equipment?
YES
NO
If yes, briefly describe changes:
Please initial each statement indicating you have read and understand them:
I understand my facility will be inspected by Snohomish Health District within 30 days.
I understand that a fee(s) will be charged if additional inspections are required.
I understand that changes and/or improvements may be needed.
I understand that all changes and/or improvements must be completed by the date listed during
my inspection.
I understand that my facility may be closed if changes and/or improvements are not completed
by the date listed during my last inspection.
I understand that I may need to make changes that were not required of the previous owner.
I understand that all changes to menu, equipment, and the building must be approved in writing
by Snohomish Health District.
I understand that I may be required to submit a remodel plan review which has additional fees.
I understand that my permit expires December 31 of each year and must be renewed at that
time or late fees may be assessed.
Print First & Last Name(s):
Owner/Representative Signature:
You are NOT APPROVED to operate until after inspection.
Date
SHD Initials
Date
SHD Initials
You are APPROVED to remain open pending inspection.
This 30-day conditional Permit to Operate expires on:
POST THIS PAPER IN A CONSPICUOUS AREA
Fee Schedule - Food Safety
EFFECTIVE December 1, 2011
TITLE
FEE
DESCRIPTION
LATE CHARGE FOR RENEWAL OF ANNUAL PERMITS
EXPIRING DECEMBER 31
$300.00
Annual permit fee and completed
Health District invoice must be
received in the Environmental
Health Division office by 5 p.m.
on the last business day of the
following January.
LESS THAN FULL YEAR PERMIT / NEW ANNUAL PERMITS
EXPIRING DECEMBER 31
Does NOT apply to Change of
Ownership or Temporary Event
fees.
Permits obtained on or after April 1 will be pro-rated at 75% of
the annual fee.
Permits obtained on or after July 1 will be pro-rated at 50% of
the annual fee.
Permits obtained on or after October 1 will be pro-rated at 25%
of the annual fee.
TITLE
FEE
DESCRIPTION
CHANGE OF OWNERSHIP
$132.00
Annual operating permit
FOOD SERVICE WITH ONSITE SEWAGE DISPOSAL REVIEW
$168 .00
Fee charged annually with food
service permit
FOOD SERVICE ESTABLISHMENT PERMIT FEES
GENERAL FOOD
Includes but not limited to restaurant (with or without lounge), concession stand, mobile food
vehicle, food stand concession, commissary, bakery, caterer, grocery with multiple permits,
limited grocery with or without food prep, private club, retail meat dealer, retail fish dealer,
tavern with or without food prep, year round campground/park food service.
0-12 seats
a) Low Risk
b) Medium Risk
c) High Risk
Seat count includes lounge seats
13-50 seats
a) Low Risk
b) Medium Risk
c) High Risk
Seat count includes lounge seats
51-150 seats
a) Low Risk
b) Medium Risk
c) High Risk
Seat count includes lounge seats
151-250 seats
a) Low Risk
b) Medium Risk
c) High Risk
Seat count includes lounge seats
Over 250 seats
a) Low Risk
b) Medium Risk
c) High Risk
Seat count includes lounge seats
$326.00
$489.00
$651.00
Annual permit fee
Annual permit fee
Annual permit fee
$357.00
$531.00
$704.00
Annual permit fee
Annual permit fee
Annual permit fee
$389.00
$573.00
$788.00
Annual permit fee
Annual permit fee
Annual permit fee
$420.00
$615.00
$840.00
Annual permit fee
Annual permit fee
Annual permit fee
$452.00
$657.00
$893.00
Annual permit fee
Annual permit fee
Annual permit fee
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
TITLE
FEE
DESCRIPTION
CATERING ENDORSEMENT (for licensed food establishments that $25.00
also offer catering services)
In addition to
General Food fee
Annual permit fee
MOBILE FOOD VEHICLE (except frozen food vendors refer to
General Food annual permit fee 0-12)
General Food fee
plus $130.00
per vehicle
Annual permit fee
ATHLETIC FIELD CONCESSION STAND
a) Low Risk
b) Medium Risk
c) High Risk
$132.00
$210.00
$289.00
Annual permit fee
Annual permit fee
Annual permit fee
VENDING MACHINES
With potentially hazardous foods – risk level – Low
$121.00
Annual permit fee
FOOD THERMOMETERS
a) Dial probe
b) Digital tip sensitive
$9.00
$24.00
Fee includes sales tax
Fee includes sales tax
FOOD WORKER CARDS
a) 2-year initial or 3-year renewal
b) Replacement for lost card
$10.00
$10.00
MANAGER COURSES
a)
$175.00
b) Manager Recertification$132.00
Manager Recertification without purchasing book$79.00
d) Serve Safe Certification and Test$175.00
Manager Certification
c)
Instructional and supplies fee
Instructional and supplies fee
Instructional fee
Includes Serve Safe curriculum,
book, materials, and test.
e)
Manager Self-Inspection Program Establishment Fee CreditFor qualified food establishments with certified managers, up
to 25% of the prior year’s annual establishment permit fee will
be credited to the establishment upon completion of the
current year’s inspection program per SHD procedures.
PLAN REVIEWS
a) Limited Grocery
$168.00
Plan review and pre-operational
inspection fee
b)
General Plan Review New Food Service Establishment including $630.00
School and Satellite Kitchens
Plan review and pre-operational
inspection fee
c)
Multiple Permit Facility
$630.00
Base fee for plan review and preoperational inspection PLUS
$150.00 for each additional
permitted facility plan review and
pre-operational inspection
d)
Food Stand Concession, Mobile Food Vehicle
$420.00
Base fee for plan review and preoperational inspection PLUS
$168.00 for each additional hour
over 2.5 hours.
e)
Site Inspection to re-open former food service establishment
$168.00
f)
Hazard Analysis Critical Control Point Review (HACCP)
$168.00
Per inspection to reopen former
Food Service Establishment
When required by WAC for menu
items
Plus lab fees
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
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TITLE
FEE
DESCRIPTION
Base fee for alteration to existing
facility or revision of approved plan
PLUS $168.00 per hour for each
additional hour over 1 hour
Applicable on projects idle for
more than one year
Plan Review Continued
g)
Plan Revision
$168.00
h)
Reactivate Plan Review
$168.00
REINSPECTION AND REINSTATEMENT FEES
a) Reinspection and office conference per III.B.3, Enforcement
Procedures
b) Reinspection after first preoccupancy inspection
c) Reinstatement following closure by Health Officer's Order
d) Reinstatement fee following closure by Health Officer’s Order for
an existing, immediate health hazard.
e) Reinspection due to uncorrected red item violation
CAMPGROUNDS / PARKS
a) Food service / all year
b)
Food service / seasonal (3 consecutive months or less)
SCHOOLS
a) Central kitchen, no direct food service
b) Satellite kitchen with food service
c) School kitchen with food service
$273.00
$168.00
$315.00
$541.00
Reinspection and office
conference fee
Reinspection fee
Reinstatement fee
Reinstatement fee
$168.00
Reinspection fee
General
Food Fees
Annual permit fee
$336.00
Annual permit fee
$525.00
$336.00
$400.00
Annual permit fee
Annual permit fee
Annual permit fee
TEMPORARY FOOD SERVICES
LATE FEE CHARGE Temporary Food Service & Mobile Food
$48.00
Vehicle
Non-refundable fee charged if the application is not received in the
Environmental Health Division office seven (7) days before the event.
a)
Low Risk
Annual / Restrictive
b)
High Risk
Annual / Restrictive
c)
d)
Food Demonstrator
(Low Risk foods only)
Annual
(Low Risk foods only)
Judged Cook-off
e)
f)
Mobile Food Vehicle
Exempt or Product ID only
Late charge fee
Valid 1-21 consecutive days
No more than 3 days per week at
same location (see WAC 246-215011)
Valid 1 day
Valid 2-3 consecutive days
Valid 4-8 consecutive days
Valid 9-21 consecutive days
No more than 3 days per week at
same location (see WAC 246-215011)
Valid 1-21 consecutive days
$79.00
$200.00
$79.00
Event permit fee
Annual permit fee for first location
PLUS $100.00 for each additional
location
Event permit fee
Event permit fee
Event permit fee
Event permit fee
Annual permit fee for first location
PLUS $168.00 for each additional
location
Event permit fee
No location restrictions apply
$184.00
Annual permit fee
1-20 entrants – not open to public
1-20 entrants – open to public
21-over entrants –not open to public
21-over entrants – open to public
Operating with an annual permit
$263.00
$578.00
$263.00
$840.00
$37.00
$40.00
Event permit fee
Event permit fee
Event permit fee
Event permit fee
Event permit fee
Processing fee
$111.00
$163.00
$221.00
$378.00
$475.00
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
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ENVIRONMENTAL HEALTH DIVISION / Miscellaneous Fees
APPEAL PROCEDURE:
a) Step One
b)
NO FEE
Step Two
$920.00
Fee refundable if appellant
prevails in Step Two
MISCELLANEOUS PERMIT FEE:
a) The Health Officer is authorized to establish fees on an individual basis for any Environmental Health Division operations which
do not precisely conform to any of the defined categories. Such fees to be determined by the Health Officer to be the closest
related fee or $168.00 per hour.
b) Post emergency waiver of Clearance and Repair fees for qualified damaged structures.
RECORD RETRIEVAL
Duplicating
$.15
Per page
SERVICE CHARGE
$25.00
Returned check (bank service
charge)
REFUND PROCESSING FEE
$20.00
May be waived for a bona fide
reason approved by the Director
Adopted by the Board of Health 10/11/11
FeeScheduleFoodSafety_EH_07_2014_kkc
Environmental Health Division
3020 Rucker Avenue, Suite 104  Everett, WA 98201-3900  fax: 425.339.5254  tel: 425.339.5250
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