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Mobile Food Service - Flathead City
Environmental Health Services 1035 First Ave. West Kalispell, MT 59901 (406) 751-8130 Fax: 751-8131 Community Health Services 751-8110 FAX 751-8111 Environmental Health Services 751-8130 FAX 751-8131 Family Planning Services 751-8150 FAX 751-8151 Home Health Services 751-6800 FAX 751-6807 WIC Services 751-8170 FAX 751-8171 Animal Shelter 752-1310 FAX 752-1546 Flathead City-County Health Department Temporary/Mobile Food Purveyor Plan Review Form Establishment Name: Owner Name: Physical Address: Physical City, State & Zip: Legal (Sec-Twn-Rng-Trc): Telephone & Fax: Mailing Address: Mailing City, State & Zip: Office use only: Plan Review Fee: Amount Paid: Date of Payment: Payment Method (Cash, Check #, etc.): Receipt #: Providing quality public health services to ensure the conditions for a healthy community. Fee Schedule Type Non-Profit Temporary Mobile Cost Waived $25 $90 Mobile or Temporary Food Purveyor Plan Review Form This form must to be completed and submitted for Flathead City-County Health Department approval prior to beginning construction, remodeling or a change of menu. Please complete the entire form – if any blank or question is left unanswered (not applicable may be an acceptable answer in some cases), the plan review will be considered incomplete and immediately denied. Required Documentation: 1. Temporary and mobile food service operations are required to have a commissary servicing area for various purposes including filling potable water, dumping waste water, cleaning, storage, etc. A signed commissary agreement form must accompany this application. 2. A proposed menu for the operation must be submitted with this application. In addition to major menu items (i.e. hamburgers, hotdogs, etc.), the menu should include toppings (i.e. shredded lettuce, sliced tomatoes, etc.), condiments (i.e. ketchup, relish, chili, etc.) and beverages (i.e. canned/bottled soda, fountain drinks, etc.). 3. A diagram or floor plan of the operation including equipment locations, sink locations, the type of overhead cover that will be used (i.e. canopy, tent, enclosed trailer, etc.), the type of ground cover (flooring) to be used and the type of wall covering that are present. Desired opening date: ______________________ How much water will be available on-site? __________gallons Potable water must be obtained from an approved source. Where will potable water tanks/containers be filled? _______________________________________________________ Waste water, including grey water from hand washing must be collected and disposed of in an approved treatment system. Where will waste water be disposed? ____________________________________________________________________________ S:\FOOD & CONSUMER\PlanReview\MobilePlanReview2014.doc 03/2014 Review 2 Food Workers: 1. Only authorized individuals that are essential to the operation are allowed in food service areas. Do you understand and intend to comply with this requirement? Yes / No 2. Food service workers, including yourself will be expected to be knowledgeable about safe food handling practices including, but not limited to: safe food temperature controls, good hygienic practices, safe food storage and proper sanitizing. How will food service workers be trained? ______________________________________________________________________ ______________________________________________________________________ 3. Food service establishments must have a policy regarding ill workers or workers that have cuts/lesions? Please describe or attach the policy: ______________________________________________________________________ ______________________________________________________________________ 4. Food workers, including yourself, are expected to maintain a high level of personal hygiene. Activities such as smoking, applying makeup/hair spray, eating or drinking from an open top container are not permitted in food service areas. Hair must be adequately restrained. Jewelry on wrists and hands must be limited to a simple wedding band. Please indicate how compliance with these items will be ensured or attach written policy (if applicable): ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 5. How will adequate hand washing be accomplished and monitored? ______________________________________________________________________ ______________________________________________________________________ 6. Direct bare hand contact with food must be minimized. What methods will be used to ensure this standard? ______________________________________________________________________ ______________________________________________________________________ 7. Personal articles such as coats, boots, umbrellas, purses, cell phones, etc. must be stored away from food preparation and storage areas. Where will these items be stored? ______________________________________________________________________ Food: 1. Food must come from an approved/licensed source. Where will food supplies be purchased? ______________________________________________________________________ ______________________________________________________________________ 2. Food supplies must be free of spoilage or adulteration. How will this standard be ensured? ______________________________________________________________________ ______________________________________________________________________ 3. Food must be stored in food grade containers and must not be stored on the ground. Describe how food will be stored prior to, during and after service. ______________________________________________________________________ ______________________________________________________________________ S:\FOOD & CONSUMER\PlanReview\MobilePlanReview2014.doc 03/2014 Review 3 4. Food requiring refrigeration (meat, dairy, some opened condiments, etc.) must be kept at 41oF or lower to prevent the growth of pathogens. How will food that requires refrigeration be kept cold? How will this be monitored? Note: Ice chests can accomplish this for short periods, but cannot be relied on for long term storage (greater than 4 hours). ______________________________________________________________________ ______________________________________________________________________ 5. Raw animal products (beef, pork, poultry, fish, eggs) must be stored and handled to prevent cross-contamination with ready-to-eat food. How will this be ensured? ______________________________________________________________________ ______________________________________________________________________ 6. If the menu requires food to be thawed prior to preparation, how will this be accomplished? __________________________________________________________ 7. Are there any food items that require advanced preparation (sliced/diced tomatoes, shredded cheese/lettuce, etc.). Please describe: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 8. Cooked food that is held hot for delayed service must be maintained at a temperature of 135oF or higher to prevent growth of pathogens. How will food that requires hot holding be kept hot? How will this be monitored? Note: residential crock pots have been found to be inconsistent at maintaining proper temperature and are not approved for commercial food service. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 9. A calibrated probe thermometer is required to measure cooking and holding temperatures. Describe how your thermometer is calibrated. ______________________________________________________________________ ______________________________________________________________________ 10. If any food items will be cooled and reheated, please describe the cooling and process. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Cleaning and Sanitizing: 1. An approved food-safe sanitizer at a safe and effective concentration must be available at all times of operation. Please describe the product and concentration to be used. How will the concentration be measured? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 2. Describe where and how dishes and/or utensils will be washed and sanitized. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 3. How will solid waste (trash) be stored and disposed? ______________________________________________________________________ ______________________________________________________________________ S:\FOOD & CONSUMER\PlanReview\MobilePlanReview2014.doc 03/2014 Review 4 Approval of these plans and specifications by this Health Regulatory Authority does not indicate compliance with any other code, law, or regulation that may be required—Federal, state, or local. It further does not constitute endorsement or acceptance of the completed establishment (structure or equipment). A preopening inspection of the establishment with equipment will be necessary to determine if it complies with the local and state laws governing food service establishments. STATEMENT: I hereby certify that the above information is correct, and I fully understand that any division from the above without prior permission from this Health Regulatory Office may nullify this approval. Signature(s): _______________________________________________________________ _______________________________________________________________ Owner(s) or responsible representative(s) Date: ________________ For Office Use Only Sanitarian sign off:____________________________________________________________ Letter ___ Phone ____ E-mail: ____ Date of Approval ___________________ Denial Date: _____________________ _____________________ _____________________ S:\FOOD & CONSUMER\PlanReview\MobilePlanReview2014.doc 03/2014 Review 5 VARIOUS IMPORTANT CONTACTS BUILDING DEPARTMENTS Kalispell 201 1st Avenue East – Kalispell (406) 758-7730 Columbia Falls 130 6th St West – Columbia Falls (406) 892-4349 Whitefish (Building, Planning, & Zoning) PO Box 158 510 Railway St – Whitefish (406) 863-2410 State Building Inspector Steve Clark (406) 439-2982 State Plumbing/Mechanical Inspector Building Codes Bureau Dave Micone PO Box 10096 – Kalispell (406)752-5117, (406)439-4106 PLANNING / ZONING Flathead County Planning 1035 1st Ave West Kalispell MT 59901 (406) 751-8200 FIRE Deputy State Fire Marshall Dawn Drollinger 445 Main Street – Kalispell 257-2584 Kalispell 201 1st Ave E Kalispell, MT 59901 (406) 758-7732 LIQUOR LICENSING Liquor Licensing Bureau P.O. Box 1712 Helena, MT 59604-1712 (406) 444-6900 FAX: (406) 444-0722 WATER SUPPLY Department of Environmental Quality 655 Timberwolf, Ste 3 Kalispell, MT 59901 (406) 755-8985 Well Log Data: http://mbmggwic.mtech.edu/sqlserver/v11/menus/menuData.asp FOR FOOD MANUFACTURING: MT DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES ATTN: Jeff Havens (406) 444-5302 or [email protected] S:\FOOD & CONSUMER\PlanReview\MobilePlanReview2014.doc 03/2014 Review 6
