"Temporary Food Service Permit Application Form" - Caroline county, Maryland

Temporary Food Service Permit Application Form is a legal document that was released by the Maryland Department of Health - a government authority operating within Maryland. The form may be used strictly within Caroline county.

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  • Released on September 1, 2015;
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Caroline County Health Department
Division of Environmental Health
______________________________________________________________________________________
Leland Spencer, M.D., MPH, Health Officer
Attillio Zarrella, Th.D., Deputy Health Officer
TEMPORARY FOOD SERVICE PERMIT APPLICATION
THIS APPLICATION MUST BE SUBMITTED A MINIMUM OF 3 WEEKS PRIOR TO EVENT.
These instructions apply to any person/organization which establishes a Temporary Food Service Facility to sell or provide food to the
public for a temporary period.
How to apply:
1. Carefully read the entire application (7 pages).
2. Complete the application. Return pgs 1 & 2 to this department. Retain pgs 3-7, these pages must be on site during the event.
3. Applicant must be available for an interview with the Food Program Supervisor before final approval can be granted.
FACILITY/ORGANIZATION NAME:
CONTACT NAME:
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT PHONE:
ALTERNATE PHONE:
FAX:
EMAIL:
NAME OF EVENT:
DATE(S) OF EVENT:
LOCATION OF EVENT:
BAKE SALES & COTTAGE FOODS –
Per COMAR 10.15.03, no permit is required to sell baked goods & Cottage Food products that are non-potentially hazardous. Baked
goods are breads, cakes, cookies, and pastries that are cooked with dry heat. Fruit pies made from high acid fruits such as apples,
cherries, strawberries, etc. are acceptable. Potentially hazardous baked goods such as pumpkin/sweet potato pies, cheesecakes,
meringues, and pastries with potentially hazardous fillings or toppings are prohibited. Baked Goods & Cottage Foods must be labeled
according to COMAR 10.15.03.27 (compliance sheet attached).
Foods shall not be prepared in homes where there are house pets, reptiles, birds, etc. All foods shall be prepared, portioned, and
packaged in a sanitary environment prior to transporting to the sale location. Food preparers shall not have open wounds or sores on
hands or forearms and be in general good health.
I understand that failure to comply with COMAR 10.15.03 Regulations Governing Food Service Facilities will result
in the automatic suspension of the operating license, and all food operations must cease IMMEDIATELY.
.
Signature of Applicant:
Date:
-HEALTH DEPARTMENT USE ONLY-
 Approved
 Disapproved
Health Department Signature:
Date:
.
Date Received: ____________
ID: ____________
Set Up Time: ___________
Water Supply From: _________________
Revised-September 2015
th
403 S 7
Street, Rm 248, Denton, MD 21629
www.carolinehd.org
PHONE: 410/479-8045
FAX: 410/479-4082
Caroline County Health Department
Division of Environmental Health
______________________________________________________________________________________
Leland Spencer, M.D., MPH, Health Officer
Attillio Zarrella, Th.D., Deputy Health Officer
TEMPORARY FOOD SERVICE PERMIT APPLICATION
THIS APPLICATION MUST BE SUBMITTED A MINIMUM OF 3 WEEKS PRIOR TO EVENT.
These instructions apply to any person/organization which establishes a Temporary Food Service Facility to sell or provide food to the
public for a temporary period.
How to apply:
1. Carefully read the entire application (7 pages).
2. Complete the application. Return pgs 1 & 2 to this department. Retain pgs 3-7, these pages must be on site during the event.
3. Applicant must be available for an interview with the Food Program Supervisor before final approval can be granted.
FACILITY/ORGANIZATION NAME:
CONTACT NAME:
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT PHONE:
ALTERNATE PHONE:
FAX:
EMAIL:
NAME OF EVENT:
DATE(S) OF EVENT:
LOCATION OF EVENT:
BAKE SALES & COTTAGE FOODS –
Per COMAR 10.15.03, no permit is required to sell baked goods & Cottage Food products that are non-potentially hazardous. Baked
goods are breads, cakes, cookies, and pastries that are cooked with dry heat. Fruit pies made from high acid fruits such as apples,
cherries, strawberries, etc. are acceptable. Potentially hazardous baked goods such as pumpkin/sweet potato pies, cheesecakes,
meringues, and pastries with potentially hazardous fillings or toppings are prohibited. Baked Goods & Cottage Foods must be labeled
according to COMAR 10.15.03.27 (compliance sheet attached).
Foods shall not be prepared in homes where there are house pets, reptiles, birds, etc. All foods shall be prepared, portioned, and
packaged in a sanitary environment prior to transporting to the sale location. Food preparers shall not have open wounds or sores on
hands or forearms and be in general good health.
I understand that failure to comply with COMAR 10.15.03 Regulations Governing Food Service Facilities will result
in the automatic suspension of the operating license, and all food operations must cease IMMEDIATELY.
.
Signature of Applicant:
Date:
-HEALTH DEPARTMENT USE ONLY-
 Approved
 Disapproved
Health Department Signature:
Date:
.
Date Received: ____________
ID: ____________
Set Up Time: ___________
Water Supply From: _________________
Revised-September 2015
th
403 S 7
Street, Rm 248, Denton, MD 21629
www.carolinehd.org
PHONE: 410/479-8045
FAX: 410/479-4082
NAME OF MENU
PURCHASED FROM
PREPARATION
DATE PURCHASED
DATE PREPARED
ITEM
LOCATION
Revised-September 2015
th
403 S 7
Street, Rm 248, Denton, MD 21629
www.carolinehd.org
PHONE: 410/479-8045
FAX: 410/479-4082
INSTRUCTIONS FOR SPECIAL FOOD EVENTS IN CAROLINE COUNTY
MINIMUM HEALTH STANDARDS: Authority COMAR 10.15.03, Article 43 MD Code.
1. PERSON-IN-CHARGE: Designate a responsible adult to be in charge during each shift. It is this person’s
responsibility to monitor food temperatures, food preparation and storage, personal hygiene and food handling
practices. All personnel must be trained on proper hand washing and food handling.
2. FOOD: All food, including ice and drinks, must be obtained from approved, licensed commercial sources. Food
may not be prepared in home kitchens. Serve easy to prepare foods. Foods involving more than one handling,
preparation or cook step are more likely to cause food-borne illness.
3. STORAGE: Foods that are not stored in their original containers must be stored in containers constructed of food
grade plastic or stainless steel. Styrofoam coolers are not acceptable. Food products, serving products and
equipment must be kept off the ground.
4. FOOD PROTECTION: Overhead protection will be provided for all food, food containers and food prep areas. Open
“pit” style grills should have covers or other appropriate protection. All food must be protected from insects, birds,
weather, heat and direct sunlight. Raw food products must have separate containers and utensils and kept in
separate areas from cooked and/or ready-to-eat foods. All foods must be transported and held at the correct
internal temperature.
5. EQUIPMENT: Must be of acceptable commercial grade design, in good condition, easily cleanable and sanitized
before use.
6. PROBE THERMOMETER: A probe thermometer must be provided to monitor internal temperatures of foods.
Thermometers must be able to read from 0ºF to 220ºF. Thermometers must be cleaned and sanitized before and
after checking foods.
7. FOOD COLD HOLDING: All foods must be held at 0ºF or less if frozen, or 41ºF or less if refrigerated.
8. FOOD COOKING: Final cook temperatures must be monitored. See attached chart for minimum temperatures.
9. FOOD HOT HOLDING: All hot food must be held at a minimum internal temperature of 135ºF or above.
10. FOOD SURFACES: Equipment and utensils must be thoroughly cleaned and sanitized every 4 hours or more often
as needed. Sanitizer of the appropriate strength should be used for cleaning surfaces. Cloths used for wiping
surfaces should be used for no other purpose and kept in a sanitizer solution of 50 ppm chlorine when not in use.
All food contact surfaces must be made with a non-absorbent material.
11. PERSONNEL: Must be healthy, wear appropriate clothing and minimal jewelry, have hair tightly restrained above
the collar, and not eat, drink, chew gum or tobacco while handling food. Exclude anyone with diarrhea, illness,
coughing & sneezing, or inadequate hand washing or food handling practices. Smoking is prohibited in the food
area. It is the responsibility of the person in charge to train and monitor personnel to prevent food-borne illness.
12. FOOD HANDLING: NO BARE HAND CONTACT with food. Use a separate utensil for each food item. Gloves are
not required, but if used, they should be used in the appropriate manner. Hands must be washed first and the
gloves put on by handling the wrist part only. Gloves should be changed between tasks and as often as needed.
13. UTENSIL/EQUIPMENT CLEANLINESS: Must provide extra clean and sanitized utensils to be changed every 4
hours or more frequently if necessary. If a 3 compartment sink is available utensils must be washed, rinsed,
sanitized and air dried. Chlorine sanitizer strength is 50 ppm, and 100 ppm for any in-place sanitization (1
tablespoon of bleach to 1 gallon of water = 50 ppm). Chemical test strips must be provided.
14. HANDWASHING: A cleanable container (minimum 4 gallons) with a locking spigot (push-button spigots are not
acceptable), filled with tempered (minimum 100⁰F) potable water, and bucket underneath to catch wastewater can
be used. Single use paper towels and hand soap must be provided at the hand sink. Personnel must wash hands
for a minimum of 20 seconds. Pans filled with soapy water are not acceptable for hand washing. Hand sanitizer
may be used, but cannot replace hand soap or hand washing. Hands must be washed before prep, after
contamination, and after rest room use.
15. EVENT LOCATION: Toilet facilities must be provided, well supplied and easily accessible.
16. WASTE: Covered garbage containers must be provided at each food stand. All trash must be disposed of properly
and regularly to prevent vermin infestation. Waste water from hand washing, utensil washing, and cleaning may
NOT be disposed down storm drains or on the ground. Used grease may not be disposed on the ground.
17.
.
INSPECTION: An inspection may be required; the facility must be ready for operation at the time of inspection
Revised-September 2015
th
403 S 7
Street, Rm 248, Denton, MD 21629
www.carolinehd.org
PHONE: 410/479-8045
FAX: 410/479-4082
Cooking Temperature Chart
PRODUCT
Final Cook Temperature (F)
Beef
145º for 15 seconds
(intact muscle)
Fish & other Seafood
145º for 15 seconds
Comminuted (Ground) Meat or Injected Meat
155º for 15 seconds
(hamburger, ground pork, raw sausage, fish cakes)
Microwaved Potentially Hazardous Foods
165º; let stand for 2 minutes
Poultry
165º for 15 seconds
(chicken, turkey, ground turkey, etc.)
Roasts
145º for 3 minutes or see Roasting
(whole intact roasts)
Chart
Pork
155°F for 15 seconds
Stuffing, Stuffed Meats, Casseroles
165º for 15 seconds
Ready to eat foods for hot holding
135⁰F for 15 seconds
Egg Dishes
155º for 15 seconds
Vegetables and All Other Foods
145º for 15 seconds
REHEAT: 165º F or more, within 2 hours
HOT HOLD: 135º F or more
COLD HOLD: 41º F or less
Revised-September 2015
th
403 S 7
Street, Rm 248, Denton, MD 21629
www.carolinehd.org
PHONE: 410/479-8045
FAX: 410/479-4082
WHOLE ROAST COOKING CHART
Whole Roasts
(beef,
Minimum Internal Temp
Holding Time
at
#
*
pork, ham, corned beef,
Specified
lamb, venison, bison)
Temperature
(F)
(C)
130
54
121 minutes
132
56
77 minutes
134
57
47 minutes
136
58
32 minutes
138
59
19 minutes
140
60
12 minutes
142
61
8 minutes
144
62
5 minutes
145
63
3 minutes
# Minimum oven temperature for roasts less than 10 lbs is 250F.
For roasts greater than 10 lbs, oven temperatures are as follows:
Dry Heat: 350F
Convection Oven: 325F
High Humidity: 250F
* Holding times may include post oven heat rise.
Roasts cooked according to one of the parameters specified above may be hot held at 130F or more.
Leftover roasts must be reheated for hot holding by either:
1. Rapidly reheating to 165F within 2 hours then hot held at 140F or more.
2. Thoroughly re-cooking using the oven parameters and minimum time and temperature conditions
specified above and then hot holding at 130F or more.
Revised-September 2015
th
403 S 7
Street, Rm 248, Denton, MD 21629
www.carolinehd.org
PHONE: 410/479-8045
FAX: 410/479-4082