Mobile Trucks and Trailers Guidelines for Plan Revie · Mobile Trucks and Trailers Guidelines for...

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1 Environmental Health Division 3020 Rucker Avenue, Suite 104 Everett, WA 98201-3900 fax: 425.339.5254 tel: 425.339.5250 Mobile Trucks and Trailers Guidelines for Plan Review 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. 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. Mark’s Mobile Sample L&I Approval Stamp

Transcript of Mobile Trucks and Trailers Guidelines for Plan Revie · Mobile Trucks and Trailers Guidelines for...

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Environmental Health Division 3020 Rucker Avenue, Suite 104 Everett, WA 98201-3900 fax: 425.339.5254 tel: 425.339.5250

Mobile Trucks and Trailers Guidelines for Plan Review

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.

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.

Mark’s Mobile

Sample L&I Approval Stamp

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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.

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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]

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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 pre-opening inspection to obtain SHD approval.

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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

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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.

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): Private Well Public Water District:

Commissary Sewage Disposal (check one):

Onsite Sewage System Sewer Sewer District:

APPLICANT SIGNATURE DATE

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OFFICE USE ONLY

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? Yes No

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? Route Single Location

Sales Site Name:

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?

Yes No

Hot Water Heater: Size: Make: Model Number:

Mechanical Water Pump: Make: Model Number:

Is the mechanical pump capable of pressurizing both the hot and cold water systems to 15 psi? Yes No

Hand Wash Sink size is: inches wide, inches long, deep.

Is a mixing faucet installed on the hand sink? Yes No

3-Compartment Sink: Is a 3-compartment sink installed? 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

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:

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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 Yes No Handwashing sink Yes No

Approved waste water disposal Yes No Food preparation sink for vegetables Yes No

Garbage disposal Yes No Food preparation sink for raw meats Yes No

Dry storage for food and single service Yes No Approved 3-compartment sink Yes No

Refrigeration space _____cubic feet Yes No Approved restroom Yes No

Freezer space _____cubic feet Yes No Entrance key for after-hours access Yes No

Ice in pounds per day ______lbs. Yes 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

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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 Address

4:00am – 5:00am Commissary 3020 Rucker Avenue, Everett

5:15am – 6:30am Alice’s Gym 3389 Hansen Avenue, Edmonds

7:45am – 8:15am Fish Market 14432 Poplar Street, Mountlake Terrace

8:30am – 10:00am Phil’s Tires 836 Stevens Way, Mountlake Terrace

10:30am- Return to Commissary

4:30pm – 6:00pm Batting Cage 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)

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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 OFFICE USE ONLY

Other PERMIT #__________________________

OTHER

Mailed / Delivered / PU_______________ Date / Initials

Catering Only (PLU 374)

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.)

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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 If no, what is your reopening date?

Copy of menu submitted. (REQUIRED) 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

You are APPROVED to remain open pending inspection. This 30-day conditional Permit to Operate expires on:

POST THIS PAPER IN A CONSPICUOUS AREA

Date SHD Initials

Environmental Health Division 3020 Rucker Avenue, Suite 104 Everett, WA 98201-3900 fax: 425.339.5254 tel: 425.339.5250

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 Seat count includes lounge seats

a) Low Risk $326.00 Annual permit fee

b) Medium Risk $489.00 Annual permit fee

c) High Risk $651.00 Annual permit fee

13-50 seats Seat count includes lounge seats

a) Low Risk $357.00 Annual permit fee

b) Medium Risk $531.00 Annual permit fee

c) High Risk $704.00 Annual permit fee

51-150 seats Seat count includes lounge seats

a) Low Risk $389.00 Annual permit fee

b) Medium Risk $573.00 Annual permit fee

c) High Risk $788.00 Annual permit fee

151-250 seats Seat count includes lounge seats

a) Low Risk $420.00 Annual permit fee

b) Medium Risk $615.00 Annual permit fee

c) High Risk $840.00 Annual permit fee

Over 250 seats Seat count includes lounge seats

a) Low Risk $452.00 Annual permit fee

b) Medium Risk $657.00 Annual permit fee

c) High Risk $893.00 Annual permit fee

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 CATERING ENDORSEMENT (for licensed food establishments that also offer catering services)

$25.00 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 $132.00 Annual permit fee

b) Medium Risk $210.00 Annual permit fee

c) High Risk $289.00 Annual permit fee

VENDING MACHINES

With potentially hazardous foods – risk level – Low $121.00 Annual permit fee

FOOD THERMOMETERS

a) Dial probe $9.00 Fee includes sales tax

b) Digital tip sensitive $24.00 Fee includes sales tax

FOOD WORKER CARDS

a) 2-year initial or 3-year renewal $10.00

b) Replacement for lost card $10.00

MANAGER COURSES

a) Manager Certification $175.00 Instructional and supplies fee

b) Manager Recertification $132.00 Instructional and supplies fee

c) Manager Recertification without purchasing book $79.00 Instructional fee

d) Serve Safe Certification and Test $175.00 Includes Serve Safe curriculum, book, materials, and test.

e) Manager Self-Inspection Program Establishment Fee Credit For 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 School and Satellite Kitchens

$630.00 Plan review and pre-operational inspection fee

c) Multiple Permit Facility $630.00 Base fee for plan review and pre-operational 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 pre-operational inspection PLUS $168.00 for each additional hour over 2.5 hours.

e) Site Inspection to re-open former food service establishment $168.00 Per inspection to reopen former Food Service Establishment

f) Hazard Analysis Critical Control Point Review (HACCP) $168.00 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

3

TITLE FEE DESCRIPTION

Plan Review Continued

g) Plan Revision $168.00 Base fee for alteration to existing facility or revision of approved plan PLUS $168.00 per hour for each additional hour over 1 hour

h) Reactivate Plan Review $168.00 Applicable on projects idle for more than one year

REINSPECTION AND REINSTATEMENT FEES

a) Reinspection and office conference per III.B.3, Enforcement Procedures

$273.00 Reinspection and office conference fee

b) Reinspection after first preoccupancy inspection $168.00 Reinspection fee

c) Reinstatement following closure by Health Officer's Order $315.00 Reinstatement fee

d) Reinstatement fee following closure by Health Officer’s Order for an existing, immediate health hazard.

$541.00 Reinstatement fee

e) Reinspection due to uncorrected red item violation $168.00 Reinspection fee

CAMPGROUNDS / PARKS

a) Food service / all year General Food Fees

Annual permit fee

b) Food service / seasonal (3 consecutive months or less) $336.00 Annual permit fee

SCHOOLS

a) Central kitchen, no direct food service $525.00 Annual permit fee

b) Satellite kitchen with food service $336.00 Annual permit fee

c) School kitchen with food service $400.00 Annual permit fee

TEMPORARY FOOD SERVICES

LATE FEE CHARGE Temporary Food Service & Mobile Food Vehicle Non-refundable fee charged if the application is not received in the

Environmental Health Division office seven (7) days before the event.

$48.00 Late charge fee

a) Low Risk Valid 1-21 consecutive days $79.00 Event permit fee

Annual / Restrictive No more than 3 days per week at same location (see WAC 246-215-011)

$200.00 Annual permit fee for first location PLUS $100.00 for each additional location

b) High Risk Valid 1 day $111.00 Event permit fee

Valid 2-3 consecutive days $163.00 Event permit fee

Valid 4-8 consecutive days $221.00 Event permit fee

Valid 9-21 consecutive days $378.00 Event permit fee

Annual / Restrictive No more than 3 days per week at same location (see WAC 246-215-011)

$475.00 Annual permit fee for first location PLUS $168.00 for each additional location

c) Food Demonstrator (Low Risk foods only)

Valid 1-21 consecutive days $79.00 Event permit fee

Annual (Low Risk foods only)

No location restrictions apply $184.00 Annual permit fee

d) Judged Cook-off 1-20 entrants – not open to public $263.00 Event permit fee

1-20 entrants – open to public $578.00 Event permit fee

21-over entrants –not open to public $263.00 Event permit fee

21-over entrants – open to public $840.00 Event permit fee

e) Mobile Food Vehicle Operating with an annual permit $37.00 Event permit fee

f) Exempt or Product ID only $40.00 Processing fee

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

NO FEE

b) 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