Transcription of West Windsor Township
1 WestWindsorTownship271 ClarksvilleRoad, WestWindsor, NJ08550 'Tel. (609) 936-8400 ' Fax (609) , licenseapplicationforthespecificevent, separatefeeis $ complete. themenuorplanofoperationchangessignifica ntlyduringtheseason, thevendormustupdatetheplanonfilewiththeH ealthDepartmentbyresubmittingpages2 and3 , : ( 8:24). Pleasereviewthefollowingguidelines:1. Completedapplicationsmustbereceivedat leastthirty (30) dayspriortothedate(s) Planyourmenucarefully. Thepreparationof potentiallyhazardousfoods (anyfooditemswhichconsistinwholeorin partofmilkormilkproducts, eggs, meat, poultry, rice, fish, shellfishorediblecrustacean) is strictlyregulatedbytheNewJerseyStateSani taryCodeandmaybeprohibited, ifdeemednecessary. Allpotentiallyhazardousfoodsmustbemainta inedat Safecookingtemperaturesforpotentiallyhaz ardousfoodsareasfollows: 130 Fforraresteakorroasts; 145 F forfish, meat, porkandgameanimals; 155 F forgroundmeat/fish, injectedmeatsorrawshelleggs; 165 F forpoultry, stuffedfish/ Safeholdingtemperaturesforpotentiallyhaz ardousfoodsareasfollows: 41'Fandbelowforcoldholdingand135 F Indicatingthermometersarerequiredtomonit orsafetemperaturesof potentiallyhazardousfoodsandmustbeonsite .
2 Athin-tippedprobethermometer (rangefrom0- 220 F) Foodsmustbeprotectedfromcontaminationwhi lebeingstored, prepared, displayedorserved. Allfoodmustbekeptcoveredwhenondisplayorb ehinda sneezeguard. Overheadprotectionis Shellfishtagsmustbeonsite, Icemustbefromanapprovedsource. Icefroma homeona privatewellis Handwashingfacilitiesarerequiredandshoul dconsistof dispensedwater, handcleaningliquidin apumpdispenserandindividual, disposablepapertowels. Handwashstationsmustbeset-upuponarrival, RiskType2 and3 musthavea RiskType1 mayusecontainerswithpre-moistenedtowelet tes13. A "wash, rinseandsanitizestation" shallbeprovidedforutensils, pans, 1/ 3 cupofbleachper5 Dustand/or mudcontrolmaybenecessaryforthegroundsurf aceof If foodis storedorpreparedoff-site, applicantsmustdesignatea BaseofOperationandprovidethemostrecentin spectionresults, ie. placard. 2/21/17 Page0 REQUIREMENTSFORATEMPORARYFOODEVENTDOYOUH AVE?HANDWASHSTATIONAND4 HANDWIPESRisk2 & 3 Risk1,2 & temporaryhandwashingstationFOODMONITORIN GTHERMOMETERSREFRIGERATIONTHERMOMETERSD oyouneeda ThinProbeThermometer?
3 ReraAthinprobethermometerisneededtomonit orthinfoods (ex. meatpattiesandfishfillets)SANITIZER: BLEACHORQUATSTESTSTRIPSD otheteststripsmatchyoursanitizer? 'W&MAwscWAffTHREECOMPARTMENTSINKSEEAPPLI CATIONFORCOMPLETEREQUIREMENTSANDREMINDER SCALLWESTWINDSORTOWNSHIPHEALTHDEPARTMENT AT609-936-8400 FORADDITIONALINFORMATIONIWESTWINDSORTOWN SHIPHEALTHDEPARTMENT271 CLARKSVILLEROAD WESTWINDSOR, NJ08550 - 609-936-84002018 APPLICATIONFORATEMPORARYFOODESTABLISHMEN TLICENSEEVENTLOCATIONDATESTOHOURSSPONSOR PHONE# ( FAX #VENDOR/TEMPORARYFOODFACILITYOWNER/OPERA TOROFTEMPORARYFOODFACILITYMAILINGADDRESS PHONE # EMAILPERSONINCHARGEOFFOODHANDLING:Includ efoodmanager's certificationifapplicable) :TAXEXEMPTNUMBER(IFAPPLICABLE)APPLICATIO NISINCOMPLETEWITHOUTFEEE ventsthatbeginMondaythroughFriday (before5pm)----------------------------- ---------------------------$ , Sundays, LegalHolidaysorafter5:00pm-------------- -----------------------$ : Anyapplicationcompletedlessthan7calendar dayspriortooperation----$ : Date:PrintName:FOROFFICEUSEONLYLICENSE:# ISSUED:' PAID$ CHECK#:'= CASHRev.
4 1/10/18 Page1 PLANOFOPERATIONBASEOFOPERATION:LOCATIONO FFOODPREPARATIONANDSTORAGEPRIORTOTHEEVEN TrSatisfactoryrConditionalMenuitemQuanti tyServedEquipmentusedArriveateventDescri beindetailHotorcoldonsiteHot, cold, orfrozenIndicatesources: IcePotableWater1. ListofSources(s) wherefoodwillbebroughtfromandpurchased:2 . Willfoodpreparationbeconductedoff-siteof theevent?YESNO3. Ifyes, wherewillthefoodsbeprepared? (NOTE: FOODSCANNOTBEPREPAREDATHOME)4. Howarefoodtemperaturesmaintainedduringtr ansport?5. Howwillpotentiallyhazardoushotfoodsbehel dat135 F andabove?ofunits: SteamTableSternoGrillOther6. Willarefrigeratedtruckbeusedforcoldfoods torage? YESNO7. Howwillpotentiallyhazardouscoldfoodbekep tat 41 F orbelow?units: RefrigeratorFreezerIceChestOther8. Whatmaterialswillbeusedforoverheadprotec tion?Rev. 1/10/18 Page29. Whatequipmentwillbeusedto protectfoodondisplay?SneezeGuards_Covers Sealed/Wrapped_Other10. Howwillwastewaterbedisposedoffromyourfoo dfacilityoperation?Sketchthelayoutinclud inghandwashstation, three-basinutensilwash, cookingequipment, coldholdequipment, foodpreptables, !
5 THERMOMETERS! Placethemincoolers, refrigerators, (hairnetsorbaseball-typecaps) eatwhileengagedin foodhandlingor whilein grills, : Date:Rev. 1/10/18 Page3
