The Temporary Food Permit Hawaii form is an essential document for any organization or individual planning to sell or distribute food to the public for a limited time in Hawaii. This permit allows food establishments to operate for up to twenty days within a 120-day period, ensuring compliance with health and sanitation standards set by the state. To obtain this permit, applicants must provide specific information about their event, including the location, date, and details about the food being served.
In Hawaii, organizing a temporary food event requires careful planning and adherence to health regulations, which is where the Temporary Food Permit Hawaii form comes into play. This essential document is designed for establishments, organizations, or individuals who wish to sell or distribute food to the public for a limited period, specifically not exceeding 20 dates within a 120-day timeframe. The application process involves providing key details such as the name of the organization, event location, and contact information for the representative. Additionally, applicants must specify the date and time of the event, along with the name and address of the approved commercial kitchen where food will be prepared and stored. It’s crucial to remember that home kitchens cannot be used for this purpose. Furthermore, the form requires a list of food items to be served, ensuring that all offerings comply with health standards. A site plan indicating the booth layout and handwashing facilities is also necessary. Applicants should be aware that the $25 fee is non-refundable and that submissions must be made at least ten working days before the event to allow for processing. Understanding these requirements will help ensure a smooth application process and successful event execution.
Filling out the Temporary Food Permit Hawaii form can be a straightforward process, but mistakes can lead to delays or denials. One common error is failing to provide a complete name of the organization or establishment. Each permit is specific to one organization, and missing this crucial detail can result in an incomplete application.
Another frequent mistake involves the location or address of the event. Applicants sometimes list multiple locations instead of a single address. This can confuse the processing team, as each permit is only valid for one event site. Ensure that the address is accurate and clearly stated to avoid complications.
Contact information is vital, yet many applicants overlook this section. Providing a contact person’s name and their phone or fax number is essential for communication. Incomplete or incorrect contact details can lead to missed notifications about the permit status, which could jeopardize the event.
Many people also forget to specify the date and time of the event correctly. Each date must be listed on a separate line, and applicants should not exceed the maximum of 20 dates within a 120-day period. Misunderstanding this requirement can lead to processing delays or outright rejection of the application.
Another common oversight is related to the approved kitchen or commissary. Applicants sometimes fail to include the name and address of the approved kitchen or neglect to provide the permit number. Remember, home kitchens are not acceptable for food preparation, and all kitchens must be approved by the Department of Health.
Finally, applicants often neglect to attach a site plan or booth layout. This document is essential for illustrating the setup of the food distribution area, including handwashing facilities and equipment. Without it, the application may be deemed incomplete, delaying the approval process. It is crucial to ensure that all sections of the form are filled out accurately and completely to facilitate a smooth application process.
SANITATION BRANCH
STATE OF HAWAII
54 HIGH STREET, ROOM 300
DEPARTMENT OF HEALTH
WAILUKU, HAWAII 96793
TELEPHONE NUMBER: (808) 984-8230 FAX: (808) 984-8237
APPLICATION FOR TEMPORARY FOOD ESTABLISHMENT PERMIT
(Please type or print in black or blue ink)
(A)
NAME OF ORGANIZATION OR ESTABLISHMENT
(B)
LOCATION OR ADDRESS OF EVENT (ONLY ONE) Whale Day Celebration
Kalama Park: 1900 S. Kihei Road, Kihei, HI 96753
(C)
CONTACT PERSON
(D)
CONTACT PERSON PHONE #
FAX PHONE #
DAY
(E) DATE OF EVENT
(F) TIME OF EVENT
1.
2/21/2009
9:00 a.m. - 5:30 p.m.
11.
2.
12.
3.
13.
4.
14.
5.
15.
6.
16.
7.
17.
8.
18.
9.
19.
10.
20.
(G) NAME OF APPROVED KITCHEN (COMMISSARY)
(H) STREET ADDRESS OF KITCHEN
(I) PERMIT NO.
KITCHEN USE AUTHORIZED BY: (J) (OR ATTACH LETTER OF AUTHORIZATION)
(K) SIGNATURE OF AUTHORIZED PERSON
(L) KITCHEN PHONE NUMBER
(M) PRINT NAME OF AUTHORIZED PERSON
(N) TITLE
(O)
LIST FOOD ITEMS. NO HOME PREPARED FOOD.
REMINDER: KEEP HOT FOOD ABOVE 140° F. KEEP COLD FOOD BELOW 45 °F.
(CONTINUE FOOD ITEMS ON A SEPARATE PAPER IF NEEDED)
(P) ATTACH: SITE PLAN – INCLUDE HAND WASHING FACILITIES, BOOTH LAYOUT
The Sanitation Branch, Department of Health reserves the right to deny your Temporary Food Establishment Permit or revoke the permit for failure to comply with the sanitary requirements of Hawaii Administrative Rules, Title 11, Department of Health, Chapter 12, Food Establishment Sanitation. The permit applicant may be required to submit a complete menu and schematic plan of the proposed operation.
THIS PERMIT IS ONLY VALID FOR TWENTY (20) DATES IN ANY 120 DAY PERIOD
(Q) DATE
(R) SIGNATURE OF APPLICANT
(S) TITLE
(T) PRINT NAME OF APPLICANT
FEE $25.00 NON REFUNDABLE
SUBMIT APPLICATION AND FEE AT LEAST TEN WORKING DAYS PRIOR TO EVENT
MAKE CHECKS PAYABLE TO:
(BANK ACCOUNT NAME AND ADDRESS MUST BE ON THE CHECK)
SUBMIT COMPLETED APPLICATION AND FEE TO:
54 HIGH STREET, RM. 300
WAILUKU, HI 96793
THERE WILL BE A SERVICE FEE OF $25.00 FOR ANY CHECK DISHONORED BY THE BANK.
APPROVED:
DATE
SIGNATURE OF AGENT/DEPARTMENT OF HEALTH
R.S. LIC. NO.
Department of Health Seal
SECTION BELOW FOR OFFICIAL HEALTH DEPARTMENT USE ONLY
FEE
$25.00
DATE PAID
METHOD OF PAYMENT
RECEIPT NO.
RECEIVED BY
SAN APP TFE MAUI 11/07
INSTRUCTIONS FOR
TEMPORARY FOOD PERMIT APPLICATIONS
•All establishments, organizations, or individuals distributing or selling food to the public for a limited period of time (not exceeding 20 dates within a 120 day period) are required to submit a Temporary Food Establishment Permit Application to the Department of Health, Sanitation Branch. Applications will not be processed if the form is incomplete.
•Applications and $25.00 fee should be submitted at least ten (10) working days prior to event.
•All exemptions will be decided by the Department of Health Sanitation Branch.
•Approved permit may be picked-up OR faxed OR mailed to you (include a self-addressed, stamped envelope with the application).
A.NAME OF ORGANIZATION OR ESTABLISHMENT: Name of organization or establishment administering the food operation. Each permit applies to one (1) organization or establishment only.
B.LOCATION OR ADDRESS OF EVENT: Site of food distribution. Each permit applies to one (1) location.
C.CONTACT PERSON: Name of person(s) representing the organization or establishment.
D.CONTACT PHONE OR FAX NUMBER: Phone number of person(s) representing the organization or establishment.
E.DATE OF EVENT: One date per line (Maximum of 20 dates within a 120 day period, starting from the date of the first event).
F.TIME OF EVENT: Start to end time of event.
G.NAME OF APPROVED KITCHEN (COMMISSARY): Name of approved commercial kitchen (commissary) where food preparation, food storage, utensil washing, etc. will be done.
The proposed approved kitchen (commissary) must still be approved by the Department of Health for the temporary food event. Home kitchens are not acceptable for use.
H.STREET ADDRESS OF KITCHEN: Street address of approved commercial kitchen (commissary) where food preparation, food storage, utensil washing, etc. will be done.
I.PERMIT NO.*: Permit number of the approved commercial kitchen (commissary) where food preparation, food storage, utensil washing, etc. will be done.
*Permit number issued by the State Department of Health.
J.(OR ATTACH LETTER OF AUTHORIZATION): Instead of having the Authorized Person sign the application, a letter of authorization from the person in charge of the kitchen may be submitted which must include information G, H, I, K, L, M, and N.
K.SIGNATURE OF AUTHORIZED PERSON: Signature of person giving permission to use the approved commercial kitchen (commissary).
L.KITCHEN PHONE NUMBER: Phone number of approved commercial kitchen (commissary).
M.PRINT NAME OF AUTHORIZED PERSON: Print name of “(K) Signature of Authorized Person.”
N.TITLE: Title of “(K) Signature of Authorized Person.”
O.LIST OF FOOD ITEMS: All food and drink items being sold or distributed at the event (in the case of “BBQ” chicken sales, include the number of pieces of half or whole chickens to be sold).
P.SITE PLAN, BOOTH LAYOUT: On a separate paper draw a site plan and indicate the booth where food will be distributed including handwashing facilities, warmers, burners, cookers, etc.
Q.DATE: Date submitting application.
R.SIGNATURE OF APPLICANT: (Applicant and contact person need not be the same person).
S.TITLE: Title of “(R) Signature of Applicant.”
T.PRINT NAME OF APPLICANT: Print name of “(R) Signature of Applicant.”
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Special Event Permit: This permit is for organizing events that involve food distribution. Like the Temporary Food Permit, it requires details about the event, including location and date, ensuring that food safety measures are in place.
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