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Temporary Food Permit Application Goldendale Office Klickitat County Health Department White Salmon Office 228 West Main Street 501 NE Washington St/ PO Box 159 MS-CH 14 White Salmon, WA 98672 Goldendale, WA 98620 [PHONE REDACTED] [PHONE REDACTED] All individuals, groups, or affiliations planning to hold events that serve food AND are open to the public are required to get a permit. If you advertise (newspaper, television, radio, flyers, signs, banners or other means) to the public, you are required to get a permit. According to state law (WAC 246-215) all food served to the public must follow current food service regulations. The permit provides proof to your customers that your operation has been reviewed and meets food safety and sanitation requirements. The permit MUST also be posted on site during your operation. Submit the completed application with all applicable fees either in person or by mailing it to one of the locations listed below at least 14 days prior to the event. Permits must be attained in advance and will not be sold on site. Permit Fee Schedule $20 Temporary Permit Level I Low Hazard Menu: items requiring food handling, but most without temperature requirements. Such as; fountain drinks, espresso drinks, sno-cones, scooped ice cream, nacho cheese, or hot dogs. $35 Temporary Permit Level II Moderate to High Hazard Menu: Any potentially hazardous food that requires temperature control or raw foods that require cooking. Such as; sliced melons, cut leafy greens, pre-cooked items, raw hamburgers, raw chicken, eggs, or steak. $80 Seasonal Temporary Permit (4 months max): Covers all levels of hazardous menus. The Health Department must be informed of all events and locations where food will be sold under this permit. Permit must be posted at each site for each event. $150 Annual Temporary Permit: Covers all levels of hazardous menus. The Health Department must be informed of all events and locations where food will be sold under this permit. Permit must be posted at each site and each event. Late: Applications received less than 14 calendar days prior to the first event will be charged a late fee. The late fee is twice the operating fee. No exceptions. Permit fees are not refundable. Name of Concessions: Applicant name: Day and Evening Phone: *Mailing Address: City: State, ZIP: *Person in charge of booth: Organization or Business: Event Name: Event Location: Time of Event: Date of Event: *Please use your preferred mailing address. *At least one food handler with a valid Washington Food Worker Card must be in the booth at all times. ---PAGE BREAK--- Temporary Food Permit Application Goldendale Office Klickitat County Health Department White Salmon Office 228 West Main Street 501 NE Washington St/ PO Box 159 MS-CH 14 White Salmon, WA 98672 Goldendale, WA 98620 [PHONE REDACTED] [PHONE REDACTED] Please provided a complete a rough sketch of your booth layout and floor plan. Include all food prep areas, cooking areas and equipment, where your handwashing unit is, any food storage, and your warewashing facilities. Please note: All mobile units must be approved by the Washington State Department of Labor and Industries. Describe your method of sanitizing equipment and surfaces: There is no bare hand contact allowed with ready to eat foods in Klickitat County. Describe your method(s) to prevent bare hand contact: What equipment will you use for cooking foods? What equipment will you use to hot hold foods? How will you prevent public access into the booth? What equipment will you use to cold hold food? Describe how you will prevent cross contamination of ready to eat foods with raw food items: Please note: All cold holding units (excluding ice units) are required to have a thermometer in the unit. All booths are required to have a thermometer for cooking or hot-holding items. No food may be prepared outside the temporary event, unless prepared in a licensed facility. A large roast thermometer will not be sufficient for testing the cooking temperature of thin food items. Any event lasting longer than 8 hours per day, will require NSF approved refrigeration. Location of Food Prep area: Booth/Tent Outside Booth Inside Mobile Unit Water Source Public Private Ground Overhead Wastewater disposal ---PAGE BREAK--- Temporary Food Permit Application Goldendale Office Klickitat County Health Department White Salmon Office 228 West Main Street 501 NE Washington St/ PO Box 159 MS-CH 14 White Salmon, WA 98672 Goldendale, WA 98620 [PHONE REDACTED] [PHONE REDACTED] Please list all foods that will be served directly to the public at the event. Food prepared in a private home OR home-canned foods cannot be served to the public. No need to list canned/bottled beverages for sale. Menu Items To Be Cooked From Raw Supplier Final Cook Temp Menu Items Intended For HOT Holding Supplier Equipment Used Menu Items Intended For COLD Holding Supplier Equipment Used ---PAGE BREAK--- Temporary Food Permit Application Goldendale Office Klickitat County Health Department White Salmon Office 228 West Main Street 501 NE Washington St/ PO Box 159 MS-CH 14 White Salmon, WA 98672 Goldendale, WA 98620 [PHONE REDACTED] [PHONE REDACTED] ***PLEASE READ*** A permit is required for each vendor. The permit must be posted or easily accessible during the entire event or service. A photocopy is not valid. A valid Washington State Food Workers Card is required for the person in charge of the booth. A person with a valid card must be available at the booth during hours of operation. A food card can be obtained at www.foodworkercard.wa.gov. Handwashing Stations are required for all outdoor events. For outdoor events, handwashing booths are required to be set-up and functional prior to cooking or food prep. All handwashing stations must have paper towels, soap, warm water, and contiguous flow. A wastewater bucket is also required. Wastewater buckets cannot be dispensed on the ground or in storm water drains. All booths must have a food thermometer capable of measuring 0° to 220° Fahrenheit. Potentially hazardous foods must be stored at 41° F or hot held at 135° F (or higher). Final cooking before hot holding should be done on an open flame, grill, or stove. All “precooked” items must be completely reheated to 165° F for at least 15 seconds, prior to being hot held. Equipment and utensils that are intended to be re-used on site or used for multiple days during an event, must be washed using the three basin method on-site, or in a commercial kitchen. For one-day events, we recommend bringing multiple sets of clean utensils. During service hours, in-use utensils must be stored in cold running water or ice water. Water hoses used during temporary events should be approved for potable use (drinking). The nozzle of the hose MUST be stored 6 inches off the ground. All food must be from an approved source. Ice is a food and must also be from an approved source. Food on display must be presented in a manor to prevent contamination. All food should be covered to prevent contamination via pests or airborne debris. There is no bare hand contact with ready to eat foods in Klickitat County. A booth must provide a method to prevent bare hand contact. Single service items (paper cups, plastic utensils) must be stored in a manor to prevent contamination. Sick individuals may not work in any food concession. Anyone with a communicable disease, such as the flu, a cold, or has an open sore or infected wound on their hand is prohibited from working. Gloves must be worn if you have a band-aid on your hand. Toilet facilities must be conveniently located within 200 feet of the food booth. Garbage cans need to be present, on in the booth and one outside for accessibility. Lids need to be available to discourage rodents, insects, and birds. Wastewater from dishwashing or handwashing should NEVER be dumped into the street, storm drains, or on the ground. Use a container to collect wastewater and discard in city sewer or an approved sewage disposal system. 5 gallon Thermal Container