Get Dhec Form 1769 2015-2025

This guide provides clear instructions on how to complete the Dhec Form 1769 for obtaining a retail food establishment permit. By following the steps outlined, users can efficiently fill out the form online, ensuring that all necessary information is accurately provided.

Follow the steps to successfully complete the Dhec Form 1769.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the establishment name and address in the specified fields. Ensure that the county is correctly selected, followed by the establishment's phone and fax numbers.
3. Provide the names and contact details of the permit holder or owners. Specify a 24-hour emergency contact number for any urgent issues that may arise.
4. If the business phone number or fax number differs from the one provided, make sure to include that information. Also, fill in the billing address if it is different from the establishment address.
5. Enter the e-mail address of the permit holder. Indicate whether you want to receive inspection reports by e-mail in PDF format as well as a printed copy.
6. Select the type of ownership by checking the appropriate box. This could be individual, partnership, limited liability company (LLC), corporation, or non-profit organization.
7. List the managers or individuals responsible for daily operations, including their titles, names, addresses, and emergency contact numbers.
8. Provide details about food safety training for the responsible individual, including the course taken, date of certification, and institution.
9. Specify the number and capacity of refrigeration units, the source of water supply, and total square footage of the facility.
10. Indicate the type of sewage disposal and waste disposal methods being utilized. This includes municipal sewer systems or septic tanks.
11. Outline the days and hours of operation for the establishment.
12. In the operations information section, check the appropriate types of retail food establishments applicable to your business.
13. Provide necessary details about food preparation, special processes, and outdoor cooking if applicable.
14. If there is a Barbeque Pit Room, fill in the details regarding its location and attach the menu of meals served.
15. Affirm the accuracy of all provided information by signing the application. This certification implies understanding of the requirements and regulations as stated.
16. Once you have filled in all fields, review the form for accuracy. You can then save changes, download, print, or share the completed form as necessary.

Start completing your Dhec Form 1769 online today for a smooth application process.