
BUCKS COUNTY DEPARTMENT OF HEALTH APPLICATION FOR LICENSE TO CONDUCT AND OPERATE A FOOD FACILITY In accordance with the provision of the "Local Health Administration Law", No. 315, approved.
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How to fill out the SA 13R 05 10 online
Filling out the SA 13R 05 10 application for a license to conduct and operate a food facility is an essential step for anyone looking to establish a food business in Bucks County. This guide will walk you through each section of the form to ensure that your application is completed accurately and efficiently.
Follow the steps to complete your application successfully
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Indicate the type of license you are requesting by checking either 'New' or 'Change of Ownership'. Remember, the food license is not transferable.
- Provide the name and address of the facility. This information will be displayed on the Food Facility License. Include the business telephone and fax numbers.
- Enter the name of the applicant or business owner, along with their contact telephone number, email address, and physical address, including city, state, and zip code.
- Specify the number of seats and total square footage of the facility. Select only one type of facility from the given options, such as 'All Facilities with a Pennsylvania Liquor License' or 'Take Out Service Only'.
- If applying for a Mobile Food Unit License, complete the section with the truck's make, year, manufacturer's serial number, and registration number.
- List the name of the Certified Food Safety Manager(s) and their certificate number along with the certification expiration date.
- Confirm whether you have attached the evidence of the Pennsylvania Department of Revenue Sales and Use License or Exemption Certificate by checking 'Yes' or 'No'.
- Finally, the application must be signed by the business owner or a corporate officer, with the date of signing included.
- Review all provided information for accuracy and completeness. Once confirmed, save your changes, and you may print or share the form as needed.
Complete your application online to ensure your food facility is licensed appropriately.
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