Get City Of Dallas Food Establishment Permit

NO CUTTING OF ANY FOOD ON-SITE. NO STERNO FOR OUTSIDE USE NO ICE CHEST FOR FOOD STORAGE. Submit a copy of the State County City permit and current inspection report for foods prepared or manufactured beyond Dallas City limits. TEMPORARY FOOD ETABLISHMENT PERMIT REQUEST Separate Form Required For Each Stand PERMIT FEES ARE NOT REFUNDABLE Environmental Health Services 7901 Goforth Dallas Texas 75238 Special Event Police Dept. Approval YES NO Date s of EventTime of Operation From To Location of Event Street Address MAPSCO Organization Responsible Person Address Phone Do you operate food establishments at other locations If Yes provide names and addresses Food Items To Be Served Place of Preparation Storage NOTE ONLY LISTED FOODS AND BEVERAGES MAY BE AUTHORIZED I acknowledge receipt of a copy of City of Dallas Guidelines for Temporary Food Establishments and understand that failure to meet provisions for a Temporary Food Establishment described in the City of Dallas Food Establishment Code Chapter 17 can result in citations for violations and penalties to be assessed in court. TEMPORARY FOOD ETABLISHMENT PERMIT REQUEST Separate Form Required For Each Stand PERMIT FEES ARE NOT REFUNDABLE Environmental Health Services 7901 Goforth Dallas Texas 75238 Special Event Police Dept. Approval YES NO Date s of EventTime of Operation From To Location of Event Street Address MAPSCO Organization Responsible Person Address Phone Do you operate food establishments at other locations If Yes provide names and addresses Food Items To Be Served Place of Preparation Storage NOTE ONLY LISTED FOODS AND BEVERAGES MAY BE AUTHORIZED I acknowledge receipt of a copy of City of Dallas Guidelines for Temporary Food Establishments and understand that failure to meet provisions for a Temporary Food Establishment described in the City of Dallas Food Establishment Code Chapter 17 can result in citations for violations and penalties to be assessed in court. I certify that all facts stated in this application are true and correct to the best of my knowledge and belief* Applicant Signature Date Applicant s Drivers License No* D. O. B. Special Conditions Comply with all TEMPORARY FOOD GUIDELINES as required by the City of Dallas Health Dept. Home preparation of food is not allowed* Must have MECHANICAL HEATING OR REFRIGERATION for all potentially hazardous foods. Provide hand and utensil wash set up stem type dial thermometers for measuring internal food temperature. Approval YES NO Date s of EventTime of Operation From To Location of Event Street Address MAPSCO Organization Responsible Person Address Phone Do you operate food establishments at other locations If Yes provide names and addresses Food Items To Be Served Place of Preparation Storage NOTE ONLY LISTED FOODS AND BEVERAGES MAY BE AUTHORIZED I acknowledge receipt of a copy of City of Dallas Guidelines for Temporary Food Establishments and understand that failure to meet provisions for a Temporary Food Establishment described in the City of Dallas Food Establishment Code Chapter 17 can result in citations for violations and penalties to be assessed in court. I certify that all facts stated in this application are true and correct to the best of my knowledge and belief* Applicant Signature Date Applicant s Drivers License No* D.