Consumer Protection Division Policy, Standards, And Quality Assurance Section Public Sanitation and Retail Food Safety Unit Mobile Food Unit Variance Request Template for a Central Preparation Facility.

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How to fill out the TX 23-15130 online

Filling out the TX 23-15130 form is an essential step for mobile food unit operators seeking a variance for operating without a Central Preparation Facility. This guide will provide you with clear instructions on how to complete the form effectively and efficiently.

Follow the steps to accurately complete the TX 23-15130 form online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the name of your establishment in the designated field. Ensure that the name matches your official license.
  3. Input your license or file number, making sure it corresponds with your establishment records.
  4. Fill in the mailing address, ensuring that it is complete and accurate for any necessary correspondence.
  5. Enter your name as the applicant, followed by your phone number and email address. This information is crucial for communication regarding your request.
  6. In the section asking for the owner's or authorized manager's name, include the name of the individual who will be submitting the variance request.
  7. Select whether you are the owner or authorized manager by circling the appropriate option within the form.
  8. Sign and date the form where indicated. The signature confirms your request for a variance of rule §228.221(b)(1).
  9. Prepare a public health rationale to justify your variance request. This can be documented in the provided checklist and should comprehensively address all required criteria.
  10. Gather additional documentation such as the Certified Food Manager Certificate, servicing area authorization, menu of food items to be sold, and photos of the mobile food unit and equipment.
  11. Once you have filled out the form and compiled all required documents, submit your variance request by email, fax, or mail to the Texas Department of State Health Services, ensuring all submission guidelines are followed.
  12. After submission, ensure to save changes made to the form, and keep a copy for your records. You can download or print it as needed.

Complete your TX 23-15130 variance request online today and ensure compliance with food safety standards.

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