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Free Temporary Food Permit Hawaii Template

The Temporary Food Permit Hawaii form is a necessary application for any organization or individual looking to distribute or sell food to the public for a limited time in Hawaii. This permit is valid for up to twenty dates within a 120-day period and ensures compliance with health and safety regulations. Completing the form accurately and submitting it on time is essential for a successful event.

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Free Temporary Food Permit Hawaii Template

Overview

The Temporary Food Permit Hawaii form is an essential document for organizations or individuals looking to distribute or sell food to the public during special events. This permit is required for any temporary food establishment operating for a limited period, specifically not exceeding 20 dates within a 120-day timeframe. The application process involves several key components, including providing the name of the organization, the event's location, and contact information for the responsible person. Additionally, applicants must specify the date and time of the event, as well as details about the approved kitchen where food preparation will take place. It is crucial to remember that home-prepared food is not permitted, and all food items must be listed on the application. A site plan indicating the booth layout and handwashing facilities must also be submitted. The form emphasizes the importance of maintaining food safety standards, such as keeping hot food above 140°F and cold food below 45°F. A non-refundable fee of $25 is required, and applications should be submitted at least ten working days prior to the event. The Department of Health reserves the right to deny or revoke the permit if sanitary requirements are not met, ensuring that public health remains a priority during food distribution events.

Document Preview Example

SANITATION BRANCH

STATE OF HAWAII

54 HIGH STREET, ROOM 300

DEPARTMENT OF HEALTH

WAILUKU, HAWAII 96793

TELEPHONE NUMBER: (808) 984-8230 FAX: (808) 984-8237

APPLICATION FOR TEMPORARY FOOD ESTABLISHMENT PERMIT

(Please type or print in black or blue ink)

(A)

NAME OF ORGANIZATION OR ESTABLISHMENT

(B)

LOCATION OR ADDRESS OF EVENT (ONLY ONE) Whale Day Celebration

Kalama Park: 1900 S. Kihei Road, Kihei, HI 96753

(C)

CONTACT PERSON

(D)

CONTACT PERSON PHONE #

FAX PHONE #

DAY

(E) DATE OF EVENT

(F) TIME OF EVENT

DAY

(E) DATE OF EVENT

(F) TIME OF EVENT

2/21/2009

9:00 a.m. - 5:30 p.m.

11.

12.

13.

14.

15.

16.

17.

18.

19.

10.

20.

(G) NAME OF APPROVED KITCHEN (COMMISSARY)

(H) STREET ADDRESS OF KITCHEN

(I) PERMIT NO.

KITCHEN USE AUTHORIZED BY: (J) (OR ATTACH LETTER OF AUTHORIZATION)

(K) SIGNATURE OF AUTHORIZED PERSON

(L) KITCHEN PHONE NUMBER

(M) PRINT NAME OF AUTHORIZED PERSON

(N) TITLE

(O)

LIST FOOD ITEMS. NO HOME PREPARED FOOD.

REMINDER: KEEP HOT FOOD ABOVE 140° F. KEEP COLD FOOD BELOW 45 °F.

(CONTINUE FOOD ITEMS ON A SEPARATE PAPER IF NEEDED)

(P) ATTACH: SITE PLAN – INCLUDE HAND WASHING FACILITIES, BOOTH LAYOUT

The Sanitation Branch, Department of Health reserves the right to deny your Temporary Food Establishment Permit or revoke the permit for failure to comply with the sanitary requirements of Hawaii Administrative Rules, Title 11, Department of Health, Chapter 12, Food Establishment Sanitation. The permit applicant may be required to submit a complete menu and schematic plan of the proposed operation.

THIS PERMIT IS ONLY VALID FOR TWENTY (20) DATES IN ANY 120 DAY PERIOD


	(Q) DATE		(R) SIGNATURE OF APPLICANT

	(S) TITLE		(T) PRINT NAME OF APPLICANT
FEE $25.00 NON REFUNDABLE		SUBMIT APPLICATION AND FEE AT LEAST TEN WORKING DAYS PRIOR TO EVENT
MAKE CHECKS PAYABLE TO:		STATE OF HAWAII		(BANK ACCOUNT NAME AND ADDRESS MUST BE ON THE CHECK)
SUBMIT COMPLETED APPLICATION AND FEE TO:				SANITATION BRANCH
				54 HIGH STREET, RM. 300
				WAILUKU, HI 96793

THERE WILL BE A SERVICE FEE OF $25.00 FOR ANY CHECK DISHONORED BY THE BANK.

APPROVED:

DATE	SIGNATURE OF AGENT/DEPARTMENT OF HEALTH	R.S. LIC. NO.	Department of Health Seal
	SECTION BELOW FOR OFFICIAL HEALTH DEPARTMENT USE ONLY

FEE

$25.00

DATE PAID

METHOD OF PAYMENT

RECEIPT NO.

RECEIVED BY

SAN APP TFE MAUI 11/07

INSTRUCTIONS FOR

TEMPORARY FOOD PERMIT APPLICATIONS

•All establishments, organizations, or individuals distributing or selling food to the public for a limited period of time (not exceeding 20 dates within a 120 day period) are required to submit a Temporary Food Establishment Permit Application to the Department of Health, Sanitation Branch. Applications will not be processed if the form is incomplete.

•Applications and $25.00 fee should be submitted at least ten (10) working days prior to event.

•All exemptions will be decided by the Department of Health Sanitation Branch.

•Approved permit may be picked-up OR faxed OR mailed to you (include a self-addressed, stamped envelope with the application).

A.NAME OF ORGANIZATION OR ESTABLISHMENT: Name of organization or establishment administering the food operation. Each permit applies to one (1) organization or establishment only.

B.LOCATION OR ADDRESS OF EVENT: Site of food distribution. Each permit applies to one (1) location.

C.CONTACT PERSON: Name of person(s) representing the organization or establishment.

D.CONTACT PHONE OR FAX NUMBER: Phone number of person(s) representing the organization or establishment.

E.DATE OF EVENT: One date per line (Maximum of 20 dates within a 120 day period, starting from the date of the first event).

F.TIME OF EVENT: Start to end time of event.

G.NAME OF APPROVED KITCHEN (COMMISSARY): Name of approved commercial kitchen (commissary) where food preparation, food storage, utensil washing, etc. will be done.

The proposed approved kitchen (commissary) must still be approved by the Department of Health for the temporary food event. Home kitchens are not acceptable for use.

H.STREET ADDRESS OF KITCHEN: Street address of approved commercial kitchen (commissary) where food preparation, food storage, utensil washing, etc. will be done.

I.PERMIT NO.*: Permit number of the approved commercial kitchen (commissary) where food preparation, food storage, utensil washing, etc. will be done.

*Permit number issued by the State Department of Health.

J.(OR ATTACH LETTER OF AUTHORIZATION): Instead of having the Authorized Person sign the application, a letter of authorization from the person in charge of the kitchen may be submitted which must include information G, H, I, K, L, M, and N.

K.SIGNATURE OF AUTHORIZED PERSON: Signature of person giving permission to use the approved commercial kitchen (commissary).

L.KITCHEN PHONE NUMBER: Phone number of approved commercial kitchen (commissary).

M.PRINT NAME OF AUTHORIZED PERSON: Print name of “(K) Signature of Authorized Person.”

N.TITLE: Title of “(K) Signature of Authorized Person.”

O.LIST OF FOOD ITEMS: All food and drink items being sold or distributed at the event (in the case of “BBQ” chicken sales, include the number of pieces of half or whole chickens to be sold).

P.SITE PLAN, BOOTH LAYOUT: On a separate paper draw a site plan and indicate the booth where food will be distributed including handwashing facilities, warmers, burners, cookers, etc.

Q.DATE: Date submitting application.

R.SIGNATURE OF APPLICANT: (Applicant and contact person need not be the same person).

S.TITLE: Title of “(R) Signature of Applicant.”

T.PRINT NAME OF APPLICANT: Print name of “(R) Signature of Applicant.”

How to Fill Out Temporary Food Permit Hawaii

To complete the Temporary Food Permit Hawaii form, follow these steps carefully. Make sure all information is accurate and complete to avoid delays in processing your application. After submitting the form, you will wait for approval from the Department of Health.

Fill in the Name of Organization or Establishment: Write the name of the organization or establishment that will be operating the food service.
Provide the Location or Address of the Event: Enter the specific address where the food will be distributed.
Identify the Contact Person: List the name of the person representing the organization.
Enter the Contact Phone and Fax Number: Provide the phone number and, if applicable, the fax number for the contact person.
Specify the Date of the Event: Write the date of the event. You can list up to 20 dates within a 120-day period.
Indicate the Time of the Event: State the start and end time of the event.
Provide the Name of Approved Kitchen (Commissary): Enter the name of the commercial kitchen where food will be prepared and stored.
Write the Street Address of the Kitchen: Provide the complete address of the approved kitchen.
Include the Permit Number: Write the permit number for the approved kitchen.
Attach a Letter of Authorization (if applicable): If someone else is signing the application, include a letter of authorization from the kitchen manager.
Sign the Application: The authorized person must sign the application to confirm permission to use the kitchen.
Provide the Kitchen Phone Number: List the phone number of the approved kitchen.
Print the Name of the Authorized Person: Clearly print the name of the person who signed the application.
Indicate the Title of the Authorized Person: Write the title of the person who signed.
List Food Items: Detail all food and drink items that will be sold or distributed at the event. Include specifics like quantities if necessary.
Attach a Site Plan: On a separate paper, draw a layout of the booth and indicate handwashing facilities and equipment.
Enter the Date of Submission: Write the date you are submitting the application.
Sign as the Applicant: The applicant must sign the form, which can be a different person from the contact person.
Indicate the Title of the Applicant: Write the title of the applicant who signed.
Print the Name of the Applicant: Clearly print the name of the applicant.
Submit the Application and Fee: Include the non-refundable fee of $25. Make sure to submit the application at least ten working days before the event.

Common mistakes

Filling out the Temporary Food Permit Hawaii form can be a straightforward process, but many applicants make common mistakes that can delay or even prevent approval. Understanding these pitfalls can help ensure a smoother application experience.

One frequent mistake is leaving sections incomplete. Each part of the application is essential for processing. If any field is left blank, the Department of Health may reject the application outright. Applicants should carefully review the form to ensure all required information is provided.

Another common error involves submitting the application too close to the event date. The guidelines specify that applications must be submitted at least ten working days prior to the event. Failure to adhere to this timeline can result in denial of the permit, leaving the applicant without a legal means to serve food.

Inaccurate information can also cause issues. For instance, applicants sometimes list the wrong address for the event or fail to provide the correct permit number for the approved kitchen. Such inaccuracies can lead to confusion and potential delays in processing.

Additionally, some applicants neglect to attach necessary documentation, such as a site plan or a letter of authorization from the kitchen. These attachments are crucial for demonstrating compliance with health regulations. Without them, the application may be deemed incomplete.

Another mistake involves the food items listed on the application. It is important to remember that home-prepared foods are not allowed. Applicants must ensure that all food items are prepared in an approved commercial kitchen to comply with state regulations.

Lastly, applicants often overlook the payment details. The application requires a non-refundable fee of $25, which must be submitted with the application. Not including the fee or providing incorrect payment information can lead to immediate rejection of the application.

By being aware of these common mistakes, applicants can improve their chances of obtaining a Temporary Food Permit in Hawaii. Attention to detail and adherence to guidelines are key to a successful application process.

Documents used along the form

The Temporary Food Permit in Hawaii is an essential document for organizations or individuals planning to sell food to the public for a limited time. Along with this permit, several other forms and documents may be required to ensure compliance with health and safety regulations. Below is a list of related documents that are often used in conjunction with the Temporary Food Permit.

Site Plan: A detailed drawing indicating the layout of the food booth, including locations for food preparation, serving areas, and handwashing facilities.
RV Bill of Sale: A necessary document to complete the sale of a recreational vehicle, which can be created using the form available at billofsaleforvehicles.com/editable-texas-rv-bill-of-sale.
Menu: A comprehensive list of all food and beverage items that will be served at the event, ensuring transparency and compliance with health regulations.
Letter of Authorization: A document that grants permission for the applicant to use an approved commercial kitchen for food preparation, signed by the kitchen’s authorized person.
Health Inspection Certificate: A certificate confirming that the food establishment or kitchen has passed health inspections and meets safety standards.
Food Handler's Permit: A certification that indicates the individual preparing or serving food has completed a food safety training course.
Proof of Insurance: Documentation showing that the food vendor has liability insurance to cover any potential incidents during the event.
Event Permit: A permit from the event organizers that allows the food vendor to operate at the specific location and time of the event.
Vendor Application: A form that vendors must fill out to register for participation in the event, often required by the event organizers.
Tax Identification Number: A number required for tax purposes, ensuring that the vendor is compliant with state and federal tax regulations.

Gathering these documents can help ensure a smooth application process for the Temporary Food Permit and compliance with local health regulations. It is advisable to check with the local health department for any additional requirements specific to the event or location.

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Obtain Answers on Temporary Food Permit Hawaii

What is a Temporary Food Permit in Hawaii?

A Temporary Food Permit allows organizations or individuals to distribute or sell food to the public for a limited time, not exceeding 20 dates within a 120-day period. This permit is essential for ensuring that food safety standards are met during temporary food events.

Who needs to apply for a Temporary Food Permit?

Any establishment, organization, or individual planning to sell or distribute food to the public for a limited time must apply for this permit. This includes food trucks, pop-up restaurants, and vendors at events like fairs or festivals.

How do I apply for a Temporary Food Permit?

To apply, complete the Temporary Food Establishment Permit Application. Make sure to provide all necessary information, including the name of your organization, event location, contact details, and a list of food items. Submit the application along with a $25 non-refundable fee at least ten working days before your event.

What information is required on the application?

Name of the organization or establishment
Event location
Contact person and their phone number
Date and time of the event
Name and address of the approved kitchen (commissary)
List of food items being sold
Site plan indicating booth layout and handwashing facilities

Can I use a home kitchen for food preparation?

No, home kitchens are not acceptable for food preparation. You must use an approved commercial kitchen (commissary) that has been authorized by the Department of Health.

What happens if my application is incomplete?

If your application is incomplete, it will not be processed. Ensure that all sections are filled out correctly and that you include any required attachments, such as the site plan and authorization letter if applicable.

How long is the Temporary Food Permit valid?

The permit is valid for a maximum of 20 dates within a 120-day period, starting from the date of your first event. Keep track of your event dates to remain compliant.

What should I do if my check for the application fee is returned?

If your check is returned for any reason, a service fee of $25 will be charged. It's important to ensure that your check is valid and that it includes the necessary bank account name and address.

Document Attributes

Fact Name	Details
Governing Law	The Temporary Food Permit is governed by Hawaii Administrative Rules, Title 11, Department of Health, Chapter 12, Food Establishment Sanitation.
Application Fee	A non-refundable fee of $25.00 is required upon submission of the application.
Submission Timeline	Applications must be submitted at least ten working days prior to the event to ensure processing.
Event Duration	The permit is valid for a maximum of 20 dates within any 120-day period.
Approved Kitchen Requirement	Food must be prepared in an approved commercial kitchen (commissary); home kitchens are not permitted.
Contact Information	Applicants must provide a contact person's name and phone number to facilitate communication regarding the permit.

Misconceptions

Understanding the Temporary Food Permit in Hawaii can be challenging due to several common misconceptions. Here are six misconceptions clarified:

Anyone can prepare food at home for events. This is not true. The Temporary Food Permit requires that all food be prepared in an approved commercial kitchen. Home kitchens are not permitted for food preparation.
The permit is valid indefinitely. In reality, the Temporary Food Permit is only valid for a maximum of 20 dates within a 120-day period. Each event must be specified on the application.
You can submit the application at any time. This is misleading. Applications must be submitted at least ten working days prior to the event. Late submissions may not be processed.
All food items can be listed without restrictions. This is incorrect. Only commercially prepared food items can be listed. Home-prepared food items are strictly prohibited.
Once approved, the permit cannot be revoked. This is a misconception. The Department of Health reserves the right to revoke the permit if sanitary requirements are not met.
There are no fees associated with the application. This is false. A non-refundable fee of $25.00 is required when submitting the application.

Being aware of these misconceptions can help ensure a smoother application process and compliance with local regulations.

Key takeaways

When it comes to organizing a food event in Hawaii, obtaining a Temporary Food Permit is essential. Here are some key takeaways to help you navigate the process:

Eligibility: Any organization, establishment, or individual selling food to the public for a limited time must apply for this permit. Remember, it’s valid for a maximum of 20 dates within a 120-day period.
Timely Submission: Submit your application and the non-refundable $25 fee at least ten working days before your event. Late applications may not be processed.
Complete Information: Ensure that all sections of the application are filled out completely. Incomplete forms will delay processing.
Approved Kitchen Requirement: Food must be prepared in an approved commercial kitchen, not a home kitchen. Be sure to provide the kitchen's name and permit number.
Menu Details: List all food items you plan to serve. This includes any specific quantities, especially for items like BBQ chicken. No home-prepared food is allowed.
Site Plan Submission: Include a site plan with your application. This should detail the booth layout and indicate where handwashing facilities will be located.
Permit Collection: Once approved, you can pick up your permit, or it can be faxed or mailed to you. If you want it mailed, remember to include a self-addressed, stamped envelope.

Following these guidelines will help ensure a smooth application process for your food event in Hawaii. Enjoy your event planning!