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Home My WebLink Aboutmff-application-adaRonald Browder Director the “New Business Info Session” the first Wednesday – 1 1131 Harbor Bay Parkway, Alameda, CA 94502 | Health.AlamedaCountyCA.gov/ACEHD | (510) 567-6700 PAY FEES IN PERSON OR BY MAIL submit your application and payment to Alameda County Environmental Health Department at 1131 Harbor Bay Parkway, Alameda, CA. Make check payable to “Alameda County Environmental Health Department.” FOR ONLINE PAYMENT once you have received your electronic invoice, go to this link: https:// deh.acgov.org/billing-fees- permits.page? FOR BILLING ASSISTANCE contact dehwebbilling@acgov.org or call (510) 567-6858 TO APPLY FOR PERMIT FEE EXEMPTION FOR QUALIFIED VETERANS visit https://deh.acgov.org/operations-assets/docs/mff/Veterans_Exemption_Form.pdf Submit the forms with your application to dehmobilefood@acgov.org. Your documents will be reviewed for compliance with exemption requirements. CHECK ONE PERMIT CATEGORY A-H BELOW AND FOLLOW THE INSTRUCTIONS IN THE RELATED BOX ☐D.☐ New / ☐ Renew Annual Permit for a Certified ☐E.☐ One Single Event One Time a Year $207 ☐F.☐ New / ☐ Renew Packaged Ice Cream Truck/Prepackaged CMFO Push Cart B.☐ Change of Ownership $207 G.☐ New / ☐ Renew Vending Machine C.☐ Renew an annual permit for H.☐ New / ☐ Renew Whole Produce Vendor ☐ “A” BOX C. RENEW A PERMIT FOR A TRUCK/TRAILER/CMFO CART Pay Your Invoice, Schedule an Appointment with Your Inspector, and Submit Your Application to Your Inspector One Week Prior to Your Appointment. Call 510-567-6731 to be directed to your inspector. Provide Current Food Safety Certificate and/or Food Handler Cards Provide Current DMV Registration, Business License, CA Driver License and/or Valid Government ID. Provide Applicable Licenses i.e. CA Dairy License, CA Processed Food Registration, Cottage Food Reg. Bring the Truck/Trailer/CMFO to the Appointment. All Equipment Must Operate in Approved Working Condition to Receive the Permit. 2 3 BOX D. A NEW OR TO RENEW A PERMIT FOR SELLING PACKAGED PRODUCTS AT A CFM Provide Food Safety Certificate and/or Food Handler Cards Provide a Picture of the Product(s) Package Labels Provide Current DMV Registration for the Transport Vehicle. Provide Current CA Driver License/Valid Government I.D Other: i.e. , CA Milk and Dairy License, CA Processed Food Registration, Cottage Food Reg CDFA Meat, Poultry Egg Dairy, Commercial Fishing License, ETC Question #1 on Page 5 is not Applicable. Complete Question in Box #4. Renewal: SUBMIT APPLICATION AND DOCUMENTS DIRECTLY TO DEHMOBILEFOOD@ACGOV.ORG BOX E. ONE SINGLE EVENT PER YEAR. Name and Date of the Event _________________________ Pictures of All 4 Sides of the MFF/CMFO and Inside for the MFF. CA Housing and Community Development Insignia (N/A for CMFO carts). *Picture of a current CA County Environmental Health Permit, CDL, DMV registration *If There is not a Current Permit for the MFF/CMFO Then You do not Qualify for This Category. BOX F. NEW OR RENEW ALL PRE-PACKAGED FOOD TRUCKS/CMFO PUSH CARTS Provide Picture of the current or expired CA County Environmental Health Permit for this MFF or CMFO. Current DMV Registration, Business License, CA Driver License and/or Valid Government ID. Questions #1 AND #2 on Page 5 are not Applicable. Complete Question #4 where Applicable. Renewal: Submit application to the inspector or call 510-567-6731 to directed. BOX G. NEW OR RENEW A PERMIT FOR VENDING MACHINES NAMA OR NSF 25 Certificate for Each Vending Machine. Questions #1 AND #2 on Page 5 are not Applicable. Complete Question #4 where Applicable. Renewal: Submit Application to the inspector or Call 510-567-6731 to directed. BOX H. NEW OR RENEW A PERMIT FOR WHOLE PRODUCE VENDOR TRUCK Proof of Purchase of the produce such as Product Receipts or Product Invoices Current DMV Registration, CA Driver License and/or Valid Government ID. Questions #1 AND #2 on Page 5 are not Applicable. Complete Question #4 where Applicable. Renewal: Submit Application to the Inspector or Call 510-567-6731 to directed. ’s may have differ 4 LIST ALL OF YOUR MENU ITEMS IN THE TABLE BELOW. FOOD SHALL NOT BE MADE IN A PRIVATE RESIDENCE (CAL CODE SECTION 114285). Food/Beverage items (Ex. Tacos, salads, burgers, fries, sandwich, sodas, etc.) List all ingredients for this menu item Prepared in the commissary kitchen? Y/N Prepared on the vehicle? Y/N 5 2.What is the kW power rating, make and model of your generator? 1.Explain how you will prevent cross contamination when customers want to use their own refillable cups, mugs, containers or plates. Not applicable to CFM applicants and vending machines. 3. How many employees work with food? _________________ Do they all have food handler cards? _________________ Have they been trained to do assigned duties? ___________________ Have you designated a person in charge during operations? ____________________ 4.To develop your standard operating procedures, answer the following questions: a)Where is the food purchased from, including ice? ________________________________ b)Where will the waste water tanks and steam table be emptied? ☐At home ☐At the commissary every day ☐Any drain near where we operate c)Check mark any portable equipment that is used on the MFF: d)How will food-contact surfaces be cleaned and sanitized if they can not be taken to the 3- compartment sink? ☐Wipe with a towel ☐Use approved clean in place procedures ☐It is not necessary e)How will the potable water tank be sanitized? ☐Add soap to the tank ☐ Add sanitizing solution to the tank using approved methods ☐Add hot water to the tank f)How and where will you clean the MFF? ☐At home ☐Using mops and brooms at the commissary ☐ With water, once a month g)If an employee calls out ill, when is it safe for the employee to return to work? ☐When the employee says they feel better ☐ When the employee no longer has symptoms ☐If the employees have seen a doctor h)How will you verify food temperatures? ☐By touching the pot ☐By tasting it ☐By using a probe thermometer i)How will you verify your sanitizer is used at the proper concentration? ☐Using proper test strips ☐ Smelling the sanitizer ☐ Checking the sanitizer temperature GENERAL QUESTIONS – MULTIPLE CHOICE QUESTIONS MAY HAVE MORE THAN ONE CORRECT ANSWER. ☐Microwave ☐Induction Burner ☐Other: ________________________ ☐Toaster ☐Rice Cooker ☐Blender ☐Slicer ☐Coffee Maker ☐Tortilla Press ☐Knives ☐Electric Mixer ☐Cutting Board ☐Mixing Bowl 6 j)How will you set up the 3-compartment sink on the MFF or at the commissary? ☐Scrape, stack, rinse ☐ Wash, rinse, dry ☐ Wash, rinse, sanitize k)Where will you keep copies of the food handler cards on the MFF? ☐In a folder, easily accessible ☐In the glove compartment ☐Copies are not needed l)What will you do if your generator breaks down while you are working? ☐Close, store food safely, & get the generator fixed ☐ Keep working ☐Hope the inspector does not com today m)What will you do if while you are working, there is no water coming from the faucets? ☐Buy bottled water ☐ Close & return to the commissary for water ☐ Sell prepackaged food n)Where will you store clean and dirty cloth towels inside the MFF? ☐I do not need towels ☐ Designate a container and a laundry bag ☐ On the floor o)Where will the produce be washed? ☐At home ☐At the commissary ☐ On the truck (provide procedure) p)What will you do with any left-over hot food once the MFF is closed for the day? ☐Put it in containers for tomorrow ☐ Cool it and reheat it for tomorrow ☐ Discard it q)Where will the potentially hazardous food be stored on the MFF? ☐In an approved refrigerator ☐On the counter, if still frozen ☐In the hand sink r)Under which of these circumstances must I close my business? ☐Vermin infestation ☐No power ☐ No hot water ☐No refrigeration ☐No sanitizer ☐No water ☐ Drains are clogged ☐No handwashing s)When storing food on ice, what is the best practice? ☐Use metal containers ☐ Containers fully submerged in ice ☐ Maintain at 41ºF t)What is the best way to keep your facility vermin free? ☐Clean the facility daily ☐Place screens on all doors and passthroughs ☐Monitor for pests ☐Seal all cracks and crevices ☐Keep doors and windows shut ☐ Use licensed pest control operator IT IS THE BUSINESS OWNER’S LEGAL OBLIGATION TO BE COMPLIANT WITH ALL REQUIREMENTS OF THE CALIFORNIA RETAIL FOOD CODE. NON-COMPLIANCE MAY RESULT IN PERMIT SUSPENSION OR REVOCATION. Ronald Browder Director COMMISSARY / COMMERCIAL KITCHEN AGREEMENT Section 1: Pursuant to California Retail Food Code, I will notify Alameda County Environmental Health upon termination of this agreement or if the operator voluntarily ceases using this facility Commissary / Commercial Kitchen Owner Name Street Address City & Zip Code Cell Phone # Alternate Phone # I, (Facility Owner / Manager)̀_________________________________________________________________ Agree to provide the following services to (Operator) ___________________________________________ SERVICES PLEASE MARK YES OR NO Facilities to prepare or package food Toilet & handwashing facilities Waste tank/sewage disposal Garbage disposal Potable (drinkable) water supply Electrical hook-up Equipment/utensil storage Warewash facility (i.e. 3 compartment sink) ☐YES/ ☐NO ☐YES/ ☐NO ☐YES /☐NO ☐YES /☐NO ☐YES /☐NO ☐YES /☐NO ☐YES /☐NO ☐YES /☐NO Dry food storage Waste grease removal Chemical storage Overnight parking (MFPU) Enclosed overnight parking (carts) Refrigeration/frozen food storage Supply food product – i.e. ice, meats ☐YES /☐NO ☐YES /☐NO ☐YES /☐NO ☐YES /☐NO ☐YES /☐NO ☐YES /☐NO ☐YES /☐NO Any “NO” answers must be explained below. Additional commissary agreements may be required: The printed name and signature of the facility owner/operator is required for the department to accept this document Print Authorized Signer Name AA Phone Authorized Signer Signature Date Section 2: is required for Commissary/Commercial Kitchen facilities located OUTSIDE of Alameda County or in the City of Berkeley If the proposed facility is located outside of Alameda County and Berkeley, the local Environmental Health Department shall verify that the commissary and/or commercial kitchen has a current health permit by signing below. The establishment is in ______________________________________ County/City. An REHS signatures verifies that the facility indicated in Section 1 meets CALCODE: Section 114294 – 114297. Out of County REHS Name (Please Print) Phone Out of County REHS Signature And date received E-mail address 1131 Harbor Bay Parkway, Alameda, CA 94502 | Health.AlamedaCountyCA.gov/ACEHD | (510) 567-6700 1131 Harbor Bay Parkway, Alameda, CA 94502 | Health.AlamedaCountyCA.gov/ACEHD | (510) 567-6700 MOBILE FOOD FACILITY ROUTE SHEET Ronald Browder Director business’s PART E