Temporary Food Facility (TFF) Permit Application

Temporary Food Facility (TFF) Permit Application - Off Campus Caterer

A temporary food facility permit will be required for food given away or sold to the campus community and/or the general public. Failure to adhere to Temporary Food Facilities guidelines or activities identified by an EH&S representative to not meet California Health & Safety Code may be subject to immediate closure and destruction of adulterated foods.

Instruction

Please provide detailed information within the appropriate fields. Any missing information or lacking descriptions may cause a delay in the review of your application. If approved, the Temporary Food Facility permit will be sent by EH&S to the email provided on the application.

1. Business/Owner Information

Business Name/Organization*

Owner/Operator Name*

Business Address*

Email*

Contact Phone Number*

(Area code-###-####)

Phone

Name of the Person-in-Charge of the booth while at the event.*

2. Event Information

Event Name*

Event Coordinator Name*

Please provide the name coordinating the event, or person requesting the catering services.

Event Coordinator Contact Phone Number*

(Area code-###-####)

Phone

Event Start Date*

Event End Date*

Event Start Time*

Select or enter value

Booth Set Up Time*

Select or enter value

3. Food and Equipment Information

Equipment Information*

Please describe some of the food service equipment to be used within the booth. (e.g., Steam table, deep fryer, flat grill, and etc.)

Food Activity Type*

Please select the type of food activity that will occur at your booth.

Select

Temporary Food Venue Type*

Select

Foods to be Served at the Event*

Please briefly describe the food to be sold or served. (e.g., beef tacos, stir-fry noodles, deep fried corn dogs, prepackaged ice-cream bars, etc.)

Food Temperature Control Measures*

Describe how food temperatures will be monitored, and maintained below 41F degrees or above 135F degrees.

Describe Cooking Equipment*

Briefly describe or list the type of food equipment that will be used.

Fire Extinguisher Equipped*

Food activities involving any type of cooking or fire hazard must readily have appropriate fire extinguishing equipment.

Select

Handwashing*

Select One

Select

Three Compartment Sink w/integrated drainboards; Hot & Cold water*

Select One

Select

Documents to be Uploaded

Please upload the following documents: 1. Proof of Liability Insurance with ADDITIONALLY INSURED naming "The State of California, the Trustees of the California State University, the University, ASI, Cal Poly Pomona Foundation and the employees, officers, and agents of each of them are included as Additional Insured, except for professional liability and workers' compensation insurance" 2. Copy of a Health Permit from a County or City Health jurisdiction.

File Upload

Drag and drop files here or

Certification

By checking the boxes and entering my name below, I hereby declare and affirm that the facts stated in this application are true and correct to the best of my knowledge, information, and belief.

I have reviewed Cal Poly Pomona's Temporary Food Facilities & Community Events Guidelines*

I agree to comply with ALL local and State governing authorities laws and orders.*

I agree to display CPP Temporary Food Facility (TFF) Permit at my booth.*

Signature Name*

Send me a copy of my responses

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