FACILITY SERVICE INFORMATION Sample Clauses

FACILITY SERVICE INFORMATION. TYPE OF MOBILE UNIT: Type 1 – Commercially packaged non-TCS foods Type 2 – Commercially packaged TCS-foods Type 3 – Non-complex food preparation Type 4 – Complex food preparation LOCATION WHERE MFF/TFS UNIT WILL BE PARKED/STORED WHEN NOT IN USE: Same as Owner Mailing Address Same as MFF Other: Street Address City State Zip Code LOCATION WHERE FOOD IS PREPARED AND/OR STORED AND/OR WHERE EQUIPMENT IS CLEANED AND SANITIZED (I.E. COMMISSARY): Same as Owner Mailing Address Same as MFF Other: Street Address City State Zip Code AT THIS LOCATION: Check ALL that apply: Store food (freezers, refrigerators, dry storage) Prepare food Clean and sanitize equipment All food is stored and prepared in our fully equipped MFF unit at this address All equipment is cleaned and sanitized on our fully equipped MFF unit at this address EMPLOYEE INFORMATION: Anticipated # of employees/volunteers, including owner Do you have a Certified Food Manager on Staff? YES, attach copy of National Certificate (ANSI Approved Managers Exam) NO, do you have a person-in-charge enrolled in Food Safety Training? YES, Name, date, and location of course: NO, explain: Exempt (non-profit) or other exempt facility Do you have an employee health policy? YES NO Do you have a written employee policy for cleanup of vomiting or diarrheal events in the facility? YES NO SECTION 3: WATER, SEWER, WASTE INFORMATION SERVICING AREA PROVIDING POTABLE WATER*: Location MFF is filled with potable water Street Address City State Zip Code *Only an approved water source may be used to fill MFF water tanks. WATER SOURCE: You must contact the Department of Environmental Protection (DEP) to determine if your facility qualifies as a public water system (PWS). If DEP determines your facility qualifies as a public water system, then the water supply must be approved by DEP. Written documentation must be provided including your assigned Public Water System (PWS) ID# and approval letter from DEP. If DEP determines your facility does NOT qualify as a public water system, written documentation from DEP must be provided and current water tests for Total Coliform (4 initial samples in 24 hours) and 1 initial sample for Nitrate/Nitrite. The facility is using: A municipal (community) water supply. Provide name of municipal water supplier: (ex: Pa American Water) AND copy of water bill. A non-community water supply that is not owned/operated by the facility. Provide name of the regulated water supplier and its Public Water System ID#: ...

FACILITY SERVICE INFORMATION. DAYS & TIMES OF OPERATION: Check anticipated days and time the facility will be operational: Monday Time Tuesday Time Wednesday Time Thursday Time Friday Time Saturday Time Sunday Time