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Temporary Food Service Application

  1. Temporary Food Service Application
    This is a temporary permit application for those who wish to serve food to the public in Ashfield. All fields with an asterisk next to them must be answered.
  2. PublicHealth-250x200
  3. Name of Applicant/Owner
    In this section please enter the name of applicant and the name of owner if different from the applicant.
  4. Enter n/a if it is not applicable.
  5. Are you the owner?*
  6. Address
    The address below must be your resident physical address. If you have a PO Box please enter it as well in case we send out mail to you.
  7. Event and Coordinator Name
    Please enter the event name where food will be served. Also enter all the required information on the event coordinator as well.
  8. Food and Beverage List
    Please list all the foods and beverages that you will be serving at the event. Enter "none" if you have nothing to list.
  9. Note: Potentially Hazardous Food Products (PHFs) require a health inspector on site. Check with us if you have any questions on this.
  10. Preparation and Cooking Facilties
  11. On-Site Facilities*
    If yes please describe the facilities and equipment used.
  12. Off-Site Facilities
    If yes please indicate the location of the facilities.
  13. If it is not applicable enter "n/a" in the field above.
  14. In the box above, describe equipment and means of transporting food. Hot food is 140℉ or above. Cold food is 45℉ or below.
  15. Leave This Blank:

  16. This field is not part of the form submission.