Maricopa County Environmental Services Department Environmental Health Special Events Program Temporary Permit Application
1001 N. Central Ave. #300 Phoenix, AZ 85004 phone: (602)506-6824 specialevents@mail.maricopa.gov PERMIT/APPROVAL APPLICATION PROCESS
1. Steps required to obtain a special event food service permit/approval are included in this application packet. 2. Applicable licensing time frames are defined in A.A.C. R9-8-104. Once submitted, the Department has up to 30 days to determine if the application and supporting information is administratively complete. If determined the application is incomplete, a notice of deficiency will be sent to the applicant requesting additional information. At this time, the timeframe clock will be suspended until the applicant provides the Department with the requested information. Once administratively complete, the Department will evaluate the submittal for compliance with applicable codes. The Department has up to 60 additional days to make a final determination on the status of the permit. If a comprehensive request for additional information is made by the Department, the timeframe clock will be suspended until the applicant provides the Department with the requested information. Administrative Review Time (working days) Substantive Review Time (working days) Overall Time (working days)

30

60

90

3. If there are questions about the application process or assistance is needed please contact a Development Services Technician at 602-506-6824. 4. The Department’s website is located at http://maricopa.gov/EnvSvc/ 5. You may receive clarification from the Department of its interpretation or application of a statute, ordinance, regulation, delegation agreement or authorized substantive policy statement as provided in A.R.S. §11-1609.

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Maricopa County Environmental Services Department Environmental Health Special Events Program Temporary Permit Application
1001 N. Central Ave. #300 Phoenix, AZ 85004 phone: (602)506-6824 specialevents@mail.maricopa.gov A.R.S. §11-1602: REGULATORY BILL OF RIGHTS
A. TO ENSURE FAIR AND OPEN REGULATION BY COUNTIES, A PERSON: 1. IS ELIGIBLE FOR REIMBURSEMENT OF FEES AND OTHER EXPENSES IF THE PERSON PREVAILS BY ADJUDICATION ON THE MERITS AGAINST A COUNTY IN A COURT PROCEEDING REGARDING A COUNTY DECISION AS PROVIDED IN A.R.S. §12-348. 2. IS ENTITLED TO RECEIVE INFORMATION AND NOTICE REGARDING INSPECTIONS AS PROVIDED IN A.R.S. §11-1603 (EFFECTIVE JUNE 30, 2012). 3. IS ENTITLED TO HAVE A COUNTY NOT BASE A LICENSING DECISION IN WHOLE OR IN PART ON LICENSING CONDITIONS OR REQUIREMENTS THAT ARE NOT SPECIFICALLY AUTHORIZED AS PROVIDED IN A.R.S. §11-1604. 4. MAY HAVE A COUNTY APPROVE OR DENY THE PERSON'S LICENSE APPLICATION WITHIN A PREDETERMINED PERIOD OF TIME AS PROVIDED IN A.R.S. §11-1605 (EFFECTIVE DECEMBER 31, 2012). 5. IS ENTITLED TO RECEIVE WRITTEN OR ELECTRONIC NOTICE FROM A COUNTY ON DENIAL OF A LICENSE APPLICATION (EFFECTIVE DECEMBER 31, 2012): (A) THAT JUSTIFIES THE DENIAL WITH REFERENCES TO THE STATUTE, ORDINANCE, REGULATION, DELEGATION AGREEMENT OR AUTHORIZED SUBSTANTIVE POLICY STATEMENTS ON WHICH THE DENIAL IS BASED AS PROVIDED IN A.R.S. §11-1605. (B) THAT EXPLAINS THE APPLICANT'S RIGHT TO APPEAL THE DENIAL AS PROVIDED IN A.R.S. §111605. 6. IS ENTITLED TO RECEIVE INFORMATION REGARDING THE LICENSE APPLICATION PROCESS AT THE TIME THE PERSON OBTAINS AN APPLICATION FOR A LICENSE AS PROVIDED IN A.R.S. §11-1606. 7. MAY INSPECT ALL ORDINANCES, REGULATIONS AND SUBSTANTIVE POLICY STATEMENTS OF A COUNTY, INCLUDING A DIRECTORY OF DOCUMENTS, AT THE OFFICE OF THE COUNTY OR ON THE COUNTY'S WEBSITE AS PROVIDED IN A.R.S. §11-1607. 8. UNLESS SPECIFICALLY AUTHORIZED, MAY EXPECT COUNTIES TO AVOID DUPLICATION OF OTHER LAWS THAT DO NOT ENHANCE REGULATORY CLARITY AND TO AVOID DUAL PERMITTING TO THE MAXIMUM EXTENT PRACTICABLE AS PROVIDED IN A.R.S. §11-1604. 9. MAY FILE A COMPLAINT WITH THE BOARD OF SUPERVISORS CONCERNING AN ORDINANCE, REGULATION OR SUBSTANTIVE POLICY STATEMENT THAT FAILS TO COMPLY WITH A.R.S. §11-1602.

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Maricopa County Environmental Services Department Environmental Health Special Events Program Temporary Permit Application
1001 N. Central Ave. #300 Phoenix, AZ 85004 phone: (602)506-6824 specialevents@mail.maricopa.gov Vendors who offer food &/or drink for human consumption at special events are defined as a food establishment. All food establishments who operate at special events occuring within Maricopa County are required to obtain the applicable food service permit from this Department. The following are a list of permits that can be obtained in order to operate a food establishment at a special event. Each permit has various requirements and limitations. Temporary Food Establishment means a food establishment that operates in conjunction with a fair, rodeo, exhibition, or

similar public event that operates for not more than fourteen (14) consecutive days within any permit year, provided it is the same permittee, at the same location, and the same event. At the termination of the event, the temporary food establishment shall be removed from the premises. Use Attached Application - Contact the Special Events Program for questions.

Promotional Food Establishment means a Food Establishment that is promoting a Food product or the use of equipment at a public celebration or similar event and no Food is offered for sale, but is given away to the public. “Promotional Food Establishment” does not include: Promotional activities in a permitted Food Establishment as defined in the Health Code. The promotion of Non-Potentially Hazardous Food products as defined in the Health Code. The cutting of raw fruits and vegetables for service to customers.

Use Attached Application - Contact the Special Events Program for questions.

Seasonal Food Establishment means a fixed or Mobile Food Establishment that operates in conjunction with one public

celebration or similar seasonal event for fifteen (15) to one hundred twenty (120) days within any permit year. At the termination of the event, the Seasonal Food Establishment shall be removed from the premises or shall cease operation as determined by the Department. Use Attached Application - Contact the Special Events Program for questions.

Food Catering is a food establishment where a pre-arranged number of meals and/or food products are prepared at one permitted premise for immediate service and consumption at another pre-arranged off-site location for a temporary event or other occurrence. A copy of the catering permit must be maintained at the food catering operation at all times (photocopies are acceptable). Food service will generally be limited to holding and serving as well as grilling of meats and vegetables only. Approval for limited re-heating and assembly of foods on-site may also be granted after reviewing the application. All food preparation (breading, chopping, mixing, etc.) must be accomplished at the catering kitchen.

Mobile Food Unit means and refers to an enclosed vehicle-mounted food establishment designated to be readily movable from which food is composed, compounded, processed or prepared and from which the food is vended, sold or given away. This unit would have a Mobile Food Permit with the Mobile Food Office. Contact the Mobile Food Program for questions.

Pushcart means a vehicle designated to be readily movable that is limited to the serving of non-potentially hazardous foods,

drinks, or commissary-wrapped potentially hazardous foods maintained at proper temperatures, or limited to the assembling and serving of frankfurters. Unpackaged non-potentially hazardous food items approved for sale or dispensed from a Pushcart shall be limited to popcorn, nuts, pretzels and similar bakery products, shaved ice, snow cones, Italian ice, and Non-Potentially Hazardous drinks. This unit would have a Pushcart Permit with the Mobile Food Office. Contact the Mobile Food Program for questions.

Food Peddler means a retail food establishment in operation from a vehicle that is designated to be readily movable and is

limited to the service of commercially processed and packaged foods. Food Peddlers may dispense Non-Potentially Hazardous drinks and assemble snow cones from approved and properly installed equipment. This unit would have a Food Peddler Permit with the Mobile Food Office. Contact the Mobile Food Program for questions.

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Maricopa County Environmental Services Department Environmental Health Special Events Program Temporary Permit Application
1001 N. Central Ave. #300 Phoenix, AZ 85004 phone: (602)506-6824 specialevents@mail.maricopa.gov Food production and sales must be conducted in a safe and sanitary manner at all times. Improper preparation, storage, or handling of food can promote bacterial growth and transmit viruses which can lead to foodborne illness. In order to reduce this risk to the public, food vendors must follow these requirements:
Hand washing facilities must be set-up at all times. This includes a minimum of five (5) gallons of hot water in an insulated container with a continuous flow spigot, a container for wastewater, hand soap, and paper towels. Employees must wash their hands, as a minimum, before starting work, between tasks, after smoking, and before returning from a toilet break. All employees must use non-latex gloves when handling ready to eat food. A three-bin set-up for the wash, rinse, and sanitizing of utensils must be set up at all times. (If utensils are going to require washing during event) Wastewater from the hand wash station and utensil wash must be disposed of into an approved sewer or holding tank. The wastewater tank must be 15% greater in size than the fresh water tank. All foods must be from an approved source. No home stored/prepared food allowed. Prepare foods fresh daily for service. A Commissary Agreement is required for all advance storage and preparation of food before an event. The vendor must provide inspector with a commissary visits log at the event. Carryover of potentially hazardous food in day to day operations is prohibited. The establishment must have sufficient equipment to maintain all food at the proper temperature. (Greater than 135 F for hot holding or less than 41 F for cold holding). A metal-stem or digital probe thermometer is required to check cooking, hot-holding, and cold-holding temperatures (with a range of 0°F-220 °F). An approved sanitizing solution and test strips must be available to check the concentration of these approved sanitizers: chlorine, quaternary ammonia, or iodine. Employee drinks must have lids and straws to prevent hand-to-mouth contamination and should be properly stored. Employees cannot eat or smoke in the food establishment area at any time. Employee food handler cards and the certified food manager card must be on-site for the length of the event for inspection purposes. All Caterers, Food Peddlers, Pushcarts, and Mobile Units operating above and beyond their permit requirements are required to obtain a Temporary Food Service Permit. Each permit certificate shall be kept onsite and displayed in a conspicuous place. Failure to have the permit certificate onsite could result in closure of the establishment.

Please note: If an imminent health hazard is observed at your operation during this event, your permit may be immediately suspended. Permit suspension will remain in place until a Department representative approves operation. A Department representative may or may not be able to approve operation prior to completion of the event.
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Maricopa County Environmental Services Department Environmental Health Special Events Program Temporary Permit Application
1001 N. Central Ave. #300 Phoenix, AZ 85004 phone: (602)506-6824 specialevents@mail.maricopa.gov PLEASE PROVIDE ALL REQUESTED INFORMATION BELOW (Please Print) Business Name: Business Address: City: Business Phone: Event Name: Event Address: Event Coordinator Name: Business Owner Name: Business Owner Address: City: Business Owner Phone: Business Owner Email: State: Business Owner Fax: Zip Code: Business Fax: Event Date/Time(s): City: Coordinator Phone: Zip Code:

Delivery of Inspection Reports
Pursuant to A.R.S. § 41-1009, the Department may enter your establishment to conduct inspections. You have the right to receive a copy of the Department’s inspection report at the time of the inspection, within thirty (30) days after the inspection, or as otherwise provided by federal law. By signing below, I agree that the Department may send me a copy of its inspection report by e-mail to the following email address or by facsimile transmission to the following fax number. It is the responsibility of the permit holder to update the Department if there is a change in contact information. Email Address: Fax Number: Signature:

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Maricopa County Environmental Services Department Environmental Health Special Events Program Temporary Permit Application
1001 N. Central Ave. #300 Phoenix, AZ 85004 phone: (602)506-6824 specialevents@mail.maricopa.gov Please provide the following menu information All Permit Types
List all menu items:

Will food be prepared offsite prior to the event?

Yes

No Yes

(if yes, please complete commissary section below)

Are you using a MCESD Food Catering or Mobile Food permit?

No

(if yes, please complete MCESD section below)

MCESD Permit Information
Type of Permit (check one): Permit #: Food Catering Mobile Food Unit Pushcart Yes Food Peddler No

Will you be cooking foods at the event?

Please list all food items being cooked at the event:

Commissary Information
Commissary Business Name: Commissary Contact Name: List foods prepared at commissary: Date food prepared: Time food prepared: Commissary Permit #: Contact Phone:

I agree to provide commissary services for the above Temporary Food Service Establishment. My facility meets all criteria outlined in the Maricopa County Environmental Health Code, Chapter VIII.

Commissary Operator Signature

Title

Date

I hereby certify that the above information is correct, agree to comply with the Maricopa County Health Code, and I fully understand that any deviation from the above without prior permission from this Environmental Health Regulatory Office may nullify final approval.

Signature

Printed Name

Date

NOTE: Approval of these plans and specifications by this Regulatory Authority does not indicate compliance with any other code, law or regulation that may be required--federal, state, or local. It further does not constitute endorsement or acceptance of the completed establishment (structure or equipment). Multiple construction inspections and a final inspection of the establishment with equipment in place and operating will be necessary to determine if it complies with the Maricopa County Environmental Health Code governing establishments.

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Maricopa County Environmental Services Department Environmental Health Special Events Program Temporary Permit Application
1001 N. Central Ave. #300 Phoenix, AZ 85004 phone: (602)506-6824 specialevents@mail.maricopa.gov Supplemental Requests for Additional Information (for annual permits only) Arizona law, A.R.S. 11-1605, limits Maricopa County Environmental Services Department (MCESD) to one request for additional information (set of review comments) when reviewing your application, unless the applicant agrees to allow additional requests. A County Ordinance requires MCESD and the applicant to agree to extend the time frame by 25% if an agreement is made to allow MCESD to submit supplemental requests for additional information. Indicate below your choice to either agree to supplemental information requests, or acknowledge that MCESD is limited to one request. The agreement will remain in place for the duration of the licensing process unless a revised agreement is approved by the parties. Select One:  I agree that MCESD may submit supplemental requests for additional information and I agree to an extension of 25% of the supplemental review and overall licensing timeframe.  I acknowledge that MCESD is limited to one set of review comments. MCESD will approve or deny my application based on my application materials and my response to not more than one set of review comments. Project Name/Location: Applicant Name: Signature: Title: Date:

Department Approval Name: Signature: Project Number:
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Title: Date:

Maricopa County Environmental Services Department Environmental Health Special Events Program Temporary Permit Application
1001 N. Central Ave. #300 Phoenix, AZ 85004 phone: (602)506-6824 specialevents@mail.maricopa.gov Please provide the following information (check items that apply):
1. Please describe your booth set-up (walls and flooring): Enclosed Trailer: Easy-up tent w/ 3 walls: Floor Mats: Floor Tarp: Asphalt: Concrete: Other: Other:

2. Please describe your hand wash station. (See Minimum requirements): Gravity Flow: Plumbed in booth: Other: 3. Do you have continuous flow of water at your hand wash station? Yes: No: 4. Do you have hand soap and paper towels for your hand wash station? Yes: No: 5. Please describe your ware wash station: Temporary 3-bin set up: Plumbed in booth: 6. Please describe all hot holding equipment: Chafing Dish: Cambros: Griddle/Grill: 7. Please describe all cold holding equipment: Ice Chest: Commercial Refrigerator: 8. Please describe all cooking equipment: Griddle/Grill: Fryer: 9. Please indicate type of thermometer available for use: Stem-type (Required): Infared: Steamer: Fridge Temp Gauge: Other: Steamers: Commercial Freezer: Other: N/A: Other:

10. Where will you be getting the water for your hand wash and ware wash stations? Commissary: Onsite w/ potable hose: Other: 11. How much water will you have onsite in gallons? Less than 5 gallons: 5-30 gallons: 12. What is the size of your catch bucket for the hand wash station? Less than 6 gallons: 6-45 gallons: 13. Where will you dump the wastewater after the event? Onsite approved container: Commissary: 14. Where do you dump the grease? Onsite grease barrel: Commissary: Greater than 30 gallons: Greater than 45 gallons: Other: Other: Clean in Place:
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15. How do you wash your equipment? Wash, Rinse, Sanitize: Commissary Dishwasher:

Maricopa County Environmental Services Department Environmental Health Special Events Program Temporary Permit Application
1001 N. Central Ave. #300 Phoenix, AZ 85004 phone: (602)506-6824 specialevents@mail.maricopa.gov 16. What type of sanitizer do you use? Bleach: Quat Ammonia: 17. Do you have test strips to check the concentration? Yes: No: 18. Where do you purchase your food and do you keep receipts? Store(s): 19: Do you do any preparation prior to the event? If yes, where? Commissary Name: Yes: Yes: No: No:

20. Where do you store your potentially hazardous foods before and between event days (i.e. carryover)? Commissary: No carrover: Onsite at event: 21. How many employees will be handling food? Less than 3: 3 to 10: 22. Are your employees licensed food handlers? Yes: No: 23. Will a Certified Food Manager be onsite? Yes: No: 24. Do you have an illness policy? Yes: No: Describe: S N More than 10:

25. Do you know the Big Five Illnesses? (Please list below) H E S 26. Do you know the 8 major allergens? Yes: No: 27. Please provide a drawing or picture of your booth layout below.

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Maricopa County Environmental Services Department Environmental Health Special Events Program Temporary Permit Application
1001 N. Central Ave. #300 Phoenix, AZ 85004 phone: (602)506-6824 specialevents@mail.maricopa.gov Office Use Only
Application Fees (Fees are subject to change.)
Quantity Application Type
Temporary Permit Greater than 7 days before event Temporary Permit Less than 7 days before an event Seasonal Permit Greater than 7 days before an event Seasonal Permit Less than 7 days before an event Temporary Permit Annual Variance

Fee $85 $135 $180 $230 $60

Plan Review N/A N/A N/A N/A $75 Total Fees Due

Expedite N/A N/A N/A N/A $75

Total Fee $ $ $ $ $ $

Permit Number

Permit Number

Reviewing EHS: Type of Lawful Presence: Comments:

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