Name of Event. Date(s) & Time of Event. Location of Event. Name of Temporary Food Stand. Contact Person. Mailing Address.

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Cleveland County 315 E. Grover Street, Shelby, NC 28150 (704) 484-5130 Fax (704) 484-5135 Environmental Health For Additional Information please visit: www.health.clevelandcounty.com Temporary Food Establishment (TFE) Application $75 fee and application for EACH booth required and must be submitted NO LESS THAN 15 DAYS PRIOR TO THE EVENT. Name of Event Date(s) & Time of Event Location of Event Name of Temporary Food Stand Contact Person Mailing Address City State Zip Code Contact Phone #s During event Business phone Email address Are you claiming an exemption due to non-profit or un-regulated foods? Yes ( ) No ( ) *Must meet requirements for non-profit organization. Please indicate date and time booth set up will be complete and ready for inspection: Vendor location at event if known Will the booth be connected to ( ) water, ( ) sewer, ( ) electricity? Note: A potable water grade hose is required when connecting to a water source. If connecting to a water supply, you must also connect to a sewer connection. Grease and wastewater MUST NOT be poured out on the ground or into storm drains.

What is the source of ice that will be used? Will vendor prepare any foods prior to event? Yes ( ) No ( ) If yes, indicate location and time of preparation Note: Local groups may be allowed to prepare foods in advance of the event in an approved temporary food stand commissary if approved by the Health Department prior to the operation. List ALL menu items to be prepared on-site: If needed, supply additional sheet. The food booth will be in a ( ) tent, ( ) mobile unit, ( ) building, ( ) other. Draw a diagram depicting your food booth set up. Indicate placement of hand washing station, utensil washing sink, drying rack, fan placement, cooking equipment, refrigeration, prep areas, and all other equipment used. Page 1 and Page 2 ONLY must be completed and returned to the Cleveland County Administration Building, Environmental Health/ Building Inspections Permits Office, 311 E. Marion Street in Shelby, NC 28150 with payment no less than 15 days prior to the beginning date of the event. All other pages are for your reference. If you have any questions, please contact the Environmental Health Office at 704-484-5130. Applicants Signature: Date Submitted:

2013 Highlighted rules changes for Temporary Food Stands Raw meat, poultry, and fish must be purchased in ready to cook portions unless providing sufficient equipment and prep areas. Subject to approval. Menu may be limited unless proven appropriate equipment provided. No bare hand contact of ready to eat foods. Date marking required for ready to eat foods held more than 24 hours. No cooking and cooling of foods for subsequent days use unless approved at permitting. Foods must be secured to protect from tampering and contamination. Non-mechanical coolers must have a drainage port. Potentially hazardous foods from previous events may not be used if removed from original packaging. Employees are required to wear effective hair restraints, clean outer clothing, and have good hygiene; no tobacco use. Employee health policy required. Three basins for washing, rinsing and sanitizing must be provided with adequate space for air-drying. No longer accepting a minimum of 1 basin sink. A food prep sink is required when washing produce. Food shields or barriers are required to protect food and food contact surfaces from contamination. Overhead protection is required to protect all food, utensils, and equipment with the exception of cookers with attached lids being used to cook bulk foods such as roast, shoulder, and briskets. When cooking individual servings, overhead cover is required. Currently, this includes grilled corn in the shuck as well. Public access is limited to dining areas only. Storage beside units must be blocked from public access. Indoor/outdoor carpeting, matting, tarps, or similar non-absorbent material is required as ground covering in the absence of asphalt, concrete or grass. Handwashing facilities must be at least a 2-gallon minimum container with unassisted free-flowing faucet, wastewater receptacle and warm water. All potable water holding tanks, containers and hoses shall be drained, washed, rinsed and sanitized and must be labeled for their purpose as well as protected from contamination. Wastewater collection containers must be as large as the potable water tanks. If connected to a municipal hose bibb, you will be required to be connected to a municipal sewer. Lights must be shielded or shatterproof if provided and lights are required for nighttime operations. Label toxic materials and store to prevent contamination of food and equipment.

EXEMPTIONS Effective October 15, 2001, in order to be exempt from the NC permitting requirement to prepare or serve food or drink for pay no more frequently than once a month for a period not to exceed two consecutive days, including permitted establishments that are operating off of their permitted premises, or an elderly nutrition program of the Division of Aging that is preparing and serving food for a fund-raising event for one day a month, one of the following three criteria must be met: 1) Establishments that are incorporated as Nonprofit Corporations in accordance with Chapter 55A of the General Statutes, which states Nonprofit corporation means a corporation intended to have no income or intended to have income none of which is distributable to its members, directors, or officers, except as permitted by Article 13 of this Chapter, and includes all associations without capital stock formed under Subchapter B of Chapter 54 of the General Statutes or under any act or acts replaced thereby. Documentation must be verified by the Department of the Secretary of State in Raleigh. Questions on obtaining this Documentation should be directed to the Corporations Division; 919-807-2225. Their fax is 919-807-2039. Their website is: www.secretary.state.nc.us/corporations 2) Establishments that are exempt from federal income tax under the Internal Revenue Code, as defined in G.S. 105-228.90. Documentation must be verified by producing a ruling or determination letter issued to your organization by the IRS. Forms and other information can be obtained at www.irs.gov or ftp.irs.gov. Publication 557 Tax-Exempt Status for Your Organization discusses the necessary information. 3) Establishments that are political committees as defined in G.S. 163-278.6(14), which states the term political committee means a combination of two or more individuals, or any person, committee, association, or organization, the primary or incidental purpose of which is to support or oppose any candidate or political party or to influence or attempt to influence the result of an election or which accepts contributions or makes expenditures for the purpose of influencing or attempting to influence the nomination or election of any candidate at any election. The term includes, without limitation, any political party s State, county or district executive committee.

Effective September 1, 2012 15A NCAC 18A.2665 TEMPORARY FOOD ESTABLISHMENT AND TEMPORARY FOOD ESTABLISHMENT COMMISSARY PERMIT REQUIREMENTS (a) A permit shall be issued by the regulatory authority to each temporary food establishment and temporary food establishment commissary that complies with Rules.2665 through.2669 of this Section. Temporary food establishments and temporary food establishment commissaries are not eligible for transitional permits. A single permit shall be issued for a temporary food establishment that does not operate consecutive days as long as the total number of days does not exceed 21. The permit shall be posted in a conspicuous place designated by the regulatory authority. The permit shall include: (1) Name and location of the temporary food establishment and temporary food establishment commissary; (2) Permit holder; (3) Name and location of the event; (4) Dates of operation; and (5) Any other conditions necessary to remain in compliance with this Section. (b) No food preparation shall occur prior to a permit being issued by the regulatory authority. (c) When affiliated with a temporary food establishment for an event where the food will be served, a temporary food establishment commissary permit for prior food preparation may be issued for advance or off-site preparation. A temporary food establishment commissary may commence operation no more than 7 days prior to the event and operate for the length of the event up to a time period not to exceed 21 consecutive days. (d) Temporary food establishments and temporary food establishment commissaries shall make application to the regulatory authority no fewer than 15 calendar days prior to commencing operation. This 15-day requirement does not prohibit the submission of applications for substitute vendors provided that these applications are submitted no fewer than 3 business days prior to the event. Applications shall be submitted to the regulatory authority and shall include the following: (1) Name, mailing address, and telephone number of the permit holder of the temporary food establishment or temporary food establishment commissary; (2) Name and location of the event at which the temporary food establishment operated immediately prior to the current event for which applying, if applicable; (3) Name, mailing address, and telephone number of the event organizer; (4) Event name, location, dates, and hours of operation; (5) Proposed menu, food handling procedures, including anticipated food volume and sources; (6) Food equipment list; (7) Proposed water supply; (8) Provisions for sewage and other waste disposal; and (9) Any information necessary to ensure compliance. (e) The regulatory authority shall require documentation to verify any provision of Rules.2665 through.2669 of this Section. (f) The regulatory authority may condition the permit to ensure compliance with Rules.2665 through.2669 of this Section. 15A NCAC 18A.2666 TEMPORARY FOOD ESTABLISHMENT FOOD HANDLING REQUIREMENTS (a) All sources of food in temporary food establishments shall comply with Chapter 3 of the Food Code as amended by Rule.2653. (b) Raw meat, poultry, and fish in temporary food establishments shall be purchased in ready-tocook portions, except that cutting and skewering shall be allowed where evaluation by the regulatory authority determines sufficient preparation areas and food equipment are provided.

(c) Salads containing ingredients that are cooked and cooled shall not be prepared in the temporary food establishment or temporary food establishment commissary, but may be served. (d) Shellstock and shucked shellfish in temporary food establishments shall comply with Chapter 3 of the Food Code as amended by Rule.2653 of this Section. (e) All food in temporary food establishments shall be protected in accordance with Chapter 3 of the Food Code as amended by Rule.2653 of this Section and the following also apply: (1) The regulatory authority may approve food preparation and storage for a temporary food establishment at a permitted temporary food establishment commissary or other permitted food establishment; (2) Temporary food establishment or temporary food establishment commissary operations shall not be conducted in any room or area used for purposes not related to the temporary food establishment or other permitted food establishment; (3) Food shall be secured in a manner to prevent tampering and contamination at all times; (4) Ready-to-eat food shall not be stored in direct contact with ice; non-mechanical coolers must be provided with a drainage port; (5) All food shall be stored above the ground or floor and arranged to prevent contamination of foods; (6) Potentially hazardous food (time/temperature control for safety food) that has been heated at the temporary food establishment or temporary food establishment commissary shall not be sold or held for use on subsequent days. Approval shall be granted to allow cooling and reheating of potentially hazardous food time/temperature control for safety food) if the food can be handled in accordance with the rules of this Section; and (7) The regulatory authority shall further limit the food to be prepared or served, based on methods of preparation and the adequacy of facilities, equipment, utensils, and available utilities. (f) Food prepared at a previous event or potentially hazardous food (time/temperature control for safety food removed from original packaging shall not be served at a subsequent event in a temporary food establishment. 15A NCAC 18A.2667 TEMPORARY FOOD ESTABLISHMENT EMPLOYEE REQUIREMENTS (a) Food employees in temporary food establishments shall wear effective hair restraints, clean outer clothing, and maintain good hygienic practices as specified in Part 2-4 of the Food Code as amended by Rule.2652 of this Section. (b) Employees in temporary food establishments shall wash their hands in a handwashing facility before starting work, after each visit to the toilet, and as often as necessary to remove soil and contamination. (c) Employees in temporary food establishments shall not use tobacco in any form or consume food in food preparation, storage or serving areas, utensil washing, or utensil storage areas. (d) Employees in temporary food establishments may consume beverages in the food establishment only if covered and consumed in a manner to prevent contamination of food and food-contact surfaces. (e) Employees in temporary food establishments shall comply with the requirements in Subpart 2-201 of the Food Code as amended by Rule.2652 of this Section.

15A NCAC 18A.2668 TEMPORARY FOOD ESTABLISHMENT EQUIPMENT AND UTENSIL REQUIREMENTS (a) Equipment and utensils in temporary food establishments shall be kept clean and maintained in good repair. Those surfaces that come into contact with food, drink, or utensils shall comply with Parts 4-1 and 4-2 of the Food Code as amended by Rule.2654 of this Section. (b) Equipment and utensils in temporary food establishments shall be cleaned, sanitized, stored, and handled in accordance with Parts 4-6 and 4-7 of the Food Code as amended by Rule.2654 of this Section. (c) When multi-use utensils other than eating and drinking utensils are used in temporary food establishments, three basins of sufficient size to submerge, wash, rinse, and sanitize utensils shall be provided. Other equivalent products and procedures may be used in accordance with Part 4-7 of the Food Code as amended by Rule.2654 of this Section. At least one drainboard, table, or counter space shall be provided for air-drying. (d) When multi-use eating and drinking utensils are used in temporary food establishments, a three-compartment sink of sufficient size to submerge, wash, rinse, and sanitize utensils must be provided. Drainboards shall be provided as specified in Section 4-301.13 of the Food Code as amended by Rule.2654 of this Section. (e) Wash, rinse, and sanitizing solutions shall be maintained in temporary food establishments as specified in Sections 4-501.18 and 4-501.19 of the Food Code as amended by Rule.2654 of this Section. (f) A food preparation sink must be provided for washing produce in temporary food establishments. (g) Food shields or other effective barriers in temporary food establishments shall be installed in a manner to protect food and food contact surfaces from contamination. 15A NCAC 18A.2669 TEMPORARY FOOD ESTABLISHMENT PHYSICAL REQUIREMENTS (a) A temporary food establishment shall be located in an area kept in a clean and sanitary condition. The arrangement of temporary food establishments shall restrict public access to all areas of the food establishment except dining areas. (b) For outdoor cooking, overhead protection shall be provided such that all food, utensils, and equipment are protected. When bulk foods such as roasts, shoulders, and briskets are cooked, cooking equipment with attached lids, such as smokers, roasters, and other cooking devices, provide sufficient cover for the food being cooked. Food in individual servings such as hot dogs, hamburgers, and meat kabobs shall have additional overhead cover. (c) Effective measures such as fans, screens, walls, or a combination thereof, shall be provided to keep dust, insects, rodents, animals, and other sources of potential contamination out of the food establishment and shall comply with Paragraph 6-501.115(B) of the Food Code as amended by Rule.2656 of this Section regarding live animals. (d) Indoor/outdoor carpeting, matting, tarps, or similar nonabsorbent material is required as ground covering in the absence of asphalt, concrete, grass, or other surfaces that control dust or mud. (e) The temporary food establishment and temporary food establishment commissary shall be equipped with a handwashing facility used only for employee handwashing. This facility shall consist of at least a two gallon container with an unassisted free flowing faucet such as a stopcock or turn spout, soap, single-use towels, and a wastewater receptacle. Warm water shall be used for handwashing. (f) Water under pressure shall be provided as follows: (1) The water supply used shall be in accordance with 15A NCAC 18A.1700, 15A NCAC 18C, or 02 NCAC 09C.0703; (2) All potable water holding tanks, containers, and hoses used to transport or store water at the temporary food establishment shall be drained, washed, rinsed, and sanitized; (3) Containers and hoses used to store, haul, or convey potable water shall be approved for potable water use, shall not be used for any other purpose, and shall be protected from contamination. Potable water hoses and containers shall be labeled; and (4) Warm water shall be available and used for cleaning.

(g) Wastewater shall be disposed in accordance with 15A NCAC 18A.1900 or 15A NCAC 02H.0200. Portable wastewater containers may be used when the volume of potable water can be determined by the dimensions of sinks, basins, and interim storage containers and the portable wastewater containers are sized to contain the wastewater volume generated. Wastewater containers and hoses shall be labeled and not used for any other purpose. Wastewater containers shall not be emptied into waterways, storm drains, or on the ground. (h) Employees must have access to toilet facilities that are kept clean and in good repair. (i) Garbage and refuse shall be collected and stored in garbage containers with properly fitted lids. Nothing in this Rule shall prohibit uncovered garbage containers in the food establishment during periods of operation. Garbage and refuse shall be removed as needed and disposed in a manner to prevent vermin breeding and harborage. The premises shall be kept clean. (j) Lighting shall comply with Section 6-202.11 of the Food Code as amended by Rule.2656 of this Section. Lighting is required for nighttime operations. (k) Temporary food establishments and temporary food establishment commissaries shall remain connected to necessary utilities at all times food is prepared, served, or stored in the food establishment. (l) Toxic materials shall be labeled, used, and stored to prevent the contamination of food, equipment, utensils, linens, and single-service articles and meet the provisions of Sections 7-101.11 and 7-203.11 of the Food Code as amended by Rule.2657 of this Section.