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Food Safety

Special Event/Farmers Market Vendor Application Form

This application must be submitted at least 14 days prior to any event.
If you require assistance, please call Health Connection at 705-721-7520 (1-877-721-7520) ext. 8811

Please note required fields are marked with an * Asterisk.

EVENT INFORMATION

Disclaimer: Applications must be received by SMDHU at least 14 days prior to the event

*

Date of Event:

e.g., 2024-02-01
e.g., 2024-02-10

VENDOR INFORMATION

e.g., 705-721-7520
* Vendor Set Up:


* Is Food Handler Certified?


If Yes, Attach Certificate
Only Adobe Acrobat format (PDF) accepted!

Disclaimer: As per Ontario Regulation 493/17, one food handler is required to be onsite every hour of operation.

ORGANIZER INFORMATION

e.g., 705-721-7520

WATER SUPPLY

If private water supply used – attached recent drinking water results
Only Adobe Acrobat format (PDF) accepted!
Do you have water lines made of food-grade material?:


Is a backflow device provided?:


HYDRO

WASTE WATER & GARBAGE DISPOSAL

FOOD HANDLING, SOURCES AND STORAGE

Where is food prepared and handled?:




For inspected premises, please include latest public health inspection report:
Only Adobe Acrobat format (PDF) accepted!
How will food be transported to the event?:



Cold Holding Equipment (4C or lower):





Cooking Equipment:








Hot Holding Equipment:






Indicate type of equipment you will have onsite (please select all that apply):












Multiple Event Participation

If you are attending more than one special event, not including Farmers Markets, within Simcoe Muskoka District, please list the events.

Please note: If you are serving the same foods as detailed above on the application, you do not need to submit an application for these events you have specified below. If the food served/sold at another event is different please submit a new food vendor application detailing the types of foods and source information.

Are you requesting exemption from Ontario Regulation 493/17, if Religious, Fraternal Organizations or Service Club?:

If yes, a sign must be posted notifying patrons event not inspected. A donors list must be provided if exempted from regulations and accepting food from an un-inspected source

FORM COMPLETION (Vendor)

e.g., 2024-02-01

"The Health Unit collects personal information in the course of doing business. Personal information about you is collected directly from you or from the person acting on your behalf. Personal health information collected may include, for example, your name, date of birth, address, contact information, health card number, health history, and information you provide during visits or calls to the health unit."

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