CAPS Ref: ……………………...APPLICATION FOR THE REGISTRATION OF A FOOD BUSINESS ESTABLISHMENT

(Regulation (EC) No. 852/2004 on the Hygiene of Foodstuffs, Article 6(2))This form should be completed by food business operators in respect of new food business establishments and submitted to the relevant food authority 28 days before commencing food operations. On the basis of the activities carried out, certain food business establishments are required to be approved rather than registered. If you are unsure whether any aspect of your food operations would require your establishment to be approved, please contact the District Council for guidance.1. Address of establishment (or address at which moveable establishment is kept):

Post code 2. Name of food business (Trading name):

Telephone no. 3. Full Name of food business operator: 4. Address of food business operator:

Post codeTelephone no. E-mail: Type of food business (please tick ALL the boxes that apply):

Farm Shop Wholesale/cash and carry Food manufacturing/processing

Catering Restaurant/café/snack bar Private house used for a food business

Packer Hotel/pub/guest house Moveable establishment e.g. ice cream van

Importer Distribution/warehousing Hospital/residential home/school

Retailer Seasonal Slaughterer Staff restaurant/canteen/kitchen

Market stall Food Broker Takeaway

Market Other (please give details):

5. Type of business:Sole Trader Partnership Limited Company (If Limited Company, please complete 6 below)Other (please give details):

6. Limited company name: Company no. Registered Office address:

Post code7. Number of vehicles or stalls kept at, or used from, the food business establishment and used

for the purposes of preparing, selling or transporting food: 5 or less 6-10 11-50 51 plus

8. Water supplied to the food business establishment: Public (mains) supply Private supply

9. Full name of manager (if different from operator):10. If this is a new business what date you intend to open:11. If this is a seasonal business what period do you intend to be open each year:12. Number of people engaged in food business Count part-time worker(s) as one-half (25 hrs

per week or less):0 -10 11-50 51 plus (please tick one box)

Signature of food business operator: Date:Name (BLOCK CAPITALS):

CAPS Ref: ……………………...

CAPS Ref: ……………………...

Guidance Tips

1. Insert full postal address of the premises or storage place for moveable vehicle2. Insert full trading name3. Insert full name of the person(s) responsible for ensuring that the requirements of the food law

are met within this business

4. Include the address to which the food authority would normally send correspondence

5. Tick all boxes that apply to your premises:

■ Food Manufacturing and Processing - do not include catering operations and retail take-away

foods

■ Packer - do not include wrapping of food for customers in retail premises

■ Importer - include only if you purchase food directly from outside the UK

■ Distribution and Warehousing - include only if storage and distribution is to other food businesses

■ Catering - include if you prepare food for consumption on your own premises or act as an outside caterer

■ Moveable Establishment - includes stalls and vehicles

6. Tick one box only7. If it is a limited company complete in full using details as registered with Companies House8. Tick as appropriate9. Tick as appropriate10. This should be the main contact at the premises11. Remember 28 days notice is required12. If variable please give maximum span13. Indicate numbers at periods of maximum employment

AFTER THIS FORM HAS BEEN SUBMITTED, FOOD BUSINESS OPERATORS MUST NOTIFY ANY CHANGES TO THE ACTIVITIES STATED ABOVE TO THE DISTRICT

COUNCIL WITHIN 28 DAYS OF THEM OCCURINGReturn the completed form to your local District Council

Richmondshire District CouncilMercury House, Station Road

Richmond, North Yorkshire, DL10 4JX

01748 829100environment@richmondshire.gov.uk

Richmondshire.gov.uk

CAPS Ref: ……………………...CATERING SELF ASSESSMENT FORM

Name of Business (Trading Name):

Address where the food is made:

Telephone Number:

Email:

Website (if applicable):

1. Please provide a description of your business:

2. Type(s) of foods that you make and handle: (Tick all that apply)Type of food Make Handle Type of food Make HandleMeat JamFish ChutneyFresh Cream/Soft Cheese/Yogurt/Formula Milk

Sponge Cakes/Cupcakes

Eggs Biscuits/CookiesReady Meals Fruit CakesSandwiches Decorative IcingSoups (with meat content) Other (specify)Soups (vegetable content only)3. How often do you produce the food listed above?

Daily

Weekly

Monthly

Other (please describe)

4. Where do you sell or serve your food?

From a market stall / farmers market

Supply it to another retailer/caterer

By email / telephone, direct to the person who will eat itFor consumption on the premises

From the premises for consumption elsewhere

5. If food is consumed on the premises how many people do you provide food for?

5 or less6 to 20Over 20

6. Do you cater specifically for vulnerable groups (childminders with children under 5, elderly persons over 65)?

YES / NO7. Tick to indicate which of the following personal hygiene measures that you take before preparing food

Wear an apron or tabard Exclude childrenRemove jewellery Wear a hat

Tie hair back Wash handsExclude pets, pet food and bedding

8. Do any of the foods that you prepare need to be stored in a refrigerator? YES/NOIf yes, how do you monitor your refrigeration temperatures?

9. Do you cook any food on the premises? YES/NOIf yes, how do you ensure that it is properly cooked?

10. How do you clean equipment and surfaces that come into contact with food?

CAPS Ref: ……………………...11. What type of cleaning chemicals are used?

12. Will the food be wrapped? If yes, please give details of the type of packaging you will use

13. Is your business supplied by a private water supply? YES / NO

14. Please provide details of any formal food hygiene training you have undertaken

15. Please provide a sketch plan of your work area below indicating the locations of: Sinks Indicate where you wash your hands Location of fridges/freezer Location of doors and windows Work surface used for food preparation Cooker

16. Please provide any additional relevant information:

Form completed by (Capitals) :

Signed :

Date: