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Annual Operational Permit - Food Vendors

2. Vendor Information
   The mobile food vendor must submit all required documentations outlined in this application.

   The mobile food vendor must submit all required documentations outlined in this application.

4. Today's Date
   Today's Date

6. Type of Business*

   1. Food Truck

   1. Pushcart

   1. Trailer

   1. Special Event Cooking

8. Special Event Date and Start Time*
   Special Event Date and Start Time

   Special Event Date and Start Time

9. End Time*
   End Time

11. Company/Business Name:*

12. Trade Name (DBA):

14. Owner Name*

15. Phone*

16. E-mail

18. Address1*

20. City

21. State

22. Zip

24. Brief Description of Operation

26. Name of Person or Entity Listed on Registration*

27. License Plate Number:

29. Will propane (LPG) tanks be used?

    1. Yes
    2. No

30. Quantity

    1. 1
    2. 2

31. Tank size:

32. Certification Date*
    Certification Date

    Recertification required every 12 years

34. Requalification Guidance for Propane Cylinders
    U.S.DOT propane Cylinder One Sheet

36. Mobile Food Trucks or Trailers that have any commercial cooking equipment that produce grease laden vapors shall be required to have an Automatic fire-extinguishing system.

    Mobile Food Trucks or Trailers that have any commercial cooking equipment that produce grease laden vapors shall be required to have an Automatic fire-extinguishing system.

38. Is Cooking Hood System installed?

    1. Yes
    2. No
39. Your last hood extinguishing system test date?
    Your last hood extinguishing system test date?

40. Last Hood Cleaning per NFPA 96
    Last Hood Cleaning per NFPA 96

42. Hood System test records

    If available please upload test records. Thank you

44. What type(s) of appliance(s) will be used?

    1. Deep Fryer
    2. Griddle
    3. Stove

    1. Solid Fuel
    2. Other

45. Describe Other:

47. Fire Extinguishers

    1. Type "K"
    2. Type "ABC"

48. Fire Extinguisher inspection date
    Fire Extinguisher inspection date

50. Acknowledgement*

    In pressing the submit button, you agree that the information provided is accurate. Submission is in lieu of a signature.

    1. I agree
Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit Submit and Print

* indicates a required field