applicationforapproval by v9rmce

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									                                                                           Investment and Regeneration
                                                                           Environmental Health
                                                                           Riverbank Court
                                                                           Wakefield Road
                                                                           Huddersfield HD5 9AA
                                                                           Tel: 01484 226400
                                                                           Fax: 01484 226409




              Application for Approval of a Food Business Establishment
               Subject to Approval under Regulation (EC) No 853/2004

    If you need any help or advice on how to complete this form or about the products to which the
  Regulation relates, or if you are unsure whether approval is required, please contact the Food Safety
           and Advice Team on 01484 226455 or email environmental.health@kirklees.gov.uk




To be completed by the Food Business Operator in BLOCK CAPITALS using a black pen.

              Trading Name and Address of Establishment for which approval is sought




                                                                    Post Code:




  Tick as             Type(s) of Product(s) of Animal Origin for which approval is sought
appropriate

               Minced Meat

               Meat Preparations

               Mechanically Separated Meat

               Meat Products

               Live Bivalve Molluscs (Shellfish)

               Fishery Products

               Dairy Products

               Eggs (not Primary Production) / Egg Products




F1 Application for Products Approval                                                       page 1 of 7
November 2009
                               Name and Address of Food Business Operator




                                                                                          Post Code:

Telephone (incl dialling code)
Fax (incl dialling code)
Email



                                         Management of the Establishment
                                        1                                 2                                  3
Full names of managers

                                        1                                 2                                  3
Job titles


                                        1                                 2                                  3
Full names of others in control

                                        1                                 2                                  3
Job titles




  Tick all
                             Activities to be conducted in and/or from the Establishment
that apply

             Stand-alone cold store
             Wholesale market
             Manufacture

             Other processing (please specify): ................................................................................
             Packing
             Storage
             Distribution
             Cash and carry / wholesale
             Catering (preparation of food for consumption in the establishment)
             Retail (direct sale to consumers or other customers)
             Market stall or mobile vendor

             Other (please specify): ...................................................................................................


F1 Application for Products Approval                                                                                      page 2 of 7
November 2009
  Tick all
that apply                         Method of transporting products from the establishment

             Own vehicle(s)

             Contract/Private Hire

             Purchaser's own vehicle

             Other (please specify): ..................................................................................................




  Tick all
that apply        Other establishments to be supplied with products from the establishment

             Other businesses that manufacture or process food

             Wholesale packers

             Cold stores that are not part of the establishment to which this application relates

             Restaurants, hotels, canteens or similar catering businesses

             Take-away businesses

             Own retail shops, supermarkets, stalls, or mobile outlets

             Other retail shops, supermarkets, stalls, or mobile outlets

             Members of the public direct from the establishment to which this application relates

             Other (please specify): ..........................................................................................................................




  Tick all
that apply            Other activities conducted within or on same site as the establishment

             Slaughter, including cattle, sheep, pigs, poultry,
                                                                                                 Approval Code:
             game, etc

             Cutting of fresh (including chilled and frozen)
                                                                                                 Approval Code:
             meat, poultry meat or game

             Storage of fresh (including chilled and frozen)
                                                                                                 Approval Code:
             meat, poultry or game




F1 Application for Products Approval                                                                                                           page 3 of 7
November 2009
                                       Information & Documentation
The following information is required in order to process your application. Tick the information being sent with
this application. Information/documentation not being sent now will still be required in advance of approval
decision.

              A detailed scale plan of the (proposed) establishment showing the location of rooms and other
              areas to be used for the storage and processing of raw materials, products and waste, and the
              layout of facilities and equipment

              A description of the (proposed) food safety management system based on HACCP principles

              A description of the (proposed) maintenance arrangements for the establishment and equipment

              A description of the (proposed) cleaning arrangements for the establishment, equipment and
              transport

              A description of the (proposed) arrangements for waste collection and disposal

              A description of the (proposed) water supply

              A description of the (proposed) water supply quality testing arrangements

              A description of the (proposed) arrangements for product testing

              A description of the (proposed) pest control arrangements

              A description of the (proposed) arrangements for monitoring the health of staff

              A description of the (proposed) staff hygiene training arrangements

              A description of the (proposed) arrangements for record keeping

              A description of the (proposed) arrangements for applying the identification mark to product
              packaging or wrapping




       Activities & Products to be handled in the establishment
Which of the following activities will be conducted in the establishment? Tick where
appropriate and give the approximate quantities to be handled per week.


  Tick as
appropriate                                Minced Meat and Meat Preparations

                Handling minced meat

                Handling meat preparations

Give full details of activities and specific products handled:




Average number of tonnes of minced meat to be handled in the establishment
per week

Average number of tonnes of meat preparations to be handled in the
establishment per week


F1 Application for Products Approval                                                                page 4 of 7
November 2009
                                       Mechanically separated meat

Give full details of activities and specific products handled:




Average number of tonnes of mechanically separated meat to be handled in the
establishment per week




                                               Meat Products

Give full details of activities and specific products handled:




Average number of tonnes of meat products to be handled in the establishment
per week



  Tick as
appropriate                   Live Bivalve Molluscs (shellfish) and Fishery Products

                Live Bivalve Molluscs (shellfish)

                Fishery Products

Give full details of activities and specific products handled:




Average number of tonnes of live bivalve molluscs to be handled in the
establishment per week

Average number of tonnes of fishery products to be handled in the
establishment per week




F1 Application for Products Approval                                                   page 5 of 7
November 2009
  Tick as
appropriate                                Raw Milk and Dairy Products

                Raw milk

                Dairy products

Give full details of activities and specific products handled:




Average number of litres of raw milk to be handled in the establishment per
week

Average number of litres/tonnes of dairy products to be handled in the
establishment per week



                            Eggs (not Primary Production) / Egg Products

Give full details of activities and specific products handled:




Average number of tonnes of eggs to be packed in the establishment per week

Average number of tonnes of egg products to be handled in the establishment
per week



                                        Stand-alone Cold Store

Give full details of activities and specific products handled:




Average number of tonnes of product to be handled in the establishment per
week




F1 Application for Products Approval                                          page 6 of 7
November 2009
                                                         APPLICATION

As the food business operator of the establishment named in this application, I hereby apply for
approval to use that establishment for the purposes of handling products of animal origin for which
Regulation (EC) No 853/2004 lays down requirements.



Signed: ..................................................................................   Date: ..........................................


Name in BLOCK letters: .....................................................................................................................



When you have completed this form and collected the other information required, please send
it to the address on the front of this form.




                                                               IMPORTANT
              Any change to the details on this form, including any changes in the operations carried
              out and products handled in the establishment, must be notified to the Authority at the
                                     address shown on the front of this form.




F1 Application for Products Approval                                                                                        page 7 of 7
November 2009

								
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