Temporary Food Establishment (TFE) Application

*Food Vendors that ARE EXEMPT from TFE permitting MUST complete this application but do NOT have to pay the $75 fee.
Are you claiming a nonprofit corporation exemption? (ref. G.S. 130A-250) Yes No
Are you selling only foods regulated by the North Carolina Department of Agriculture? Yes No
Are you operating as a NC permitted Mobile Food Unit or Pushcart? Yes No
If yes, then attach a copy of your Mobile Food Unit or Pushcart permit to this application.
Note: Exemption claims including a nonprofit corporation exemption, operating under only NC Dept. of Agriculture regulated foods or operating as a NC permitted Mobile Food Unit or Pushcart are subject to review by this department. NC permitted Mobile Food Units & Pushcarts are required to report to their permitted commissary daily.
Name of Event:
Date(s) & Time of Event:
Location of Event:
Name of Temporary Food Establishment:
Name of Permit Holder:
Mailing Address:
City	State	Zip Code
Contact Phone #'s:
During Event	Business Phone
Email Address:

A completed application and a $75 fee for EACH booth must be submitted NO LESS THAN 15 DAYS prior to the event.

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 with backflow prevention is required when connecting to a water source.

Grease and wastewater MUST NOT be poured out onto the ground or into storm drains.

If NOT connecting to an approved potable water supply at the event location, then state your source of
potable water for the event? (Note: water supply used shall be in accordance with 15A NCAC 18A.1700,
15A NCAC 18C, or 02 NCAC 09C .0703)
If NOT connecting to an approved sewer system at the event, then state how you will handle
and dispose of wastewater?
What is the source of ice that will be used?
Will vendor prepare any foods prior to the event Yes No If yes, indicate location and time of
preparation:

Note: Local food vendors may apply for a Temporary Food Establishment Commissary permit and if

permitted would be allowed to prepare food at this commissary up to 7 days in advance of the event.

NC permitted Food Establishments may also operate as a commissary for an event upon approval by the

Cleveland County Health Department.

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.

A completed application and a $75 fee for EACH booth must be submitted NO LESS THAN 15 DAYS prior to the event.

APPLICATION AND PAYMENT CAN BE SUBMITTED IN PERSON OR BY MAIL TO:

Cleveland County Permits Office

1333 Fallston Road

Shelby, NC 28150

*** Please call 980-484-4779 to arrange for submission and payment of fees***

Applicant’s Signature:	Date Submitted:

Rev. 12/23

Checklist for TFE permitting

Food Handling

__ Foods from an approved source.

__ Raw meat, poultry, and fish must be purchased in ready to cook portions unless providing sufficient equipment and

prep areas. Subject to approval.

__ No bare hand contact with ready to eat foods. (Provide gloves as needed.)

__ Date marking system for ready to eat foods held more than 24 hours.

__ No cooking and cooling of foods for subsequent days use unless approved at permitting.

__ No food preparation prior to the event or issuance of permit

__ Non-mechanical coolers must have a drainage port.

__ Potentially hazardous foods from previous events not 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.

Food Protection

__ Foods must be secured to protect from tampering and contamination.

__ A food prep sink available if 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 limited to dining areas only. Storage beside units must be blocked from public access.

__Toxic materials labeled and stored to prevent contamination of food and equipment.

Physical Requirements

__ Hot water heating facilities provided.

__ Three basins for washing, rinsing and sanitizing provided with adequate space for air-drying or three compartment

sink provided if using multiuse utensils.

__ Wash, rinse, and sanitize solutions maintained as specified in food code. Test strips provided.

__ 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, warm water, soap and single use towels.

__ 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,

connection to municipal sewer required.

__ Lights must be shielded or shatterproof if provided and lights are required for nighttime operations.

__ Premises clean and garbage handled in a sanitary manner

__ Fly, and rodent control provided

__ Toilet facilities conveniently located for employees

__ All required equipment based on menu is in place.

__ Thermometers provided.

__ Recommended single service condiment packages no bulk condiment dispensing from hand pumps

Specialist may condition permit to ensure compliance with rules .2665 through .2669