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FOOD DISTRIBUTION FORM

Environmental Health & Safety

FOOD FOR ON-CAMPUS DISTRIBUTION

Note: This form is to be used when food is to be distributed or sold on or in University properties, including off-campus
preparation for distribution or sale on campus, and the food is not being obtained from a commercial company. The
University follows all local and state health and sanitation regulations and guidelines with regard to food handling. Submit
this completed form to EHS by campus mail (MS 4472), fax (979.845.1348), or email ([email protected]) no later
than seven working days prior to the event. This signed form, which indicates approval, must be displayed at the food
distribution site at the time of the event. Incomplete or illegible forms will not be approved. Any changes must be
documented, submitted, and approved prior to the event.

Today’s Date: ____________________ Event Date: ______________________ Event Time: ______________________

Organization/Department: ____________________________________________________________________________
Activity/Event: _____________________________________________________________________________________
Name of Representative: _____________________________________________________________________________
Phone: _______________________ Fax: ________________________ Email: __________________________________

Distribution Site: ___________________________________________________________________________________

Location of Food Preparation? † On-Site † Other ____________________ Time Prep Begins: __________________
Time Food Distribution Begins: _____________________ Time Food Distribution Ends: ________________________
List All Food Items to be Prepared, Served, Distributed, and/or Sold:
______________________________ ________________________________ ______________________________
______________________________ ________________________________ ______________________________
______________________________ ________________________________ ______________________________
______________________________ ________________________________ ______________________________

I have read the FOOD DISTRIBUTION SANITATION REQUIREMENTS and will adhere to them. I
understand that TAMU and/or the Brazos County Health Department has the right to prohibit or end
the distribution of food at my event if I do not fully comply with the requirements.

Representative’s Signature: ____________________________________ Date: ________________

EHS OFFICE USE ONLY

Date Form Received: __________________ BCHD Permit #: __________________ Date: ______________
This event is: † APPROVED † DENIED

____________________________________________ ______________________________
AUTHORIZED SIGNATURE DATE
1111 Research Parkway, Suite 220
4472 TAMU
College Station, TX 77843-4472

Tel. 979.845.1348 Fax 979.845.1348

[email protected]
http://ehsd.tamu.edu/
 FOOD DISTRIBUTION SANITATION REQUIREMENTS

PERMIT

• All temporary events involving production or preparation of potentially hazardous food will need
to fill out an application for a temporary food permit from the Brazos County Health Department
(http://www.brazoshealth.org/EHS/tempevent.php) at least three days before the planned
event. The application fee is $60.00 per event. A copy of this permit must be submitted to
EHS before the event can be approved.

FOOD AND EQUIPMENT

• Do not prepare any foods at home. All food served must be prepared on the site of the
event or in a permitted establishment that has proper facilities for preparing food and sanitizing
equipment and utensils.

• All food items that will be prepared must be from an approved source (sources that comply
with the law - FDA, USDA, State Health Department), such as a grocery store, discount
warehouse, etc. and be properly labeled.

• Proper temperature must be maintained when transporting food and once it is on site.
Hazardous foods must be maintained at proper temperature: 41° F or colder, or 135° F or
hotter at all times.

• Cooking Temperatures should be monitored closely following these guidelines: (all in °F)
Brisket (Raw Meat) – 145°F
Hamburger Meat – 155°F
Hot Dogs – 155°F
Chicken (poultry) - 165°F
* After the food is cooked it must be held at a temperature of 135° F or higher.

• Thermometers must be available and used to monitor temperatures of hazardous foods.

• No cross contamination of cooked and un-cooked foods.

• All ice must be from an approved source and arrive at the site in sealed bags and be handled
in a way that protects it from contamination. Ice used to fill drink cups must be stored separate
from ice used to store food. Use scoops with handles for dispensing ice. Do not use cups.

• Proper hand washing facilities must be available and used. A water container with spigot (such
as a cooler), a bucket to collect wastewater, hand soap, hand sanitizer, and disposable paper
towels are required.

• Approved facilities must be provided to wash and sanitize all utensils. A three compartment
sink system (or three containers) should be set up in a series to wash, rinse, and sanitize.
Wash – Soap and water
Rinse – Clean water
Sanitize- Bleach water (1 tablespoon to 1 gallon of water, or 100 ppm) or other
means of sanitization (iodine solution, quaternary ammonia, etc.)
FOOD AND EQUIPMENT, cont.

• Always keep bleach available to sanitize all utensils, food preparation, and food service
surfaces. Proper dilution is 1 tablespoon of bleach to one gallon of water (100 ppm).

• All food contact equipment, utensils, and surfaces must be in good repair and need to be
cleaned and sanitized with the bleach solution above.

• Foods, including condiments, which are displayed for self-service must be protected by the use
of food shields or other effective means (i.e. pump dispenser for condiments).

• Only single service items may be used to serve the public, such as plastic utensils and
paperware.

• Waste receptacles must be provided for the public to properly dispose of trash.

• All wastes, including wastewater, resulting from the booths operation must be disposed of in a
sanitary manner (not drained on the ground or into storm sewers).

• Floor and overhead covering adequate for booth.

• Barbecue pits outside of buildings shall not be located within 10 feet of combustible walls or
roofs or other combustible material.

• Portable fire extinguishers shall be provided for barbecue pits.

• Barbecue pits will not be placed near facility air intake vents.

PERSONNEL

• Food handler representative shall have permit available for inspection at any time during the
event.

• No person shall work in a food service booth while infected with a communicable disease that
can be transmitted by or while afflicted with a boil, an infected wound, or an acute respiratory
infection. No person suspected of being affected with a disease or condition shall be working in
a food service booth.

• The food handler representative or person in charge of the food service booth shall have the
responsibility to remove a food handler if he/she has reason to suspect that he/she has
contracted any such communicable disease or has become a carrier of such a disease.

PERSONAL HYGIENE

• Food handlers shall wash their hands thoroughly with warm water and soap, dry them off with
a disposable paper towel, and follow with a hand sanitizer.
- Before starting work
- After visiting the toilet
- After coughing or sneezing into the hands or handkerchief
- After taking money, eating, drinking, smoking, etc.
FOOD HANDLER PRACTICES

• Food handlers must wear gloves and hair restraints when preparing or serving food.

• Food handlers shall consume food in designated areas only. Food, drink, and other personal
items shall be kept separate from food intended for the public.

• Food handlers shall not use tobacco in any form while engaged in food preparation or service,
nor while in areas where equipment and utensils are washed.

• Food handlers shall carry and serve food in a sanitary manner.

• Food handlers shall handle glasses, plates and chinaware in a sanitary manner.

• Food handlers shall use sanitary plastic disposable gloves if food must be manipulated by
hand.

• Food handlers shall refrain from sneezing or coughing onto food.

• Food handlers shall use only clean and sanitary equipment.

• Food handlers shall use separate cutting boards, blocks, tables, grinders, slicers, and other
utensils for raw and cooked food. If this is not possible and the same equipment and utensils
must be used, food handlers shall thoroughly clean and sanitize equipment used for raw food
after each use.

• Food handlers shall handle food and drink in a manner to prevent cross contamination of
bacteria during storage, preparation, display, and service of food.
Any person who may be involved in the handling, preparation, or service of food at the event shall read these
requirements and sign below. This page must be submitted with your Food Distribution Form.

I certify that I have read the FOOD DISTRIBUTION SANITATION REQUIREMENTS and agree to
operate accordingly. I understand that TAMU and/or the Brazos County Health Department has the
right to prohibit or end the distribution of food at my event if I do not fully comply with the
requirements.

Name: ___________________________________________ Date: _____________________________

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EHS shall have the authority to implement and make exceptions to these rules, and to make, adopt, revise, and amend
procedural rules and regulations as it deems necessary to protect the public health.