Registration of a Food Premises Application

Food Act 1984

There are some hard words in this form.  The hard words are underlined.  Click on the words to read what they mean on our definitions page.

For the current fee due please call Council's Health Department on (03) 5153 9500.

A member of the Customer Service Team will be in contact within one (1) working day to arrange for payment of this application once received.

There are some rules that need to be followed for this permit. You can read the rules at the bottom of this page.

Fields marked with an asterisk (*) must be completed

Proprietor Details
Name/s * (required)
Email address * (required)
Postal address * (required)
Phone Number
Home
Work
Mobile
Fax
Business Details
Trading name * (required)
Business address * (required)
Australian Business Number (ABN) * (required)
Phone number - Work * (required)
Phone number - Mobile
Work email address
Work fax
Description of use of Premises
Please give a brief description of the Food Premises * (required)
Number of full time staff (2 casual or part time staff is equal to 1 full time)? * (required)
What is the main language spoken? * (required)
Is tobacco sold? * (required)	Yes No
Is tobacco sold from a vending machine? * (required)	Yes No
Does the business have sit-in dining? * (required)	Yes No
Does the business have a licence to sell liquor? * (required)	Yes No
Do you have a private drinking water supply? * (required)	Yes No
Food Safety Supervisor
Food Safety Supervisor name
Food Safety Supervisor postal address
Food Safety Supervisor phone number - Home
Food Safety Supervisor phone number - Work
Food Safety Supervisor phone number - Mobile
Food Safety Supervisor email address
Food Safety Supervisor fax
Food Recall Contact
Food Recall Contact name
Food Recall Contact postal address
Food Recall Contact phone number - Home
Food Recall Contact phone number - Work
Food Recall Contact phone number - Mobile
Food Recall Contact email address
Food Recall Contact fax
Food Safety Program (FSP)
FSP Class
Type of FSP
If you have already given Council a Food Safety Program (FSP) - (please tick the box) * (required)	The FSP given to Council before has been reviewed and has not changed The FSP given to Council before has been reviewed and changed. A new FSP or changed version is attached
New or changed Food Safety Program
Everyone must fill in this section
As the proprietor of the food business detailed above, I hereby apply to register this business under the terms of the Food Act 1984 until * (required)As the proprietor of the food business detailed above, I hereby apply to register this business under the terms of the Food Act 1984 until * (required)	RadDatePicker RadDatePicker Open the calendar popup. Calendar Title and navigation Title and navigation << < December 2018 > << December 2018   M T W T F S S 48 26 27 28 29 30 1 2 49 3 4 5 6 7 8 9 50 10 11 12 13 14 15 16 51 17 18 19 20 21 22 23 52 24 25 26 27 28 29 30 53 31 1 2 3 4 5 6
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Food Safety Program (FSP) Requirements

You must submit a copy of your FSP unless your business has been exempt from having a FSP. A food business is free from having a FSP if it sells only prepackaged and low risk shelf foods, eg. packet chips, soft drinks, confectionary.

FSP Class 1: businesses are high risk, such as hospitals that should already have a FSP and are subject to third party audit.

FSP Class 2: are all the remaining businesses except those that are exempt from having a FSP.

Non-standard FSP type: a FSP developed independently and requires a third party audit.

Standard FSP type: a FSP developed using a State Government approved template and is not subject to a third party audit.

You must have a Food Safety Supervisor unless your business is exempt from having a FSP. Contact Council if you need more information on Food Safety Supervisor requirements.

The information given by you is collected by the East Gippsland Shire Council for the purposes of carrying out the Food Act 1984 and Tobacco Act 1987. The information shall not be given to any party unless needed by law, or in line with Sections 54A to 54D of the Food Act 1984 and Privacy and Data Protection Act 2014.

Any information given is also protected against wrongful release by Sections 54 and 60H of the Food Act 1984 and by the Privacy and Data Protection Act 2014.

Part or all of the information given, which forms part of a register, is available for public inspection as per Section 43(5) of the Food Act 1984.

Privacy Statement

The East Gippsland Shire Council asks for details about you to collect rates, approve permits and licences, and run a range of community services.  The information you give to us on this form is used only for the reasons set out in the form and is not given to anybody else. Sometimes we may supply details about you to someone else, but only if we are allowed by law, or to protect someone or property.

When information is given out, Council will always try to make sure your privacy is protected in line with the Privacy and Data Protection Act 2014.  You may ask for more information about Council’s Privacy Policy by contacting our Information Privacy Officer on 03 5153 9500 or e-mail feedback@egipps.vic.gov.au