Thank you for helping us update our records and completing this information online. If you have any questions, please email susans@bfhd.wa.gov.

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* 1. Please complete the following information regarding your food business. Thank you.

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* 2. Do you plan to make changes to your business in 2015?

  No Yes
Changes to the building (such as plumbing or layout)?
Changes to the menu?
Change your mailing address?
Close or sell your operation? (Note--you are the recorded owner until Change of Ownership paperwork is returned to our office)

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* 3. Nutrition Labeling.

  No Yes
Do you currently include information on calorie content with your menu (either printed or online)? 
Would you be interested in and/or willing to post nutrition information for your establishment? 

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* 4. Licensed Caterers and Mobile Food Operators:

  Yes No
We are often asked for a list of food establishments that cater. If you are licensed as a caterer or mobile food operator, would you like to have your business contact information provided online? Please include your contact in the comment field.
What is the name of the commissary you will use in 2015? Please include the name in the comment field.

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* 5. Completing this update online is confirming you are an approved designee of the food establishment.

If you agree to the following statement, please enter your name in the box below.

I, as the applicant, certify that I am the owner or designee of the above establishment. I further certify that I grant permission to allow the Health Officer and/or his/her representative(s) to enter said establishment at their discretion for the purposes of application, evaluation, pre-operational inspection or any subsequent inspections or investigations. I understand if food is suspected of being contaminated and a threat to public health and/or violation of WAC 246-215, said food will be voluntarily removed from human food channels by myself and/or my designee in the presence of the Health Officer. I understand that any food service operating permit may be immediately suspended or revoked for failure to comply with Benton-Franklin District Board of Health Regulations of the WAC 246-215. In the event of suspension or revocation of my food service permit, I will be required to immediately cease and desist all food service operations until such time as a new permit, or continued operation is authorized by the Health Officer. I understand the information completed above is accurate as of the date of application.

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* 6. Thank you. Please feel free to include any questions or comments if you would like additional information. We hope you had a safe and successful 2014 and are eager to see you next year.
Food program staff

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