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KIRKLEES COUNCIL
ENVIRONMENTAL SERVICES
APPLICATION FOR REGISTRATION OF FOOD ESTABLISHMENTS
(Regulation (EC) No 852/2004 on the Hygiene of Foodstuffs)
This form should be completed by food business operators in respect of new food business establishments and submitted to
Kirklees Council, Environmental Services, Flint Street, Fartown, Huddersfield HD1 6LG 28 days before commencing food
operations. Depending on the type of activities carried out, certain food business establishments are required to be approved
rather than registered. If you are unsure whether any aspect of your food operations would require your establishment to be
approved, please contact the Food Safety Team on 01484 414739
1.
Address of establishment (or address at which moveable premises are kept):
Post Code:
2.
Name of food business (trading name):
Telephone No:
3.
Email Address:
Full name of food business operator:
Date of Birth:
4.
Address of food business operator:
Post Code:
Telephone Number:
5.
6.
7.
Email Address:
Type of establishment: (Please tick all the boxes that apply)
Farm Shop
Food manufacturing/processing
Packer
Importer
Wholesale/cash and carry
Distribution/warehousing
Retailer
Moveable premises (eg ice cream van)
Restaurant/café/snack bar
Catering
Staff restaurant/canteen/kitchen
Hotel/pub/guest house
Market
Hospital/residential home/school
Private house used for food business
Market Stall
Food Broker
Takeaway
Other please give details:
Seasonal Slaughterer
.................................................................................
Type of business:
Sole Trader
Partnership
Limited Company (if limited company
please complete section 7)
Other please give details:
.................................................................................................................................
Limited company name:
Company No:
Registered Office address:
Post Code:
8.
Food-related activities (please give full details of ALL food-related activities):
9.
Number of vehicles or stalls kept at, or used from, the
establishment and used for the purposes of preparing,
selling or transporting food:
10. Water supplied to establishment:
5 or less
6-10
11-50
Public (mains) supply
51 plus
Private supply
11. Name of Manager if different to operator:
12. If this is a new food business, date intended to open:
13. Opening times daily.
Seasonal period if applicable
14. Number of people engaged in the food business:
Count each part-timer (ie 25 hrs per week or less) as ½
0-10
11-50
51 plus
It is an offence to give false or incomplete information
Signature of food business operator:
Date:
Name (in BLOCK CAPITALS):
Position in company/business:
After this form has been submitted, food business operators must notify Environmental Services of any
changes to the activities stated above within 28 days of the changes taking place.