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2. Company Name*
3. Contact Name (Owner)*
5. Applicant's Address*
6. Municipality
7. State
8. Zip Code
10. Email Address*
11. Business Phone*
12. Cell Phone (unlisted)
14. Name of Establishment (trade name)*
15. Establishment Address
17. Name of Event*
18. Location of Event*

    1. Municipal Complex
    2. Privately Owned Property

    Please select one of the options.  Please note the additional requirements for events held on Township owned property

20. Address of Event
21. Municipality
22. State
23. Zip Code
25. Date of Event*
26. Rain Date(s) if applicable
28. Acknowledgement*

    1. Yes, I acknowledge

    By checking this box I, the applicant, acknowledge that all Special Event Applications must be submitted at least 3 weeks prior to the event for approval.  

32. Fee Information

    Special Event Food Licenses can be issued for one-week maximum.  Please remit $50.00 per week; Checks can be made payable to Wall Township and may be placed in the mail, delivered in person, or by using our drop box (available 24/7).  Credit and Debit payments are now also accepted; please call the Clerk's Office to provide details.

34. Required Inspections

    Satisfactory inspection from the Wall Township Fire Prevention Bureau: 

    Telephone: (732)820-4854 

    Address: 1612 Route 71, Wall NJ 07719

    Website:www.wallfirebureau.com

    Satisfactory inspection from the Board of Health:

    Telephone:(732)294-2060

    Address:1 Municipal Plaza, Freehold NJ 07728

    Website:http://twp.freehold.nj.us/health

35. Required Evidence of Insurance

    For events held on Township Property only* 

    Workmans Compensation: required for anyone other than owner operated vendors

    Automobile Insurance: required for food trucks only

    General Liability: Required for all vendors 

    Certificate of Liability Insurance: Provide minimum of (1) one million dollars per occurrence with Wall Township named as additionally insured.

37. Township Property Verification*

    1. Township Property - Insurance Info Required
    2. Privately Owned Property - Insurance Not Applicable

    By checking this box, you acknowledge the insurance requirements

38. Document Upload

    Please upload insurance information if applicable.  

40. Chapter 119*

    1. Yes, I consent
    2. No, I do not consent

    By checking this box, I consent that I have reviewed and understand Township Code Chapter 119 pertaining to food establishments

44. Health Department Disclaimer

    New Jersey State Law mandates that certain food handling procedures be adhered to at all times.

    Foods must be obtained from approved sources and may not be prepared in a private home. Both hot and cold foods must be held and served within prescribed temperature limits.  Bare hand contact with “Ready to Eat” foods is prohibited, and proper employee hygiene must be observed.  Proper food preparation, transportation and on site holding procedures are all vital to ensuring a safe event.

    As such the Freehold Area Health Department, in accordance with existing local ordinance requires that all participants obtain a temporary retail food license to cover your operation

46. Menu Items*

    Please list full menu with particular attention to any items which require temperature control and/or are “potentially hazardous”.

48. Proper washing, rinsing and sanitizing of equipment, especially food contact surfaces is required.
50. Where is product stored when not on site?*
51. Where is ware washing performed? *
52. Where is your equipment stored when not in use? *

    (Facility name, address and phone number)

53. What is the source of your food products?*
55. How will your products be transported to the site? *
56. Will the product be transported cold and prepared on site or will it be precooked at an offsite location and transported hot to the site?*
57. What arrangements will you have to ensure the product remains within acceptable temperatures during transportation to and from the event? (All cold food must be less than 41 degrees F. All hot food must be 135 degrees F or above.)*
58. What arrangements will you have to ensure the product remains within acceptable temperatures while on site during the event? *
60. How will you properly reheat any products that may fall below 135 degrees during the course of the event? *

    (Temperature abused products which cannot be reheated to 165 degrees for 15 seconds will be embargoed/destroyed.)  Sharing of critical equipment is unacceptable.  You must be appropriately equipped to properly conduct your operation

61. Temperature Info

    Muscle meats, pork and fish must be cooked to an internal temperature of 145 degrees for 15 seconds.  Comminuted (ground) meats (hamburger for example) must be cooked to an internal temperature of 145 degrees for 3 minutes, or 150 degrees for 1 minute or 158 degrees for 1 second.

62. Will a thin probe stem type thermometer be available so that you may monitor cooking and holding temperatures during the course of the event?*
63. What type of measures do you intend to employ to ensure that the product is protected against potential customer contamination, insects and dirt or dust contamination while on site?*
65. Ready to Eat

    As per the revisions to the code effective January 2, 2007, bare hand contact with “Ready to Eat” foods is now prohibited

67. Are gloves appropriate for your operation and will they be available for proper handling of ready to eat foods?*
68. What measures will you employ to minimize cross contamination between raw and cooked or “Ready to Eat” products?*
70. Hand Washing

    Hand washing is one key component in reducing the transmission of bacteria and minimizing potential cross contamination between raw items, cooked and “Ready to Eat” foods.

72. What type of measures will you employ to provide for employee’s hand washing facilities at your specific site?*
73. Will a source of water for cleaning be available? Describe source of water, if available.*
74. How will you wash, rinse and sanitize any equipment and/or utensils which become soiled during the event?*
76. N.J.A.C. 8:24 Disclaimer

    NOTE:  This office reserves the right to issue further requirements based upon the nature of the proposed operation, in accordance with N.J.A.C. 8:24.

Leave This Blank:


78. 1. Receive an email copy of this form.
79. Email address

    This field is not part of the form submission.

80. Submit

* indicates a required field