Temporary Food Establishment Permit
Asterisks (*) indicate required fields
Completion of a permit application is one step in the process of obtaining a temporary food service permit. Please call the Health District Office at (409) 938-2411 for
additional information
Who needs a Temporary Food Establishment Permit
Today's Date
*
IRS Tax Exempt Number (If applicable)
Special Event
*
Sponsor
*
Date(s) of Event
*
Time of Operation: From
*
To
*
Location of Event (Street Address)
*
Organization
*
Responsible Person
*
Address
*
City
*
State
*
Zip
*
Phone
*
Email
*
Do you operate food establishments at other locations?
*
-- none selected --
Yes
No
If yes, provide names and addresses
Applicants Drivers License Number
*
State
*
Food items to be served
Source / Vendor
Place of Preparation
Transporting / cold Holding Facilities
Cooking Equipment
Hot Holding Facilities
Special Conditions
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