APPLICATION FOR THE REGISTRATION OF A

FOOD BUSINESS ESTABLISHMENT

(Regulation (EC) No. 852/2004 on the Hygiene of Foodstuffs, Article 6(2))

This form should be completed by food business operators in respect of new food business establishments and submitted to the relevant district council 28 days before commencing food operations. On the basis of the 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 Causeway Coast and Glens Borough Council for guidance.

1. Address of establishment __________________________________________________________________

(or address at which moveable establishment is kept)

_______________________________________________________ Postcode ________________________

2. Name of food business ____________________________________________________________________

(trading name)

Telephone No. ________________________________ Mobile No. __________________________________

3. Full Name of food business operator _________________________________________________________

4. Head Office address of food business operator _________________________________________________

(where different from address of establishment)

____________________________________________________ Post code ____________________________

Telephone No ___________________________ E-mail ___________________________________________

5. Type of food activity (Please tick ALL the boxes that apply):

Staff restaurant/canteen/kitchen	□	Hospital/residential home/school	□

Retailer (including farm shop)	□	Distribution/warehousing	□

Restaurant/café/snack bar	□	Food manufacturing/processing	□

Market/ Market stall	□	Importer	□

Takeaway	□	Catering	□

Hotel/pub/guest house	□	Packer	□

Private house used for a food business	□	Moveable establishment e.g. ice cream van	□

Wholesale/cash and carry	□	Food Broker	□

Other (please give details):

________________________________________________________________________________________

6. If this is a new business, the date you intend to open ___________________________________________

Signature of food business operator ___________________________________________________________

Date: ______________________________________________________________________________________

Name: _____________________________________________________________________________________

(BLOCK CAPITALS)

Please return your completed form to:

Causeway Coast and Glens Borough Council, Ballycastle Office, 7 Mary Street, Ballycastle, BT54 6QH