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Food Business Notification Form

Food Business Notification Form

* Mandatory Field

Part 1 - Food Business Ownership Details
Name of the Proprietor*
Contact Person*
Mailing Address
Postal Address*
Suburb/Town*
Post Code*
Contact
Business Telephone*

Do not use spaces

Mobile Phone

Do not use spaces

Fax Number

Do not use spaces

E-mail

Notes on Completing the Food Business Ownership Details

All written communications with the proprietor of a food business will be sent to this address, and phone communications will be to this number. A mobile, fax or e-mail contact is optional.

Part 2 - Business Location Information
ABN Number
Registered Business Name*
Trading Name of Business
Street Address (Not a PO Box)*
Suburb/Town*
Post Code*
Address Type (tick one box only)*
Number of Employees Handling Food*
Number of Full-Time Employees Handling Food*

(example: Two full-time employees plus three employees working half time would equal 3.5 full time equivalent employees)

Date Business Commenced*
(dd/mm/yyyy)
Date Commenced*
Please Provide a Short Description of the Business and its Operation
Additional Information
Trading Hours*
Does your Food Business have an Income Tax Exemption (a certificate is provided by the Australian Taxation Office)?

Proof of this exemption will allow for waiver of inspection fee, in accordance with the City of Mitcham inspection fee policy.

Notes on Completing Business Location Information

The address information in this section relates to information about the business location. This may be different to the business owner address information.

ABN

Optional entry if the business is not required to have an ABN. All businesses with an annual turnover of $50,000 or non-profit organisations with an annual turnover of $100,000 require an ABN. Organisations with a lower annual turnover may choose to register for an ABN. Contact the Australian Taxation office for information on applying for an ABN. Phone 13 28 61.

Registered Business Name

Mandatory entry if you trade other than under your own personal name. If the food business has been registered under the National Corporations Act 2001 administered by the Australian Securities & Investments Commission (ASIC), then the registered company name should be entered here. If the food business has been registered under state or territory legislation and not under the National Corporations Act 2001, then that registered business name should be entered here. If you are unsure if you are legally required to have a registered business name contact the Office of Consumer and Business Affairs on (08) 8204 9779.

Common Trading Name

Required if the business does not have a registered business name. If a business name is not registered, indicate the name under which the business is known or operates.

Business Location Address

The business location address must be a street address not a post office box or similar postal address.

Address Type

A business will select one of the 3 options. A street address indicates a business such as a retail shop, factory, food transport depot or similar permanent premises. Two options are provided for mobile food vending / transport vehicles. For mobile vehicles stationed at a permanent location such as a pie cart operating from a leased site select the second option. A business operating a mobile vehicle such as an ice-cream van or a food transport vehicle delivering food would tick the third option to show the address where the vehicle is normally garaged.

Numbers of Employees and Number of Full Time Equivalent Employees

Include only those employees handling food.

Date Commenced

The date when the business began at this location. If an exact date is not known, provide the year and mention in the note box underneath that the exact date is unknown.

Part 3 - Food Business Sector Information

Businesses will be categorised under three sectors - manufacturing, retail & food service and distribution. It is possible for a business to select more than one sector. For example a large bakery manufacturing products primarily for wholesale may also have a retail outlet on the same site. In this case both the manufacturing sector and retail and food service sector would be selected. Alternatively a bakery predominantly operating as a retailer should tick the retail and food service sector not the manufacturing sector.

Please tick one or more of the appropriate box(es) below to indicate the sector or sectors in which your business operates. Then go to the following section(s) to complete questions for each sector ticked.*

Manufacturing Sector

(a) Please tick the types of food manufactured by your business (MAY BE MORE THAN ONE)
If OTHER please specify
(b) Does your business only manufacture low risk foods
(c) Do all foods manufactured by your business have a Pathogen Reduction step
(d) Does your business manufacture uncooked fermented comminuted meat products (salami and similar uncooked meat products)

Notes on the Manufacturing Sector

This food sector is subdivided into broad categories based on the type of food produced. There is an option for OTHER to cover a food type that does not fit into one of the defined food categories. A food business may choose more than one category of food.

Low Risk Food

Low risk food is a food that is unlikely to contain pathogenic (potentially harmful) micro-organisms and will not normally support their growth due to food characteristics. Examples are grains and cereals, bread, carbonated beverages, sugar-based confectionery, alcohol, and fats and oils.

Pathogen Reduction Step

A pathogen reduction step is a processing step that significantly reduces the microbial population present in a food material. Examples are cooking, pasteurisation, canning or fermentation, or any other processing step that is capable of significantly reducing the level of pathogenic organism present.

Uncooked Fermented Comminuted Meat Products

These are manufactured and processed meat products such as salami and mettwurst that do not include cooking in the process of manufacture.

Retail and Food Service Sector

(a) What best describes your food business type? TICK ONLY ONE BOX that represents the predominant description of the business
Businesses Serving at Risk Persons
None of the Above
If other business or specialty food shop, please specify
(b) Does your business only sell low risk foods (packaged and unpackaged) or medium risk foods received and sold in the manufacturers or suppliers original sealed packaging

Notes on the Retail Food Service Sector

The retail and food service sector is based on the type of business description. Within this group is a sub group defined as businesses serving at risk persons. These businesses will be classified as high priority. The category OTHER is also included for businesses not covered in the provided options.

Low Risk Food

Low risk food is a food that is unlikely to contain pathogenic (potentially harmful) micro-organisms and will not normally support their growth due to food characteristics. Examples are grains and cereals, bread, carbonated beverages, sugar-based confectionery, alcohol, and fats and oils. For the retail and food service sector low risk food also includes whole fruit and vegetables.

Medium Risk Food

A medium risk food is a food that may contain pathogenic (potentially harmful) micro-organisms but will not normally support their growth due to food characteristics; or food that is unlikely to contain pathogenic micro-organisms due to food type or processing but may support formation of toxins or growth of pathogenic micro-organisms. Examples are cut fruit and vegetables, orange juice, canned meats, pasteurised milk, dairy products, ice cream, peanut butter and milk-based confectionery.

Distribution Businesses

(a) What best describes your food distribution business type? TICK ONE BOX ONLY
None of the Above
If other business type, please specify
(b) Does your business only sell low risk foods or (packaged and unpackaged) medium risk foods received and sold in the manufacturers or suppliers original sealed packaging?

Notes on the Food Distribution Sector

Food transport includes general carriers that transport food.

Please Enter Your Name and Date Submitted
Notification Submitted by (name):*
Date*
(dd/mm/yyyy)
If you see this, leave this form field blank.
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Contact:
City of Mitcham -ABN 92 180 069 793
131 Belair Road, Torrens Park SA 5062
T: +61 8 8372 8888 | F: +61 8 83728101
E: mitcham@mitchamcouncil.sa.gov.au
Last date modified: 2017-11-24T12:35:49
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