Temporary Food/Drink Stall Application

APPLICATION FOR APPROVAL TO CONDUCT TEMPORARY FOOD/DRINK STALL
If you are applying to operate at the Millthorpe Markets hosted by the Millthorpe Public School P&C (in December & April), please use the Millthorpe Markets specific form available here.
Application Type*

Annual Approval – approval expires 31 December 2025 - $33.00 fee

Business Details
Stall Name*
Business Name*
Applicant Name*

First NameLast Name
ABN*
What Local Council Area does the stall originate?

Blayney ShireOther
Postal Address*

Postal Address

CityState

Postal Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Public Liability Insurance

All stall holders are required to have public liability insurance for a minimum of $20 million with Blayney Shire Council listed as an interested party. Please ensure documents are valid for the date of the event/s.
Please upload your Public Liability Insurance here*

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Food Safety Supervisor
This information is required for all stalls serving the following:

Hot food, Sandwiches, Cakes/slices/scones, Icecream/slushies/donuts
Food Safety Supervisor Name*

First NameLast Name
Certificate Identification*
Expiry Date*

DayMonthYear
Please upload your Food Safety Supervisor Certificate (FSS) here*

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NOTE: A copy of the Food Safety Supervisor Certificate is to be available for perusal on demand by an authorised officer AT ALL times the food outlet is operating.

Home Council Approval
Please upload your approval/letter from your Home Council here*

Please provide a copy of approval/registration or last inspection report
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Stall Layout
Please upload a plan of your stall below.

Label each area with the corresponding numbers from the legend including;
1. Hand Washing
2. Food Preparation
3. Fridge or Cold Storage
4. Equipment Washing Facilities.
Please feel free to add any additional areas/items that you may have.

Click here to download template and example.
Stall/van construction and layout (dimensional plan/s)*

.
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What type of power do you require? *
Please let us know if you are able to bring your own generator

Declaration
I have read, understood and will fully comply with the NSW Food Authority 'Guidelines for Food Businesses at Temporary Events.' I declare that the information provided on this form is accurate, complete and correct. I understand that this is an application and approval of this application is not guaranteed.
Signature*

Clear
Name*

First NameLast Name
Date*

DayMonthYear
Should be Empty:

APPLICATION FOR APPROVAL TO CONDUCT TEMPORARY FOOD/DRINK STALL