LCDHE Mobile Food Establishment Plan Review

Mobile Food Establishment Plan Review
Name *

First Name Last Name
Email *
example@example.com
Name of Mobile Unit *
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City

Zip Code
Website
Type of Unit *

Mobile (Trailer/Food Catering Truck) Push Cart Self-Contained Unit Prepackaged Only
Owner information *

First Name Last Name
Phone Number *

Area Code Phone Number
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Owner Email *
example@example.com
A brief written description of the scope of work. Describe your mobile operation
Proposed Menu *

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Provide drawings and/or photos of the mobile unit. If photos are provided, ensure that photos are taken inside and outside the mobile unit including pictures of water tanks, water inlets/outlets, water heaters, hand sinks, refrigerators, and any equipment used to prepare food. *

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Provide equipment specification sheets. These must include make and model numbers and all equipment must be designed and constructed to be durable and to retain their characteristic qualities under normal use conditions. Please note: If a specification sheet lists more than one piece of equipment, identify the specific equipment to be used. *

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Completed Mobile Plan Review Packet is required. You can find that file here.
Completed Mobile Plan Review Packet (If this packet is incomplete, plan review will be delayed. *

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Additional Files

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Problems with this form? Email kodonnell@larimer.org.
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