Foodstuffs, Cosmetics and Disinfectants Act, 1972 (Act No. 54 of 1972

Regulations

Regulations Governing General Hygiene Requirements for Food Premises and the Transport of Food

Annexures

Annexure A : Application Form of a Certificate of Acceptability for Food Premises
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ANNEXURE A

[Regulation 3(2)]

 

APPLICATION FORM OF A CERTIFICATE OF ACCEPTABILITY FOR FOOD PREMISES

 

A.        PERSON IN CHARGE

Surname and first names of person in whose name the certificate of acceptability must be issued:

 

.................................................................

I.D. Number .........................................

 

ADDRESS

Postal address:

Residential address:

Tel. No.: Business

Tel. No.: Residential

 

 

B.        PARTICULARS FOR FOOD PREMISES

Name of food premises (if any)

Erf No. (if applicable)

Type of food premises (e.g. building, vehicle, stall)

Location address or address where the food premises can be inspected

 

If the following are not situated on the food premises, note the address or describe the location thereof:

Erf No.

Address

Sanitary (latrine) facilities

 

Cleaning facilities (wash-basins for facilities)

 

Hand-washing facilities

 

Storage facilities for food/facilities

 

Preparation premises

 

 

C.FOOD CATEGORY

 

List and describe the food items or the nature or type of food involved

 

D.NATURE OF HANDLING

 

List and describe what your activities will entail (e.g. preparation or packing and processing)

 

E.STAFF

 

Number of person employed or to be employed

 

Men

Women

Total

 

F.        PARTICULARS OF EXEMPTION BEING APPLIED FOR [Regulation 14(1)]

 

G.        PARTICULARS OF APPLICANT

Name


Capacity (e.g. owner, managing director, secretary, manager)

Postal address

Tel no:

 

 

Date if application:

 

Signature